| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
502 |
331 |
$264K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
586 |
411 |
$124K |
| 0001A |
|
305 |
241 |
$9K |
| 0011A |
|
534 |
281 |
$8K |
| 0012A |
|
346 |
248 |
$8K |
| 0002A |
|
241 |
205 |
$7K |
| 0003A |
|
279 |
274 |
$2K |
| 0064A |
|
113 |
111 |
$1K |
| 0071A |
|
20 |
20 |
$840.00 |
| 0013A |
|
51 |
44 |
$600.00 |
| 0031A |
|
46 |
27 |
$560.00 |
| 91322 |
|
32 |
32 |
$161.65 |
| 90480 |
|
32 |
32 |
$40.00 |
| 90662 |
|
16 |
16 |
$0.00 |
| 90653 |
|
20 |
20 |
$0.00 |
| 0124A |
|
17 |
17 |
$0.00 |
| M0201 |
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
216 |
215 |
$0.00 |
| 90674 |
|
49 |
44 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
271 |
238 |
$0.00 |
| 90694 |
|
108 |
106 |
$0.00 |
| 0134A |
|
13 |
13 |
$0.00 |