| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| R0070 |
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen |
3,505 |
3,226 |
$179K |
| R0075 |
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen |
2,444 |
2,284 |
$43K |
| Q0092 |
Set-up portable x-ray equipment |
6,334 |
5,656 |
$30K |
| 71045 |
Radiologic examination, chest; single view |
6,443 |
4,508 |
$16K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
253 |
242 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
280 |
207 |
$1K |
| 74018 |
|
119 |
76 |
$960.69 |
| 73560 |
|
168 |
100 |
$717.75 |
| 71010 |
|
20 |
20 |
$205.60 |
| 73502 |
|
13 |
12 |
$107.75 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
18 |
17 |
$104.55 |
| 80053 |
Comprehensive metabolic panel |
13 |
12 |
$100.32 |
| 2001F |
|
59 |
58 |
$0.00 |
| 2010F |
|
59 |
58 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |
| 3008F |
|
57 |
56 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
17 |
$0.00 |
| 3074F |
|
16 |
16 |
$0.00 |
| 2000F |
|
55 |
54 |
$0.00 |
| G0471 |
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) |
19 |
15 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
19 |
$0.00 |
| 4058F |
|
12 |
12 |
$0.00 |
| 1159F |
|
55 |
54 |
$0.00 |
| 3078F |
|
15 |
15 |
$0.00 |
| 1160F |
|
19 |
19 |
$0.00 |
| 99401 |
|
12 |
12 |
$0.00 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
50 |
38 |
$0.00 |