| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2030 |
Assist living waiver/month |
5,165 |
4,645 |
$8.17M |
| T2031 |
Assist living waiver/diem |
978 |
931 |
$2.16M |
| A9999 |
Dme supply or accessory, nos |
5,312 |
4,217 |
$514K |
| E1392 |
Portable oxygen concentrator |
3,145 |
2,589 |
$398K |
| E1390 |
Oxygen concentrator |
2,871 |
2,680 |
$296K |
| A0427 |
Als1-emergency |
658 |
579 |
$221K |
| S5161 |
Emer rspns sys serv permonth |
7,942 |
6,557 |
$139K |
| T2033 |
Res, nos waiver per diem |
74 |
67 |
$109K |
| E0601 |
Cont airway pressure device |
1,740 |
1,512 |
$103K |
| 11719 |
|
4,018 |
1,934 |
$96K |
| 99213 |
|
36,687 |
11,716 |
$85K |
| E0466 |
Home vent non-invasive inter |
47 |
47 |
$48K |
| E0439 |
Stationary liquid 02 |
369 |
362 |
$42K |
| A0428 |
Bls |
153 |
107 |
$36K |
| A0425 |
Ground mileage |
1,551 |
1,221 |
$33K |
| A0429 |
Bls-emergency |
111 |
100 |
$31K |
| U0003 |
Cov-19 amp prb hgh thruput |
500 |
238 |
$30K |
| 84443 |
|
1,608 |
1,584 |
$27K |
| 82306 |
|
942 |
933 |
$27K |
| E0277 |
Powered pres-redu air mattrs |
298 |
248 |
$26K |
| E0434 |
Portable liquid 02 |
1,091 |
806 |
$24K |
| 80053 |
|
2,171 |
2,104 |
$21K |
| 99070 |
|
388 |
283 |
$20K |
| D9410 |
|
216 |
215 |
$19K |
| E0444 |
Portable 02 contents, liquid |
386 |
364 |
$18K |
| 85025 |
|
2,659 |
2,514 |
$17K |
| 87635 |
|
535 |
172 |
$17K |
| D7140 |
|
46 |
13 |
$17K |
| E0431 |
Portable gaseous 02 |
915 |
869 |
$16K |
| 83036 |
|
1,690 |
1,666 |
$15K |
| 11721 |
|
366 |
323 |
$14K |
| E0562 |
Humidifier heated used w pap |
710 |
685 |
$13K |
| E0443 |
Portable 02 contents, gas |
291 |
267 |
$12K |
| D0150 |
|
913 |
545 |
$12K |
| V5160 |
Dispensing fee binaural |
24 |
24 |
$12K |
| 90837 |
|
7,851 |
2,688 |
$12K |
| 80061 |
|
897 |
882 |
$11K |
| E0265 |
Hosp bed total electr w/ mat |
189 |
187 |
$10K |
| E0570 |
Nebulizer with compression |
787 |
745 |
$9K |
| 82607 |
|
521 |
510 |
$8K |
| P9604 |
One-way allow prorated trip |
144 |
117 |
$7K |
| D0274 |
|
88 |
76 |
$7K |
| 80048 |
|
762 |
710 |
$6K |
| 92014 |
|
42 |
40 |
$5K |
| 11720 |
|
79 |
78 |
$5K |
| 99334 |
|
76 |
37 |
$5K |
| 90999 |
|
278 |
24 |
$4K |
| 84439 |
|
622 |
613 |
$4K |
| A7031 |
Replacement facemask interfa |
84 |
81 |
$4K |
| 98960 |
|
24 |
23 |
$3K |
| 71046 |
|
26 |
26 |
$3K |
| A7030 |
Cpap full face mask |
34 |
33 |
$3K |
| 90832 |
|
36,442 |
7,931 |
$3K |
| R0070 |
Transport portable x-ray |
34 |
32 |
$3K |
| V2020 |
Vision svcs frames purchases |
44 |
41 |
$3K |
| 83970 |
|
57 |
57 |
$3K |
| 92591 |
|
26 |
26 |
$3K |
| E0442 |
Stationary o2 contents, liq |
91 |
91 |
$2K |
| A7034 |
Nasal application device |
30 |
30 |
$2K |
| G0471 |
Ven blood coll snf/hha |
367 |
310 |
$2K |
| 82746 |
|
97 |
96 |
$2K |
| V5299 |
Hearing service |
64 |
62 |
$2K |
| 82728 |
|
100 |
100 |
$2K |
| D0180 |
|
43 |
43 |
$1K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
15 |
14 |
$1K |
| Q0092 |
Set up port xray equipment |
55 |
50 |
$1K |
| 87086 |
|
150 |
146 |
$1K |
| P9603 |
One-way allow prorated miles |
214 |
188 |
$1K |
| A7032 |
Replacement nasal cushion |
27 |
26 |
$1K |
| A7038 |
Pos airway pressure filter |
192 |
187 |
$1K |
| 83550 |
|
130 |
128 |
$1K |
| V5011 |
Hearing aid fitting/checking |
26 |
26 |
$1K |
| D0140 |
|
528 |
311 |
$1K |
| U0005 |
Infec agen detec ampli probe |
106 |
58 |
$1K |
| 99214 |
|
19,888 |
