| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
42,895 |
33,245 |
$20.19M |
| A9274 |
Ext amb insulin delivery sys |
13,325 |
10,961 |
$13.29M |
| A4230 |
Infus insulin pump non needl |
17,710 |
15,600 |
$5.43M |
| E0784 |
Ext amb infusn pump insulin |
10,465 |
8,815 |
$5.18M |
| A9277 |
External transmitter, cgm |
12,067 |
10,299 |
$4.83M |
| A9278 |
External receiver, cgm sys |
5,978 |
5,023 |
$2.19M |
| A4239 |
Non-adju cgm supply allow |
10,110 |
9,320 |
$737K |
| K0553 |
Ther cgm supply allowance |
14,539 |
12,078 |
$657K |
| A4225 |
Sup/ext insulin inf pump syr |
24,576 |
19,807 |
$643K |
| A4222 |
Infusion supplies with pump |
1,362 |
1,172 |
$592K |
| A6257 |
Transparent film <= 16 sq in |
3,606 |
2,872 |
$241K |
| A4231 |
Infusion insulin pump needle |
974 |
838 |
$231K |
| A4224 |
Supply insulin inf cath/wk |
8,332 |
6,168 |
$231K |
| A9999 |
Dme supply or accessory, nos |
289 |
287 |
$225K |
| E0787 |
Cgs dose adj insulin inf pmp |
125 |
103 |
$134K |
| A4232 |
Syringe w/needle insulin 3cc |
4,090 |
3,073 |
$47K |
| A5120 |
Skin barrier, wipe or swab |
4,720 |
4,080 |
$33K |
| K0554 |
Ther cgm receiver/monitor |
970 |
773 |
$32K |
| A4253 |
Blood glucose/reagent strips |
591 |
445 |
$24K |
| E2103 |
Non-adju cgm receiver/mon |
364 |
327 |
$14K |
| A4238 |
Adju cgm supply allowance |
431 |
355 |
$12K |
| A5500 |
Diab shoe for density insert |
164 |
155 |
$11K |
| K0552 |
Sup/ext non-ins inf pump syr |
327 |
301 |
$10K |
| A5512 |
Multi den insert direct form |
111 |
105 |
$3K |
| A4259 |
Lancets per box |
16 |
12 |
$96.53 |