| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
251,131 |
204,633 |
$24.71M |
| 00003 |
|
53,882 |
35,598 |
$8.74M |
| 99213 |
|
272,210 |
181,432 |
$1.35M |
| H1001 |
Antepartum management |
17,604 |
12,655 |
$639K |
| 99214 |
|
65,869 |
41,158 |
$637K |
| G0467 |
Fqhc visit, estab pt |
27,763 |
18,656 |
$318K |
| G9012 |
Other specified case mgmt |
1,943 |
879 |
$247K |
| 99212 |
|
80,529 |
53,123 |
$223K |
| 87426 |
|
3,728 |
2,569 |
$51K |
| J3490 |
Drugs unclassified injection |
1,877 |
1,684 |
$44K |
| 99203 |
|
2,952 |
2,158 |
$35K |
| 87428 |
|
2,464 |
1,630 |
$34K |
| J7307 |
Etonogestrel implant system |
130 |
94 |
$31K |
| 81025 |
|
33,026 |
21,917 |
$20K |
| 59409 |
|
91 |
91 |
$20K |
| 99392 |
|
5,536 |
5,533 |
$16K |
| 81002 |
|
64,546 |
35,184 |
$14K |
| G2025 |
Dis site tele svcs rhc/fqhc |
6,419 |
4,533 |
$13K |
| 87811 |
|
571 |
462 |
$13K |
| 59425 |
|
5,308 |
3,627 |
$11K |
| 99243 |
|
672 |
405 |
$9K |
| 99394 |
|
3,185 |
3,176 |
$8K |
| 59430 |
|
130 |
128 |
$8K |
| 99215 |
Prolong outpt/office vis |
1,039 |
600 |
$8K |
| 99393 |
|
4,897 |
4,896 |
$7K |
| 99391 |
|
2,027 |
2,023 |
$6K |
| 99238 |
|
389 |
362 |
$6K |
| H1003 |
Prenatal at risk education |
1,182 |
1,181 |
$5K |
| 90671 |
|
35 |
35 |
$5K |
| J1050 |
Medroxyprogesterone acetate |
1,936 |
1,888 |
$4K |
| Q0091 |
Obtaining screen pap smear |
5,654 |
3,903 |
$4K |
| 99204 |
|
257 |
175 |
$4K |
| S9445 |
Pt education noc individ |
307 |
272 |
$4K |
| 96110 |
|
1,702 |
1,700 |
$3K |
| 90656 |
|
396 |
368 |
$3K |
| 87880 |
|
14,380 |
11,692 |
$2K |
| 99222 |
|
63 |
60 |
$2K |
| 99211 |
|
3,526 |
1,965 |
$2K |
| 99395 |
|
737 |
577 |
$2K |
| 90686 |
|
5,162 |
4,745 |
$2K |
| 87804 |
|
9,357 |
8,062 |
$2K |
| 58300 |
|
30 |
16 |
$2K |
| H1000 |
Prenatal care atrisk assessm |
26 |
26 |
$1K |
| 85018 |
|
19,476 |
17,597 |
$1K |
| J3420 |
Vitamin b12 injection |
3,001 |
2,558 |
$999.31 |
| 0001A |
|
14 |
14 |
$938.00 |
| 83036 |
|
6,204 |
4,803 |
$922.62 |
| 99233 |
Prolong inpt eval add15 m |
28 |
25 |
$870.20 |
| 11982 |
|
43 |
27 |
$809.49 |
| 90619 |
|
696 |
692 |
$783.00 |
| 99000 |
|
831 |
511 |
$675.18 |
| 90697 |
|
714 |
711 |
$675.00 |
| 11981 |
|
19 |
12 |
$608.27 |
| 99188 |
|
2,230 |
2,230 |
$522.00 |
| J1885 |
Ketorolac tromethamine inj |
2,642 |
1,762 |
$513.45 |
| 92551 |
|
9,148 |
9,084 |
$478.59 |
| A4550 |
Surgical trays |
148 |
94 |
$438.91 |
| 90715 |
|
285 |
199 |
$401.50 |
| 99174 |
|
3,396 |
3,391 |
$280.50 |
| 99202 |
|
69 |
46 |
$277.13 |
| 90662 |
|
185 |
163 |
$262.00 |
| 83655 |
|
2,121 |
2,121 |
$233.75 |
| 82947 |
|
797 |
564 |
$204.60 |
| J1100 |
Dexamethasone sodium phos |
194 |
190 |
$164.89 |
| 99396 |
|
285 |
247 |
$128.23 |
| 99173 |
|
6,679 |
6,593 |
$120.90 |
| 90680 |
|
57 |
57 |
$108.00 |
| 86580 |
|
2,275 |
1,987 |
$94.93 |
| 93000 |
|
293 |
197 |
$87.54 |
| J3301 |
Triamcinolone acet inj nos |
567 |
512 |
$83.43 |
| 87420 |
|
742 |
720 |
$80.26 |
| 90381 |
|
15 |
15 |
$72.00 |
| 90620 |
|
32 |
25 |
$54.00 |
| J1750 |
Inj iron dextran |
145 |
106 |
$51.84 |
| 90633 |
|
319 |
317 |
$36.00 |
| 92227 |
|
116 |
97 |
$27.82 |
| 90688 |
|
712 |
511 |
$13.76 |
| 90651 |
|
165 |
165 |
$9.00 |
| G0008 |
Admin influenza virus vac |
197 |
159 |
$6.00 |
| 98941 |
|
44 |
43 |
$3.96 |
| 3077F |
|
5,266 |
3,691 |
$0.00 |
| 3078F |
|
33,587 |
21,174 |
$0.00 |
| 98940 |
|
12 |
12 |
$0.00 |
| 90670 |
|
322 |
319 |
$0.00 |
| Z6400 |
|
523 |
523 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| 86703 |
|
37 |
22 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 3079F |
|
9,623 |
6,562 |
$0.00 |
| 3074F |
|
34,169 |
21,382 |
$0.00 |
| 3075F |
|
6,283 |
4,424 |
$0.00 |
| Z1034 |
|
23,077 |
16,556 |
$0.00 |
| 88720 |
|
20 |
12 |
$0.00 |
| 99024 |
|
17 |
14 |
$0.00 |
| 3080F |
|
2,945 |
2,084 |
$0.00 |
| Z1032 |
|
445 |
441 |
$0.00 |
| 90723 |
|
84 |
83 |
$0.00 |
| 94640 |
|
299 |
243 |
$0.00 |
| Z1038 |
|
128 |
123 |
$0.00 |
| 90647 |
|
126 |
126 |
$0.00 |
| 88142 |
|
16 |
16 |
$0.00 |
| 86780 |
|
44 |
24 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
33 |
28 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |