| Code | Description | Claims | Beneficiaries | Total Paid |
| 92507 |
|
3,218 |
704 |
$256K |
| G9012 |
Other specified case mgmt |
7,840 |
2,716 |
$254K |
| 90999 |
|
558 |
50 |
$130K |
| 99213 |
|
20,785 |
18,790 |
$109K |
| 99214 |
|
1,854 |
1,707 |
$67K |
| G9008 |
Mccd,phys coor-care ovrsght |
35,116 |
13,996 |
$45K |
| 87491 |
|
4,140 |
4,086 |
$37K |
| 87591 |
|
4,132 |
4,078 |
$37K |
| E1390 |
Oxygen concentrator |
1,018 |
991 |
$26K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
615 |
610 |
$21K |
| 80053 |
|
9,620 |
8,980 |
$20K |
| 97110 |
|
1,075 |
398 |
$20K |
| D1120 |
|
630 |
627 |
$19K |
| 80061 |
|
6,932 |
6,902 |
$19K |
| 36415 |
|
4,760 |
4,505 |
$18K |
| 84443 |
|
5,634 |
5,583 |
$17K |
| 97140 |
|
772 |
282 |
$16K |
| D1206 |
|
736 |
730 |
$15K |
| 99212 |
|
4,388 |
4,082 |
$13K |
| 85025 |
|
8,782 |
7,978 |
$12K |
| T4541 |
Large disposable underpad |
1,286 |
1,279 |
$12K |
| 82306 |
|
2,130 |
2,125 |
$12K |
| B9002 |
Enter nutr inf pump any type |
160 |
159 |
$12K |
| 83036 |
|
6,400 |
6,360 |
$12K |
| 99199 |
|
661 |
569 |
$11K |
| B4035 |
Enteral feed supp pump per d |
373 |
373 |
$11K |
| 87389 |
|
2,192 |
2,183 |
$10K |
| U0003 |
Cov-19 amp prb hgh thruput |
351 |
273 |
$8K |
| D1310 |
|
725 |
701 |
$8K |
| 81220 |
|
210 |
209 |
$8K |
| 99215 |
Prolong outpt/office vis |
343 |
327 |
$7K |
| 86003 |
|
138 |
137 |
$7K |
| 88305 |
|
321 |
292 |
$7K |
| 87624 |
|
948 |
948 |
$7K |
| 88175 |
|
1,201 |
1,200 |
$6K |
| D9999 |
|
203 |
182 |
$6K |
| 76805 |
|
104 |
104 |
$5K |
| 80307 |
|
267 |
241 |
$5K |
| A6250 |
Skin seal protect moisturizr |
425 |
424 |
$5K |
| G0463 |
Hospital outpt clinic visit |
32 |
29 |
$5K |
| E0601 |
Cont airway pressure device |
294 |
290 |
$5K |
| E0431 |
Portable gaseous 02 |
903 |
885 |
$5K |
| 86803 |
|
1,108 |
1,100 |
$4K |
| 97014 |
|
381 |
133 |
$4K |
| T4534 |
Youth size pull-on |
167 |
164 |
$4K |
| T4535 |
Disposable liner/shield/pad |
551 |
548 |
$4K |
| 97112 |
|
355 |
134 |
$4K |
| B9998 |
Enteral supp not otherwise c |
348 |
334 |
$4K |
| T4523 |
Adult size brief/diaper lg |
183 |
179 |
$4K |
| T4530 |
Ped size brief/diaper lg |
186 |
185 |
$3K |
| 87086 |
|
2,429 |
2,323 |
$3K |
| D0603 |
|
614 |
592 |
$3K |
| 97530 |
|
533 |
312 |
$3K |
| 80081 |
|
311 |
310 |
$3K |
| 97010 |
|
1,230 |
661 |
$3K |
| 76641 |
|
35 |
24 |
$3K |
| D0120 |
|
241 |
241 |
$3K |
| 90460 |
|
814 |
813 |
$2K |
| B4088 |
Gastro/jejuno tube, low-pro |
