DEPARTMENT OF HEALTH &-HUMAN SERVICES 	 Office of Inspector General 
Washington, D.C.  20201 
DEC 022010 
TO: 	 Donald M. Berwick, M.D. 
Administrator 
Centers for Medicare & Medicaid Services 
FROM:  Stuart Wright 
Deputy Inspector General 
for Evaluation and Inspections 
SUBJECT: 	 Memorandum Report:  Medicare Market Shares ofMail Order Diabetic Testing 
Strips,OEI-04-10-00130 
This memorandum report provides information on the types of mail order diabetic testing strips 
associated with Medicare claims for the 3-month period ending December 2009.  Section 
lS4(d)(3)(B) of the Medicare Improvements for Patients and Providers Act (MIPPA) requires the 
Office of Inspector General (OIG) to complete a study to determine market shares of diabetic 
testing strips before 2011.1,2 
SUMMARY 
Medicare covers diabetic testing strips provided by mail order suppliers and local pharmacies or 
supplier storefronts.  According to the Centers for Medicare & Medicaid Services (CMS), 
62 percent of diabetic testing strips were provided to Medicare beneficiaries via mail order in 
2009.3 
The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) requires CMS to 
phase in, with several rounds of bidding, a durable medical equipment, prosthetics, orthotics, and 
supplies (DMEPOS) Competitive Bidding Program.  Under this program, suppliers compete to 
become Medicare contract suppliers in certain geographic areas for selected DMEPOS items, 
including mail order diabetic testing strips.  The payment amolmts resulting from the accepted 
bids will replace the Medicare fee schedule ammmts in these areas. 
t Market share is the percentage of total sales attributable to a particular product in a single industry. 

2 P.L. 110-275, Social Security Act,  1847(b)(10)(B), 42 U.S.C.  1395w-3(b)(10)(B). 

3 Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 

2011, CMS-1503-FC (Nay. 2, 2010 display date).  Accessed at http://www.ofr.goY/OFRlJp]oad/OFRQill.aJ2010
27969  PLpdf on November 4,2010. 
 Page 2  Donald M. Berwick, M.D. 
The Competitive Bidding Program does not currently include diabetic testing strips purchased at 
a local pharmacy or supplier storefront (i.e., nonmail order).  Beneficiaries who do not wish to 
order their diabetic testing strips through the mail may continue to receive their preferred type 
from a local pharmacy or supplier storefront for the fee schedule amount.   
 
Initial rounds of bidding did not require that winning suppliers provide a specific number or 
percentage of diabetic testing strip types available on the market.  However, the MIPPA requires 
that CMS award Competitive Bidding Program contracts for mail order diabetic testing strips to 
suppliers who provide at least 50 percent, by volume, of all types of mail order diabetic testing 
strips (i.e., the MIPPA 50-percent requirement).4     
 
We determined the Medicare market shares for diabetic testing strip types associated with a 
random sample of Medicare claims for the 3-month period ending December 2009.  Our sample 
of 1,210 claims was selected from a population of approximately 574,000 claims for mail order 
diabetic testing strips provided to beneficiaries during this period.  We projected our sample data 
to the population of mail order diabetic testing strips to estimate the Medicare market shares.   
 
We found that suppliers submitted claims for at least 75 types of mail order diabetic testing strips 
for the 3-month period ending December 2009.  Two types of diabetic testing strips accounted 
for approximately 26 percent of the Medicare mail order market share, 7 types of diabetic testing 
strips accounted for approximately 50 percent of the Medicare mail order market share, and 19 
types accounted for approximately 81 percent.  CMS may consider these data when determining 
whether future rounds of suppliers mail order diabetic testing strip bids comply with the MIPPA 
50-percent requirement.   
 
BACKGROUND 
 
Diabetes is a chronic disease in which a person has a high blood sugar (i.e., glucose) level either 
because the body does not produce enough insulin or cells do not respond properly to the insulin 
that the body does produce.5  Diabetes may be managed through a variety of methods, including 
healthy eating, physical activity, and insulin injections.6  If diabetics do not properly manage 
their glucose levels, medical complications (e.g., hypoglycemia, cardiovascular disease, and 
retinal damage) may occur.   
 
