| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
62,848 |
60,734 |
$26.45M |
| A9274 |
Ext amb insulin delivery sys |
17,996 |
17,111 |
$8.70M |
| A9277 |
External transmitter, cgm |
13,692 |
13,168 |
$7.18M |
| E0784 |
Ext amb infusn pump insulin |
3,204 |
2,987 |
$5.36M |
| E1399 |
Durable medical equipment mi |
34,058 |
16,328 |
$2.88M |
| A9278 |
External receiver, cgm sys |
3,479 |
3,374 |
$1.61M |
| A4230 |
Infus insulin pump non needl |
10,820 |
10,364 |
$1.47M |
| K0553 |
Ther cgm supply allowance |
20,414 |
19,806 |
$1.22M |
| A4232 |
Syringe w/needle insulin 3cc |
9,434 |
9,084 |
$434K |
| A4239 |
Non-adju cgm supply allow |
6,562 |
6,414 |
$366K |
| A9900 |
Supply/accessory/service |
1,161 |
487 |
$185K |
| A4224 |
Supply insulin inf cath/wk |
3,181 |
2,899 |
$87K |
| A4225 |
Sup/ext insulin inf pump syr |
4,442 |
4,250 |
$86K |
| K0554 |
Ther cgm receiver/monitor |
1,463 |
1,245 |
$65K |
| E1161 |
Manual adult wc w tiltinspac |
298 |
292 |
$19K |
| T4541 |
Large disposable underpad |
452 |
441 |
$16K |
| E2103 |
Non-adju cgm receiver/mon |
183 |
181 |
$13K |
| A4253 |
Blood glucose/reagent strips |
76 |
76 |
$8K |
| E1028 |
W/c manual swingaway |
610 |
439 |
$8K |
| A4927 |
Non-sterile gloves |
462 |
449 |
$7K |
| E0955 |
Cushioned headrest |
407 |
392 |
$4K |
| T4524 |
Adult size brief/diaper xl |
38 |
38 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
370 |
342 |
$3K |
| T4537 |
Reusable underpad bed size |
170 |
160 |
$2K |
| A4259 |
Lancets per box |
38 |
38 |
$723.65 |
| A6212 |
Foam drg <=16 sq in w/border |
14 |
12 |
$676.19 |
| T4535 |
Disposable liner/shield/pad |
12 |
12 |
$445.44 |
| A4216 |
Sterile water/saline, 10 ml |
45 |
42 |
$327.01 |
| A4450 |
Non-waterproof tape |
91 |
85 |
$311.16 |
| A5120 |
Skin barrier, wipe or swab |
66 |
64 |
$290.18 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
14 |
12 |
$124.72 |
| A4245 |
Alcohol wipes per box |
13 |
13 |
$105.08 |