16 |
15 |
$2K |
| 99203 |
|
50 |
50 |
$2K |
| 82274 |
|
769 |
742 |
$2K |
| 86480 |
|
241 |
239 |
$2K |
| 76815 |
|
49 |
46 |
$2K |
| 87635 |
|
411 |
397 |
$2K |
| 87088 |
|
1,722 |
1,660 |
$2K |
| 82652 |
|
345 |
345 |
$2K |
| K0001 |
Standard wheelchair |
224 |
223 |
$2K |
| E0443 |
Portable 02 contents, gas |
53 |
52 |
$2K |
| A4335 |
Incontinence supply |
404 |
403 |
$2K |
| 86592 |
|
2,499 |
2,485 |
$2K |
| 82728 |
|
678 |
670 |
$2K |
| 81001 |
|
3,084 |
2,965 |
$2K |
| 84439 |
|
1,160 |
1,150 |
$2K |
| E0562 |
Humidifier heated used w pap |
445 |
445 |
$2K |
| 59425 |
|
84 |
52 |
$2K |
| 84460 |
|
533 |
529 |
$2K |
| 82607 |
|
661 |
658 |
$2K |
| 83615 |
|
458 |
448 |
$2K |
| 92014 |
|
223 |
223 |
$2K |
| 87510 |
|
437 |
433 |
$2K |
| 80074 |
|
247 |
247 |
$2K |
| 90686 |
|
784 |
784 |
$2K |
| 87480 |
|
434 |
430 |
$2K |
| 87660 |
|
434 |
430 |
$2K |
| 80305 |
|
134 |
134 |
$2K |
| 99394 |
|
36 |
36 |
$2K |
| V2020 |
Vision svcs frames purchases |
76 |
76 |
$2K |
| H1001 |
Antepartum management |
36 |
26 |
$2K |
| 92015 |
|
427 |
427 |
$1K |
| 84450 |
|
433 |
424 |
$1K |
| 85027 |
|
1,450 |
1,301 |
$1K |
| 92004 |
|
58 |
58 |
$1K |
| 82570 |
|
1,647 |
1,612 |
$1K |
| 76813 |
|
26 |
26 |
$1K |
| 83970 |
|
81 |
75 |
$1K |
| 99393 |
|
99 |
99 |
$1K |
| 82043 |
|
1,471 |
1,458 |
$1K |
| 82746 |
|
475 |
474 |
$1K |
| E0776 |
Iv pole |
131 |
126 |
$1K |
| 84403 |
|
168 |
167 |
$1K |
| 81329 |
|
149 |
147 |
$1K |
| 99173 |
|
196 |
196 |
$1K |
| 87186 |
|
607 |
587 |
$1K |
| D0145 |
|
24 |
24 |
$1K |
| 87340 |
|
504 |
499 |
$1K |
| 83013 |
|
41 |
41 |
$1K |
| T4526 |
Adult size pull-on med |
63 |
63 |
$1K |
| 92340 |
|
46 |
46 |
$1K |
| 99283 |
|
12 |
12 |
$1K |
| 84702 |
|
393 |
317 |
$1K |
| 77067 |
|
14 |
14 |
$1K |
| 84153 |
|
366 |
366 |
$1K |
| 83001 |
|
241 |
240 |
$997.17 |
| 83540 |
|
662 |
655 |
$974.97 |
| G2012 |
Brief check in by md/qhp |
1,781 |
1,549 |
$923.52 |
| 80048 |
|
641 |
593 |
$917.17 |
| 93000 |
|
46 |
45 |
$893.55 |
| 84146 |
|
160 |
159 |
$886.72 |
| 86038 |
|
398 |
394 |
$883.59 |
| 92060 |
|
155 |
155 |
$881.21 |
| 87077 |
|
582 |
565 |
$844.19 |
| 83002 |
|
192 |
192 |
$784.93 |
| G0480 |
Drug test def 1-7 classes |
12 |
12 |
$767.40 |
| 84481 |
|
174 |
171 |
$764.48 |
| 84436 |
|
502 |
499 |
$747.68 |
| 99211 |
|
144 |
140 |
$711.41 |
| 83550 |
|
546 |
540 |
$691.67 |
| 82785 |
|
111 |
110 |
$684.32 |
| D0220 |
|
524 |
510 |
$677.00 |
| 87070 |
|
319 |
