| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9274 |
Ext amb insulin delivery sys |
12,840 |
7,217 |
$3.05M |
| A9276 |
Disposable sensor, cgm sys |
4,605 |
3,793 |
$2.55M |
| E1399 |
Durable medical equipment mi |
677 |
611 |
$1.29M |
| E0784 |
Ext amb infusn pump insulin |
2,780 |
2,525 |
$1.12M |
| A4253 |
Blood glucose/reagent strips |
14,041 |
10,894 |
$987K |
| A4230 |
Infus insulin pump non needl |
3,536 |
1,893 |
$721K |
| A9277 |
External transmitter, cgm |
4,301 |
3,691 |
$632K |
| A4239 |
Non-adju cgm supply allow |
777 |
744 |
$369K |
| A4232 |
Syringe w/needle insulin 3cc |
3,567 |
1,878 |
$181K |
| A4259 |
Lancets per box |
11,844 |
9,460 |
$156K |
| A4250 |
Urine reagent strips/tablets |
3,877 |
2,399 |
$123K |
| E0607 |
Blood glucose monitor home |
1,859 |
1,668 |
$107K |
| A9278 |
External receiver, cgm sys |
238 |
175 |
$59K |
| E0260 |
Hosp bed semi-electr w/ matt |
396 |
378 |
$44K |
| E1140 |
Wheelchair standard detach a |
102 |
96 |
$41K |
| A4245 |
Alcohol wipes per box |
7,326 |
5,764 |
$37K |
| A4258 |
Lancet device each |
1,778 |
1,610 |
$22K |
| E1390 |
Oxygen concentrator |
305 |
275 |
$16K |
| E0971 |
Wheelchair anti-tipping devi |
382 |
287 |
$16K |
| E0143 |
Walker folding wheeled w/o s |
349 |
315 |
$15K |
| A4256 |
Calibrator solution/chips |
1,734 |
1,566 |
$14K |
| E2601 |
Gen w/c cushion wdth < 22 in |
275 |
267 |
$10K |
| E2103 |
Non-adju cgm receiver/mon |
28 |
26 |
$6K |
| K0001 |
Standard wheelchair |
1,016 |
1,000 |
$4K |
| E0431 |
Portable gaseous 02 |
308 |
270 |
$3K |
| E0163 |
Commode chair with fixed arm |
82 |
67 |
$3K |
| K0195 |
Elevating whlchair leg rests |
181 |
177 |
$787.36 |