| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
12,039 |
10,667 |
$2.95M |
| A9277 |
External transmitter, cgm |
3,847 |
3,372 |
$1.54M |
| L0650 |
Lso sc r ant/pos pnl pre ots |
984 |
621 |
$450K |
| K0553 |
Ther cgm supply allowance |
5,869 |
4,407 |
$303K |
| A9278 |
External receiver, cgm sys |
665 |
581 |
$253K |
| A4239 |
Non-adju cgm supply allow |
3,352 |
2,468 |
$212K |
| K0823 |
Pwc gp 2 std cap chair |
2,781 |
2,052 |
$172K |
| A4595 |
Tens suppl 2 lead per month |
27,114 |
17,155 |
$166K |
| A9274 |
Ext amb insulin delivery sys |
509 |
423 |
$148K |
| K0002 |
Stnd hemi (low seat) whlchr |
3,453 |
2,595 |
$34K |
| E0730 |
Tens four lead |
3,170 |
2,229 |
$28K |
| A4224 |
Supply insulin inf cath/wk |
876 |
692 |
$24K |
| L1833 |
Ko adj jnt pos r sup pre ots |
117 |
70 |
$15K |
| A4225 |
Sup/ext insulin inf pump syr |
866 |
693 |
$11K |
| E0143 |
Walker folding wheeled w/o s |
1,548 |
1,154 |
$8K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
1,202 |
831 |
$7K |
| K0554 |
Ther cgm receiver/monitor |
370 |
248 |
$5K |
| K0825 |
Pwc gp 2 hd cap chair |
41 |
25 |
$4K |
| E0156 |
Walker seat attachment |
625 |
450 |
$2K |
| E0973 |
W/ch access det adj armrest |
155 |
99 |
$2K |
| K0001 |
Standard wheelchair |
288 |
231 |
$1K |
| E2365 |
U1 sealed leadacid battery |
41 |
24 |
$1K |
| E0149 |
Heavy duty wheeled walker |
199 |
161 |
$938.24 |
| E0731 |
Conductive garment for tens/ |
16 |
14 |
$822.08 |
| A4557 |
Lead wires, pair |
776 |
517 |
$745.36 |
| E0601 |
Cont airway pressure device |
41 |
26 |
$477.85 |
| K0003 |
Lightweight wheelchair |
67 |
60 |
$215.05 |
| E0570 |
Nebulizer with compression |
48 |
24 |
$32.52 |