| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
22,842 |
7,540 |
$1.99M |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
3,365 |
3,119 |
$1.08M |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
2,717 |
2,620 |
$919K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
827 |
758 |
$453K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
2,699 |
2,445 |
$264K |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
118 |
116 |
$43K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
652 |
630 |
$30K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
852 |
738 |
$29K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
98 |
92 |
$2K |
| A4245 |
Alcohol wipes, per box |
34 |
30 |
$1K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
70 |
68 |
$508.81 |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
38 |
31 |
$115.17 |