Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Managed care

Kaiser Foundation Health Plan INC

Kaiser Foundation Health Plan INC was paid $12.77M by Medicaid between Feb 2020 and Mar 2024, across 658 billing codes. Its largest line is 90999, dialysis (unlisted procedure) — 21% of everything it billed.

33Billing provider infoKAISER FOUNDATION HEALTH PLAN INC
OAKLAND, CA 94612
33aNPI1215504824assigned 06/10/2021
28Total paid$12.77M
24GClaims313,881
24DCodes billed658
24AFirst – last monthFeb 2020 – Mar 2024
Compared with peers

Next to other Health Maintenance Organization providers in California

Rank by total paid#17 of 151
Median peer was paid$59K
This provider vs. median216×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

$0$2.5M$5.0M$7.5M2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
2020595$0.00
20211,392$0.00
20227,574$97K
2023304,147$12.67M
2024incomplete173$4K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
90999 Dialysis (unlisted procedure)Unlisted dialysis procedure, inpatient or outpatient 21% 13,969 990 $2.63M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 11% 3,082 2,976 $1.41M
0120 7.0% 198 193 $893K
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 5.5% 1,363 1,348 $706K
0111 4.2% 101 100 $536K
0121 3.8% 124 123 $486K
H2019 Therapeutic behavioral services, billed per 15 minutesTherapeutic behavioral services, per 15 minutes 2.8% 2,155 564 $354K
99282 Emergency department visit for the evaluation and management, low to moderate severity 1.7% 920 906 $223K
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 1.7% 342 334 $216K
S5102 Adult day care, billed per dayDay care services, adult; per diem 1.6% 2,882 605 $203K
74177 Computed tomography, abdomen and pelvis; with contrast material 1.4% 641 609 $179K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 1.4% 3,203 1,626 $178K
646 more codes
0450 Emergency room services 1.3% 790 $167K
0113 1.1% 22 $145K
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% 262 $114K
90885 <1% 1,258 $103K
0206 <1% 19 $81K
A0427 Emergency ambulance ride, advanced life support <1% 140 $78K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 79 $76K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 70 $75K
70450 Computed tomography, head or brain; without contrast material <1% 718 $72K
H0004 Behavioral health counseling and therapy, per 15 minutes <1% 613 $72K
71046 Radiologic examination, chest; 2 views <1% 1,654 $63K
71045 Radiologic examination, chest; single view <1% 1,556 $62K
78815 Positron emission tomography (PET) for limited area imaging <1% 56 $62K
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r <1% 2,519 $57K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 285 $55K
77067 Screening mammography, bilateral, including computer-aided detection <1% 994 $55K
83036 Hemoglobin; glycosylated (A1C) <1% 8,157 $55K
90947 <1% 486 $53K
84443 Thyroid stimulating hormone (TSH) <1% 5,381 $50K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 358 $48K
80061 Lipid panel <1% 5,111 $45K
97535 Self-care/home management training, each 15 minutes <1% 772 $44K
0301 <1% 335 $43K
A0130 Non-emergency transportation: wheelchair van <1% 713 $43K
G0300 Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes <1% 260 $42K
T4535 Disposable liner/shield/guard/pad/undergarment, for incontinence, each <1% 886 $41K
82565 <1% 12,948 $41K
G9008 Coordinated care fee, physician coordinated care oversight services <1% 5,457 $40K
H0031 Mental health assessment, by non-physician <1% 19 $38K
E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate <1% 565 $37K
