| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
222,426 |
193,502 |
$39.43M |
| 00003 |
|
5,159 |
4,163 |
$1.15M |
| 92012 |
|
51,078 |
34,110 |
$732K |
| 92014 |
|
36,124 |
25,539 |
$691K |
| G0467 |
Fqhc visit, estab pt |
27,111 |
15,441 |
$582K |
| 99213 |
|
130,233 |
76,924 |
$498K |
| 90832 |
|
20,197 |
8,204 |
$375K |
| 92004 |
|
12,127 |
7,907 |
$274K |
| 99214 |
|
38,887 |
25,276 |
$253K |
| 90791 |
|
4,660 |
2,502 |
$189K |
| 92002 |
|
6,492 |
4,338 |
$138K |
| 99212 |
|
32,926 |
19,613 |
$122K |
| 0011A |
|
2,114 |
1,264 |
$84K |
| 0012A |
|
1,749 |
1,095 |
$80K |
| 96110 |
|
1,539 |
1,074 |
$30K |
| 99392 |
|
4,280 |
2,829 |
$24K |
| 99393 |
|
2,742 |
1,872 |
$24K |
| 0001A |
|
359 |
235 |
$18K |
| G9008 |
Mccd,phys coor-care ovrsght |
131 |
75 |
$16K |
| 99394 |
|
1,478 |
973 |
$14K |
| 0013A |
|
262 |
143 |
$14K |
| 0002A |
|
266 |
168 |
$14K |
| 99202 |
|
1,393 |
976 |
$12K |
| 99203 |
|
3,675 |
2,368 |
$12K |
| 90686 |
|
5,424 |
4,349 |
$12K |
| 92015 |
|
3,626 |
2,498 |
$12K |
| G0466 |
Fqhc visit new patient |
371 |
203 |
$11K |
| 99391 |
|
1,997 |
1,409 |
$10K |
| 87635 |
|
596 |
582 |
$10K |
| 90792 |
|
249 |
174 |
$9K |
| 90460 |
|
7,192 |
5,233 |
$8K |
| 92552 |
|
1,877 |
1,296 |
$8K |
| 0003A |
|
113 |
60 |
$6K |
| 92133 |
|
411 |
249 |
$6K |
| 90715 |
|
835 |
572 |
$5K |
| 99204 |
|
1,034 |
676 |
$4K |
| G0470 |
Fqhc visit, mh estab pt |
144 |
61 |
$4K |
| 92551 |
|
2,766 |
1,836 |
$4K |
| 0071A |
|
64 |
32 |
$3K |
| 81002 |
|
9,424 |
5,741 |
$3K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
1,312 |
1,311 |
$3K |
| 90694 |
|
162 |
134 |
$3K |
| 0072A |
|
58 |
29 |
$3K |
| 96372 |
|
1,290 |
891 |
$3K |
| 90674 |
|
1,471 |
991 |
$3K |
| 90471 |
|
14,274 |
9,645 |
$3K |
| 90688 |
|
435 |
365 |
$3K |
| 83036 |
|
3,847 |
2,606 |
$2K |
| 99396 |
|
321 |
205 |
$2K |
| 90837 |
|
28 |
12 |
$2K |
| 85018 |
|
7,419 |
4,834 |
$2K |
| 99244 |
|
119 |
86 |
$2K |
| 87426 |
|
55 |
53 |
$2K |
| 80305 |
|
911 |
419 |
$2K |
| 99173 |
|
5,115 |
3,241 |
$2K |
| G2025 |
Dis site tele svcs rhc/fqhc |
2,222 |
1,772 |
$2K |
| 98941 |
|
1,658 |
1,079 |
$2K |
| 90670 |
|
1,823 |
1,267 |
$1K |
| 92083 |
|
124 |
72 |
$1K |
| G9012 |
Other specified case mgmt |
13 |
13 |
$1K |
| 99215 |
Prolong outpt/office vis |
194 |
127 |
$1K |
| 98940 |
|
839 |
553 |
$1K |
| 90647 |
|
1,680 |
1,096 |
$1K |
| 90746 |
|
73 |
50 |
$1K |
| 0134A |
|
31 |
28 |
$1K |
| 90633 |
|
1,309 |
861 |
$1K |
| 81025 |
|
1,699 |
1,101 |
$1K |
| 87880 |
|
290 |
213 |
$1K |
| 90723 |
|
1,190 |
829 |
$990.00 |
| 82962 |
|
1,963 |
1,337 |
$982.64 |
| 99395 |
|
246 |
159 |
