| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,446 |
1,432 |
$208K |
| S5161 |
Emer rspns sys serv permonth |
2,135 |
2,095 |
$54K |
| 97124 |
|
466 |
201 |
$47K |
| S5130 |
Homaker service nos per 15m |
22,410 |
4,298 |
$21K |
| E0431 |
Portable gaseous 02 |
392 |
390 |
$10K |
| K0738 |
Portable gas oxygen system |
174 |
174 |
$8K |
| 90834 |
|
614 |
439 |
$7K |
| 99214 |
|
884 |
750 |
$4K |
| T1019 |
Personal care ser per 15 min |
151,100 |
3,729 |
$1K |
| 85025 |
|
165 |
160 |
$947.94 |
| 90837 |
|
225 |
164 |
$560.00 |
| 84443 |
|
27 |
26 |
$453.60 |
| 80048 |
|
53 |
51 |
$397.62 |
| A0425 |
Ground mileage |
15 |
12 |
$228.16 |
| 87635 |
|
81 |
73 |
$102.62 |
| 90832 |
|
944 |
651 |
$82.00 |
| 80053 |
|
12 |
12 |
$52.80 |
| 97803 |
|
292 |
282 |
$42.43 |
| A0130 |
Noner transport wheelch van |
54,032 |
5,405 |
$32.00 |
| T1002 |
Rn services up to 15 minutes |
4,570 |
2,707 |
$30.60 |
| S9470 |
Nutritional counseling, diet |
325 |
265 |
$0.00 |
| S5170 |
Homedelivered prepared meal |
1,362 |
1,270 |
$0.00 |
| G0162 |
Hhc rn e&m plan svs, 15 min |
1,531 |
1,224 |
$0.00 |
| 98968 |
|
931 |
660 |
$0.00 |
| T1003 |
Lpn/lvn services up to 15min |
1,443 |
935 |
$0.00 |
| 99367 |
|
3,718 |
2,505 |
$0.00 |
| 69210 |
|
60 |
54 |
$0.00 |
| 97116 |
|
595 |
236 |
$0.00 |
| 97530 |
|
1,239 |
746 |
$0.00 |
| S9127 |
Social work visit, in the ho |
425 |
322 |
$0.00 |
| G0175 |
Opps service,sched team conf |
13,201 |
5,661 |
$0.00 |
| 98969 |
|
1,075 |
358 |
$0.00 |
| 99442 |
|
141 |
104 |
$0.00 |
| 99211 |
|
7,350 |
3,954 |
$0.00 |
| 97110 |
|
2,776 |
1,125 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
96 |
90 |
$0.00 |
| T1001 |
Nursing assessment/evaluatn |
1,603 |
1,326 |
$0.00 |
| G0163 |
Hhc lpn/rn obs/asses ea 15 |
698 |
393 |
$0.00 |
| S9986 |
Not medically necessary svc |
1,039 |
998 |
$0.00 |
| 99490 |
Ccm add 20min |
65 |
38 |
$0.00 |
| 97164 |
|
636 |
618 |
$0.00 |
| 96152 |
|
540 |
362 |
$0.00 |
| 98966 |
|
13,321 |
5,071 |
$0.00 |
| 90658 |
|
174 |
171 |
$0.00 |
| 97799 |
|
843 |
229 |
$0.00 |
| A9901 |
Delivery/set up/dispensing |
107 |
82 |
$0.00 |
| 97168 |
|
225 |
221 |
$0.00 |
| 99212 |
|
78 |
66 |
$0.00 |
| H2032 |
Activity therapy, per 15 min |
252 |
199 |
$0.00 |
| 97161 |
|
128 |
119 |
$0.00 |
| 81002 |
|
134 |
127 |
$0.00 |
| D4910 |
|
18 |
18 |
$0.00 |
| D0180 |
|
13 |
13 |
$0.00 |
| 97150 |
|
313 |
96 |
$0.00 |
| 99487 |
Ccm add 20min |
25 |
19 |
$0.00 |
| K0739 |
Repair/svc dme non-oxygen eq |
12 |
12 |
$0.00 |
| 11719 |
|
18 |
18 |
$0.00 |
| S0390 |
Rout foot care per visit |
12 |
12 |
$0.00 |
| 99000 |
|
392 |
347 |
$0.00 |
| 96151 |
|
1,124 |
1,091 |
$0.00 |
| G0494 |
Lpn care ea 15min hh/hospice |
240 |
231 |
$0.00 |
| T1502 |
Medication admin visit |
801 |
398 |
$0.00 |
| 99213 |
|
931 |
783 |
$0.00 |
| T1503 |
Med admin, not oral/inject |
813 |
127 |
$0.00 |
| S5101 |
Adult day care per half day |
3,735 |
3,648 |
$0.00 |
| 96372 |
|
841 |
417 |
$0.00 |
| S5185 |
Med reminder serv per month |
6,389 |
6,056 |
$0.00 |
| 98967 |
|
2,851 |
1,849 |
$0.00 |
| 83036 |
|
132 |
127 |
$0.00 |
| 97112 |
|
207 |
113 |
$0.00 |
| G0164 |
Hhc lis nurse train ea 15 |
338 |
244 |
$0.00 |
| G0299 |
Hhs/hospice of rn ea 15 min |
2,774 |
1,765 |
$0.00 |
| A0120 |
Noner transport mini-bus |
3,794 |
525 |
$0.00 |
| T1004 |
Nsg aide service up to 15min |
20,146 |
818 |
$0.00 |
| G0506 |
Comp asses care plan ccm svc |
1,106 |
1,077 |
$0.00 |
| 99510 |
|
198 |
109 |
$0.00 |
| G0300 |
Hhs/hospice of lpn ea 15 min |
1,183 |
792 |
$0.00 |
| G0493 |
Rn care ea 15 min hh/hospice |
1,955 |
1,327 |
$0.00 |
| S9977 |
Meals per diem |
1,668 |
1,434 |
$0.00 |
| T1016 |
Case management |
11,996 |
4,765 |
$0.00 |
| 97010 |
|
183 |
89 |
$0.00 |
| G0151 |
Hhcp-serv of pt,ea 15 min |
909 |
596 |
$0.00 |
| 97535 |
|
754 |
497 |
$0.00 |
| S9445 |
Pt education noc individ |
868 |
660 |
$0.00 |
| 97166 |
|
73 |
73 |
$0.00 |
| 97165 |
|
374 |
363 |
$0.00 |
| E1399 |
Durable medical equipment mi |
14 |
12 |
$0.00 |
| D1206 |
|
28 |
28 |
$0.00 |
| 36415 |
|
2,160 |
1,777 |
$0.00 |
| G0008 |
Admin influenza virus vac |
262 |
253 |
$0.00 |
| S9097 |
Home visit wound care |
1,297 |
376 |
$0.00 |
| 97139 |
|
145 |
121 |
$0.00 |
| 99441 |
|
103 |
87 |
$0.00 |
| D1330 |
|
65 |
62 |
$0.00 |
| 97140 |
|
166 |
100 |
$0.00 |
| G9473 |
Chap services at hospice |
40 |
38 |
$0.00 |
| S0257 |
End of life counseling |
37 |
37 |
$0.00 |
| 99443 |
|
18 |
17 |
$0.00 |
| S5102 |
Adult day care per diem |
134 |
131 |
$0.00 |
| 99368 |
|
107 |
94 |
$0.00 |
| G0155 |
Hhcp-svs of csw,ea 15 min |
72 |
60 |
$0.00 |
| 99366 |
|
60 |
55 |
$0.00 |
| 97162 |
|
24 |
24 |
$0.00 |