A0429 Emergency ambulance ride, basic life support <1% 36 $35K
G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes <1% 367 $35K
T2005 Non-emergency transportation; stretcher van <1% 211 $35K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 1,698 $33K
H2014 Skills training and development, per 15 minutes <1% 250 $32K
0762 <1% 119 $31K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 8,633 $31K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 112 $30K
77386 <1% 53 $30K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 414 $30K
E0601 Continuous positive airway pressure (cpap) device <1% 72 $30K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 451 $30K
70551 Magnetic resonance imaging, brain; without contrast material <1% 153 $28K
71275 Computed tomographic angiography, chest, with contrast material <1% 140 $28K
76830 Ultrasound, transvaginal <1% 417 $28K
84460 <1% 8,482 $27K
T4541 Incontinence product, disposable underpad, large, each <1% 1,198 $26K
80051 <1% 8,604 $26K
S0209 Wheelchair van, mileage, per mile <1% 820 $26K
E0260 Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress <1% 364 $26K
T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each <1% 502 $25K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 2,145 $24K
H0032 Mental health service plan development by non-physician <1% 160 $24K
T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each <1% 467 $24K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 840 $24K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 808 $23K
86900 <1% 675 $23K
97153 Applied behavior analysis (autism therapy), per 15 minutes <1% 762 $22K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 2,068 $22K
0250 <1% 4,647 $22K
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r <1% 270 $21K
T4528 Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each <1% 280 $21K
K0001 Standard wheelchair <1% 634 $20K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 132 $20K
85027 <1% 5,768 $19K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 1,211 $18K
A0425 Ground mileage, per statute mile <1% 529 $17K
82274 <1% 1,405 $17K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B <1% 1,523 $17K
E0562 Humidifier, heated, used with positive airway pressure device <1% 117 $17K
T1030 Nursing care, in the home, by registered nurse, per diem <1% 163 $17K
99214 Doctor's office visit, returning patient (more involved) <1% 927 $17K
86885 <1% 337 $17K
93017 <1% 64 $16K
83970 <1% 1,064 $16K
90834 Psychotherapy session, about 45 minutes <1% 248 $16K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 97 $16K
E0143 Walker, folding, wheeled, adjustable or fixed height <1% 249 $16K
78451 <1% 16 $16K
73630 <1% 554 $16K
70496 <1% 42 $16K
70498 <1% 47 $15K
A7030 Full face mask used with positive airway pressure device, each <1% 142 $15K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 418 $15K
T4523 Adult sized disposable incontinence product, brief/diaper, large, each <1% 163 $15K
A7034 Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap <1% 253 $14K
T4534 Youth sized disposable incontinence product, protective underwear/pull-on, each <1% 149 $14K
72125 Computed tomography, cervical spine; without contrast material <1% 101 $14K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 80 $14K
81513 <1% 650 $14K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 1,064 $14K
T1031 Nursing care, in the home, by licensed practical nurse, per diem <1% 134 $14K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 1,865 $14K
0350 <1% 55 $13K
87088 <1% 2,777 $13K
74183 <1% 37 $13K
93976 <1% 87 $13K
