| 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 |
9,053 |
7,752 |
$1.48M |
| E0784 |
External ambulatory infusion pump, insulin |
269 |
232 |
$774K |
| A7030 |
Full face mask used with positive airway pressure device, each |
7,479 |
5,979 |
$416K |
| E0601 |
Continuous positive airway pressure (cpap) device |
11,707 |
8,625 |
$416K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
2,010 |
1,793 |
$391K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
11,377 |
9,178 |
$289K |
| A7031 |
Face mask interface, replacement for full face mask, each |
6,980 |
5,693 |
$162K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
9,213 |
7,266 |
$157K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
4,453 |
3,540 |
$148K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
737 |
687 |
$116K |
| A7035 |
Headgear used with positive airway pressure device |
7,249 |
5,732 |
$84K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
763 |
592 |
$78K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
938 |
852 |
$64K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,371 |
1,168 |
$54K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
442 |
373 |
$53K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,919 |
1,547 |
$47K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
1,769 |
1,631 |
$47K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
416 |
339 |
$45K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
13,018 |
10,564 |
$35K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,175 |
3,397 |
$33K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,548 |
1,284 |
$32K |
| E0570 |
Nebulizer, with compressor |
524 |
450 |
$18K |
| A4231 |
Infusion set for external insulin pump, needle type |
89 |
84 |
$10K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,347 |
1,036 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
314 |
280 |
$4K |
| A7036 |
Chinstrap used with positive airway pressure device |
119 |
92 |
$667.56 |
| A7015 |
Aerosol mask, used with dme nebulizer |
121 |
114 |
$169.60 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
17 |
16 |
$18.26 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
56 |
51 |
$9.29 |