| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
22,842 |
7,540 |
$1.99M |
| A4222 |
Infusion supplies with pump |
3,365 |
3,119 |
$1.08M |
| A9277 |
External transmitter, cgm |
2,717 |
2,620 |
$919K |
| A9274 |
Ext amb insulin delivery sys |
827 |
758 |
$453K |
| A4230 |
Infus insulin pump non needl |
2,699 |
2,445 |
$264K |
| A9278 |
External receiver, cgm sys |
118 |
116 |
$43K |
| K0553 |
Ther cgm supply allowance |
652 |
630 |
$30K |
| A4239 |
Non-adju cgm supply allow |
852 |
738 |
$29K |
| A5500 |
Diab shoe for density insert |
98 |
92 |
$2K |
| A4245 |
Alcohol wipes per box |
34 |
30 |
$1K |
| A5512 |
Multi den insert direct form |
70 |
68 |
$508.81 |
| A6257 |
Transparent film <= 16 sq in |
38 |
31 |
$115.17 |