82728 <1% 2,341 $13K
77080 <1% 305 $13K
E0471 Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) <1% 51 $13K
73562 <1% 323 $12K
A0428 Ambulance service, basic life support, non-emergency transport, (bls) <1% 68 $12K
80053 Comprehensive metabolic panel <1% 363 $12K
G0378 Hospital observation service, per hour <1% 482 $12K
G0151 Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes <1% 191 $12K
82607 <1% 1,127 $12K
73030 <1% 273 $12K
T4524 Adult sized disposable incontinence product, brief/diaper, extra large, each <1% 120 $12K
82043 <1% 2,191 $12K
0112 <1% 15 $12K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 386 $12K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 1,398 $12K
E0570 Nebulizer, with compressor <1% 123 $12K
87505 <1% 131 $12K
36415 Collection of venous blood by venipuncture <1% 5,884 $11K
0351 <1% 45 $11K
72141 <1% 74 $11K
93971 <1% 124 $11K
A4352 Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each <1% 13 $11K
70486 <1% 86 $11K
76770 <1% 113 $10K
T4522 Adult sized disposable incontinence product, brief/diaper, medium, each <1% 151 $10K
0483 <1% 41 $10K
72100 <1% 187 $10K
83880 <1% 794 $10K
73130 <1% 237 $10K
0305 <1% 294 $10K
73610 <1% 291 $10K
84075 <1% 3,863 $10K
S5170 Home delivered meals, including preparation; per meal <1% 109 $10K
E0830 Ambulatory traction device, all types, each <1% 73 $9K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 974 $9K
86003 <1% 273 $9K
70491 <1% 48 $9K
E0163 Commode chair, mobile or stationary, with fixed arms <1% 99 $9K
K0003 Lightweight wheelchair <1% 179 $9K
99213 Doctor's office visit, returning patient (routine) <1% 1,118 $9K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 745 $9K
84450 <1% 3,779 $9K
71250 <1% 99 $9K
73564 <1% 167 $9K
84153 <1% 573 $8K
82310 <1% 2,765 $8K
87481 <1% 651 $8K
86480 <1% 290 $8K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 91 $8K
74018 <1% 161 $8K
0260 <1% 103 $8K
82247 <1% 4,009 $8K
S9131 Physical therapy; in the home, per diem <1% 62 $8K
97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes <1% 306 $8K
E0603 Breast pump, electric (ac and/or dc), any type <1% 80 $8K
86803 <1% 1,488 $8K
E1399 Durable medical equipment, miscellaneous <1% 60 $8K
86780 <1% 1,538 $8K
0352 <1% 39 $8K
84702 <1% 1,078 $8K
0410 <1% 51 $8K
90837 Psychotherapy session, about an hour <1% 295 $8K
96361 Intravenous infusion, hydration; each additional hour <1% 317 $7K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets <1% 130 $7K
86901 <1% 676 $7K
84520 <1% 6,778 $7K
73110 <1% 176 $7K
76801 <1% 80 $7K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 128 $7K
93970 <1% 42 $7K
83550 <1% 2,131 $7K
76641 <1% 119 $7K
A7035 Headgear used with positive airway pressure device <1% 354 $7K
96375 Therapeutic injection; each additional sequential IV push <1% 766 $7K
82947 <1% 5,421 $7K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 126 $6K
84132 <1% 2,625 $6K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 1,061 $6K
0320 <1% 191 $6K
0306 <1% 222 $6K
70544 <1% 25 $6K
A7032 Cushion for use on nasal mask interface, replacement only, each <1% 67 $6K
72197 <1% 21 $6K
E0630 Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) <1% 82 $6K
B4161 Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit <1% 13 $6K
B4160 Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit <1% 18 $6K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 43 $6K
K0007 Extra heavy duty wheelchair <1% 57 $6K
86141 <1% 736 $6K
84484 <1% 1,615 $6K
73502 <1% 107 $6K
84439 <1% 1,230 $6K
83735 <1% 2,065 $6K