Diabetes disproportionately affects older adults.  Approximately 23 percent of individuals ages 
60 and older reported having diabetes in 2007, while only 8 percent of individuals of all ages 
reported having this disease.7  Medicare covers services and testing supplies to help beneficiaries 
with diabetes manage their condition.   
 
                                                 
4 MIPPA, P.L. 110-275  154(d)(3)(A), Social Security Act,  1847(b)(10)(A), 42 U.S.C.  1395w-3(b)(10)(A). 
5 National Institutes of Health (NIH), Diabetes Overview:  What is Diabetes?  Accessed at 
http://www.diabetes.niddk.nih.gov/dm/pubs/overview/index.htm on March 11, 2010.  
6 NIH, Diabetes Overview:  How is Diabetes Managed?  Accessed at 
http://www.diabetes.niddk.nih.gov/dm/pubs/overview/index.htm#managed on March 11, 2010.  
7 The most current data available are from 2007.  Additionally, data are not available for individuals ages 65 and 
older.  CMS, Diabetes Self Management Overview.  Accessed at http://www.cms.hhs.gov/DiabetesSelfManagement/ 
on March 23, 2010. 
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 3  Donald M. Berwick, M.D. 
Diabetics may use small, hand-held meters to test the concentration of glucose in their blood.  
Each time that they test their glucose levels, individuals insert a diabetic testing strip into their 
meter.  A diabetic testing strip is a small, thin, one-time-use piece of plastic on which a sample 
of blood is placed after pricking the skin.  The meters reading of an individuals glucose level 
provides information required for individuals to manage their diabetes.8  Diabetics may need to 
perform glucose tests several times a day to assist them in maintaining their glucose at the 
appropriate level. 
 
Physicians prescriptions must indicate the number of times per day a diabetic Medicare 
beneficiary should test his or her blood glucose level.9, 10  Because some beneficiaries should test 
their glucose more frequently than others, the number of diabetic testing strip boxes per 
Medicare claim varies.11  Mail order suppliers submit one Medicare claim for a beneficiarys     
3-month supply of diabetic testing strips.12  Each claim indicates the number of boxes provided 
to the beneficiary for the 3-month period.  
 
Suppliers submit claims using Healthcare Common Procedure Coding System (HCPCS) codes to 
receive Medicare reimbursement.  Medicare claims for diabetic testing strips are billed using 
HCPCS code A4253.  The modifier KL (i.e., A4253 KL) designates diabetic testing strips 
provided via mail order.13 
 
Medicare determines the highest dollar amount that suppliers may be reimbursed for each 
HCPCS code (fee schedule amount).  Medicare pays 80 percent of the fee schedule amount and 
the beneficiary is responsible for the remaining 20 percent.  Medicare reimburses suppliers for 
diabetic testing strips based on fee schedule amounts, which vary by State.  The average 2009 fee 
schedule amount for mail order diabetic testing strips was $32.50 per box. 
 
The Competitive Bidding Program and Diabetic Testing Strips 
The MMA required CMS to phase in, with several rounds of bidding, the Competitive Bidding 
Program.14  The payment amounts resulting from the Competitive Bidding Program will replace 
the fee schedule amounts for selected DMEPOS items (including mail order diabetic testing  
 
 
 
                                                 
8 Diabetes self-management may include insulin injections, planned meal times, and medication.  
9 CMS, Local Coverage Determination for Glucose Monitors (L11530).  Accessed at 
http://www.medicarenhic.com/dme/medical_review/mr_lcds/mr_lcd_current/L11530_2008-10-01_PA_2008-10.pdf 
on September 1, 2010.   
10 Physicians do not prescribe a specific type of diabetic testing strip for a beneficiarys use. 
11 Medicare provides coverage for up to 100 testing strips per month for insulin-dependent beneficiaries and up to 
100 testing strips every 3 months for noninsulin-dependent beneficiaries.  Medicare allows additional testing strips if 
deemed medically necessary and documented in physician records.  CMS, MLN Matters Number SE1008.  Accessed 
at http://www.cms.gov/MLNMattersArticles/downloads/SE1008.pdf on August 16, 2010. 
12 CMS, Local Coverage Determination for Glucose, loc. cit. 
13 Mail order refers to DMEPOS items ordered by phone, email, internet, or mail, and delivered to Medicare 
beneficiaries by common carriers like the U.S. Postal Service, Federal Express, or United Parcel Service.  Mail order 
does not include items purchased from a local pharmacy or supplier storefront.  CMS, MLN Matters Number 
MM5641.  Accessed at http://www.cms.gov/MLNMattersArticles/downloads/mm5641.pdf on October 26, 2010. 
14 MMA, P.L. 108-173  302(b)(1), Social Security Act,  1847, 42 U.S.C.  1395w-3. 
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 4  Donald M. Berwick, M.D. 
strips) in certain Competitive Bidding Areas (CBA).15  The selected DMEPOS items are 
generally high-cost and high-volume DMEPOS items that have a high savings potential under 
the Competitive Bidding Program.16 
 
