| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
70,069 |
55,887 |
$9.91M |
| G0470 |
Fqhc visit, mh estab pt |
15,092 |
12,595 |
$2.23M |
| T1040 |
Comm bh clinic svc per diem |
15,726 |
9,189 |
$2.00M |
| 90834 |
|
27,005 |
13,607 |
$1.99M |
| D9450 |
|
43,993 |
25,051 |
$1.40M |
| D1110 |
|
18,013 |
11,860 |
$483K |
| D2740 |
|
946 |
659 |
$464K |
| G0467 |
Fqhc visit, estab pt |
11,566 |
9,106 |
$400K |
| 99395 |
|
2,710 |
2,696 |
$386K |
| D0210 |
|
5,112 |
3,415 |
$191K |
| D0120 |
|
15,066 |
10,006 |
$172K |
| 90791 |
|
1,371 |
1,352 |
$163K |
| D0140 |
|
6,368 |
3,939 |
$151K |
| D2392 |
|
4,128 |
2,302 |
$144K |
| 90832 |
|
3,304 |
2,648 |
$141K |
| 99214 |
|
7,503 |
6,825 |
$131K |
| G2025 |
Dis site tele svcs rhc/fqhc |
8,701 |
5,826 |
$128K |
| 92340 |
|
4,540 |
3,531 |
$127K |
| D0274 |
|
6,399 |
4,271 |
$118K |
| 90853 |
|
3,688 |
1,523 |
$112K |
| 92014 |
|
2,637 |
2,565 |
$105K |
| D2391 |
|
3,673 |
1,843 |
$102K |
| 90682 |
|
1,701 |
1,692 |
$100K |
| 99213 |
|
6,905 |
6,079 |
$93K |
| 91322 |
|
594 |
584 |
$83K |
| 90651 |
|
695 |
687 |
$82K |
| D9110 |
|
3,828 |
2,079 |
$75K |
| D0220 |
|
7,360 |
4,486 |
$64K |
| D0150 |
|
3,094 |
2,059 |
$60K |
| 90750 |
|
426 |
422 |
$60K |
| 99396 |
|
751 |
750 |
$57K |
| 90471 |
|
9,273 |
9,009 |
$57K |
| 92004 |
|
791 |
789 |
$53K |
| D2393 |
|
1,404 |
742 |
$52K |
| 92015 |
|
4,145 |
4,057 |
$49K |
| D2950 |
|
463 |
308 |
$48K |
| 90686 |
|
2,530 |
2,514 |
$46K |
| D7140 |
|
936 |
309 |
$43K |
| 90715 |
|
1,085 |
1,074 |
$35K |
| 92310 |
|
356 |
354 |
$33K |
| 97810 |
|
1,441 |
553 |
$33K |
| 96372 |
|
3,773 |
2,959 |
$32K |
| 99050 |
|
562 |
542 |
$29K |
| 90480 |
|
542 |
531 |
$24K |
| D0270 |
|
3,195 |
2,090 |
$22K |
| 92250 |
|
1,161 |
1,070 |
$18K |
| 90677 |
|
78 |
76 |
$18K |
| D2751 |
|
59 |
30 |
$17K |
| D4341 |
|
1,131 |
306 |
$16K |
| 92341 |
|
458 |
457 |
$16K |
| D2331 |
|
288 |
167 |
$15K |
| 90732 |
|
156 |
154 |
$11K |
| D0230 |
|
1,201 |
646 |
$9K |
| 0011A |
|
222 |
222 |
$9K |
| 0134A |
|
198 |
196 |
$9K |
| D0180 |
|
231 |
226 |
$7K |
| 0012A |
|
138 |
138 |
$6K |
| 90739 |
|
52 |
51 |
$6K |
| 90472 |
|
1,728 |
1,642 |
$6K |
| D2332 |
|
101 |
37 |
$5K |
| D2330 |
|
87 |
62 |
$5K |
| 97811 |
|
153 |
74 |
$5K |
| D2335 |
|
84 |
38 |
$4K |
| 71046 |
|
204 |
202 |
$3K |
| 99385 |
|
29 |
29 |
$3K |
| 90673 |
|
53 |
53 |
$3K |
| 93000 |
|
185 |
183 |
$3K |
| 81025 |
|
392 |
378 |
$2K |
| D0330 |
|
50 |
41 |
$2K |
| 90746 |
|
37 |
37 |
$2K |
| 90734 |
|
26 |
26 |
$2K |
| 81003 |
|
1,050 |
879 |
$2K |
| 99215 |
Prolong outpt/office vis |
98 |
93 |
$2K |
| 77067 |
|
26 |
26 |
$2K |
| 90460 |
|
77 |
76 |
$1K |
| 87880 |
|
116 |
114 |
$1K |
| D2394 |
|
25 |
12 |
$1K |
| 90649 |
|
14 |
14 |
$1K |
| 90630 |
|
61 |
60 |
$996.66 |
| 99211 |
|
47 |
39 |
$990.84 |
| 0064A |
|
20 |
20 |
$825.66 |
| 90632 |
|
13 |
13 |
$778.83 |
| D1206 |
|
29 |
28 |
$696.00 |
| 97026 |
|
65 |
32 |
$674.35 |
| 0124A |
|
14 |
14 |
$642.18 |
| 83036 |
|
64 |
64 |
$534.09 |
| 0004A |
|
12 |
12 |
$504.57 |
| 90656 |
|
16 |
16 |
$265.80 |
| 99443 |
|
78 |
72 |
$212.73 |
| D1354 |
|
19 |
12 |
$210.00 |
| 92370 |
|
23 |
17 |
$201.42 |
| 99442 |
|
40 |
38 |
$166.48 |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
14 |
14 |
$113.96 |
| 81002 |
|
29 |
24 |
$85.96 |
| 86580 |
|
12 |
12 |
$72.48 |
| 87811 |
|
16 |
16 |
$41.38 |
| J1380 |
Estradiol valerate 10 mg inj |
378 |
207 |
$14.53 |
| J1071 |
Inj testosterone cypionate |
1,114 |
613 |
$7.83 |
| D9995 |
|
390 |
193 |
$0.00 |
| Q9992 |
Buprenorphine xr over 100 mg |
116 |
114 |
$0.00 |
| D1330 |
|
863 |
588 |
$0.00 |
| 11980 |
|
68 |
68 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
571 |
558 |
$0.00 |
| 36415 |
|
45 |
44 |
$0.00 |
| 91306 |
|
401 |
400 |
$0.00 |
| 91301 |
|
1,440 |
1,399 |
$0.00 |
| S0302 |
Completed epsdt |
42 |
42 |
$0.00 |
| G0008 |
Admin influenza virus vac |
75 |
75 |
$0.00 |
| 91303 |
|
13 |
13 |
$0.00 |
| J0561 |
Penicillin g benzathine inj |
12 |
12 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral |
183 |
181 |
$0.00 |
| 91313 |
|
85 |
83 |
$0.00 |
| 90679 |
|
13 |
13 |
$0.00 |
| 91300 |
|
194 |
194 |
$0.00 |
| 90611 |
|
454 |
439 |
$0.00 |
| 90749 |
|
87 |
87 |
$0.00 |
| D9944 |
|
14 |
12 |
$0.00 |
| G2211 |
Complex e/m visit add on |
15 |
15 |
$0.00 |
| 46607 |
|
12 |
12 |
$0.00 |
| 99051 |
|
13 |
12 |
$0.00 |
| D9996 |
|
24 |
13 |
$0.00 |
| 46601 |
|
12 |
12 |
$0.00 |