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2019 Totals |
Total claims |
Inpatient |
Skilled nursing facility (SNF) |
Home health agency (HHA) |
Hospice |
Outpatient (OP) |
Physician/ Supplier† |
Durable medical equipment (DME)† |
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Table
D.1. Total Medicare* fee-for-service (FFS) reimbursements** (in millions) by
setting 2010–2019 [2019] |
1128985085 |
$138,660 |
$27,171 |
$17,999 |
$20,935 |
$80,902 |
$106,376 |
$8,502 |
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Table
C.1a. Total number of Medicare* fee-for-service (FFS) claims** by setting,
2010–2019 [2019] |
1128985085 |
10668696 |
4451224 |
6203636 |
5423396 |
176142536 |
871655241 |
54440356 |
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Table C.2. Total number of Medicare fee-for-service (FFS) claims paid*
by setting and chronic condition classification, 2010–2019 |
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👇sort by |
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2019
Chronic Condition |
FFS BeneCnt [b2a] |
Prev Rate [b2a] |
Total |
Inpatient |
Skilled nursing facility (SNF) |
Home health agency (HHA) |
Hospice |
Outpatient (OP) |
Physician/ Supplier† |
Durable medical equipment (DME)† |
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|
Hypertension |
18792401 |
59.00% |
862566079 |
9426103 |
4142642 |
5629366 |
2496195 |
130606690 |
666777966 |
43487117 |
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Hyperlipidemia |
15925681 |
50.00% |
729335923 |
7681578 |
3253592 |
4362658 |
1339921 |
106707855 |
570232551 |
35757768 |
|
Rheumatoid
arthritis/Osteoarthritis |
11209201 |
35.20% |
574560844 |
5694847 |
2764970 |
4010474 |
1505701 |
85153686 |
448892970 |
26538196 |
|
Ischemic
heart disease |
8856093 |
27.80% |
484927429 |
6196591 |
2732546 |
3521773 |
1824008 |
69502589 |
375868536 |
25281386 |
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Diabetes |
8771622 |
27.50% |
441514335 |
4953990 |
2247240 |
3009477 |
1332515 |
65066642 |
335425589 |
29478882 |
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Chronic
kidney disease |
8280804 |
26.00% |
483729487 |
6694401 |
3064529 |
3706560 |
1854867 |
70077100 |
370760120 |
27571910 |
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Anemia |
7195348 |
22.60% |
468334606 |
6720383 |
3252814 |
3689784 |
1499762 |
65497050 |
366405456 |
21269357 |
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Depression |
6172840 |
19.40% |
361265084 |
4633013 |
2596586 |
2753183 |
1307141 |
53684155 |
279480973 |
16810033 |
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Benign
prostatic hyperplasia▲ |
2604982 |
18.00% |
142339215 |
1842154 |
844509 |
1001433 |
338558 |
18893486 |
113005701 |
6413374 |
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Cataract |
5614119 |
17.60% |
223580520 |
1436429 |
701280 |
800825 |
267277 |
33277199 |
177729347 |
9368163 |
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Acquired
hypothyroidism |
5262192 |
16.50% |
265556924 |
2868225 |
1399512 |
1792417 |
763608 |
38966693 |
207272169 |
12494300 |
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Heart
failure |
4657176 |
14.60% |
320596690 |
5056078 |
2460439 |
2878148 |
1694227 |
44465295 |
245821323 |
18221180 |
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Chronic
obstructive pulmonary disease |
3730918 |
11.70% |
249764451 |
3831145 |
1693905 |
2084689 |
906988 |
34896546 |
186838628 |
19512550 |
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Alzheimer’s
disease, related disorders, or senile dementia |
3540308 |
11.10% |
207190971 |
3190263 |
2584063 |
2427888 |
2849296 |
25315514 |
162109065 |
8714882 |
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Glaucoma |
3068702 |
9.60% |
126858055 |
828623 |
359440 |
580007 |
172399 |
17968213 |
101375879 |
5573494 |
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Atrial
fibrillation |
2805567 |
8.80% |
188924722 |
2642384 |
1284885 |
1384866 |
532814 |
26974245 |
147602639 |
8502889 |
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Cancer,
prostate▲ |
1091738 |
7.60% |
55175176 |
556139 |
208270 |
267589 |
132986 |
8399742 |
43435019 |
2175431 |
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Osteoporosis |
2291912 |
7.20% |
122262888 |
1301802 |
776968 |
1008452 |
285985 |
18008169 |
95649388 |
5232124 |
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Cancer,
female breast‡ |
1072697 |
6.20% |
58747851 |
544942 |
246766 |
321631 |
140350 |
9822908 |
45479758 |
2191496 |
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Asthma |
1651510 |
5.20% |
106250535 |
1334243 |
466216 |
714843 |
132128 |
15559623 |
81484139 |
6559343 |
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Alzheimer's
disease |
1255744 |
3.90% |
64006860 |
900180 |
869546 |
802394 |
1388030 |
7596831 |
49995073 |
2454806 |
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Stroke/Transient
ischemic attack |
1238014 |
3.90% |
91144419 |
1568654 |
870225 |
781495 |
327054 |
11117055 |
72945621 |
3534315 |
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Cancer,
colorectal |
393852 |
1.20% |
25548512 |
390853 |
154339 |
185025 |
110702 |
4013771 |
19510995 |
1182827 |
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Cancer,
lung |
365414 |
1.10% |
28916384 |
424342 |
129047 |
173821 |
173286 |
4687215 |
21830337 |
1498336 |
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Acute
myocardial infarction |
304933 |
1.00% |
26753484 |
748914 |
237202 |
222456 |
82243 |
3082853 |
21386699 |
993117 |
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Cancer,
endometrial‡ |
125525 |
0.70% |
8085410 |
111682 |
45277 |
52391 |
22152 |
1403046 |
6155865 |
294997 |
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Hip/Pelvic
fracture |
235452 |
0.70% |
20005601 |
497863 |
486933 |
254422 |
114512 |
2034954 |
15921859 |
695058 |
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Cancer,
male breast▲ |
9027 |
0.10% |
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Total Bene Cnt [b2a] |
126523772 |
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Total from each setting |
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6737942455 |
82075821 |
39873741 |
48418067 |
23594705 |
972779125 |
5229393665 |
341807331 |
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Total from Row5 [c1a] color code |
|
|
1128985085 |
10668696 |
4451224 |
6203636 |
5423396 |
176142536 |
871655241 |
54440356 |
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Yellow Row/color code Row |
|
|
5.968141249 |
7.693144598 |
8.957927303 |
7.804788514 |
4.350540694 |
5.5226815 |
5.999383035 |
6.278565317 |
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* The
number of claims represents the total of all FFS claims (regardless of the
diagnosis on the claim) of that type for all beneficiaries who were eligible
for or enrolled in Medicare on or after January 1, YYYY and identified with
that chronic condition. The Chronic Conditions Warehouse (CCW) team has
excluded denied claims for noninstitutional claim types |
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** The CCW
team may have counted beneficiaries in more than one chronic condition
category and/or claim type. |
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NOTE: These
counts consider FFS administrative claims only. The beneficiaries included in
these counts may have any combination of Medicare coverage, including full or
partial FFS and/or health maintenance organization (HMO) coverage. The
application of coverage restrictions/criteria will impact the size of these
samples |
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