CMS uses bids submitted by DMEPOS suppliers to determine the competitive bidding payment 
amounts.  Bids are evaluated based on suppliers eligibility, their financial stability, and the bid 
price.17  Contracts are awarded to the suppliers who generally offer lower prices and meet 
applicable quality and financial standards.18  
 
Medicare covers diabetic testing strips provided by mail order contract suppliers and local 
pharmacies or supplier storefronts.  The Competitive Bidding Program does not currently include 
nonmail order diabetic testing strips (i.e., those purchased at a local pharmacy or supplier 
storefront).  Once the Competitive Bidding Program goes into effect for mail order diabetic 
supplies, beneficiaries may still receive their diabetic testing strips from a local pharmacy or 
supplier storefront for the fee-schedule price, if they do not wish to order them through the mail. 
 
Round 1 of the Competitive Bidding Program and the Round 1 Rebid 
Suppliers began submitting bids for Round 1 of the Competitive Bidding Program on May 15, 
2007.  Contracts between CMS and suppliers became effective on July 1, 2008.  Under contracts 
awarded to suppliers in Round 1, Medicare payments decreased by an average of 26 percent 
across all selected DMEPOS categories.19   
 
Two weeks after the Round 1 contracts between CMS and suppliers became effective, Congress 
enacted the MIPPA, which instituted the following changes to the Competitive Bidding Program.  
The MIPPA: 
 
  terminated contracts awarded to suppliers in Round 1; 
                                                 
15 A CBA is defined by specific ZIP Codes related to Metropolitan Statistical Areas, which are areas designated by 
the Office of Management and Budget that include major cities and the suburban areas surrounding them.  The  
10 CBAs included in Round 1 were Charlotte (Charlotte-Gastonia-Concord, North Carolina and South Carolina); 
Cincinnati (Cincinnati-Middletown, Ohio, Kentucky, and Indiana); Cleveland (Cleveland-Elyria-Mentor, Ohio); 
Dallas (DallasFort WorthArlington, Texas); Kansas City (Kansas City, Missouri and Kansas); Miami  
(MiamiFort LauderdaleMiami Beach, Florida); Orlando (Orlando-Kissimmee, Florida); Pittsburgh (Pittsburgh, 
Pennsylvania); Riverside (RiversideSan BernardinoOntario, California); and San Juan  
(San JuanCaguasGuaynabo, Puerto Rico).  Metropolitan Statistical Areas, Competitive Bidding Areas, and Zip 
Codes.  Accessed at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/01a_MSAs_and_CBAs.asp on February 23, 
2010. 
16 CMS, General Overview of the Final Rule for Competitive Acquisition for Certain Durable Medical Equipment, 
Prosthetics, Orthotics, and Supplies.  Accessed at 
 https://www.cms.gov/DMEPOSCompetitiveBid/Downloads/DMEPOSRegSumm.pdf on  
October 14, 2010; 73 Fed. Reg. 17992, 18010 (Apr. 10, 2007). 
17 Overview of the DMEPOS Competitive Bidding Program.  Accessed at 
http://www.dmecompetitivebid.com/palmetto/cbic.nsf/DocsCat/Home on October 8, 2010. 
18 CMS, CMS Media Release Database Fact Sheet.  Details for:  Expansion of Competitive Bidding Program for 
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.  Accessed at 
http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=2812 on March 11, 2010.    
19 CMS, Medicare to Save Average Of 26% for Some Durable Medical Equipment, Prosthetics, Orthotics, and 
Supplies in Selected Areas.  Accessed at http://www.cms.gov/apps/media/press/release.asp?Counter=2996 on 
October 22, 2010. 
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 5  Donald M. Berwick, M.D. 
  required CMS to repeat the Round 1 competition (i.e., Round 1 Rebid) in 2009; and 
 
  instituted the MIPPA 50-percent requirement for mail order diabetic testing strips in 
rounds subsequent to the Round 1 Rebid.20 
 