A7033 Pillow for use on nasal cannula type interface, replacement only, pair <1% 70 $6K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose <1% 63 $6K
A4230 Infusion set for external insulin pump, non needle cannula type <1% 18 $6K
73560 <1% 95 $6K
76536 <1% 73 $6K
86235 <1% 109 $5K
83540 <1% 2,172 $5K
86923 <1% 59 $5K
76870 <1% 63 $5K
82746 <1% 474 $5K
A7031 Face mask interface, replacement for full face mask, each <1% 67 $5K
E0604 Breast pump, hospital grade, electric (ac and / or dc), any type <1% 163 $5K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV <1% 489 $5K
74178 <1% 12 $5K
84403 <1% 404 $5K
74174 <1% 13 $5K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed <1% 77 $5K
85610 <1% 2,110 $5K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 70 $5K
83690 <1% 1,835 $5K
T4530 Pediatric sized disposable incontinence product, brief/diaper, large size, each <1% 76 $5K
92227 <1% 369 $5K
B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape <1% 28 $5K
A7037 Tubing used with positive airway pressure device <1% 243 $5K
E0431 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing <1% 277 $5K
J2785 Injection, regadenoson, 0.1 mg <1% 44 $5K
E2103 Non-adjunctive, non-implanted continuous glucose monitor or receiver <1% 43 $5K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries <1% 54 $4K
G0152 Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes <1% 62 $4K
87340 <1% 1,437 $4K
0420 <1% 72 $4K
72131 <1% 37 $4K
E1392 Portable oxygen concentrator, rental <1% 86 $4K
0124A <1% 111 $4K
B9998 Noc for enteral supplies <1% 40 $4K
K0738 Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing <1% 231 $4K
81003 <1% 3,150 $4K
A4351 Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each <1% 19 $4K
B4034 Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape <1% 36 $4K
77065 Tomosynthesis, mammo <1% 61 $4K
E0240 Bath/shower chair, with or without wheels, any size <1% 133 $4K
73700 <1% 30 $4K
80048 Basic metabolic panel (calcium, ionized) <1% 435 $4K
73080 <1% 80 $4K
82040 <1% 1,617 $4K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 56 $4K
A7038 Filter, disposable, used with positive airway pressure device <1% 268 $4K
H2000 Comprehensive multidisciplinary evaluation <1% 20 $4K
70543 <1% 12 $4K
0300 <1% 245 $4K
83520 <1% 233 $4K
87186 <1% 482 $4K
84165 <1% 186 $4K
G0157 Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes <1% 39 $4K
K0006 Heavy duty wheelchair <1% 49 $4K
87536 <1% 67 $4K
73590 <1% 81 $4K
84295 <1% 1,225 $4K
A4224 Supplies for maintenance of insulin infusion catheter, per week <1% 12 $4K
87800 <1% 78 $4K
97167 <1% 12 $4K
73221 <1% 28 $3K
A0426 Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) <1% 19 $3K
72040 <1% 58 $3K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 106 $3K
77066 Tomosynthesis, mammo <1% 42 $3K
73140 <1% 79 $3K
83721 <1% 394 $3K
74022 <1% 44 $3K
T4532 Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each <1% 17 $3K
B4150 Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit <1% 19 $3K
84100 <1% 1,862 $3K
G0155 Services of clinical social worker in home health or hospice settings, each 15 minutes <1% 27 $3K
72170 <1% 35 $3K
0730 <1% 79 $3K
81229 <1% 16 $3K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 667 $3K
81001 <1% 907 $3K
E1060 Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests <1% 36 $3K
E0781 Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient <1% 16 $2K
82570 <1% 689 $2K
0440 <1% 51 $2K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 457 $2K
A4232 Syringe with needle for external insulin pump, sterile, 3 cc <1% 21 $2K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 869 $2K
80197 <1% 156 $2K
