Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Behavioral

Spectrum Health Primary Care Partners

Spectrum Health Primary Care Partners was paid $219.58M by Medicaid between Jan 2018 and Dec 2024, across 692 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 15% of everything it billed.

33Billing provider infoSPECTRUM HEALTH PRIMARY CARE PARTNERS
GRAND RAPIDS, MI 49506
33aNPI1235188673assigned 05/10/2006
28Total paid$219.58M
24GClaims4,161,479
24DCodes billed692
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Clinical Child & Adolescent Psychologist providers in Michigan

Rank by total paid#1 of 12
Median peer was paid$232K
This provider vs. median947×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official CATIGNANI, RYAN controls 15+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$2.0M$4.0M$6.0M2018201920202021202220232024
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
2018543,713$25.12M
2019530,860$25.14M
2020501,968$23.33M
2021625,317$32.00M
2022675,926$37.04M
2023695,444$41.50M
2024incomplete588,251$35.45M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99214 Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 15% 503,378 455,380 $33.12M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 8.7% 394,386 364,362 $19.13M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 3.7% 95,181 90,216 $8.22M
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 3.3% 194,894 53,674 $7.17M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 3.0% 58,936 13,964 $6.62M
J0585 Injection, onabotulinumtoxina, 1 unit 2.9% 7,918 6,566 $6.33M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 2.8% 115,236 35,062 $6.24M
99204 Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2.8% 73,169 71,680 $6.20M
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care 2.0% 2,165 2,134 $4.43M
99244 Office or other outpatient consultation, moderate to high complexity 1.8% 41,159 40,261 $3.95M
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1.8% 67,877 66,741 $3.86M
99472 Subsequent inpatient pediatric critical care, per day, 2-5 years 1.7% 11,927 2,298 $3.81M
680 more codes
99223 Prolong inpt eval add15 m 1.5% 36,420 $3.37M
Q9991 Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg 1.4% 1,989 $3.10M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1.2% 34,788 $2.71M
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 1.2% 31,908 $2.63M
99254 1.1% 29,080 $2.50M
99205 Prolong outpt/office vis 1.1% 23,085 $2.49M
90837 Psychotherapy session, about an hour 1.1% 31,978 $2.43M
Q9992 Injection, buprenorphine extended-release (sublocade), greater than 100 mg 1.1% 1,532 $2.38M
99239 Hospital discharge day management, more than 30 minutes 1.0% 39,809 $2.22M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1.0% 33,512 $2.21M
59409 Vaginal delivery only (with or without episiotomy and/or forceps) <1% 3,023 $2.19M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 34,016 $2.01M
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 22,371 $1.99M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 24,450 $1.91M
99222 Initial hospital care, per day, moderate complexity <1% 30,086 $1.86M
99471 <1% 2,833 $1.83M
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies <1% 1,902 $1.80M
59426 <1% 2,005 $1.67M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 36,266 $1.62M
90460 Immunization administration through 18 years of age via any route, first or only component <1% 64,745 $1.51M
