| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0784 |
Ext amb infusn pump insulin |
5,797 |
5,315 |
$1.30M |
| A4239 |
Non-adju cgm supply allow |
18,523 |
17,759 |
$415K |
| A4224 |
Supply insulin inf cath/wk |
6,535 |
5,909 |
$391K |
| A9276 |
Disposable sensor, cgm sys |
1,172 |
1,149 |
$385K |
| K0553 |
Ther cgm supply allowance |
17,740 |
16,494 |
$365K |
| A4230 |
Infus insulin pump non needl |
1,910 |
1,803 |
$227K |
| A4225 |
Sup/ext insulin inf pump syr |
6,793 |
6,092 |
$178K |
| A4232 |
Syringe w/needle insulin 3cc |
2,326 |
2,166 |
$82K |
| A9277 |
External transmitter, cgm |
55 |
55 |
$37K |
| E2103 |
Non-adju cgm receiver/mon |
936 |
904 |
$21K |
| A4238 |
Adju cgm supply allowance |
757 |
695 |
$18K |
| K0554 |
Ther cgm receiver/monitor |
866 |
820 |
$17K |
| A9274 |
Ext amb insulin delivery sys |
22 |
22 |
$8K |
| A4231 |
Infusion insulin pump needle |
71 |
69 |
$7K |
| K0603 |
Repl batt alkaline 1.5 v |
81 |
68 |
$3K |
| A4253 |
Blood glucose/reagent strips |
20 |
19 |
$877.81 |
| A4259 |
Lancets per box |
16 |
15 |
$72.58 |