T4525 Adult sized disposable incontinence product, protective underwear/pull-on, small size, each <1% 50 $2K
A4385 Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each <1% 24 $2K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 239 $2K
T1001 Nursing assessment / evaluation <1% 17 $2K
84703 <1% 246 $2K
86334 <1% 67 $2K
0402 <1% 38 $2K
0270 <1% 215 $2K
0302 <1% 212 $2K
T2001 Non-emergency transportation; patient attendant/escort <1% 62 $2K
92015 Determination of refractive state <1% 451 $2K
A9900 Miscellaneous dme supply, accessory, and/or service component of another hcpcs code <1% 54 $2K
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision <1% 310 $2K
72146 <1% 12 $2K
E0185 Gel or gel-like pressure pad for mattress, standard mattress length and width <1% 61 $2K
E1038 Transport chair, adult size, patient weight capacity up to and including 300 pounds <1% 191 $2K
73552 <1% 43 $2K
0637 <1% 7,308 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 379 $2K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 126 $2K
86665 <1% 163 $2K
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants <1% 39 $2K
71101 <1% 23 $2K
85652 <1% 952 $2K
82105 <1% 174 $2K
82784 <1% 178 $2K
E0265 Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress <1% 12 $2K
T4521 Adult sized disposable incontinence product, brief/diaper, small, each <1% 27 $2K
59025 Fetal non-stress test <1% 17 $2K
J7030 Infusion, normal saline solution , 1000 cc <1% 1,694 $2K
J0131 Injection, acetaminophen, not otherwise specified,10 mg <1% 263 $2K
J0887 Injection, epoetin beta, 1 microgram, (for esrd on dialysis) <1% 747 $2K
A7046 Water chamber for humidifier, used with positive airway pressure device, replacement, each <1% 162 $2K
86704 <1% 304 $2K
73090 <1% 31 $2K
84146 <1% 224 $2K
83718 <1% 262 $2K
84156 <1% 573 $2K
82378 <1% 95 $2K
76857 <1% 14 $2K
80076 <1% 255 $2K
83655 <1% 516 $2K
83921 <1% 50 $2K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose <1% 31 $1K
87517 <1% 84 $1K
82670 <1% 187 $1K
86762 <1% 327 $1K
E0424 Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing <1% 14 $1K
81206 <1% 19 $1K
86850 <1% 169 $1K
A4604 Tubing with integrated heating element for use with positive airway pressure device <1% 43 $1K
E0720 Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation <1% 30 $1K
76642 <1% 60 $1K
87522 Neg quan hep c or qual rna <1% 49 $1K
84550 <1% 447 $1K
A0420 Ambulance waiting time (als or bls), one half (1/2) hour increments <1% 19 $1K
0921 <1% 22 $1K
87799 <1% 38 $1K
87449 <1% 146 $1K
E0776 Iv pole <1% 103 $1K
0134A <1% 37 $1K
0255 <1% 101 $1K
86592 <1% 96 $1K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 70 $1K
76881 <1% 31 $1K
11721 <1% 12 $1K
87529 <1% 91 $1K
88304 <1% 52 $1K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 97 $1K
82248 <1% 750 $1K
85730 <1% 287 $1K
A4362 Skin barrier; solid, 4 x 4 or equivalent; each <1% 13 $1K
E0247 Transfer bench for tub or toilet with or without commode opening <1% 16 $1K
73522 <1% 22 $1K
86038 <1% 188 $1K
83001 <1% 224 $1K
72082 <1% 12 $1K
92250 <1% 42 $1K
76380 <1% 19 $1K
72070 <1% 17 $1K
86787 <1% 267 $1K
E0600 Respiratory suction pump, home model, portable or stationary, electric <1% 33 $1K
A7520 Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each <1% 15 $1K
J3490 Unclassified drugs <1% 882 $1K
87040 <1% 559 $1K
84270 <1% 87 $1K
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 670 $1K
88307 <1% 21 $1K
84480 <1% 154 $1K
E0156 Seat attachment, walker <1% 72 $1K
73000 <1% 15 $1K
87497 <1% 28 $1K
86335 <1% 14 $1K
J1756 Injection, iron sucrose, 1 mg <1% 1,258 $1K
82550 <1% 261 $1K
83021 <1% 103 $1K