The MIPPA also reduced the 2009 fee schedule amounts by 9.5 percent for all DMEPOS 
included in Round 1 to offset the estimated cost savings lost by the delay in implementing 
competitive bidding payment amounts.21   
 
The Round 1 Rebid of the Competitive Bidding Program began in October 2009 and included 
nine CBAs.22  CMS announced the winning amounts for the Round 1 Rebid on July 1, 2010, and 
announced the winning contract suppliers on November 3, 2010.  Winning suppliers will begin 
providing competitively-bid DMEPOS items to beneficiaries in the nine CBAs on January 1, 
2011.   
 
Under the Round 1 Rebid of the Competitive Bidding Program, CMS estimated that payment 
reductions compared to the 2009 Medicare fee schedule amount averaged 32 percent.23  
Medicare payments for mail order diabetic supplies, which include diabetic testing strips, 
decreased by an average of 56 percent under the Round 1 Rebid.24  Medicare payments for mail 
order diabetic testing strips range from $13.88 to $15.62 per box in the nine CBAs.25  
 
The MIPPA requires that, in rounds subsequent to the Round 1 Rebid of the Competitive 
Bidding program, contracts for mail order diabetic testing strips be awarded to suppliers who 
provide at least 50 percent, by volume, of all types of diabetic testing strips.26  This 50-percent 
requirement is intended to ensure that most beneficiaries can receive their preferred type of 
diabetic testing strips under the Competitive Bidding Program.27  Further, the MIPPA  
section 154(d)(3)(B) requires OIG to complete a study to determine the market share of diabetic 
testing strip types and to submit it to the Secretary of Health & Human Services (Secretary) 
before 2011.   
                                                 
20 The 50-percent requirement did not apply to suppliers bids in Round 1 or the Round 1 Rebid. 
21 CMS, Medicare Reopens Competitive Bidding Program for Medical Equipment and Supplies, October 21, 2009.  
Accessed at http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3535 on February 22, 2010.  This 
reduction resulted in the average 2009 fee schedule amount of $32.50 per box of mail order diabetic testing strips. 
22 Puerto Rico was not included in the Round 1 Rebid. 
23 CMS, Medicare Announces the Single Payment Amounts for the Round 1 Rebid of the Medicare DMEPOS 
Competitive Bidding Program.  Accessed at  
https://www.cms.gov/DMEPOSCompetitiveBid/01A1_Announcements_and_Communications.asp on October 8, 
2010. 
24 DMEPOS Competitive Bidding - Round 1 Rebid - Weighted Average Savings.  Accessed at 
http://www.dmecompetitivebid.com/Palmetto/Cbic.nsf/files/Weighted_Average_Savings.pdf/$FIle/Weighted_Avera
ge_Savings.pdf?Open&cat=Suppliers~Single Payment Amounts on October 14, 2010. 
25 Single Payment Amounts Per CBA.  Accessed at 
http://www.dmecompetitivebid.com/Palmetto/Cbic.nsf/files/SPA_Mail-Order_Diabetic.pdf/$FIle/SPA_Mail-
Order_Diabetic.pdf?Open&cat=Suppliers~Single Payment Amounts on October 14, 2010. 
26 Specifically, the MIPPA stipulates that suppliers provide at least 50 percent (or such higher percentage as the 
Secretary may specify) of all diabetic testing strips in the aggregate and taking into account volume for the 
different products.  MIPPA section 154(d)(3)(A). 
27 75 Fed. Reg. 40040, 40214 (July 13, 2010).  Accessed at http://edocket.access.gpo.gov/2010/pdf/2010-15900.pdf 
on August 19, 2010.    
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 6  Donald M. Berwick, M.D. 
METHODOLOGY 
 