99243 <1% 23,166 $1.51M
90791 Psychiatric diagnostic evaluation <1% 14,821 $1.47M
95720 <1% 12,938 $1.44M
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 15,713 $1.32M
59514 <1% 1,741 $1.31M
99255 <1% 9,837 $1.06M
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg <1% 1,081 $1.03M
90834 Psychotherapy session, about 45 minutes <1% 19,856 $975K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 9,737 $965K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 16,440 $964K
59510 <1% 443 $961K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 14,259 $928K
95951 <1% 5,628 $895K
99245 <1% 7,021 $824K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 28,867 $812K
90671 <1% 9,525 $793K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 6,281 $757K
99238 Hospital discharge day management, 30 minutes or less <1% 18,141 $727K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 9,243 $704K
99253 <1% 11,818 $704K
59425 <1% 1,525 $704K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 70,985 $698K
90651 <1% 11,542 $669K
47562 <1% 1,985 $654K
90750 <1% 4,425 $641K
99292 <1% 7,958 $637K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 6,943 $618K
J7297 Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg <1% 796 $608K
59430 <1% 3,013 $603K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 15,763 $580K
99476 <1% 2,155 $578K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 26,078 $573K
99381 <1% 6,710 $561K
99475 <1% 1,129 $525K
90792 Psychiatric diagnostic evaluation with medical services <1% 4,408 $501K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 7,634 $496K
59025 Fetal non-stress test <1% 19,379 $489K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 7,940 $489K
J1050 Injection, medroxyprogesterone acetate, 1 mg <1% 6,386 $471K
64635 <1% 2,320 $463K
90686 <1% 55,542 $453K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study <1% 6,318 $451K
01922 <1% 4,105 $437K
76818 <1% 6,296 $416K
95718 <1% 5,738 $411K
90732 <1% 4,360 $407K
99385 <1% 4,233 $404K
J2315 Injection, naltrexone, depot form, 1 mg <1% 351 $401K
64615 <1% 5,964 $391K
99220 <1% 4,386 $391K
90715 <1% 16,316 $388K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 7,993 $374K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 2,245 $372K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 2,978 $364K
90739 <1% 2,376 $362K
90832 Psychotherapy session, about 30 minutes <1% 9,647 $362K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 7,790 $351K
99219 <1% 5,116 $350K
80305 <1% 37,142 $334K
76825 <1% 3,374 $329K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 75,645 $322K
G9002 Coordinated care fee, maintenance rate <1% 10,292 $319K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 4,960 $310K
64636 <1% 2,781 $309K
76830 Ultrasound, transvaginal <1% 5,482 $309K
99217 <1% 8,195 $298K
J2350 Injection, ocrelizumab, 1 mg <1% 17 $295K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 3,064 $291K
99221 <1% 6,665 $283K
17110 <1% 4,682 $279K
95886 <1% 5,215 $277K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 7,132 $275K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 6,372 $262K
83036 Hemoglobin; glycosylated (A1C) <1% 38,326 $258K
20610 <1% 9,151 $250K
91322 <1% 2,247 $249K
96127 <1% 86,097 $248K
76801 <1% 4,195 $246K
J2357 Injection, omalizumab, 5 mg <1% 241 $243K
76820 <1% 9,711 $238K