E0245 Tub stool or bench <1% 19 $1K
E0651 Pneumatic compressor, segmental home model without calibrated gradient pressure <1% 19 $1K
87081 <1% 852 $1K
85018 <1% 2,259 $1K
85014 <1% 576 $1K
92134 <1% 66 $1K
86765 <1% 225 $1K
87070 <1% 230 $1K
T4537 Incontinence product, protective underpad, reusable, bed size, each <1% 45 $1K
83993 <1% 101 $1K
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 170 $1K
88173 <1% 12 $1K
86225 <1% 152 $1K
86160 <1% 97 $1K
B4088 Gastrostomy/jejunostomy tube, low-profile, any material, any type, each <1% 29 $988.92
73060 <1% 21 $984.76
A9585 Injection, gadobutrol, 0.1 ml <1% 75 $966.52
0258 <1% 214 $958.53
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 86 $948.00
83615 <1% 219 $946.61
A9575 Injection, gadoterate meglumine, 0.1 ml <1% 84 $945.60
73660 <1% 40 $940.00
82465 <1% 311 $934.00
0424 <1% 80 $927.00
92523 <1% 56 $925.94
0171 Inj, epinephrine (belcher) <1% 111 $895.91
86317 <1% 121 $888.00
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 359 $877.03
G2024 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source <1% 34 $865.64
72050 <1% 27 $846.00
82627 <1% 80 $843.00
86664 <1% 93 $842.00
87324 <1% 90 $837.19
85379 <1% 233 $836.31
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) <1% 19 $827.60
E0181 Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty <1% 45 $821.74
A5056 Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each <1% 12 $810.15
A4409 Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each <1% 12 $794.76
92083 <1% 17 $790.00
84134 <1% 74 $769.24
87506 <1% 49 $760.00
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 166 $737.00
83002 <1% 138 $730.00
B9002 Enteral nutrition infusion pump, any type <1% 27 $722.40
80306 <1% 90 $718.93
83605 <1% 429 $709.07
81025 <1% 245 $697.30
82533 <1% 71 $694.00
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer <1% 101 $686.08
73100 <1% 22 $678.00
86635 <1% 58 $646.00
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 180 $639.30
87338 <1% 329 $636.72
86360 <1% 41 $636.00
E0244 Raised toilet seat <1% 18 $631.62
88342 <1% 19 $630.00
E0849 Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible <1% 18 $628.28
86140 <1% 354 $608.96
97161 <1% 102 $606.79
A6250 Skin sealants, protectants, moisturizers, ointments, any type, any size <1% 59 $599.20
82985 <1% 43 $598.68
A4670 Automatic blood pressure monitor <1% 42 $595.56
E2601 General use wheelchair seat cushion, width less than 22 inches, any depth <1% 21 $592.46
86376 <1% 90 $592.28
99072 <1% 636 $591.30
88112 <1% 13 $590.00
E0241 Bath tub wall rail, each <1% 27 $565.56
86304 <1% 44 $544.00
82977 <1% 109 $541.00
86255 <1% 27 $539.93
86696 <1% 52 $533.00
82785 <1% 41 $492.00
E0100 Cane, includes canes of all materials, adjustable or fixed, with tip <1% 36 $491.84
0307 <1% 143 $489.93
A9286 Hygienic item or device, disposable or non-disposable, any type, each <1% 57 $487.31
80321 <1% 15 $485.81
P9021 Red blood cells, each unit <1% 38 $483.53
86880 <1% 17 $467.00
86256 <1% 34 $458.00
A7005 Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable <1% 21 $447.32
A4335 Incontinence supply; miscellaneous <1% 63 $440.69
86580 <1% 154 $440.00
86706 <1% 299 $422.01
81329 <1% 84 $422.00
G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician <1% 36 $420.00
A5120 Skin barrier, wipes or swabs, each <1% 32 $415.54
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 19 $399.00
E0105 Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips <1% 14 $395.05
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 55 $391.04
J1644 Injection, heparin sodium, per 1000 units <1% 2,371 $390.89
