| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0784 |
External ambulatory infusion pump, insulin |
259 |
173 |
$174K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
1,330 |
941 |
$172K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
347 |
192 |
$63K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
603 |
389 |
$46K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
1,142 |
833 |
$28K |