43775 <1% 748 $237K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 30,374 $236K
96133 <1% 2,020 $236K
90472 Immunization administration, each additional vaccine (list separately) <1% 16,595 $235K
95782 <1% 3,237 $232K
95713 <1% 702 $230K
96139 <1% 2,354 $228K
93458 <1% 1,732 $222K
64483 <1% 1,707 $210K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 5,624 $206K
64493 <1% 1,780 $201K
99242 <1% 4,251 $196K
43249 <1% 2,404 $187K
43235 <1% 3,289 $182K
90746 <1% 3,074 $180K
96116 <1% 4,043 $179K
31575 <1% 3,600 $178K
54150 <1% 3,235 $176K
92060 <1% 4,917 $175K
00731 <1% 2,628 $173K
94060 <1% 9,872 $169K
25600 <1% 951 $168K
58300 <1% 3,354 $166K
95816 <1% 4,597 $165K
99386 <1% 1,479 $164K
95811 <1% 2,596 $161K
93320 <1% 11,509 $158K
99383 <1% 1,766 $157K
62323 <1% 1,470 $157K
95909 <1% 2,203 $156K
93971 <1% 2,529 $153K
20611 <1% 3,448 $152K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 11,922 $152K
31624 <1% 2,927 $152K
90632 <1% 2,718 $152K
31231 <1% 1,650 $151K
95251 <1% 8,481 $151K
96132 <1% 2,339 $142K
99235 <1% 1,574 $140K
99384 <1% 1,437 $137K
81025 <1% 21,200 $137K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 2,571 $137K
73630 <1% 9,401 $134K
36556 <1% 3,190 $133K
95910 <1% 1,416 $131K
94729 <1% 7,786 $131K
99252 <1% 3,212 $126K
94010 <1% 10,440 $125K
27096 <1% 1,371 $124K
99495 <1% 1,325 $123K
93000 <1% 15,728 $123K
96130 <1% 1,945 $120K
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) <1% 4,353 $119K
93970 <1% 1,310 $119K
11750 <1% 1,574 $118K
99382 <1% 1,287 $118K
99418 Prolong nursin fac eval 15m <1% 2,944 $118K
92015 Determination of refractive state <1% 11,946 $117K
95908 <1% 1,980 $116K
20680 <1% 699 $115K
30999 <1% 1,153 $111K
58301 <1% 1,992 $108K
99493 <1% 943 $108K
98967 <1% 9,353 $108K
99460 <1% 1,994 $106K
90621 <1% 2,649 $105K
87428 <1% 2,959 $105K
31500 <1% 1,519 $104K
93922 <1% 3,430 $104K
92370 <1% 5,688 $99K
99497 <1% 3,025 $99K
93308 <1% 7,166 $99K
75561 <1% 1,505 $99K
95700 <1% 746 $98K
90670 <1% 19,605 $98K
64721 <1% 513 $97K
93325 <1% 21,209 $96K
99356 <1% 2,167 $93K
99350 Prolong home eval add 15m <1% 1,083 $93K
43281 <1% 347 $93K
64494 <1% 1,591 $92K
99152 <1% 11,873 $91K
76819 Fetal biophysical profile; without non-stress testing <1% 2,335 $91K
95885 <1% 2,418 $90K
11981 <1% 1,578 $90K
58571 <1% 205 $89K
36620 <1% 4,002 $88K
93312 <1% 1,692 $87K
73564 <1% 4,641 $86K
76827 <1% 3,365 $86K
90480 <1% 3,659 $86K
92567 <1% 9,795 $85K
0124A <1% 2,614 $85K
98968 <1% 5,226 $85K
58661 <1% 198 $85K
94726 <1% 4,848 $81K
93295 <1% 4,573 $81K
57454 <1% 863 $80K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 7,771 $80K
95806 <1% 2,971 $79K
93750 <1% 3,700 $78K
98966 <1% 12,602 $78K
00635 <1% 1,293 $77K
93016 <1% 7,386 $77K
52000 <1% 843 $77K
44970 <1% 219 $75K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 5,304 $75K
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk <1% 716 $75K
95076 <1% 1,227 $75K
99284 Emergency room visit (serious) <1% 1,148 $74K
64633 <1% 430 $74K
95819 <1% 1,852 $72K
99397 <1% 1,663 $72K
58100 <1% 1,423 $72K
99349 <1% 1,179 $68K
99496 <1% 510 $67K
82947 <1% 22,746 $67K
73610 <1% 4,356 $66K
72082 <1% 2,270 $65K
99417 Prolong home eval add 15m <1% 2,604 $64K
93018 <1% 9,169 $63K
92557 <1% 2,991 $61K
11982 <1% 944 $61K
96137 <1% 1,548 $60K
93351 <1% 1,439 $60K
96118 <1% 408 $59K
99308 Subsequent nursing facility care, per day, straightforward <1% 1,600 $59K
G9007 Coordinated care fee, scheduled team conference <1% 3,590 $59K
