| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0784 |
Ext amb infusn pump insulin |
8,462 |
8,085 |
$3.85M |
| A4230 |
Infus insulin pump non needl |
12,716 |
12,383 |
$1.54M |
| A4232 |
Syringe w/needle insulin 3cc |
11,069 |
10,755 |
$382K |
| A6257 |
Transparent film <= 16 sq in |
5,352 |
5,202 |
$259K |
| A4222 |
Infusion supplies with pump |
1,628 |
1,616 |
$115K |
| E0570 |
Nebulizer with compression |
40 |
40 |
$2K |
| A4253 |
Blood glucose/reagent strips |
1,083 |
1,071 |
$2K |
| Q0513 |
Disp fee inhal drugs/30 days |
242 |
238 |
$1K |
| A4225 |
Sup/ext insulin inf pump syr |
13 |
13 |
$508.40 |
| J7613 |
Albuterol non-comp unit |
13 |
13 |
$45.73 |
| A4259 |
Lancets per box |
25 |
24 |
$1.85 |