Data Collection 
We identified the population of fee-for-service Medicare claims from CMSs National Claims 
History Durable Medical Equipment Standard Analytical File.  To identify the beneficiaries 
associated with each claim, the claims were matched with the CMS Beneficiary Enrollment 
Database.  Then, we selected a simple random sample of 1,210 of the 573,779 Medicare claims 
for mail order diabetic testing strips with a December 2009 through date of service.28  
 
We sent a documentation request to the 173 suppliers associated with the 1,210 claims in our 
sample.  We asked suppliers to indicate the type (model and manufacturer) of diabetic testing 
strips they provided to the Medicare beneficiary associated with each claim and to submit 
relevant documentation (e.g., packing slips, testing strip invoices).29   
 
We received responses from suppliers associated with 1,207 of the 1,210 claims in our sample, 
yielding a 99.8-percent response rate.  Two suppliers, responsible for three total claims in our 
sample, did not respond to the documentation request.30  We will forward information on these 
nonresponding suppliers to CMS under separate cover.   
 
Data Analysis 
We reviewed claims data, supplier responses to the documentation request, and the  
supplier-provided documentation to determine the quantity and type of mail order diabetic 
testing strips associated with each claim in our sample.  Each claim in our sample contained 
between 1 and 16 boxes, and data for the 1,207 claims provides information about 4,736 boxes 
of diabetic testing strips.31 
 
Ten suppliers (5.8 percent) provided documentation that did not match the Medicare claims data.  
We classified these discrepancies into two categories:  claims data that indicated that the supplier 
billed Medicare for more boxes of diabetic testing strips than reflected in the supplier-provided 
documentation, or claims data that indicated that the supplier billed Medicare for fewer boxes of 
diabetic testing strips than reflected in the supplier-provided documentation.  
 
Fifteen claims in our sample had one of these two categories of discrepancies.32  In these cases, 
we based our analysis on the data in the supplier documentation.  We will forward discrepancies 
between supplier documentation and claims data to CMS under separate cover.   
 
                                                 
28 Prior to selecting our sample on May 6, 2010, we analyzed claims data by through date of service over a 2-year 
period (February 2008 through February 2010) and determined that December 2009 had the most recent and 
complete claims data for mail order diabetic testing strips.  The through date of service field on the claim indicates 
the date on which beneficiaries will exhaust their 3-month supply of diabetic testing strips, if used at the frequency 
prescribed by their physicians.   
29 We contacted suppliers up to three times to obtain this information.   
30 These suppliers Medicare claims were associated with 30 boxes of diabetic testing strips in our sample.   
31 Most claims (90.1 percent) contained one to six boxes. 
32 For two claims, documentation indicates suppliers billed Medicare for more boxes than they provided to 
beneficiaries.  For 13 claims, documentation indicates suppliers billed Medicare for fewer boxes than they provided 
to beneficiaries.   
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 7  Donald M. Berwick, M.D. 
We categorized the types of diabetic testing strips by model and manufacturer.  We accounted 
for the volume of each type by determining the total number of 50-count boxes of each type of 
diabetic testing strip and the percentage of each type across all boxes.  We projected our sample 
data to the population of mail order diabetic testing strips to estimate the Medicare market shares 
of mail order diabetic testing strip types.   
 
Limitations 
Suppliers have 1 year to submit claims to CMS.  Types of diabetic testing strips associated with 
claims submitted after May 6, 2010, the date we selected our sample, are not included in our 
sample. 
 
Standards 
This review was conducted in accordance with the Quality Standards for Inspections approved 
by the Council of the Inspectors General on Integrity and Efficiency. 
 
RESULTS 
 
Suppliers Submitted Claims for at Least 75 Types of Mail Order Diabetic Testing Strips 
for the 3-Month Period Ending December 2009 
At least 75 types of diabetic testing strips from 171 suppliers were associated with mail order 
claims for the 3-month period ending December 2009.   
 
Two types of diabetic testing strips accounted for approximately 26 percent of the Medicare mail 
order market share, 7 types of diabetic testing strips accounted for approximately 50 percent of 
the Medicare mail order market share, and 19 types accounted for approximately 81 percent.  
 