31622 <1% 1,183 $59K
73110 <1% 3,536 $58K
93350 <1% 1,584 $58K
Q4050 Cast supplies, for unlisted types and materials of casts <1% 3,033 $58K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 1,280 $58K
99494 <1% 762 $57K
96131 <1% 822 $57K
93248 <1% 4,225 $57K
64634 <1% 528 $56K
95813 <1% 689 $55K
Q3014 Telehealth originating site facility fee <1% 4,381 $55K
73562 <1% 3,247 $54K
96154 <1% 868 $54K
93296 <1% 5,200 $54K
76942 <1% 1,913 $53K
93244 <1% 4,205 $53K
73130 <1% 3,465 $52K
69210 <1% 2,020 $51K
96136 <1% 2,410 $51K
93451 <1% 826 $50K
99236 Prolong inpt eval add15 m <1% 449 $50K
87210 <1% 11,271 $49K
36224 <1% 224 $49K
36415 Collection of venous blood by venipuncture <1% 14,354 $49K
73140 <1% 2,977 $48K
64405 <1% 1,453 $47K
73030 <1% 3,670 $47K
99421 <1% 4,685 $47K
97802 <1% 1,861 $46K
64642 <1% 634 $46K
81003 <1% 26,674 $45K
73502 <1% 2,293 $45K
92201 <1% 3,321 $44K
96401 <1% 883 $44K
0054A <1% 1,455 $44K
G0426 Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth <1% 756 $43K
90656 <1% 4,540 $42K
96138 <1% 2,356 $41K
90620 <1% 2,058 $39K
99442 <1% 1,224 $38K
26055 <1% 172 $38K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 1,306 $38K
99492 <1% 316 $37K
0001A <1% 1,039 $37K
43259 <1% 383 $37K
20550 <1% 1,527 $37K
G9001 Coordinated care fee, initial rate <1% 543 $37K
96156 <1% 780 $37K
99283 Emergency room visit (moderate) <1% 961 $36K
92340 Fitting of spectacles, except for aphakia; monofocal <1% 1,842 $36K
92551 <1% 6,520 $36K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 9,117 $35K
93227 <1% 2,950 $35K
96101 <1% 404 $35K
29075 <1% 831 $35K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 1,296 $34K
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination <1% 1,622 $33K
V5261 Hearing aid, digital, binaural, bte <1% 40 $33K
93460 <1% 195 $33K
36416 <1% 35,677 $32K
99406 <1% 4,668 $32K
99443 <1% 821 $32K
64450 <1% 982 $32K
0002A <1% 873 $31K
90688 <1% 3,279 $31K
73560 <1% 2,151 $30K
46600 <1% 590 $30K
92579 <1% 1,160 $30K
71046 Radiologic examination, chest; 2 views <1% 2,657 $30K
92250 <1% 1,491 $30K
51700 <1% 948 $30K
42830 <1% 412 $29K
11721 <1% 1,650 $29K
62321 <1% 245 $29K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 8,772 $29K
20553 <1% 1,244 $29K
92587 <1% 2,325 $29K
95117 <1% 4,784 $28K
73100 <1% 2,077 $28K
99218 <1% 571 $28K
72081 <1% 1,791 $28K
96040 <1% 732 $28K
90678 <1% 108 $27K
77073 <1% 1,688 $27K
93294 <1% 2,065 $27K
93321 <1% 6,031 $27K
96119 <1% 283 $26K
67311 <1% 66 $26K
52356 <1% 123 $25K
0071A <1% 683 $25K
92133 <1% 1,227 $25K
73521 <1% 1,554 $25K
64643 <1% 412 $25K
76937 <1% 3,418 $25K
90734 <1% 7,915 $24K
99498 <1% 746 $24K
99444 <1% 1,753 $24K
92226 <1% 2,113 $23K
0004A <1% 698 $23K
95874 <1% 935 $22K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes <1% 767 $22K
0072A <1% 606 $22K
58558 <1% 153 $22K
64490 <1% 197 $22K
77002 <1% 473 $22K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory <1% 946 $22K
99422 <1% 1,848 $22K
J2790 Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) <1% 303 $21K
G0105 Colorectal cancer screening; colonoscopy on individual at high risk <1% 210 $21K
73090 <1% 1,834 $21K
93299 <1% 374 $21K
90679 <1% 78 $21K
99225 <1% 7,937 $21K
90716 <1% 7,095 $21K
75574 <1% 321 $21K
93356 <1% 2,180 $20K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials <1% 163 $20K
90836 <1% 429 $20K
99251 <1% 775 $20K
93298 <1% 1,612 $20K
73080 <1% 1,528 $20K
