| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
104,764 |
72,271 |
$37.36M |
| A9277 |
External transmitter, cgm |
27,305 |
22,679 |
$10.97M |
| A9274 |
Ext amb insulin delivery sys |
17,817 |
13,456 |
$6.84M |
| A4222 |
Infusion supplies with pump |
12,863 |
10,248 |
$6.47M |
| E0784 |
Ext amb infusn pump insulin |
3,023 |
2,432 |
$3.83M |
| A4230 |
Infus insulin pump non needl |
22,587 |
15,867 |
$2.93M |
| A9278 |
External receiver, cgm sys |
4,218 |
3,463 |
$1.56M |
| A4253 |
Blood glucose/reagent strips |
15,876 |
12,930 |
$1.05M |
| K0553 |
Ther cgm supply allowance |
16,447 |
14,751 |
$889K |
| A4239 |
Non-adju cgm supply allow |
14,883 |
11,492 |
$827K |
| A6257 |
Transparent film <= 16 sq in |
6,834 |
5,330 |
$591K |
| A4232 |
Syringe w/needle insulin 3cc |
14,381 |
10,241 |
$211K |
| A4231 |
Infusion insulin pump needle |
1,563 |
1,176 |
$200K |
| K0552 |
Sup/ext non-ins inf pump syr |
5,866 |
5,008 |
$147K |
| K0554 |
Ther cgm receiver/monitor |
1,562 |
1,266 |
$121K |
| S8490 |
100 insulin syringes |
3,922 |
3,292 |
$98K |
| A5120 |
Skin barrier, wipe or swab |
10,453 |
8,454 |
$84K |
| A4259 |
Lancets per box |
6,514 |
5,510 |
$74K |
| A4225 |
Sup/ext insulin inf pump syr |
2,926 |
2,467 |
$68K |
| A9900 |
Supply/accessory/service |
44 |
31 |
$26K |
| E2103 |
Non-adju cgm receiver/mon |
303 |
225 |
$23K |
| A4245 |
Alcohol wipes per box |
5,741 |
4,742 |
$19K |
| A4456 |
Adhesive remover, wipes |
1,847 |
1,511 |
$15K |
| A4250 |
Urine reagent strips/tablets |
966 |
745 |
$11K |
| A4224 |
Supply insulin inf cath/wk |
262 |
204 |
$9K |
| A4206 |
1 cc sterile syringe&needle |
244 |
179 |
$5K |
| E0607 |
Blood glucose monitor home |
13 |
12 |
$808.05 |
| A4215 |
Sterile needle |
180 |
145 |
$715.00 |