| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0467 |
Fqhc visit, estab pt |
15,087 |
13,269 |
$565K |
| 99214 |
|
7,998 |
7,519 |
$337K |
| S0280 |
Medical home, initial plan |
461 |
460 |
$133K |
| 99213 |
|
4,441 |
3,975 |
$107K |
| 90837 |
|
654 |
423 |
$52K |
| 99215 |
Prolong outpt/office vis |
692 |
670 |
$43K |
| H0004 |
Alcohol and/or drug services |
937 |
769 |
$33K |
| 99212 |
|
976 |
931 |
$23K |
| 90834 |
|
256 |
197 |
$14K |
| 90832 |
|
326 |
266 |
$13K |
| 80305 |
|
1,472 |
1,334 |
$13K |
| 87635 |
|
306 |
296 |
$11K |
| G0470 |
Fqhc visit, mh estab pt |
1,575 |
959 |
$9K |
| 96372 |
|
1,366 |
1,165 |
$8K |
| 20552 |
|
258 |
203 |
$7K |
| G0468 |
Fqhc visit, ippe or awv |
85 |
85 |
$5K |
| H0001 |
Alcohol and/or drug assess |
25 |
25 |
$5K |
| J1040 |
Methylprednisolone 80 mg inj |
400 |
370 |
$4K |
| G0466 |
Fqhc visit new patient |
42 |
42 |
$3K |
| 90686 |
|
318 |
315 |
$3K |
| 90471 |
|
516 |
511 |
$3K |
| 0012A |
|
77 |
77 |
$3K |
| 0011A |
|
86 |
86 |
$2K |
| 99417 |
Prolong home eval add 15m |
54 |
47 |
$2K |
| 98925 |
|
91 |
88 |
$829.21 |
| 98966 |
|
93 |
86 |
$772.83 |
| 90656 |
|
31 |
31 |
$648.15 |
| 0134A |
|
17 |
17 |
$619.76 |
| 36415 |
|
339 |
330 |
$576.46 |
| J1010 |
Inj, methylpred acetate 1 mg |
72 |
67 |
$509.80 |
| 0064A |
|
13 |
13 |
$492.05 |
| 0002A |
|
12 |
12 |
$454.20 |
| J3301 |
Triamcinolone acet inj nos |
26 |
26 |
$94.62 |
| 96127 |
|
21 |
19 |
$56.62 |
| S0281 |
Medical home, maintenance |
914 |
910 |
$0.00 |
| 3074F |
|
1,600 |
1,552 |
$0.00 |
| 3075F |
|
666 |
650 |
$0.00 |
| 3080F |
|
190 |
187 |
$0.00 |
| 3079F |
|
950 |
926 |
$0.00 |
| 91301 |
|
214 |
203 |
$0.00 |
| 99000 |
|
52 |
32 |
$0.00 |
| 3078F |
|
1,410 |
1,374 |
$0.00 |
| 3077F |
|
350 |
347 |
$0.00 |
| 87804 |
|
12 |
12 |
$0.00 |
| 99392 |
|
13 |
13 |
$0.00 |
| 91300 |
|
29 |
27 |
$0.00 |