9,747 |
$1K |
| 92015 |
|
49 |
48 |
$981.65 |
| 83540 |
|
137 |
135 |
$945.63 |
| 98941 |
|
23 |
15 |
$922.78 |
| E1353 |
Oxygen supplies regulator |
167 |
154 |
$891.00 |
| S9999 |
Sales tax |
283 |
273 |
$887.40 |
| A7037 |
Pos airway pressure tubing |
33 |
33 |
$837.87 |
| 87186 |
|
71 |
70 |
$800.47 |
| D1208 |
|
89 |
87 |
$794.77 |
| 87088 |
|
73 |
73 |
$709.68 |
| 81001 |
|
212 |
208 |
$676.26 |
| D1110 |
|
47 |
46 |
$659.90 |
| 82570 |
|
102 |
101 |
$621.32 |
| A4615 |
Cannula nasal |
71 |
49 |
$616.00 |
| 82652 |
|
13 |
13 |
$612.95 |
| K0001 |
Standard wheelchair |
113 |
107 |
$600.00 |
| 84153 |
|
26 |
26 |
$585.78 |
| A0130 |
Noner transport wheelch van |
1,056,344 |
40,144 |
$514.54 |
| D0120 |
|
2,006 |
1,124 |
$490.00 |
| 82043 |
|
66 |
65 |
$460.20 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$424.08 |
| 92700 |
|
16 |
16 |
$400.00 |
| 84100 |
|
63 |
56 |
$325.86 |
| A7035 |
Pos airway press headgear |
14 |
14 |
$321.44 |
| E1354 |
Wheeled cart, port cyl/conc |
54 |
53 |
$278.25 |
| 83735 |
|
33 |
32 |
$269.34 |
| 85027 |
|
44 |
42 |
$268.40 |
| 82310 |
|
46 |
43 |
$233.91 |
| 86141 |
|
13 |
13 |
$206.18 |
| A7046 |
Repl water chamber, pap dev |
13 |
13 |
$157.69 |
| 87077 |
|
13 |
13 |
$103.32 |
| 99442 |
|
13,038 |
5,254 |
$96.84 |
| 85610 |
|
17 |
16 |
$76.77 |
| 85652 |
|
12 |
12 |
$39.72 |
| 97163 |
|
77,147 |
14,014 |
$0.00 |
| 97167 |
|
65,681 |
12,715 |
$0.00 |
| 86480 |
|
12 |
12 |
$0.00 |
| S0221 |
Medical conference, 60 min |
2,342 |
1,135 |
$0.00 |
| G0422 |
Intens cardiac rehab w/exerc |
16,963 |
1,946 |
$0.00 |
| S9470 |
Nutritional counseling, diet |
23,826 |
11,260 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
2,349 |
1,123 |
$0.00 |
| T1001 |
Nursing assessment/evaluatn |
37,578 |
15,784 |
$0.00 |
| H0032 |
Mh svc plan dev by non-md |
4,135 |
1,400 |
$0.00 |
| H2032 |
Activity therapy, per 15 min |
20,298 |
9,297 |
$0.00 |
| S5130 |
Homaker service nos per 15m |
65,759 |
11,241 |
$0.00 |
| 97161 |
|
22,918 |
7,293 |
$0.00 |
| 99001 |
|
98 |
50 |
$0.00 |
| H0046 |
Mental health service, nos |
34,515 |
7,366 |
$0.00 |
| G0079 |
Care manag h vst new pt 60 m |
12,080 |
6,294 |
$0.00 |
| D4910 |
|
398 |
209 |
$0.00 |
| H0031 |
Mh health assess by non-md |
564 |
176 |
$0.00 |
| D2140 |
|
418 |
213 |
$0.00 |
| D5110 |
|
372 |
190 |
$0.00 |
| D2150 |
|
305 |
158 |
$0.00 |
| G2211 |
Complex e/m visit add on |
24 |
15 |
$0.00 |
| Q5001 |
Hospice or home hlth in home |
52,616 |
6,765 |
$0.00 |
| S5101 |
Adult day care per half day |
112,925 |
9,639 |
$0.00 |
| G0409 |
Corf related serv 15 mins ea |
98,372 |
22,893 |
$0.00 |
| H0033 |
Oral med adm direct observe |
7,015 |
1,735 |
$0.00 |
| 97165 |
|
13,302 |
5,284 |
$0.00 |
| G9473 |
Chap services at hospice |
767 |
376 |
$0.00 |
| S5102 |
Adult day care per diem |
192,766 |
19,163 |
$0.00 |
| 98967 |
|
66,699 |
20,236 |
$0.00 |
| D5410 |
|
502 |
237 |
$0.00 |
| S0220 |
Medical conference by physic |
24,663 |
5,171 |
$0.00 |
| 99305 |
|
10,893 |
4,218 |
$0.00 |
| 92507 |
|
16,334 |
4,008 |
$0.00 |
| T1019 |
Personal care ser per 15 min |
60,084 |
4,290 |
$0.00 |
| 97166 |
|
6,425 |
2,932 |
$0.00 |
| 97162 |
|
14,486 |
5,037 |
$0.00 |
| D7111 |
|
89 |
44 |
$0.00 |
| D5130 |
|
678 |
310 |
$0.00 |
| V5008 |
Hearing screening |
521 |
279 |
$0.00 |
| E0303 |
Hosp bed hvy dty xtra wide |
12 |
12 |
$0.00 |