| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
4,734 |
4,679 |
$221K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,320 |
1,310 |
$117K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,001 |
1,992 |
$16K |
| A4256 |
Normal, low and high calibrator solution / chips |
1,888 |
1,887 |
$2K |
| A4259 |
Lancets, per box of 100 |
1,797 |
1,789 |
$1K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
26 |
26 |
$1K |
| A4258 |
Spring-powered device for lancet, each |
750 |
750 |
$408.07 |
| A4233 |
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each |
420 |
420 |
$113.27 |
| A4235 |
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each |
40 |
40 |
$9.24 |