| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4239 |
Non-adju cgm supply allow |
3,756 |
3,316 |
$668K |
| K0553 |
Ther cgm supply allowance |
2,383 |
1,780 |
$221K |
| A4253 |
Blood glucose/reagent strips |
1,590 |
1,284 |
$90K |
| A4224 |
Supply insulin inf cath/wk |
1,953 |
602 |
$32K |
| K0554 |
Ther cgm receiver/monitor |
203 |
143 |
$32K |
| E2103 |
Non-adju cgm receiver/mon |
142 |
113 |
$27K |
| A4259 |
Lancets per box |
1,445 |
1,175 |
$18K |
| A4225 |
Sup/ext insulin inf pump syr |
701 |
504 |
$9K |
| A4230 |
Infus insulin pump non needl |
272 |
194 |
$7K |
| A5120 |
Skin barrier, wipe or swab |
768 |
644 |
$6K |
| A4206 |
1 cc sterile syringe&needle |
176 |
144 |
$3K |
| A4232 |
Syringe w/needle insulin 3cc |
257 |
180 |
$2K |
| E0607 |
Blood glucose monitor home |
16 |
12 |
$1K |
| A4256 |
Calibrator solution/chips |
140 |
115 |
$677.79 |