| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Ther cgm supply allowance |
41,172 |
39,609 |
$23.71M |
| A9274 |
Ext amb insulin delivery sys |
37,017 |
36,119 |
$19.61M |
| A4239 |
Non-adju cgm supply allow |
26,824 |
26,507 |
$6.49M |
| A6258 |
Transparent film >16<=48 in |
21,075 |
20,648 |
$1.32M |
| K0554 |
Ther cgm receiver/monitor |
2,599 |
2,472 |
$1.11M |
| E0784 |
Ext amb infusn pump insulin |
2,011 |
1,958 |
$728K |
| A4230 |
Infus insulin pump non needl |
4,463 |
4,166 |
$596K |
| A4238 |
Adju cgm supply allowance |
2,121 |
2,081 |
$471K |
| E2103 |
Non-adju cgm receiver/mon |
1,299 |
1,279 |
$343K |
| A9276 |
Disposable sensor, cgm sys |
634 |
615 |
$139K |
| A4232 |
Syringe w/needle insulin 3cc |
4,825 |
4,154 |
$111K |
| A9277 |
External transmitter, cgm |
212 |
209 |
$65K |
| A4253 |
Blood glucose/reagent strips |
281 |
226 |
$15K |
| A4259 |
Lancets per box |
249 |
222 |
$3K |
| A4245 |
Alcohol wipes per box |
89 |
89 |
$344.02 |