| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4239 |
Non-adju cgm supply allow |
2,924 |
2,836 |
$853K |
| K0553 |
Ther cgm supply allowance |
1,580 |
1,569 |
$771K |
| T4523 |
Adult size brief/diaper lg |
574 |
540 |
$37K |
| T4524 |
Adult size brief/diaper xl |
166 |
164 |
$15K |
| A4253 |
Blood glucose/reagent strips |
827 |
823 |
$13K |
| A4554 |
Disposable underpads |
477 |
454 |
$12K |
| T4535 |
Disposable liner/shield/pad |
310 |
301 |
$7K |
| A4259 |
Lancets per box |
808 |
801 |
$5K |
| A4927 |
Non-sterile gloves |
1,088 |
1,056 |
$5K |
| E2103 |
Non-adju cgm receiver/mon |
13 |
12 |
$3K |
| K0554 |
Ther cgm receiver/monitor |
12 |
12 |
$3K |
| B4150 |
Ef complet w/intact nutrient |
30 |
26 |
$2K |
| A4245 |
Alcohol wipes per box |
868 |
861 |
$1K |
| T4522 |
Adult size brief/diaper med |
37 |
36 |
$1K |
| A4670 |
Automatic bp monitor, dial |
33 |
30 |
$1K |