| 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 |
20,058 |
15,920 |
$1.45M |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
9,856 |
8,782 |
$1.19M |
| E0784 |
External ambulatory infusion pump, insulin |
6,108 |
5,111 |
$1.13M |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
3,210 |
2,656 |
$800K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
10,491 |
9,347 |
$306K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
9,946 |
8,019 |
$299K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,493 |
2,252 |
$299K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
1,813 |
1,345 |
$92K |
| A4238 |
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
763 |
596 |
$60K |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
30 |
29 |
$16K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
882 |
684 |
$14K |
| A4231 |
Infusion set for external insulin pump, needle type |
90 |
73 |
$10K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
326 |
312 |
$2K |
| A4402 |
Lubricant, per ounce |
335 |
313 |
$1K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
132 |
127 |
$752.49 |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
12 |
12 |
$564.26 |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
12 |
12 |
$554.94 |
| A4456 |
Adhesive remover, wipes, any type, each |
122 |
116 |
$498.26 |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
3,254 |
3,033 |
$364.14 |
| A5120 |
Skin barrier, wipes or swabs, each |
107 |
91 |
$360.66 |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
3,238 |
3,017 |
$98.40 |
| K0603 |
Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each |
27 |
25 |
$0.00 |