| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
6,705 |
5,784 |
$738K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
2,039 |
1,877 |
$297K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
395 |
328 |
$55K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
188 |
181 |
$40K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
870 |
795 |
$22K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
87 |
78 |
$12K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
229 |
197 |
$10K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
983 |
912 |
$9K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
33 |
30 |
$4K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
12 |
12 |
$4K |
| A4452 |
Tape, waterproof, per 18 square inches |
282 |
247 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
18 |
12 |
$81.13 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
12 |
12 |
$42.72 |