| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
441 |
439 |
$24K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
343 |
343 |
$17K |
| A4670 |
Automatic blood pressure monitor |
100 |
100 |
$6K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
24 |
12 |
$710.24 |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
12 |
12 |
$557.00 |