| 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 |
3,756 |
3,316 |
$668K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
2,383 |
1,780 |
$221K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,590 |
1,284 |
$90K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
1,953 |
602 |
$32K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
203 |
143 |
$32K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
142 |
113 |
$27K |
| A4259 |
Lancets, per box of 100 |
1,445 |
1,175 |
$18K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
701 |
504 |
$9K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
272 |
194 |
$7K |
| A5120 |
Skin barrier, wipes or swabs, each |
768 |
644 |
$6K |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
176 |
144 |
$3K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
257 |
180 |
$2K |
| E0607 |
Home blood glucose monitor |
16 |
12 |
$1K |
| A4256 |
Normal, low and high calibrator solution / chips |
140 |
115 |
$677.79 |