| 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 |
1,792 |
1,779 |
$79K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,351 |
1,284 |
$65K |
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
43 |
38 |
$7K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
572 |
546 |
$3K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
16 |
15 |
$2K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
90 |
77 |
$268.80 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
26 |
26 |
$169.74 |
| J7518 |
Mycophenolic acid, oral, 180 mg |
44 |
43 |
$0.00 |