0052A <1% 575 $19K
G0109 Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes <1% 976 $19K
90707 <1% 7,159 $19K
52332 <1% 283 $19K
76377 <1% 883 $18K
92552 <1% 1,009 $17K
93280 <1% 666 $17K
99441 <1% 750 $17K
92002 <1% 403 $17K
31600 <1% 116 $17K
0051A <1% 477 $16K
73590 <1% 1,367 $16K
64495 <1% 337 $16K
20552 <1% 824 $16K
99462 <1% 663 $16K
90714 <1% 663 $15K
93923 <1% 270 $15K
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 13,531 $15K
99155 <1% 325 $15K
51798 <1% 2,679 $14K
73620 <1% 1,243 $14K
99170 <1% 167 $14K
73070 <1% 1,258 $14K
93880 <1% 240 $14K
0081A <1% 390 $14K
93282 <1% 454 $14K
72100 <1% 953 $14K
G0427 Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth <1% 171 $14K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 1,758 $14K
82044 <1% 3,618 $14K
J1040 Injection, methylprednisolone acetate, 80 mg <1% 1,574 $14K
44500 <1% 1,801 $14K
74018 <1% 1,037 $13K
95911 <1% 122 $13K
81002 <1% 5,371 $13K
69209 <1% 1,449 $13K
10060 <1% 230 $13K
83037 <1% 1,588 $13K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger <1% 31 $12K
95018 <1% 97 $12K
00813 <1% 140 $12K
58662 <1% 41 $12K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 943 $12K
99468 <1% 14 $12K
82570 <1% 3,642 $12K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results <1% 937 $12K
72170 <1% 1,007 $12K
22853 <1% 88 $11K
43244 <1% 82 $11K
J2795 Injection, ropivacaine hydrochloride, 1 mg <1% 11,882 $11K
85018 <1% 5,573 $11K
64400 <1% 205 $11K
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass <1% 875 $11K
0154A <1% 299 $11K
93304 <1% 368 $10K
31645 <1% 176 $10K
33533 <1% 17 $10K
81001 <1% 4,113 $10K
0082A <1% 262 $10K
95983 <1% 407 $10K
28470 <1% 83 $9K
94618 <1% 729 $9K
V5160 Dispensing fee, binaural <1% 27 $9K
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care <1% 1,291 $9K
74340 <1% 691 $9K
92978 <1% 203 $9K
36471 <1% 79 $9K
J1071 Injection, testosterone cypionate, 1 mg <1% 2,689 $9K
Q4008 Cast supplies, long arm cast, pediatric (0-10 years), fiberglass <1% 918 $9K
92928 <1% 29 $9K
92591 <1% 164 $9K
73600 <1% 655 $9K
43264 <1% 62 $9K
64491 <1% 148 $8K
J1030 Injection, methylprednisolone acetate, 40 mg <1% 1,364 $8K
93290 <1% 790 $8K
36226 <1% 58 $8K
96380 <1% 424 $8K
95115 <1% 1,625 $7K
99157 <1% 160 $7K
G0250 Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests <1% 3,476 $7K
96367 <1% 419 $7K
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) <1% 2,955 $7K
11102 <1% 129 $7K
88720 <1% 1,935 $7K
91200 <1% 462 $7K
72040 <1% 411 $7K
93283 <1% 163 $7K
43247 <1% 78 $6K
24530 <1% 39 $6K
91010 <1% 190 $6K
99451 <1% 314 $6K
41010 <1% 70 $6K
90694 <1% 858 $6K
0053A <1% 168 $6K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 185 $6K
99226 <1% 1,740 $5K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 389 $5K
43242 <1% 42 $5K
94664 <1% 1,449 $5K
11100 <1% 104 $5K
92558 <1% 1,032 $5K
73552 <1% 384 $5K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 234 $5K
11104 <1% 75 $5K
96121 <1% 110 $5K
J3490 Unclassified drugs <1% 1,056 $5K
64484 <1% 79 $4K
99241 <1% 182 $4K
92960 <1% 85 $4K
95836 <1% 82 $4K
49083 <1% 82 $4K
76821 <1% 83 $4K
94621 <1% 112 $4K
75563 <1% 53 $4K
86580 <1% 857 $4K
93926 <1% 72 $4K
87807 <1% 396 $4K
Q4012 Cast supplies, short arm cast, pediatric (0-10 years), fiberglass <1% 619 $4K
51797 <1% 63 $4K
96375 Therapeutic injection; each additional sequential IV push <1% 307 $4K
92555 <1% 256 $4K
93284 <1% 85 $4K
27447 <1% 18 $4K
90473 <1% 456 $4K
