| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2030 |
Assisted living, waiver; per month |
6,006 |
5,173 |
$8.20M |
| T2031 |
Assisted living; waiver, per diem |
1,151 |
968 |
$1.49M |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
8,469 |
6,466 |
$719K |
| E1392 |
Portable oxygen concentrator, rental |
5,481 |
4,417 |
$625K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,807 |
2,527 |
$189K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,129 |
366 |
$158K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,645 |
2,188 |
$140K |
| 11719 |
|
5,323 |
2,542 |
$118K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
8,102 |
6,025 |
$97K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
825 |
351 |
$76K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
234 |
205 |
$68K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
2,044 |
1,608 |
$53K |
| 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 |
638 |
241 |
$49K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
830 |
632 |
$46K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,849 |
709 |
$44K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
36 |
36 |
$37K |
| T1017 |
Targeted case management, each 15 minutes |
1,088 |
346 |
$32K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,131 |
2,108 |
$26K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
786 |
781 |
$20K |
| 80053 |
Comprehensive metabolic panel |
2,550 |
2,479 |
$20K |
| V5257 |
Hearing aid, digital, monaural, bte |
12 |
12 |
$19K |
| A0425 |
Ground mileage, per statute mile |
782 |
665 |
$17K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
138 |
138 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,169 |
2,152 |
$16K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,011 |
2,857 |
$16K |
| 80061 |
Lipid panel |
1,497 |
1,492 |
$15K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
824 |
816 |
$12K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
57 |
52 |
$10K |
| 82607 |
|
1,011 |
1,003 |
$10K |
| 82652 |
|
484 |
483 |
$10K |
| 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 |
148 |
120 |
$9K |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
354 |
130 |
$9K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
477 |
393 |
$8K |
| E0444 |
Portable oxygen contents, liquid, 1 month's supply = 1 unit |
162 |
152 |
$8K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
451 |
324 |
$8K |
| T2033 |
Residential care, not otherwise specified (nos), waiver; per diem |
34 |
27 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
369 |
369 |
$7K |
| V5160 |
Dispensing fee, binaural |
13 |
13 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
70 |
69 |
$6K |
| V2744 |
Tint, photochromatic, per lens |
63 |
63 |
$6K |
| V2020 |
Frames, purchases |
91 |
87 |
$6K |
| V2781 |
Progressive lens, per lens |
37 |
36 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
765 |
720 |
$5K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
99 |
94 |
$5K |
| 86480 |
|
108 |
108 |
$5K |
| 84439 |
|
514 |
507 |
$5K |
| E0570 |
Nebulizer, with compressor |
353 |
327 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
184 |
107 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
571 |
540 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
34 |
13 |
$4K |
| E0184 |
Dry pressure mattress |
227 |
192 |
$3K |
| 99310 |
Prolong nursin fac eval 15m |
25 |
22 |
$3K |
| 99318 |
|
33 |
33 |
$3K |
| H0032 |
Mental health service plan development by non-physician |
61 |
59 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
22 |
18 |
$3K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
17 |
12 |
$2K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
255 |
116 |
$2K |
| 92015 |
Determination of refractive state |
30 |
30 |
$2K |
| 87186 |
|
217 |
211 |
$2K |
| 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) |
297 |
242 |
$2K |
| 99304 |
|
21 |
21 |
$2K |
| 87088 |
|
244 |
237 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$2K |
| V5299 |
Hearing service, miscellaneous |
61 |
61 |
$2K |
| 92591 |
|
13 |
13 |
$1K |
| 81001 |
|
512 |
491 |
$1K |
| 11720 |
|
19 |
19 |
$1K |
| K0001 |
Standard wheelchair |
103 |
97 |
$1K |
| 82570 |
|
185 |
184 |
$893.94 |
| A4615 |
Cannula, nasal |
90 |
87 |
$747.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
93 |
93 |
$628.32 |
| V5011 |
Fitting/orientation/checking of hearing aid |
13 |
13 |
$585.00 |
| 82746 |
|
80 |
79 |
$558.31 |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
126 |
89 |
$520.42 |
| 92700 |
|
21 |
15 |
$495.00 |
| 82043 |
|
68 |
68 |
$481.44 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
23 |
19 |
$437.00 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$304.68 |
| 83550 |
|
63 |
61 |
$278.46 |
| 87077 |
|
43 |
43 |
$269.08 |
| 83540 |
|
87 |
85 |
$206.18 |
| 86803 |
|
46 |
46 |
$157.32 |
| E1353 |
Regulator |
25 |
24 |
$142.56 |
| 36415 |
Collection of venous blood by venipuncture |
19 |
12 |
$62.51 |
| A0999 |
Unlisted ambulance service |
26 |
24 |
$0.00 |
| S5102 |
Day care services, adult; per diem |
66 |
13 |
$0.00 |
| 83880 |
|
12 |
12 |
$0.00 |
| G0409 |
Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf) |
33 |
13 |
$0.00 |
| A4616 |
Tubing (oxygen), per foot |
26 |
15 |
$0.00 |
| 98960 |
|
147 |
92 |
$0.00 |
| 84156 |
|
13 |
12 |
$0.00 |