| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
2,851 |
2,476 |
$276K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
3,846 |
3,449 |
$234K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
3,935 |
3,616 |
$134K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,234 |
2,082 |
$112K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
3,040 |
3,004 |
$94K |
| A4231 |
Infusion set for external insulin pump, needle type |
905 |
903 |
$73K |
| E0784 |
External ambulatory infusion pump, insulin |
737 |
430 |
$26K |
| A4259 |
Lancets, per box of 100 |
1,420 |
1,360 |
$18K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
67 |
67 |
$8K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
60 |
40 |
$7K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
837 |
735 |
$7K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
761 |
432 |
$7K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
945 |
842 |
$6K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
154 |
134 |
$5K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
20 |
12 |
$2K |
| A4456 |
Adhesive remover, wipes, any type, each |
52 |
52 |
$1K |
| A4256 |
Normal, low and high calibrator solution / chips |
104 |
95 |
$614.25 |
| A4371 |
Ostomy skin barrier, powder, per oz |
13 |
13 |
$131.85 |