| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
378,687 |
283,974 |
$56.58M |
| 59400 |
|
1,901 |
1,900 |
$4.02M |
| D9450 |
|
116,640 |
62,176 |
$2.70M |
| 99391 |
|
17,573 |
16,509 |
$2.43M |
| 99392 |
|
12,485 |
12,463 |
$1.68M |
| 99213 |
|
51,160 |
42,955 |
$1.46M |
| G0467 |
Fqhc visit, estab pt |
39,504 |
29,640 |
$1.28M |
| 99393 |
|
8,963 |
8,946 |
$1.27M |
| 99395 |
|
7,324 |
7,232 |
$1.15M |
| T1040 |
Comm bh clinic svc per diem |
7,737 |
5,165 |
$1.01M |
| 99394 |
|
6,691 |
6,672 |
$972K |
| 59510 |
|
374 |
373 |
$880K |
| 90460 |
|
41,258 |
37,293 |
$568K |
| 92014 |
|
11,908 |
11,880 |
$538K |
| 96110 |
|
48,285 |
41,645 |
$464K |
| 90739 |
|
3,259 |
3,238 |
$440K |
| 99214 |
|
13,490 |
12,353 |
$399K |
| J7307 |
Etonogestrel implant system |
988 |
982 |
$391K |
| G0470 |
Fqhc visit, mh estab pt |
9,037 |
5,533 |
$385K |
| D0140 |
|
17,947 |
9,699 |
$383K |
| D9110 |
|
16,431 |
8,450 |
$380K |
| 99050 |
|
7,709 |
7,457 |
$358K |
| D7140 |
|
8,244 |
2,791 |
$327K |
| D0220 |
|
36,125 |
19,611 |
$309K |
| 0001A |
|
6,766 |
6,726 |
$273K |
| 81025 |
|
39,767 |
36,562 |
$270K |
| 0002A |
|
6,081 |
6,061 |
$257K |
| 90834 |
|
7,453 |
5,107 |
$253K |
| D1110 |
|
15,804 |
10,524 |
$252K |
| G2023 |
Specimen collect covid-19 |
8,370 |
7,835 |
$246K |
| 59025 |
|
12,850 |
4,223 |
$244K |
| 99173 |
|
15,703 |
15,450 |
$243K |
| 90715 |
|
10,546 |
10,511 |
$238K |
| 90651 |
|
6,525 |
6,491 |
$237K |
| 92340 |
|
8,745 |
8,340 |
$230K |
| 59409 |
|
269 |
268 |
$228K |
| 90461 |
|
20,747 |
20,351 |
$228K |
| 90677 |
|
3,170 |
3,164 |
$226K |
| D2391 |
|
14,568 |
6,643 |
$223K |
| 90471 |
|
36,140 |
35,192 |
$215K |
| 90746 |
|
3,216 |
3,182 |
$206K |
| D0210 |
|
11,759 |
8,068 |
$203K |
| D0230 |
|
29,358 |
10,290 |
$202K |
| D5212 |
|
1,625 |
915 |
$174K |
| 99460 |
|
2,619 |
2,562 |
$165K |
| 99212 |
|
8,131 |
7,217 |
$163K |
| 90750 |
|
1,242 |
1,237 |
$162K |
| D2392 |
|
8,370 |
4,922 |
$160K |
| 92012 |
|
3,601 |
3,306 |
$158K |
| 90686 |
|
24,256 |
24,200 |
$157K |
| 99462 |
|
4,679 |
2,697 |
$157K |
| 92015 |
|
13,959 |
13,931 |
$157K |
| D5211 |
|
1,592 |
867 |
$150K |
| 99396 |
|
1,946 |
1,920 |
$146K |
| 90670 |
|
10,732 |
10,703 |
$145K |
| 90832 |
|
7,360 |
5,491 |
$144K |
| 87636 |
|
1,209 |
1,185 |
$139K |
| 99211 |
|
4,342 |
2,712 |
$138K |
| 92341 |
|
4,089 |
4,079 |