313 |
$661.36 |
| G9920 |
Scrning perf and negative |
43 |
43 |
$609.00 |
| 80076 |
|
298 |
295 |
$542.56 |
| 83735 |
|
344 |
297 |
$536.83 |
| 86140 |
|
614 |
586 |
$503.96 |
| 86900 |
|
111 |
107 |
$488.10 |
| 84479 |
|
343 |
343 |
$479.66 |
| 85060 |
|
144 |
143 |
$467.31 |
| 90674 |
|
14 |
14 |
$456.26 |
| 83655 |
|
95 |
95 |
$437.50 |
| Q4081 |
Epoetin alfa, 100 units esrd |
252 |
32 |
$414.84 |
| 92134 |
|
14 |
12 |
$411.23 |
| 84550 |
|
494 |
491 |
$411.20 |
| A6402 |
Sterile gauze <= 16 sq in |
17 |
17 |
$402.56 |
| 97116 |
|
39 |
14 |
$400.44 |
| 86706 |
|
257 |
255 |
$384.40 |
| 85018 |
|
414 |
368 |
$381.15 |
| 85610 |
|
531 |
507 |
$380.60 |
| 86704 |
|
143 |
143 |
$366.32 |
| 85730 |
|
362 |
359 |
$334.40 |
| 97161 |
|
13 |
13 |
$313.56 |
| 81002 |
|
432 |
390 |
$308.90 |
| 85652 |
|
700 |
692 |
$307.78 |
| 88141 |
|
109 |
109 |
$305.37 |
| 86431 |
|
270 |
268 |
$303.51 |
| 92551 |
|
181 |
181 |
$300.51 |
| 82950 |
|
436 |
435 |
$300.51 |
| 86787 |
|
58 |
58 |
$289.48 |
| 87150 |
|
33 |
33 |
$276.60 |
| 87338 |
|
143 |
143 |
$232.71 |
| 82670 |
|
26 |
26 |
$223.50 |
| 90471 |
|
101 |
101 |
$218.54 |
| 81003 |
|
585 |
562 |
$217.50 |
| 84480 |
|
83 |
82 |
$207.89 |
| 87081 |
|
291 |
288 |
$204.31 |
| T4522 |
Adult size brief/diaper med |
188 |
188 |
$201.60 |
| 82248 |
|
217 |
217 |
$168.77 |
| 96127 |
|
130 |
111 |
$168.35 |
| 86376 |
|
26 |
26 |
$151.32 |
| 84156 |
|
168 |
154 |
$149.19 |
| 86708 |
|
111 |
111 |
$148.65 |
| 82951 |
|
29 |
29 |
$144.06 |
| 87636 |
|
44 |
41 |
$143.20 |
| 84100 |
|
226 |
196 |
$140.49 |
| 86317 |
|
13 |
12 |
$131.89 |
| 86200 |
|
77 |
76 |
$127.80 |
| 86762 |
|
13 |
13 |
$126.61 |
| 87147 |
|
141 |
138 |
$125.12 |
| D1208 |
|
12 |
12 |
$115.00 |
| 85007 |
|
247 |
194 |
$110.39 |
| D9230 |
|
34 |
32 |
$110.00 |
| 81025 |
|
68 |
66 |
$87.14 |
| D0274 |
|
51 |
51 |
$75.60 |
| A4450 |
Non-waterproof tape |
46 |
46 |
$71.72 |
| G2023 |
Specimen collect covid-19 |
67 |
53 |
$70.38 |
| D9430 |
|
132 |
130 |
$66.00 |
| 85014 |
|
40 |
36 |
$58.59 |
| 83690 |
|
95 |
79 |
$53.74 |
| J1756 |
Iron sucrose injection |
102 |
30 |
$50.92 |
| 86780 |
|
13 |
13 |
$50.16 |
| D0230 |
|
203 |
101 |
$49.50 |
| 82952 |
|
13 |
13 |
$40.69 |
| 82947 |
|
13 |
13 |
$37.68 |
| 81015 |
|
56 |
56 |
$36.60 |
| A4649 |
Surgical supplies |
15 |
13 |
$34.30 |
| 87205 |
|
40 |
36 |
$30.89 |
| 87661 |
|
42 |
42 |
$30.23 |
| D0270 |
|
13 |
12 |
$30.00 |
| 82962 |
|
15 |
13 |