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 510 $387.37
G0008 Administration of influenza virus vaccine <1% 56 $387.35
A4357 Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each <1% 13 $386.70
82950 <1% 168 $386.00
86431 <1% 142 $378.00
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 37 $354.96
99204 Doctor's office visit, new patient (more involved) <1% 152 $351.60
86735 <1% 86 $344.00
A4927 Gloves, non-sterile, per 100 <1% 132 $334.53
86709 <1% 48 $330.00
80179 <1% 101 $319.25
86695 <1% 52 $317.00
86301 <1% 28 $311.00
A4402 Lubricant, per ounce <1% 20 $306.55
97162 <1% 34 $287.49
82024 <1% 16 $285.00
E0910 Trapeze bars, a/k/a patient helper, attached to bed, with grab bar <1% 24 $273.06
87102 <1% 85 $270.00
88142 <1% 87 $269.85
86359 <1% 13 $260.00
82951 <1% 30 $258.00
85046 <1% 169 $258.00
87210 <1% 80 $253.42
0272 <1% 38 $252.87
81015 <1% 95 $252.86
82962 <1% 245 $252.73
93000 <1% 16 $252.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 172 $247.53
82330 <1% 22 $244.00
84425 <1% 61 $244.00
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 286 $234.15
0434 <1% 14 $223.28
86708 <1% 55 $222.00
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision <1% 37 $219.85
A6402 Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing <1% 27 $218.70
82140 <1% 44 $211.57
J2060 Injection, lorazepam, 2 mg <1% 111 $211.30
87086 Culture, bacterial; quantitative colony count, urine <1% 17 $207.97
83516 <1% 115 $207.80
87205 <1% 96 $204.45
86300 <1% 19 $200.00
J2270 Injection, morphine sulfate, up to 10 mg <1% 278 $197.36
81243 <1% 25 $195.00
80164 <1% 47 $195.00
80069 <1% 277 $188.25
84145 <1% 32 $184.58
J1170 Injection, hydromorphone, up to 4 mg <1% 150 $177.52
82077 <1% 179 $170.55
90686 <1% 63 $162.18
85045 <1% 116 $160.99
80349 <1% 33 $158.00
97165 <1% 15 $157.08
86308 <1% 37 $149.28
80177 <1% 23 $147.84
84478 <1% 61 $144.00
84155 <1% 636 $140.55
82390 <1% 30 $140.00
82150 <1% 61 $137.48
89051 <1% 36 $137.00
80162 <1% 15 $133.00
82272 <1% 34 $132.00
85613 <1% 14 $125.00
A4371 Ostomy skin barrier, powder, per oz <1% 14 $122.49
96367 <1% 40 $110.58
0430 <1% 16 $107.92
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 178 $102.24
88141 <1% 13 $100.00
87209 <1% 50 $100.00
85384 <1% 19 $98.72
83930 <1% 17 $96.61
83020 <1% 47 $95.00
82952 <1% 30 $92.00
80178 <1% 37 $88.61
83519 <1% 13 $88.20
83498 <1% 49 $88.20
J0604 Cinacalcet, oral, 1 mg, (for esrd on dialysis) <1% 1,813 $84.24
J7120 Ringers lactate infusion, up to 1000 cc <1% 195 $82.68
96376 <1% 54 $79.80
82803 <1% 36 $78.73
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 190 $78.65
A7015 Aerosol mask, used with dme nebulizer <1% 59 $76.12
92610 <1% 17 $72.46
84466 <1% 12 $72.00
82705 <1% 12 $66.00
J0780 Injection, prochlorperazine, up to 10 mg <1% 44 $61.06
84207 <1% 15 $60.48
84630 <1% 28 $60.00
J3475 Injection, magnesium sulfate, per 500 mg <1% 86 $58.02
83935 <1% 12 $54.00
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 153 $52.70
85049 <1% 12 $46.00
J0690 Injection, cefazolin sodium, 500 mg <1% 16 $42.05
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 74 $41.82
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion <1% 547 $40.00
86645 <1% 12 $40.00
J1815 Injection, insulin, per 5 units <1% 291 $39.30
82103 <1% 13 $35.00
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg <1% 20 $32.18
0309 <1% 12 $31.94
84305 <1% 13 $30.24
86593 <1% 34 $30.00
82374 <1% 160 $30.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg <1% 63 $28.05
J1630 Injection, haloperidol, up to 5 mg <1% 20 $27.98
A4657 Syringe, with or without needle, each <1% 3,952 $27.58