$137K |
| D0120 |
|
17,214 |
12,406 |
$133K |
| 82947 |
|
42,394 |
35,859 |
$118K |
| 83036 |
|
17,214 |
16,811 |
$116K |
| D0274 |
|
9,308 |
6,993 |
$112K |
| D0150 |
|
10,444 |
6,921 |
$109K |
| 97802 |
|
2,325 |
2,312 |
$106K |
| D2740 |
|
971 |
469 |
$102K |
| 92551 |
|
10,857 |
10,808 |
$101K |
| D4341 |
|
5,136 |
1,872 |
$95K |
| 81002 |
|
36,183 |
28,961 |
$93K |
| 92004 |
|
1,322 |
1,320 |
$89K |
| 87426 |
|
3,328 |
3,279 |
$88K |
| 0012A |
|
2,281 |
2,275 |
$85K |
| 87635 |
|
1,583 |
1,556 |
$80K |
| 59514 |
|
75 |
75 |
$74K |
| 80306 |
|
6,131 |
3,568 |
$70K |
| 87880 |
|
5,458 |
5,389 |
$69K |
| 0011A |
|
2,388 |
2,379 |
$67K |
| 87804 |
|
5,349 |
3,349 |
$66K |
| D1206 |
|
3,293 |
2,525 |
$65K |
| J0561 |
Penicillin g benzathine inj |
220 |
162 |
$64K |
| J1050 |
Medroxyprogesterone acetate |
3,668 |
3,625 |
$64K |
| 87502 |
|
1,838 |
1,820 |
$63K |
| D1120 |
|
1,437 |
1,260 |
$63K |
| D7210 |
|
763 |
358 |
$63K |
| D2331 |
|
2,880 |
1,656 |
$58K |
| D0330 |
|
1,564 |
868 |
$57K |
| 99385 |
|
341 |
339 |
$56K |
| D2330 |
|
3,150 |
1,462 |
$56K |
| 11981 |
|
491 |
488 |
$54K |
| 80305 |
|
6,505 |
4,292 |
$53K |
| 90662 |
|
1,594 |
1,585 |
$52K |
| D2393 |
|
2,660 |
1,712 |
$51K |
| 96372 |
|
7,986 |
7,348 |
$50K |
| 99188 |
|
1,792 |
1,790 |
$47K |
| 90472 |
|
7,518 |
7,276 |
$46K |
| D2150 |
|
2,348 |
1,442 |
$45K |
| 99231 |
|
1,503 |
927 |
$42K |
| 90707 |
|
2,182 |
2,169 |
$42K |
| 99383 |
|
461 |
461 |
$41K |
| 96127 |
|
5,673 |
5,455 |
$37K |
| 90688 |
|
3,493 |
3,445 |
$37K |
| D0180 |
|
3,427 |
2,408 |
$35K |
| 81003 |
|
16,005 |
12,726 |
$31K |
| 99222 |
|
324 |
321 |
$31K |
| G2025 |
Dis site tele svcs rhc/fqhc |
1,853 |
1,655 |
$30K |
| 99238 |
|
579 |
570 |
$30K |
| 99382 |
|
322 |
322 |
$29K |
| 90716 |
|
1,936 |
1,922 |
$29K |
| D2954 |
|
1,049 |
585 |
$28K |
| 99384 |
|
342 |
342 |
$28K |
| 93000 |
|
1,859 |
1,839 |
$28K |
| D2335 |
|
969 |
520 |
$27K |
| 0071A |
|
587 |
585 |
$27K |
| 90474 |
|
4,854 |
4,840 |
$26K |
| 87651 |
|
822 |
812 |
$25K |
| 0053A |
|
569 |
569 |
$25K |
| 0124A |
|
567 |
564 |
$25K |
| D2332 |
|
943 |
557 |
$25K |
| 36416 |
|
41,221 |
33,041 |
$24K |
| 0064A |
|
652 |
651 |
$24K |
| D2140 |
|
1,708 |
904 |
$24K |
| D0145 |
|
1,473 |
859 |
$23K |
| 91320 |
|
178 |
177 |
$22K |
| 90480 |
|
508 |
507 |
$22K |
| 90658 |
|
2,031 |
2,028 |
$22K |