$23.55 |
| 84703 |
|
12 |
12 |
$17.76 |
| D0350 |
|
354 |
344 |
$13.20 |
| 82565 |
|
13 |
13 |
$12.27 |
| D0272 |
|
12 |
12 |
$11.00 |
| 99000 |
|
380 |
367 |
$10.77 |
| 86593 |
|
14 |
14 |
$10.40 |
| D0210 |
|
13 |
13 |
$9.00 |
| 81000 |
|
52 |
45 |
$7.80 |
| 3008F |
|
2,062 |
1,906 |
$7.33 |
| 86901 |
|
13 |
12 |
$5.83 |
| 3074F |
|
646 |
577 |
$4.67 |
| 3078F |
|
510 |
460 |
$4.34 |
| 83721 |
|
29 |
29 |
$1.64 |
| 3079F |
|
70 |
63 |
$0.30 |
| 0502F |
|
251 |
177 |
$0.15 |
| 3725F |
|
59 |
57 |
$0.14 |
| 99392 |
|
25 |
25 |
$0.00 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
1,211 |
1,050 |
$0.00 |
| D9993 |
|
1,145 |
1,115 |
$0.00 |
| 82948 |
|
13 |
12 |
$0.00 |
| 99072 |
|
123 |
117 |
$0.00 |
| T1001 |
Nursing assessment/evaluatn |
89 |
89 |
$0.00 |
| 90832 |
|
169 |
145 |
$0.00 |
| T4528 |
Adult size pull-on xl |
108 |
108 |
$0.00 |
| T1003 |
Lpn/lvn services up to 15min |
89 |
51 |
$0.00 |
| 97803 |
|
72 |
70 |
$0.00 |
| 86318 |
|
443 |
427 |
$0.00 |
| 90791 |
|
41 |
41 |
$0.00 |
| 97164 |
|
45 |
45 |
$0.00 |
| 87811 |
|
14 |
14 |
$0.00 |
| T4527 |
Adult size pull-on lg |
12 |
12 |
$0.00 |
| G0444 |
Depression screen annual |
130 |
130 |
$0.00 |
| 1160F |
|
30 |
26 |
$0.00 |
| 90836 |
|
58 |
36 |
$0.00 |
| 86039 |
|
12 |
12 |
$0.00 |
| 90837 |
|
15 |
12 |
$0.00 |
| 0002A |
|
26 |
26 |
$0.00 |
| 3351F |
|
2,294 |
2,020 |
$0.00 |
| D0999 |
|
199 |
189 |
$0.00 |
| D1330 |
|
697 |
675 |
$0.00 |
| 1126F |
|
16 |
13 |
$0.00 |
| 99441 |
|
1,766 |
1,578 |
$0.00 |
| T1016 |
Case management |
1,459 |
1,059 |
$0.00 |
| D9995 |
|
553 |
545 |
$0.00 |
| A4657 |
Syringe w/wo needle |
356 |
35 |
$0.00 |
| 90834 |
|
779 |
631 |
$0.00 |
| 97535 |
|
106 |
101 |
$0.00 |
| 97165 |
|
17 |
17 |
$0.00 |
| S9977 |
Meals per diem |
65,473 |
11,859 |
$0.00 |
| 0515 |
|
101 |
93 |
$0.00 |
| 91301 |
|
59 |
59 |
$0.00 |
| U0005 |
Infec agen detec ampli probe |
120 |
106 |
$0.00 |
| 0012A |
|
88 |
88 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
16 |
16 |
$0.00 |
| B4150 |
Ef complet w/intact nutrient |
91 |
91 |
$0.00 |
| T1002 |
Rn services up to 15 minutes |
37 |
33 |
$0.00 |
| 99309 |
|
27 |
27 |
$0.00 |
| J1270 |
Injection, doxercalciferol |
372 |
35 |
$0.00 |
| 97018 |
|
54 |
33 |
$0.00 |
| G0008 |
Admin influenza virus vac |
14 |
14 |
$0.00 |
| 0011A |
|
72 |
72 |
$0.00 |
| 0001A |
|
34 |
34 |
$0.00 |
| G0447 |
Behavior counsel obesity 15m |
31 |
31 |
$0.00 |
| 3075F |
|
15 |
13 |
$0.00 |