Table 1 lists the top 19 types of mail order diabetic testing strips associated with Medicare claims 
for the 3-month period ending December 2009.  See Appendix A for a complete alphabetical 
listing of all 75 types.  Appendix A provides the model, manufacturer, percentage of market 
share, and 95-percent confidence intervals for market share for each diabetic testing strip type.
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 8  Donald M. Berwick, M.D. 
Table 1:  Top 19 Mail Order Diabetic Testing Strip Types Associated With Medicare 
Claims for the 3-Month Period Ending December 2009 
Model  Manufacturer  Percentage of 
Market Share 
One Touch Ultra   Lifescan  14.9 
Ascensia Contour  Bayer  11.1 
Freestyle Lite   Abbott  7.3 
Ascensia Breeze 2   Bayer  5.0 
AccuCheck Aviva  Roche  4.8 
Medisense Optium  Abbott  4.5 
AccuCheck Compact     Roche  4.1 
Embrace  Omnis Health  4.0 
Ascensia Contour TS  Bayer  3.3 
Liberty      Agamatrix  3.1 
True Balance  Home Diagnostics  3.0 
Wavesense Presto  Agamatrix  2.4 
Prodigy Autocode  Diagnostic Devices  2.3 
Freestyle     Abbott  2.1 
Liberty 2     Home Diagnostics  1.9 
TrueTrack  Home Diagnostics  1.9 
Companion  Omnis Health  1.8 
Advocate Redi-Code  Diabetic Supply of Suncoast  1.8 
True Read  Home Diagnostics  1.6 
           Total    80.9 
Source:  OIG analysis of supplier documentation and Medicare HCPCS code A4253 KL claims data for the 
 3-month period ending December 2009. 
 
CONCLUSION 
 
Suppliers submitted claims for at least 75 types of mail order diabetic testing strips for the  
3-month period ending December 2009.  Two types of diabetic testing strips accounted for 
approximately 26 percent of the Medicare mail order market share, 7 types of diabetic testing 
strips accounted for approximately 50 percent of the Medicare mail order market share, and  
19 types accounted for approximately 81 percent.  CMS may consider these data when 
determining whether future rounds of suppliers mail order diabetic testing strip bids comply 
with the MIPPA 50-percent requirement.   
 
This memorandum report is being issued directly in final form because it contains no 
recommendations.  If you have comments or questions about this report, please provide them 
within 60 days.  Please refer to report number OEI-04-10-00130 in all correspondence. 
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 9  Donald M. Berwick, M.D. 
Appendix A 
 
Market Share Estimates and Their 95-Percent Confidence Intervals for 75 Types of Mail Order Diabetic Testing Strips  
Model  Manufacturer  Percentage of  95-Percent  Confidence 
Market Share  Interval for  Market Share 
AccuCheck Active  Roche  0.93  0.491.76 
AccuCheck Aviva  Roche  4.76  3.506.42 
AccuCheck Comfort Curve  Roche  0.87  0.371.99 
AccuCheck Compact     Roche  4.12  3.005.62 
AccuCheck Compact Plus     Roche  0.44  0.191.04 
Acura  US Diagnostics  0.30  0.071.19 
Advance Intuition  Arkay  0.13  0.020.89 
Advocate  Diabetic Supply of Suncoast  0.63  0.301.34 
Advocate   Playtex  0.04  0.010.30 
Advocate Duo  Diabetic Supply of Suncoast  0.21  0.070.68 
Advocate Redi-Code  Diabetic Supply of Suncoast  1.78  1.132.78 
Ascensia Auto Disc   Bayer  0.51  0.231.12 
Ascensia Breeze 2   Bayer  5.01  3.756.65 
Ascensia Contour  Bayer  11.10  9.2413.25 
Ascensia Contour TS  Bayer  3.28  2.364.52 
Ascensia Elite  Bayer  0.17  0.050.56 
Bionime  Bionime  0.47  0.201.09 
Clever Check  Simple Diagnostics  1.08  0.611.89 
Clever Check Voice  Simple Diagnostics  0.72  0.341.52 
Clever Choice  Simple Diagnostics  0.17  0.040.79 
Companion  Apex  0.38  0.141.03 
Companion  Omnis Health  1.82  1.142.88 
Control  US Diagnostics  0.21  0.070.59 
Easy Check  Home Aide Diagnostics  1.35  0.762.40 
Easy Gluco  US Diagnostics  0.80  0.381.67 
Easy Max  ESP Bio Technologies  0.04  0.010.30 
Easy Max  Oak Tree International Holding  0.63  0.301.33 
                    continued on next page 
   
