| 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 |
2,999 |
2,914 |
$1.44M |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
9,182 |
9,014 |
$1.34M |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
3,301 |
2,481 |
$284K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
729 |
717 |
$272K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
811 |
595 |
$262K |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
229 |
227 |
$71K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
3,053 |
2,628 |
$67K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
161 |
152 |
$15K |
| A4231 |
Infusion set for external insulin pump, needle type |
323 |
264 |
$15K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
406 |
347 |
$13K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
141 |
131 |
$12K |
| A4670 |
Automatic blood pressure monitor |
174 |
172 |
$9K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
257 |
229 |
$9K |
| A4554 |
Disposable underpads, all sizes |
414 |
400 |
$9K |
| A5120 |
Skin barrier, wipes or swabs, each |
153 |
132 |
$1K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
58 |
54 |
$1K |
| A4259 |
Lancets, per box of 100 |
33 |
28 |
$314.79 |