| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Ther cgm supply allowance |
13,132 |
9,527 |
$4.00M |
| A9274 |
Ext amb insulin delivery sys |
8,801 |
8,068 |
$3.87M |
| A4238 |
Adju cgm supply allowance |
9,613 |
9,415 |
$2.11M |
| E0784 |
Ext amb infusn pump insulin |
1,455 |
1,146 |
$565K |
| A4239 |
Non-adju cgm supply allow |
3,076 |
2,995 |
$554K |
| A4230 |
Infus insulin pump non needl |
4,185 |
3,953 |
$539K |
| A9276 |
Disposable sensor, cgm sys |
1,154 |
1,105 |
$212K |
| A4253 |
Blood glucose/reagent strips |
3,251 |
1,913 |
$153K |
| K0554 |
Ther cgm receiver/monitor |
312 |
274 |
$124K |
| A4232 |
Syringe w/needle insulin 3cc |
4,675 |
3,933 |
$124K |
| A9277 |
External transmitter, cgm |
408 |
390 |
$112K |
| A6257 |
Transparent film <= 16 sq in |
4,274 |
4,141 |
$79K |
| A4259 |
Lancets per box |
2,969 |
2,168 |
$52K |
| E2102 |
Adju cgm receiver/monitor |
158 |
149 |
$26K |
| A5120 |
Skin barrier, wipe or swab |
1,797 |
1,746 |
$20K |
| E2103 |
Non-adju cgm receiver/mon |
103 |
96 |
$18K |
| A4456 |
Adhesive remover, wipes |
1,583 |
1,532 |
$17K |
| A4245 |
Alcohol wipes per box |
2,686 |
2,423 |
$16K |
| A4364 |
Adhesive, liquid or equal |
1,099 |
1,074 |
$11K |
| A9278 |
External receiver, cgm sys |
24 |
24 |
$7K |
| A4256 |
Calibrator solution/chips |
29 |
26 |
$72.20 |
| A4258 |
Lancet device each |
14 |
12 |
$21.31 |