| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4222 |
Infusion supplies with pump |
2,027 |
1,616 |
$628K |
| E0784 |
Ext amb infusn pump insulin |
2,747 |
2,376 |
$412K |
| K0553 |
Ther cgm supply allowance |
3,251 |
3,181 |
$354K |
| A4239 |
Non-adju cgm supply allow |
1,726 |
1,334 |
$253K |
| A4230 |
Infus insulin pump non needl |
1,621 |
928 |
$123K |
| A4232 |
Syringe w/needle insulin 3cc |
2,226 |
1,318 |
$48K |
| A9276 |
Disposable sensor, cgm sys |
288 |
222 |
$45K |
| A4253 |
Blood glucose/reagent strips |
1,065 |
908 |
$40K |
| A4224 |
Supply insulin inf cath/wk |
1,425 |
1,209 |
$11K |
| A4238 |
Adju cgm supply allowance |
325 |
254 |
$9K |
| K0554 |
Ther cgm receiver/monitor |
29 |
29 |
$4K |
| A4225 |
Sup/ext insulin inf pump syr |
1,358 |
1,223 |
$3K |
| A4259 |
Lancets per box |
41 |
38 |
$258.44 |