| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
243 |
222 |
$29K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
174 |
160 |
$7K |
| E0784 |
External ambulatory infusion pump, insulin |
38 |
36 |
$7K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
66 |
58 |
$2K |
| A4231 |
Infusion set for external insulin pump, needle type |
22 |
18 |
$2K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
24 |
13 |
$871.81 |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
13 |
13 |
$396.45 |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
15 |
12 |
$190.86 |
| A5120 |
Skin barrier, wipes or swabs, each |
22 |
21 |
$153.33 |