 
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 10  Donald M. Berwick, M.D. 
Appendix A   
             
Market Share Estimates and Their 95-Percent Confidence Intervals for 75 Types of Mail Order Diabetic Testing Strips 
(Continued) 
Model  Manufacturer  Percentage of  95-Percent Confidence 
Market Share  Interval for Market Share 
Easy Plus  Home Aide Diagnostics  0.36  0.111.16 
Eclipse  Infopia  0.47  0.201.09 
Element  Infopia  0.97  0.511.86 
Embrace  Infopia  0.08  0.010.60 
Embrace  Omnis Health  4.02  2.935.47 
Embrace Companion  Omnis Health  0.08  0.020.34 
Evencare  Medline Industries  0.08  0.010.60 
Evolution  Infopia  0.38  0.131.08 
EZ-Smart  VIP International  0.04  0.010.30 
Freestyle     Abbott  2.09  1.303.34 
Freestyle Flash  Abbott  0.11  0.010.75 
Freestyle Lite   Abbott  7.32  5.779.21 
Glucocard 01 Sensor  Arkay  0.08  0.020.34 
GlucoCom  Cardiocom  0.13  0.020.89 
GlucoCom  GlucoCom  0.08  0.020.34 
Infinity  US Diagnostics  0.30  0.100.87 
Liberty      Agamatrix  3.09  2.144.41 
Liberty 2     Home Diagnostics  1.90  1.173.07 
Maxima     US Diagnostics  0.80  0.411.57 
Medisense Optium  Abbott  4.46  3.296.01 
Nova Max  Nova Biomedical  1.46  0.862.47 
One Touch     Lifescan  0.38  0.141.03 
One Touch Select  Lifescan  0.76  0.401.46 
One Touch Sure Step     Lifescan  0.08  0.010.60 
One Touch Ultra  Bayer  0.04  0.010.30 
One Touch Ultra   Lifescan  14.88  12.6117.44 
One Touch Ultra 2  Lifescan  0.51  0.211.20 
continued on next page 
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips 
  Page 11  Donald M. Berwick, M.D. 
Appendix A 
 
Market Share Estimates and Their 95-Percent Confidence Intervals for 75 Types of Mail Order Diabetic Testing Strips 
(Continued) 
 Model  Manufacturer  Percentage of  95-Percent 
Market Share  Confidence Interval for 
Market Share 
One Touch Ultra Smart In Duo  Lifescan  0.04  0.010.30 
Perfect 2  GlucoPerfect  0.02  0.000.15 
Precision Xtra  Abbott  0.04  0.010.30 
 Precision Xtra  Medisense  0.04  0.010.30 
Prestige Smart System  Home Diagnostics  0.21  0.050.86 
Prodigy Advance  Diagnostic Devices  0.08  0.010.60 
Prodigy Autocode  Diagnostic Devices  2.33  1.553.46 
Protege  Progressive  0.13  0.030.54 
SmartTest  Progressive  0.08  0.010.60 
Sure Classic  Specialty Medical Supplies  0.25  0.061.01 
SureEdge  Specialty Medical Supplies  0.25  0.090.71 
True Balance  Home Diagnostics  3.00  2.064.35 
True Balance  McKesson  0.04  0.010.30 
True Read  Home Diagnostics  1.61  1.002.58 
TrueTrack  Home Diagnostics  1.86  1.172.93 
TrueTrack  Invacare  0.08  0.010.60 
Ultratrak Pro  Vertex Diagnostics  0.13  0.020.89 
Voice Prodigy      Diagnostics Devices  0.38  0.121.22 
Wavesense Amp  Agamatrix  0.08  0.010.60 
Wavesense Keynote  AgaMatrix  0.13  0.020.89 
Wavesense Presto  Agamatrix  2.41  1.603.62 
Total    100.00*   
Source:  Office of Inspector General analysis of supplier documentation and Medicare HCPCS code A4253 KL claims data for the 3-month period 
ending December 2009. 
 
* Column does not sum to total because of rounding. 
 
 
OEI-04-10-00130           Medicare Market Shares of Mail Order Diabetic Testing Strips