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 meter’s reading of an individual’s 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 beneficiary’s 

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 beneficiary’s 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 (Dallas–Fort Worth–Arlington, Texas); Kansas City (Kansas City, Missouri and Kansas); Miami 

(Miami–Fort Lauderdale–Miami Beach, Florida); Orlando (Orlando-Kissimmee, Florida); Pittsburgh (Pittsburgh, 

Pennsylvania); Riverside (Riverside–San Bernardino–Ontario, California); and San Juan 

(San Juan–Caguas–Guaynabo, 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_MailOrder_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 CMS’s 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 

Market Share 

95-Percent Confidence 

Interval for Market Share 

AccuCheck Active Roche 0.93 0.49–1.76 

AccuCheck Aviva Roche 4.76 3.50–6.42 

AccuCheck Comfort Curve Roche 0.87 0.37–1.99 

AccuCheck Compact Roche 4.12 3.00–5.62 

AccuCheck Compact Plus Roche 0.44 0.19–1.04 

Acura US Diagnostics 0.30 0.07–1.19 

Advance Intuition Arkay 0.13 0.02–0.89 

Advocate Diabetic Supply of Suncoast 0.63 0.30–1.34 

Advocate Playtex 0.04 0.01–0.30 

Advocate Duo Diabetic Supply of Suncoast 0.21 0.07–0.68 

Advocate Redi-Code Diabetic Supply of Suncoast 1.78 1.13–2.78 

Ascensia Auto Disc Bayer 0.51 0.23–1.12 

Ascensia Breeze 2 Bayer 5.01 3.75–6.65 

Ascensia Contour Bayer 11.10 9.24–13.25 

Ascensia Contour TS Bayer 3.28 2.36–4.52 

Ascensia Elite Bayer 0.17 0.05–0.56 

Bionime Bionime 0.47 0.20–1.09 

Clever Check Simple Diagnostics 1.08 0.61–1.89 

Clever Check Voice Simple Diagnostics 0.72 0.34–1.52 

Clever Choice Simple Diagnostics 0.17 0.04–0.79 

Companion Apex 0.38 0.14–1.03 

Companion Omnis Health 1.82 1.14–2.88 

Control US Diagnostics 0.21 0.07–0.59 

Easy Check Home Aide Diagnostics 1.35 0.76–2.40 

Easy Gluco US Diagnostics 0.80 0.38–1.67 

Easy Max ESP Bio Technologies 0.04 0.01–0.30 

Easy Max Oak Tree International Holding 0.63 0.30–1.33 

 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 

Market Share 

95-Percent Confidence 

Interval for Market Share 

Easy Plus Home Aide Diagnostics 0.36 0.11–1.16 

Eclipse Infopia 0.47 0.20–1.09 

Element Infopia 0.97 0.51–1.86 

Embrace Infopia 0.08 0.01–0.60 

Embrace Omnis Health 4.02 2.93–5.47 

Embrace Companion Omnis Health 0.08 0.02–0.34 

Evencare Medline Industries 0.08 0.01–0.60 

Evolution Infopia 0.38 0.13–1.08 

EZ-Smart VIP International 0.04 0.01–0.30 

Freestyle Abbott 2.09 1.30–3.34 

Freestyle Flash Abbott 0.11 0.01–0.75 

Freestyle Lite Abbott 7.32 5.77–9.21 

Glucocard 01 Sensor Arkay 0.08 0.02–0.34 

GlucoCom Cardiocom 0.13 0.02–0.89 

GlucoCom GlucoCom 0.08 0.02–0.34 

Infinity US Diagnostics 0.30 0.10–0.87 

Liberty Agamatrix 3.09 2.14–4.41 

Liberty 2 Home Diagnostics 1.90 1.17–3.07 

Maxima US Diagnostics 0.80 0.41–1.57 

Medisense Optium Abbott 4.46 3.29–6.01 

Nova Max Nova Biomedical 1.46 0.86–2.47 

One Touch Lifescan 0.38 0.14–1.03 

One Touch Select Lifescan 0.76 0.40–1.46 

One Touch Sure Step Lifescan 0.08 0.01–0.60 

One Touch Ultra Bayer 0.04 0.01–0.30 

One Touch Ultra Lifescan 14.88 12.61–17.44 

One Touch Ultra 2 Lifescan 0.51 0.21–1.20 

continued on next page 

OEI-04-10-00130 Medicare Market Shares of Mail Order Diabetic Testing Strips 
Page 11 – Donald M. Berwick, M.D. 

OEI-04-10-00130 Medicare Market Shares of Mail Order Diabetic Testing Strips 

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 

Market Share 

95-Percent 

Confidence Interval for 

Market Share 

One Touch Ultra Smart In Duo Lifescan 0.04 0.01–0.30 

Perfect 2 GlucoPerfect 0.02 0.00–0.15 

Precision Xtra Abbott 0.04 0.01–0.30 

 Precision Xtra Medisense 0.04 0.01–0.30 

Prestige Smart System Home Diagnostics 0.21 0.05–0.86 

Prodigy Advance Diagnostic Devices 0.08 0.01–0.60 

Prodigy Autocode Diagnostic Devices 2.33 1.55–3.46 

Protégé Progressive 0.13 0.03–0.54 

SmartTest Progressive 0.08 0.01–0.60 

Sure Classic Specialty Medical Supplies 0.25 0.06–1.01 

SureEdge Specialty Medical Supplies 0.25 0.09–0.71 

True Balance Home Diagnostics 3.00 2.06–4.35 

True Balance McKesson 0.04 0.01–0.30 

True Read Home Diagnostics 1.61 1.00–2.58 

TrueTrack Home Diagnostics 1.86 1.17–2.93 

TrueTrack Invacare 0.08 0.01–0.60 

Ultratrak Pro Vertex Diagnostics 0.13 0.02–0.89 

Voice Prodigy Diagnostics Devices 0.38 0.12–1.22 

Wavesense Amp Agamatrix 0.08 0.01–0.60 

Wavesense Keynote AgaMatrix 0.13 0.02–0.89 

Wavesense Presto Agamatrix 2.41 1.60–3.62 

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.