| 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 |
2,924 |
2,836 |
$853K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,580 |
1,569 |
$771K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
574 |
540 |
$37K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
166 |
164 |
$15K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
827 |
823 |
$13K |
| A4554 |
Disposable underpads, all sizes |
477 |
454 |
$12K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
310 |
301 |
$7K |
| A4259 |
Lancets, per box of 100 |
808 |
801 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
1,088 |
1,056 |
$5K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
13 |
12 |
$3K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
12 |
12 |
$3K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
30 |
26 |
$2K |
| A4245 |
Alcohol wipes, per box |
868 |
861 |
$1K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
37 |
36 |
$1K |
| A4670 |
Automatic blood pressure monitor |
33 |
30 |
$1K |