| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4239 |
Non-adju cgm supply allow |
77,096 |
68,247 |
$7.01M |
| A9276 |
Disposable sensor, cgm sys |
16,090 |
13,958 |
$5.58M |
| K0553 |
Ther cgm supply allowance |
41,076 |
36,185 |
$3.69M |
| E0784 |
Ext amb infusn pump insulin |
2,742 |
2,455 |
$3.26M |
| A9274 |
Ext amb insulin delivery sys |
7,412 |
6,824 |
$3.06M |
| A4230 |
Infus insulin pump non needl |
10,504 |
9,795 |
$1.88M |
| Z5999 |
|
3,326 |
2,730 |
$1.24M |
| A9277 |
External transmitter, cgm |
3,381 |
2,832 |
$1.10M |
| A4232 |
Syringe w/needle insulin 3cc |
10,495 |
10,003 |
$499K |
| A4224 |
Supply insulin inf cath/wk |
8,302 |
7,635 |
$332K |
| K0554 |
Ther cgm receiver/monitor |
3,144 |
2,836 |
$275K |
| E2103 |
Non-adju cgm receiver/mon |
4,323 |
3,530 |
$269K |
| A9278 |
External receiver, cgm sys |
834 |
636 |
$214K |
| A4225 |
Sup/ext insulin inf pump syr |
8,476 |
7,821 |
$163K |
| A4231 |
Infusion insulin pump needle |
909 |
842 |
$98K |
| 99429 |
|
191 |
159 |
$87K |
| A6257 |
Transparent film <= 16 sq in |
590 |
435 |
$24K |
| K0552 |
Sup/ext non-ins inf pump syr |
481 |
342 |
$15K |
| A5120 |
Skin barrier, wipe or swab |
618 |
487 |
$4K |
| A4238 |
Adju cgm supply allowance |
17 |
13 |
$1K |
| A4456 |
Adhesive remover, wipes |
24 |
24 |
$148.41 |
| A4245 |
Alcohol wipes per box |
56 |
52 |
$90.94 |
| A4250 |
Urine reagent strips/tablets |
14 |
12 |
$39.96 |