| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Ther cgm supply allowance |
66,844 |
53,389 |
$2.20M |
| A4239 |
Non-adju cgm supply allow |
40,459 |
34,785 |
$1.44M |
| K0554 |
Ther cgm receiver/monitor |
7,252 |
5,430 |
$185K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
269 |
212 |
$108K |
| E2103 |
Non-adju cgm receiver/mon |
1,712 |
1,375 |
$46K |
| A9276 |
Disposable sensor, cgm sys |
322 |
240 |
$18K |
| L2630 |
Pelvic control band & belt u |
121 |
72 |
$12K |
| E0603 |
Electric breast pump |
103 |
63 |
$8K |
| L1833 |
Ko adj jnt pos r sup pre ots |
21 |
12 |
$5K |
| L0621 |
Sio flex pelvic/sacr pre ots |
105 |
61 |
$3K |
| E0691 |
Uvl pnl 2 sq ft or less |
36 |
31 |
$3K |
| A4287 |
Disp col sto bag breast milk |
21 |
17 |
$640.80 |
| A6530 |
Compression stocking bk18-30 |
72 |
29 |
$564.61 |
| K1005 |
Disp col sto bag breast milk |
46 |
22 |
$145.40 |