| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9131 |
Pt in the home per diem |
14,680 |
2,738 |
$975K |
| T1001 |
Nursing assessment/evaluatn |
11,686 |
2,563 |
$809K |
| G0151 |
Hhcp-serv of pt,ea 15 min |
2,122 |
540 |
$143K |
| T1030 |
Rn home care per diem |
1,789 |
319 |
$128K |
| G0299 |
Hhs/hospice of rn ea 15 min |
1,746 |
419 |
$117K |
| 0011A |
|
700 |
363 |
$17K |
| 0012A |
|
586 |
350 |
$15K |
| S9129 |
Occupational therapy, in the |
134 |
51 |
$9K |
| G0152 |
Hhcp-serv of ot,ea 15 min |
57 |
26 |
$4K |
| 0013A |
|
103 |
101 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
310 |
109 |
$129.86 |
| A6446 |
Conform band s w>=3" <5"/yd |
35 |
12 |
$3.64 |
| A5120 |
Skin barrier, wipe or swab |
138 |
44 |
$0.00 |
| 91301 |
|
30 |
29 |
$0.00 |
| A4450 |
Non-waterproof tape |
20 |
12 |
$0.00 |
| A6260 |
Wound cleanser any type/size |
18 |
15 |
$0.00 |
| T1999 |
Noc retail items andsupplies |
32 |
12 |
$0.00 |
| A6210 |
Foam drg >16<=48 sq in w/o b |
39 |
14 |
$0.00 |
| A6212 |
Foam drg <=16 sq in w/border |
49 |
14 |
$0.00 |