| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4230 |
Infus insulin pump non needl |
2,851 |
2,476 |
$276K |
| A4239 |
Non-adju cgm supply allow |
3,846 |
3,449 |
$234K |
| K0553 |
Ther cgm supply allowance |
3,935 |
3,616 |
$134K |
| A4253 |
Blood glucose/reagent strips |
2,234 |
2,082 |
$112K |
| A4232 |
Syringe w/needle insulin 3cc |
3,040 |
3,004 |
$94K |
| A4231 |
Infusion insulin pump needle |
905 |
903 |
$73K |
| E0784 |
Ext amb infusn pump insulin |
737 |
430 |
$26K |
| A4259 |
Lancets per box |
1,420 |
1,360 |
$18K |
| A4385 |
Ost skn barrier sld ext wear |
67 |
67 |
$8K |
| E2103 |
Non-adju cgm receiver/mon |
60 |
40 |
$7K |
| A4224 |
Supply insulin inf cath/wk |
837 |
735 |
$7K |
| K0552 |
Sup/ext non-ins inf pump syr |
761 |
432 |
$7K |
| A4225 |
Sup/ext insulin inf pump syr |
945 |
842 |
$6K |
| A9276 |
Disposable sensor, cgm sys |
154 |
134 |
$5K |
| K0554 |
Ther cgm receiver/monitor |
20 |
12 |
$2K |
| A4456 |
Adhesive remover, wipes |
52 |
52 |
$1K |
| A4256 |
Calibrator solution/chips |
104 |
95 |
$614.25 |
| A4371 |
Skin barrier powder per oz |
13 |
13 |
$131.85 |