| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2030 |
Assist living waiver/month |
2,308 |
2,132 |
$5.49M |
| S5130 |
Homaker service nos per 15m |
33,796 |
3,344 |
$2.57M |
| T1019 |
Personal care ser per 15 min |
21,448 |
1,484 |
$1.79M |
| E1390 |
Oxygen concentrator |
1,019 |
934 |
$166K |
| S5161 |
Emer rspns sys serv permonth |
6,669 |
5,069 |
$141K |
| S9986 |
Not medically necessary svc |
837 |
312 |
$105K |
| 11721 |
|
1,901 |
1,717 |
$101K |
| 97530 |
|
3,487 |
1,107 |
$95K |
| A9999 |
Dme supply or accessory, nos |
974 |
805 |
$86K |
| T2003 |
N-et; encounter/trip |
1,035 |
419 |
$82K |
| A0120 |
Noner transport mini-bus |
693 |
256 |
$63K |
| 90837 |
|
606 |
221 |
$54K |
| S5170 |
Homedelivered prepared meal |
233 |
212 |
$54K |
| A0130 |
Noner transport wheelch van |
742 |
356 |
$42K |
| D1110 |
|
340 |
321 |
$40K |
| E0601 |
Cont airway pressure device |
308 |
280 |
$32K |
| 97110 |
|
3,701 |
1,356 |
$28K |
| 97124 |
|
206 |
138 |
$28K |
| D9986 |
|
509 |
248 |
$26K |
| E1392 |
Portable oxygen concentrator |
81 |
80 |
$25K |
| T1017 |
Targeted case management |
493 |
158 |
$22K |
| D0120 |
|
282 |
278 |
$17K |
| A0425 |
Ground mileage |
514 |
378 |
$16K |
| D1206 |
|
321 |
304 |
$15K |
| 97116 |
|
2,162 |
882 |
$14K |
| D0277 |
|
126 |
123 |
$12K |
| E0265 |
Hosp bed total electr w/ mat |
128 |
128 |
$10K |
| 97810 |
|
129 |
77 |
$10K |
| 98960 |
|
49 |
40 |
$7K |
| 83036 |
|
604 |
590 |
$6K |
| 82306 |
|
191 |
191 |
$6K |
| E0434 |
Portable liquid 02 |
26 |
24 |
$5K |
| 80061 |
|
335 |
331 |
$4K |
| 85025 |
|
574 |
540 |
$4K |
| D0150 |
|
53 |
53 |
$4K |
| 97535 |
|
191 |
89 |
$3K |
| 80053 |
|
314 |
306 |
$3K |
| 97112 |
|
472 |
227 |
$3K |
| D1354 |
|
50 |
12 |
$3K |
| 97811 |
|
13 |
12 |
$1K |
| 11719 |
|
102 |
101 |
$1K |
| V5014 |
Hearing aid repair/modifying |
19 |
12 |
$950.00 |
| 84443 |
|
48 |
48 |
$804.70 |
| 80048 |
|
86 |
79 |
$725.69 |
| V5299 |
Hearing service |
12 |
12 |
$720.00 |
| 82607 |
|
37 |
37 |
$557.96 |
| P9604 |
One-way allow prorated trip |
38 |
25 |
$408.26 |
| 92504 |
|
12 |
12 |
$360.00 |
| 87086 |
|
13 |
12 |
$104.91 |
| G0471 |
Ven blood coll snf/hha |
19 |
13 |
$94.60 |
| 80050 |
|
55 |
53 |
$46.70 |
| 36415 |
|
246 |
238 |
$8.40 |
| 98966 |
|
1,884 |
1,210 |
$0.00 |
| T1001 |
Nursing assessment/evaluatn |
1,059 |
941 |
$0.00 |
| 99367 |
|
394 |
354 |
$0.00 |
| T1003 |
Lpn/lvn services up to 15min |
648 |
470 |
$0.00 |
| 99212 |
|
29 |
27 |
$0.00 |
| 97799 |
|
1,161 |
366 |
$0.00 |
| 98968 |
|
91 |
73 |
$0.00 |
| 90658 |
|
71 |
71 |
$0.00 |
| A9901 |
Delivery/set up/dispensing |
357 |
298 |
$0.00 |
| 97164 |
|
88 |
87 |
$0.00 |
| G0444 |
Depression screen annual |
289 |
285 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
80 |
80 |
$0.00 |
| 99211 |
|
163 |
114 |
$0.00 |
| 97760 |
|
18 |
12 |
$0.00 |
| 90756 |
|
17 |
17 |
$0.00 |
| 91322 |
|
13 |
13 |
$0.00 |
| 97163 |
|
12 |
12 |
$0.00 |
| 97161 |
|
13 |
12 |
$0.00 |
| 99000 |
|
323 |
309 |
$0.00 |
| S5101 |
Adult day care per half day |
11,124 |
2,216 |
$0.00 |
| A0999 |
Unlisted ambulance service |
788 |
200 |
$0.00 |
| T1028 |
Home environment assessment |
16 |
16 |
$0.00 |
| E1399 |
Durable medical equipment mi |
63 |
58 |
$0.00 |
| S5135 |
Adult companioncare per 15m |
2,915 |
847 |
$0.00 |
| 97010 |
|
1,170 |
441 |
$0.00 |
| 99214 |
|
130 |
98 |
$0.00 |
| T1016 |
Case management |
12,238 |
6,370 |
$0.00 |
| T1002 |
Rn services up to 15 minutes |
1,713 |
969 |
$0.00 |
| G0152 |
Hhcp-serv of ot,ea 15 min |
701 |
477 |
$0.00 |
| G0442 |
Annual alcohol screen 15 min |
278 |
275 |
$0.00 |
| T1502 |
Medication admin visit |
528 |
123 |
$0.00 |
| 96150 |
|
25 |
25 |
$0.00 |
| 97140 |
|
235 |
109 |
$0.00 |
| 96156 |
|
1,044 |
1,030 |
$0.00 |
| A6260 |
Wound cleanser any type/size |
290 |
84 |
$0.00 |
| 98967 |
|
694 |
531 |
$0.00 |
| 99213 |
|
39 |
38 |
$0.00 |
| 90471 |
|
177 |
170 |
$0.00 |
| 96151 |
|
190 |
187 |
$0.00 |
| S9124 |
Nursing care, in the home; b |
31 |
31 |
$0.00 |
| S9452 |
Nutrition class |
14 |
14 |
$0.00 |
| G0151 |
Hhcp-serv of pt,ea 15 min |
90 |
39 |
$0.00 |
| A0394 |
Als iv drug therapy supplies |
33 |
12 |
$0.00 |
| 99368 |
|
19 |
19 |
$0.00 |
| G0156 |
Hhcp-svs of aide,ea 15 min |
93 |
38 |
$0.00 |
| 99308 |
|
45 |
41 |
$0.00 |