| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
32,499 |
24,879 |
$8.47M |
| A4230 |
Infus insulin pump non needl |
32,723 |
25,150 |
$5.16M |
| A9277 |
External transmitter, cgm |
7,519 |
6,097 |
$3.39M |
| E0784 |
Ext amb infusn pump insulin |
8,174 |
6,880 |
$2.74M |
| A9274 |
Ext amb insulin delivery sys |
7,499 |
4,517 |
$2.37M |
| A4253 |
Blood glucose/reagent strips |
12,890 |
10,372 |
$1.11M |
| A9278 |
External receiver, cgm sys |
1,645 |
1,353 |
$722K |
| K0552 |
Sup/ext non-ins inf pump syr |
19,422 |
13,608 |
$517K |
| A4225 |
Sup/ext insulin inf pump syr |
12,765 |
12,098 |
$413K |
| A6257 |
Transparent film <= 16 sq in |
16,225 |
11,631 |
$402K |
| K0553 |
Ther cgm supply allowance |
15,796 |
13,052 |
$278K |
| A4239 |
Non-adju cgm supply allow |
9,544 |
6,642 |
$161K |
| A4250 |
Urine reagent strips/tablets |
10,774 |
5,059 |
$131K |
| A5120 |
Skin barrier, wipe or swab |
11,905 |
9,162 |
$77K |
| A4259 |
Lancets per box |
6,690 |
5,030 |
$54K |
| A4456 |
Adhesive remover, wipes |
7,244 |
2,718 |
$39K |
| A4215 |
Sterile needle |
1,340 |
1,023 |
$32K |
| A4231 |
Infusion insulin pump needle |
541 |
428 |
$30K |
| A6258 |
Transparent film >16<=48 in |
425 |
154 |
$22K |
| K0554 |
Ther cgm receiver/monitor |
1,340 |
1,153 |
$18K |
| A4221 |
Supp non-insulin inf cath/wk |
78 |
78 |
$18K |
| E2103 |
Non-adju cgm receiver/mon |
599 |
462 |
$10K |
| A4224 |
Supply insulin inf cath/wk |
527 |
365 |
$7K |
| A6212 |
Foam drg <=16 sq in w/border |
54 |
33 |
$4K |
| A4206 |
1 cc sterile syringe&needle |
148 |
148 |
$3K |
| A4232 |
Syringe w/needle insulin 3cc |
637 |
428 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
44 |
38 |
$669.11 |
| A4258 |
Lancet device each |
365 |
267 |
$524.85 |
| A4364 |
Adhesive, liquid or equal |
235 |
100 |
$263.25 |
| A6446 |
Conform band s w>=3" <5"/yd |
16 |
13 |
$57.60 |
| K0604 |
Repl batt lithium 3.6 v |
151 |
53 |
$0.00 |
| A4235 |
Lithium batt for glucose mon |
24 |
15 |
$0.00 |