80359 <1% 14 $26.00
80324 <1% 14 $26.00
J0360 Injection, hydralazine hcl, up to 20 mg <1% 46 $24.56
83986 <1% 13 $24.25
A7013 Filter, disposable, used with aerosol compressor or ultrasonic generator <1% 41 $24.07
J1650 Injection, enoxaparin sodium, 10 mg <1% 112 $20.96
87147 <1% 14 $20.08
84590 <1% 12 $16.80
82435 <1% 17 $15.00
J3010 Injection, fentanyl citrate, 0.1 mg <1% 50 $11.51
87185 <1% 12 $10.00
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg <1% 34 $10.00
81002 <1% 58 $8.70
84315 <1% 16 $8.32
J3480 Injection, potassium chloride, per 2 meq <1% 60 $8.10
J1940 Injection, furosemide, up to 20 mg <1% 94 $4.00
99000 <1% 16 $3.63
J7042 5% dextrose/normal saline (500 ml = 1 unit) <1% 15 $3.49
A6216 Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing <1% 83 $3.02
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 72 $2.98
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 32 $2.29
99232 Hospital visit by a doctor, follow-up day 0% 47 $0.00
90677 0% 16 $0.00
G9012 Other specified case management service not elsewhere classified 0% 2,874 $0.00
Q5001 Hospice or home health care provided in patient's home/residence 0% 37 $0.00
K1034 Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count 0% 2,021 $0.00
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 0% 32 $0.00
J1270 Injection, doxercalciferol, 1 mcg 0% 2,308 $0.00
92551 0% 93 $0.00
92002 0% 48 $0.00
G0307 Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) 0% 77 $0.00
99024 0% 45 $0.00
99441 0% 69 $0.00
0370 0% 68 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 0% 13 $0.00
82525 0% 12 $0.00
0023 Pin srv add 30 min pr m 0% 13 $0.00
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 0% 55 $0.00
Q4081 Injection, epoetin alfa, 100 units (for esrd on dialysis) 0% 867 $0.00
82945 0% 62 $0.00
0710 0% 68 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 0% 25 $0.00
76813 0% 12 $0.00
C9113 Injection, pantoprazole sodium, per vial 0% 56 $0.00
82108 0% 105 $0.00
99051 0% 420 $0.00
97150 Therapeutic procedure(s), group (2 or more individuals) 0% 19 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 0% 14 $0.00
97156 0% 18 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 0% 37 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 0% 36 $0.00
J1050 Injection, medroxyprogesterone acetate, 1 mg 0% 14 $0.00
87329 0% 17 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 0% 40 $0.00
J7510 Prednisolone oral, per 5 mg 0% 15 $0.00
99177 0% 54 $0.00
J1071 Injection, testosterone cypionate, 1 mg 0% 19 $0.00
99442 0% 45 $0.00
87806 0% 14 $0.00
90832 Psychotherapy session, about 30 minutes 0% 13 $0.00
96116 0% 18 $0.00
90746 0% 16 $0.00
90791 Psychiatric diagnostic evaluation 0% 43 $0.00
99222 Initial hospital care, per day, moderate complexity 0% 19 $0.00
99203 Doctor's office visit, new patient (routine) 0% 168 $0.00
99173 0% 47 $0.00
99215 Doctor's office visit, returning patient (complex) 0% 33 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 0% 52 $0.00
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 0% 20 $0.00
A4267 Contraceptive supply, condom, male, each 0% 17 $0.00
90750 0% 22 $0.00
90853 Group psychotherapy (other than of a multiple-family group) 0% 44 $0.00
98968 0% 45 $0.00
0360 0% 18 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 0% 15 $0.00
J3371 Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg 0% 24 $0.00
80361 0% 20 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 0% 36 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 0% 41 $0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialLIU, XIAOYAN (EXECUTIVE DIRECTOR)