| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
13,450 |
11,220 |
$386K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
44,784 |
35,291 |
$321K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
5,315 |
4,161 |
$225K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,017 |
2,935 |
$65K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,048 |
2,896 |
$56K |
| A4259 |
Lancets, per box of 100 |
42,785 |
33,488 |
$54K |
| E0607 |
Home blood glucose monitor |
5,422 |
4,457 |
$48K |
| A4256 |
Normal, low and high calibrator solution / chips |
40,450 |
31,598 |
$39K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
871 |
723 |
$31K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,472 |
1,875 |
$27K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,225 |
944 |
$27K |
| A7035 |
Headgear used with positive airway pressure device |
4,830 |
3,487 |
$26K |
| A7037 |
Tubing used with positive airway pressure device |
6,591 |
4,845 |
$24K |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
1,617 |
1,375 |
$18K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,136 |
5,337 |
$18K |
| A4258 |
Spring-powered device for lancet, each |
18,355 |
14,338 |
$12K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
792 |
587 |
$10K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
217 |
152 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,280 |
1,579 |
$4K |
| E0849 |
Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible |
135 |
109 |
$1K |
| E2100 |
Blood glucose monitor with integrated voice synthesizer |
39 |
29 |
$872.22 |
| E0210 |
Electric heat pad, standard |
254 |
192 |
$469.75 |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
20 |
12 |
$434.51 |
| A7036 |
Chinstrap used with positive airway pressure device |
165 |
132 |
$300.25 |
| A4233 |
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each |
717 |
599 |
$186.55 |
| E0570 |
Nebulizer, with compressor |
40 |
40 |
$8.24 |