| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2030 |
Assisted living, waiver; per month |
5,165 |
4,645 |
$8.17M |
| T2031 |
Assisted living; waiver, per diem |
978 |
931 |
$2.16M |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
5,312 |
4,217 |
$514K |
| E1392 |
Portable oxygen concentrator, rental |
3,145 |
2,589 |
$398K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,871 |
2,680 |
$296K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
658 |
579 |
$221K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
7,942 |
6,557 |
$139K |
| T2033 |
Residential care, not otherwise specified (nos), waiver; per diem |
74 |
67 |
$109K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,740 |
1,512 |
$103K |
| 11719 |
|
4,018 |
1,934 |
$96K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36,687 |
11,716 |
$85K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
47 |
47 |
$48K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
369 |
362 |
$42K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
153 |
107 |
$36K |
| A0425 |
Ground mileage, per statute mile |
1,551 |
1,221 |
$33K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
111 |
100 |
$31K |
| 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 |
500 |
238 |
$30K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,608 |
1,584 |
$27K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
942 |
933 |
$27K |
| E0277 |
Powered pressure-reducing air mattress |
298 |
248 |
$26K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
1,091 |
806 |
$24K |
| 80053 |
Comprehensive metabolic panel |
2,171 |
2,104 |
$21K |
| 99070 |
|
388 |
283 |
$20K |
| D9410 |
|
216 |
215 |
$19K |
| E0444 |
Portable oxygen contents, liquid, 1 month's supply = 1 unit |
386 |
364 |
$18K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,659 |
2,514 |
$17K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
535 |
172 |
$17K |
| D7140 |
Extraction, erupted tooth or exposed root |
46 |
13 |
$17K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
915 |
869 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,690 |
1,666 |
$15K |
| 11721 |
|
366 |
323 |
$14K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
710 |
685 |
$13K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
291 |
267 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
913 |
545 |
$12K |
| V5160 |
Dispensing fee, binaural |
24 |
24 |
$12K |
| 90837 |
Psychotherapy, 53 minutes with patient |
7,851 |
2,688 |
$12K |
| 80061 |
Lipid panel |
897 |
882 |
$11K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
189 |
187 |
$10K |
| E0570 |
Nebulizer, with compressor |
787 |
745 |
$9K |
| 82607 |
|
521 |
510 |
$8K |
| 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 |
144 |
117 |
$7K |
| D0274 |
Bitewings - four radiographic images |
88 |
76 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
762 |
710 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
42 |
40 |
$5K |
| 11720 |
|
79 |
78 |
$5K |
| 99334 |
|
76 |
37 |
$5K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
278 |
24 |
$4K |
| 84439 |
|
622 |
613 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
84 |
81 |
$4K |
| 98960 |
|
24 |
23 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
26 |
26 |
$3K |
| A7030 |
Full face mask used with positive airway pressure device, each |
34 |
33 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
36,442 |
7,931 |
$3K |
| R0070 |
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen |
34 |
32 |
$3K |
| V2020 |
Frames, purchases |
44 |
41 |
$3K |
| 83970 |
|
57 |
57 |
$3K |
| 92591 |
|
26 |
26 |
$3K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
91 |
91 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
30 |
30 |
$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) |
367 |
310 |
$2K |
| 82746 |
|
97 |
96 |
$2K |
| V5299 |
Hearing service, miscellaneous |
64 |
62 |
$2K |
| 82728 |
|
100 |
100 |
$2K |
| D0180 |
|
43 |
43 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
14 |
$1K |
| Q0092 |
Set-up portable x-ray equipment |
55 |
50 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
150 |
146 |
$1K |
| 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 |
214 |
188 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
27 |
26 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
192 |
187 |
$1K |
| 83550 |
|
130 |
128 |
$1K |
| V5011 |
Fitting/orientation/checking of hearing aid |
26 |
26 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
528 |
311 |
$1K |
| 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 |
106 |
58 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19,888 |
9,747 |
$1K |
| 92015 |
Determination of refractive state |
49 |
48 |
$981.65 |
| 83540 |
|
137 |
135 |
$945.63 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
23 |
15 |
$922.78 |
| E1353 |
Regulator |
167 |
154 |
$891.00 |
| S9999 |
Sales tax |
283 |
273 |
$887.40 |
| A7037 |
Tubing used with positive airway pressure device |
33 |
33 |
$837.87 |
| 87186 |
|
71 |
70 |
$800.47 |
| D1208 |
Topical application of fluoride, excluding varnish |
89 |
87 |
$794.77 |
| 87088 |
|
73 |
73 |
$709.68 |
| 81001 |
|
212 |
208 |
$676.26 |
| D1110 |
Prophylaxis - adult |
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 |
Non-emergency transportation: wheelchair van |
1,056,344 |
40,144 |
$514.54 |
| D0120 |
Periodic oral evaluation - established patient |
2,006 |
1,124 |
$490.00 |
| 82043 |
|
66 |
65 |
$460.20 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
12 |
12 |
$424.08 |
| 92700 |
|
16 |
16 |
$400.00 |
| 84100 |
|
63 |
56 |
$325.86 |
| A7035 |
Headgear used with positive airway pressure device |
14 |
14 |
$321.44 |
| E1354 |
Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each |
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 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
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 by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes |
2,342 |
1,135 |
$0.00 |
| G0422 |
Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session |
16,963 |
1,946 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
23,826 |
11,260 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
2,349 |
1,123 |
$0.00 |
| T1001 |
Nursing assessment / evaluation |
37,578 |
15,784 |
$0.00 |
| H0032 |
Mental health service plan development by non-physician |
4,135 |
1,400 |
$0.00 |
| H2032 |
Activity therapy, per 15 minutes |
20,298 |
9,297 |
$0.00 |
| S5130 |
Homemaker service, nos; per 15 minutes |
65,759 |
11,241 |
$0.00 |
| 97161 |
|
22,918 |
7,293 |
$0.00 |
| 99001 |
|
98 |
50 |
$0.00 |
| H0046 |
Mental health services, not otherwise specified |
34,515 |
7,366 |
$0.00 |
| G0079 |
Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility) |
12,080 |
6,294 |
$0.00 |
| D4910 |
|
398 |
209 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
564 |
176 |
$0.00 |
| D2140 |
|
418 |
213 |
$0.00 |
| D5110 |
|
372 |
190 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
305 |
158 |
$0.00 |
| 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) |
24 |
15 |
$0.00 |
| Q5001 |
Hospice or home health care provided in patient's home/residence |
52,616 |
6,765 |
$0.00 |
| S5101 |
Day care services, adult; per half day |
112,925 |
9,639 |
$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) |
98,372 |
22,893 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
7,015 |
1,735 |
$0.00 |
| 97165 |
|
13,302 |
5,284 |
$0.00 |
| G9473 |
Services performed by chaplain in the hospice setting, each 15 minutes |
767 |
376 |
$0.00 |
| S5102 |
Day care services, adult; per diem |
192,766 |
19,163 |
$0.00 |
| 98967 |
|
66,699 |
20,236 |
$0.00 |
| D5410 |
|
502 |
237 |
$0.00 |
| S0220 |
Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes |
24,663 |
5,171 |
$0.00 |
| 99305 |
|
10,893 |
4,218 |
$0.00 |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
16,334 |
4,008 |
$0.00 |
| T1019 |
Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) |
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 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
12 |
12 |
$0.00 |