| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
13,535 |
11,781 |
$1.17M |
| G0467 |
Fqhc visit, estab pt |
2,119 |
1,719 |
$77K |
| G0470 |
Fqhc visit, mh estab pt |
1,181 |
807 |
$44K |
| 87635 |
|
768 |
744 |
$38K |
| 90834 |
|
1,357 |
975 |
$28K |
| 99395 |
|
140 |
140 |
$19K |
| 87804 |
|
1,338 |
1,195 |
$18K |
| 87880 |
|
1,298 |
1,172 |
$17K |
| 90677 |
|
112 |
96 |
$11K |
| 92340 |
|
388 |
345 |
$11K |
| 90686 |
|
1,040 |
1,030 |
$9K |
| 87426 |
|
254 |
249 |
$9K |
| 92004 |
|
128 |
125 |
$9K |
| 96127 |
|
897 |
839 |
$8K |
| 99050 |
|
411 |
398 |
$7K |
| 99394 |
|
141 |
140 |
$7K |
| 92015 |
|
619 |
607 |
$7K |
| 90715 |
|
458 |
455 |
$7K |
| 90460 |
|
997 |
965 |
$6K |
| 99391 |
|
149 |
146 |
$6K |
| 92014 |
|
120 |
120 |
$6K |
| 96110 |
|
602 |
552 |
$6K |
| 81025 |
|
770 |
656 |
$6K |
| T1040 |
Comm bh clinic svc per diem |
86 |
75 |
$5K |
| G2023 |
Specimen collect covid-19 |
372 |
360 |
$4K |
| 83036 |
|
535 |
520 |
$4K |
| 99173 |
|
555 |
543 |
$3K |
| 81002 |
|
1,141 |
1,093 |
$3K |
| 99392 |
|
141 |
141 |
$3K |
| 90471 |
|
1,147 |
1,115 |
$3K |
| 99188 |
|
82 |
80 |
$2K |
| 92551 |
|
219 |
212 |
$2K |
| 90750 |
|
18 |
13 |
$2K |
| 99393 |
|
127 |
127 |
$2K |
| 96372 |
|
146 |
142 |
$2K |
| 99384 |
|
20 |
20 |
$1K |
| 97802 |
|
12 |
12 |
$1K |
| 87807 |
|
72 |
71 |
$739.20 |
| 99383 |
|
16 |
15 |
$666.00 |
| 99401 |
|
78 |
78 |
$339.92 |
| 81003 |
|
174 |
169 |
$324.72 |
| 90472 |
|
232 |
222 |
$185.43 |
| 85018 |
|
72 |
72 |
$150.48 |
| 99408 |
|
59 |
56 |
$139.74 |
| 83655 |
|
12 |
12 |
$117.48 |
| D9450 |
|
87 |
85 |
$110.00 |
| 99214 |
|
924 |
859 |
$80.20 |
| 82962 |
|
534 |
516 |
$29.95 |
| 85014 |
|
13 |
13 |
$27.17 |
| 96160 |
|
162 |
156 |
$14.98 |
| V2784 |
Lens polycarb or equal |
62 |
58 |
$0.00 |
| S0302 |
Completed epsdt |
320 |
311 |
$0.00 |
| 99213 |
|
671 |
613 |
$0.00 |
| 36416 |
|
348 |
341 |
$0.00 |
| G8420 |
Calc bmi norm parameters |
455 |
443 |
$0.00 |
| 94760 |
|
799 |
755 |
$0.00 |
| 1000F |
|
921 |
879 |
$0.00 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
452 |
234 |
$0.00 |
| H0049 |
Alcohol/drug screening |
395 |
382 |
$0.00 |
| 99000 |
|
762 |
715 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
12 |
12 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
83 |
81 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
390 |
367 |
$0.00 |
| 90651 |
|
29 |
29 |
$0.00 |
| D0120 |
|
13 |
13 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
2,356 |
2,276 |
$0.00 |
| 90461 |
|
429 |
427 |
$0.00 |
| V2020 |
Vision svcs frames purchases |
483 |
440 |
$0.00 |
| 99051 |
|
384 |
368 |
$0.00 |
| G2212 |
Prolong outpt/office vis |
18 |
18 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
14 |
14 |
$0.00 |
| 90734 |
|
30 |
30 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
119 |
116 |
$0.00 |
| 90633 |
|
31 |
31 |
$0.00 |
| D1110 |
|
18 |
18 |
$0.00 |