G9008 Coordinated care fee, physician coordinated care oversight services <1% 107 $3K
99454 <1% 125 $3K
99201 <1% 158 $3K
0074A <1% 94 $3K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 3,127 $3K
61781 <1% 47 $3K
43274 <1% 13 $3K
62270 <1% 98 $3K
96167 <1% 74 $3K
0031A <1% 90 $3K
93272 <1% 223 $3K
99224 <1% 910 $3K
0298T <1% 2,161 $3K
31526 <1% 46 $3K
0173A <1% 77 $3K
90682 <1% 55 $3K
82962 <1% 1,403 $3K
75565 <1% 456 $3K
20600 <1% 130 $3K
29450 <1% 27 $3K
92083 <1% 94 $3K
V5011 Fitting/orientation/checking of hearing aid <1% 75 $2K
G0316 Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes) <1% 904 $2K
95724 <1% 13 $2K
95079 <1% 38 $2K
64492 <1% 37 $2K
99348 <1% 50 $2K
0073A <1% 62 $2K
99188 <1% 340 $2K
11730 <1% 40 $2K
V5020 Conformity evaluation <1% 63 $2K
11900 <1% 98 $2K
95984 <1% 53 $2K
0083A <1% 59 $2K
29065 <1% 45 $2K
99464 <1% 52 $2K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 62 $2K
90662 <1% 820 $2K
38525 <1% 13 $2K
29405 <1% 46 $2K
92285 <1% 151 $2K
74420 <1% 177 $2K
11200 <1% 49 $2K
20605 <1% 91 $2K
73000 <1% 163 $2K
99285 Emergency room visit (most serious) <1% 18 $2K
45330 <1% 66 $2K
77067 Screening mammography, bilateral, including computer-aided detection <1% 44 $2K
30901 <1% 28 $2K
82043 <1% 485 $2K
99463 <1% 29 $2K
99459 <1% 134 $2K
43273 <1% 28 $2K
51701 <1% 81 $2K
0064A <1% 58 $2K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit <1% 4,001 $2K
76882 <1% 41 $2K
31653 <1% 12 $2K
99342 <1% 33 $2K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 4,987 $1K
43450 <1% 75 $1K
92588 <1% 81 $1K
0003A <1% 38 $1K
G0425 Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth <1% 26 $1K
0121A <1% 46 $1K
76812 <1% 14 $1K
99336 <1% 17 $1K
11983 <1% 15 $1K
43255 <1% 13 $1K
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml <1% 3,804 $1K
96112 <1% 15 $1K
99307 <1% 47 $1K
J2791 Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu <1% 16 $1K
99305 <1% 13 $1K
29826 <1% 21 $1K
69990 <1% 13 $1K
76813 <1% 20 $1K
31615 <1% 18 $1K
92310 <1% 26 $1K
95805 <1% 43 $1K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg <1% 751 $949.00
51702 <1% 29 $936.02
96168 <1% 53 $926.45
Q4031 Cast supplies, long leg cast, pediatric (0-10 years), plaster <1% 56 $923.14
99177 <1% 348 $895.72
51784 <1% 77 $883.06
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg <1% 45 $851.32
38900 <1% 12 $846.24
46221 <1% 12 $844.58
90653 <1% 129 $843.25
59000 <1% 12 $831.75
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 757 $815.02
17250 <1% 17 $814.98
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 49 $784.72
Q4032 Cast supplies, long leg cast, pediatric (0-10 years), fiberglass <1% 26 $765.01
G0008 Administration of influenza virus vaccine <1% 4,188 $756.69
29425 <1% 16 $740.86
Q4040 Cast supplies, short leg cast, pediatric (0-10 years), fiberglass <1% 45 $736.46
J1010 Injection, methylprednisolone acetate, 1 mg <1% 236 $726.61
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 30 $713.43
75710 <1% 15 $688.37
92225 <1% 75 $659.91
93224 <1% 13 $650.48
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit <1% 552 $619.21
95974 <1% 13 $590.19
99354 <1% 12 $581.60
20526 <1% 12 $581.05
95970 <1% 68 $577.84
97803 <1% 24 $548.52
95938 <1% 19 $514.39
90744 <1% 7,370 $497.87
99153 Mod sedat endo service >5yrs <1% 1,514 $488.05
96160 <1% 408 $454.79
0171A <1% 12 $440.90
90713 <1% 975 $435.11
62252 <1% 13 $426.37
91038 <1% 14 $417.17