$977.50 |
| 90461 |
|
2,799 |
2,007 |
$768.28 |
| H1002 |
Carecoordination prenatal |
24 |
24 |
$679.15 |
| 99211 |
|
288 |
258 |
$670.89 |
| 93000 |
|
365 |
225 |
$609.74 |
| 90680 |
|
631 |
453 |
$549.27 |
| 90834 |
|
27 |
17 |
$537.28 |
| J3490 |
Drugs unclassified injection |
37 |
25 |
$510.04 |
| 90651 |
|
701 |
460 |
$504.00 |
| 1036F |
|
34,143 |
20,642 |
$437.78 |
| G9919 |
Scrn nd pos nd prov of rec |
17 |
17 |
$406.00 |
| 90472 |
|
5,071 |
3,302 |
$338.49 |
| 90734 |
|
424 |
284 |
$225.00 |
| 90671 |
|
503 |
344 |
$213.81 |
| 99382 |
|
105 |
77 |
$157.20 |
| 97813 |
|
373 |
182 |
$156.33 |
| 96127 |
|
655 |
434 |
$153.87 |
| 90656 |
|
207 |
154 |
$125.70 |
| 90710 |
|
743 |
480 |
$108.81 |
| 86580 |
|
70 |
60 |
$97.44 |
| 99381 |
|
93 |
69 |
$90.66 |
| 90621 |
|
55 |
39 |
$65.36 |
| 90696 |
|
173 |
105 |
$54.54 |
| 90661 |
|
128 |
89 |
$50.00 |
| 90697 |
|
383 |
265 |
$45.27 |
| 97814 |
|
291 |
133 |
$40.53 |
| 90700 |
|
92 |
57 |
$36.00 |
| J1885 |
Ketorolac tromethamine inj |
361 |
248 |
$26.59 |
| 87400 |
|
65 |
61 |
$23.16 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
23 |
20 |
$19.92 |
| S0197 |
Prenatal vitamins 30 day |
16 |
13 |
$4.05 |
| 1159F |
|
31,096 |
19,842 |
$0.22 |
| G8754 |
Dias bp less 90 |
3,463 |
2,132 |
$0.20 |
| G8752 |
Sys bp less 140 |
3,261 |
1,973 |
$0.20 |
| 1034F |
|
705 |
420 |
$0.04 |
| G8755 |
Dias bp > or = 90 |
575 |
350 |
$0.04 |
| G8753 |
Sys bp > or = 140 |
775 |
496 |
$0.03 |
| 3051F |
|
606 |
407 |
$0.03 |
| 2022F |
|
4,482 |
2,555 |
$0.02 |
| 3075F |
|
5,587 |
3,602 |
$0.00 |
| 2001F |
|
31,392 |
19,583 |
$0.00 |
| 3008F |
|
31,387 |
19,581 |
$0.00 |
| 1126F |
|
2,421 |
1,565 |
$0.00 |
| 3044F |
|
875 |
579 |
$0.00 |
| G0008 |
Admin influenza virus vac |
97 |
97 |
$0.00 |
| 3079F |
|
8,167 |
5,188 |
$0.00 |
| 3074F |
|
19,870 |
12,521 |
$0.00 |
| 99383 |
|
283 |
183 |
$0.00 |
| 91301 |
|
410 |
335 |
$0.00 |
| 3080F |
|
3,068 |
1,895 |
$0.00 |
| 90619 |
|
43 |
27 |
$0.00 |
| 90716 |
|
63 |
38 |
$0.00 |
| 90474 |
|
30 |
30 |
$0.00 |
| 3052F |
|
321 |
199 |
$0.00 |
| 1125F |
|
888 |
572 |
$0.00 |
| 99384 |
|
136 |
97 |
$0.00 |
| 90732 |
|
14 |
13 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
13 |
13 |
$0.00 |
| 0501F |
|
19 |
14 |
$0.00 |
| 3078F |
|
18,995 |
12,054 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
351 |
246 |
$0.00 |
| 0502F |
|
259 |
137 |
$0.00 |
| 90658 |
|
61 |
41 |
$0.00 |
| 3046F |
|
538 |
339 |
$0.00 |
| 90473 |
|
79 |
46 |
$0.00 |
| Z6500 |
|
13 |
13 |
$0.00 |
| 3077F |
|
4,818 |
3,046 |
$0.00 |
| 4004F |
|
55 |
35 |
$0.00 |
| 90707 |
|
41 |
25 |
$0.00 |