| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
3,357 |
2,874 |
$1.45M |
| E0784 |
Ext amb infusn pump insulin |
241 |
200 |
$846K |
| A9274 |
Ext amb insulin delivery sys |
1,401 |
1,038 |
$641K |
| A9277 |
External transmitter, cgm |
1,270 |
1,096 |
$632K |
| K0553 |
Ther cgm supply allowance |
2,691 |
2,125 |
$214K |
| A9278 |
External receiver, cgm sys |
386 |
329 |
$169K |
| A4239 |
Non-adju cgm supply allow |
1,622 |
1,441 |
$83K |
| A4238 |
Adju cgm supply allowance |
428 |
318 |
$59K |
| A5500 |
Diab shoe for density insert |
51 |
25 |
$1K |
| K0554 |
Ther cgm receiver/monitor |
16 |
13 |
$1K |
| A5512 |
Multi den insert direct form |
51 |
25 |
$0.00 |