76376 <1% 95 $408.36
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 14 $401.76
94777 <1% 14 $398.45
93242 <1% 62 $387.43
90672 <1% 322 $378.14
51741 <1% 102 $347.76
92553 <1% 12 $330.67
G0009 Administration of pneumococcal vaccine <1% 1,005 $329.10
V5266 Battery for use in hearing device <1% 13 $322.56
96161 <1% 321 $318.41
J1644 Injection, heparin sodium, per 1000 units <1% 545 $312.01
73060 <1% 28 $306.20
95012 <1% 26 $294.90
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 5,133 $277.38
93264 <1% 12 $275.55
J3010 Injection, fentanyl citrate, 0.1 mg <1% 4,194 $272.91
92556 <1% 12 $259.79
76946 <1% 12 $218.16
99407 <1% 16 $204.17
96361 Intravenous infusion, hydration; each additional hour <1% 38 $197.58
33508 <1% 36 $197.22
J2704 Injection, propofol, 10 mg <1% 72 $188.02
72070 <1% 14 $177.51
99453 <1% 14 $175.08
73120 <1% 15 $173.50
93246 <1% 26 $169.43
92228 <1% 21 $166.77
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care <1% 25 $162.36
93319 <1% 13 $154.77
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 231 $132.34
90660 <1% 64 $130.00
J7050 Infusion, normal saline solution, 250 cc <1% 290 $127.15
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) <1% 78 $125.40
J3475 Injection, magnesium sulfate, per 500 mg <1% 61 $121.31
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg <1% 983 $87.06
96415 <1% 14 $86.52
S2900 Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) <1% 1,278 $83.00
90785 <1% 14 $74.12
J7120 Ringers lactate infusion, up to 1000 cc <1% 28 $59.08
92504 <1% 99 $39.33
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) <1% 52 $29.05
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 109 $17.50
90648 <1% 13,747 $12.90
99173 <1% 10,424 $10.99
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 167 $1.19
S0020 Injection, bupivicaine hydrochloride, 30 ml <1% 437 $0.12
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg <1% 13 $0.07
90698 0% 11,456 $0.00
90723 0% 9,464 $0.00
90680 0% 17,323 $0.00
1123F 0% 222 $0.00
90696 0% 5,049 $0.00
0399T 0% 145 $0.00
G0010 Administration of hepatitis b vaccine 0% 39 $0.00
1101F 0% 289 $0.00
90381 0% 195 $0.00
3017F 0% 487 $0.00
91303 0% 56 $0.00
59200 0% 13 $0.00
1036F 0% 630 $0.00
91301 0% 49 $0.00
4086F 0% 35 $0.00
A4590 Special casting material (e.g., fiberglass) 0% 17 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 0% 55 $0.00
90633 0% 13,778 $0.00
0502F 0% 2,531 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 0% 3,469 $0.00
90461 0% 36,699 $0.00
90700 0% 5,658 $0.00
90710 0% 5,395 $0.00
20936 0% 44 $0.00
91300 0% 2,425 $0.00
90685 0% 2,523 $0.00
93784 0% 127 $0.00
1124F 0% 850 $0.00
90687 0% 151 $0.00
91321 0% 408 $0.00
20930 0% 84 $0.00
4040F 0% 281 $0.00
0649T 0% 44 $0.00
90380 0% 84 $0.00
G8482 Influenza immunization administered or previously received 0% 352 $0.00
G0444 Annual depression screening, 5 to 15 minutes 0% 16 $0.00
G8484 Influenza immunization was not administered, reason not given 0% 499 $0.00
4004F 0% 262 $0.00
G8399 Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed 0% 127 $0.00
3046F 0% 98 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 0% 812 $0.00
G8400 Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given 0% 58 $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.

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Authorized officialCATIGNANI, RYAN (VP FINANCE)
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