| 85610 |
|
6,694 |
3,231 |
$22K |
| 0051A |
|
402 |
401 |
$18K |
| 0052A |
|
393 |
391 |
$18K |
| 99397 |
|
338 |
336 |
$18K |
| 0031A |
|
371 |
371 |
$17K |
| 0072A |
|
365 |
364 |
$17K |
| 90756 |
|
648 |
648 |
$16K |
| 97803 |
|
552 |
544 |
$15K |
| 92133 |
|
889 |
514 |
$14K |
| D2751 |
|
115 |
75 |
$11K |
| 0134A |
|
261 |
261 |
$11K |
| 58300 |
|
175 |
170 |
$10K |
| D7230 |
|
163 |
114 |
$10K |
| D3310 |
|
339 |
154 |
$9K |
| 86580 |
|
1,466 |
1,441 |
$9K |
| 0004A |
|
233 |
233 |
$9K |
| 90732 |
|
98 |
97 |
$9K |
| 90837 |
|
162 |
109 |
$8K |
| 11982 |
|
62 |
62 |
$8K |
| 0111A |
|
165 |
164 |
$8K |
| 99381 |
|
39 |
39 |
$7K |
| D4342 |
|
608 |
248 |
$7K |
| 97804 |
|
230 |
196 |
$7K |
| 83014 |
|
963 |
954 |
$7K |
| D2160 |
|
425 |
275 |
$7K |
| 91322 |
|
59 |
59 |
$7K |
| 90632 |
|
142 |
141 |
$7K |
| D1351 |
|
181 |
54 |
$6K |
| 90620 |
|
2,120 |
2,113 |
$6K |
| D3320 |
|
57 |
42 |
$6K |
| D5110 |
|
40 |
14 |
$6K |
| 90887 |
|
96 |
87 |
$5K |
| 0003A |
|
106 |
105 |
$5K |
| 0013A |
|
125 |
125 |
$5K |
| 90847 |
|
47 |
45 |
$4K |
| 90791 |
|
124 |
121 |
$4K |
| D0272 |
|
178 |
153 |
$4K |
| 0164A |
|
67 |
67 |
$3K |
| 98966 |
|
295 |
284 |
$3K |
| 0154A |
|
64 |
64 |
$3K |
| 87634 |
|
81 |
81 |
$3K |
| 90734 |
|
2,539 |
2,535 |
$3K |
| 0112A |
|
61 |
61 |
$3K |
| 92002 |
|
51 |
51 |
$3K |
| D2394 |
|
49 |
37 |
$2K |
| 98967 |
|
109 |
100 |
$2K |
| 99215 |
Prolong outpt/office vis |
31 |
30 |
$2K |
| 90473 |
|
105 |
105 |
$2K |
| 99402 |
|
26 |
24 |
$1K |
| 0081A |
|
30 |
30 |
$1K |
| 36415 |
|
3,535 |
3,427 |
$1K |
| D7311 |
|
26 |
15 |
$1K |
| 0173A |
|
28 |
28 |
$1K |
| 57454 |
|
29 |
29 |
$1K |
| D4346 |
|
61 |
52 |
$1K |
| 90656 |
|
36 |
33 |
$993.97 |
| 90713 |
|
1,582 |
1,577 |
$928.62 |
| 87807 |
|
76 |
75 |
$856.49 |
| 99221 |
|
12 |
12 |
$852.00 |
| 99000 |
|
8,954 |
8,362 |
$812.57 |
| 58301 |
|
13 |
13 |
$707.91 |
| 91301 |
|
3,137 |
3,037 |
$665.19 |
| G0008 |
Admin influenza virus vac |
987 |
978 |
$416.97 |
| 91300 |
|
8,293 |
7,430 |
$400.00 |
| 99442 |
|
18 |
18 |
$353.77 |
| 99051 |
|
1,076 |
1,031 |
$342.72 |
| D0270 |
|
195 |
67 |
$302.00 |
| Q0091 |
Obtaining screen pap smear |
1,887 |
1,860 |
$299.18 |
| 90785 |
|
891 |
746 |
$292.54 |
| 99401 |
|
12 |
12 |
$291.36 |
| 99441 |
|
25 |
14 |
$272.25 |
| 92083 |
|
22 |
12 |
$230.08 |
| 94640 |
|
1,048 |
966 |
$209.40 |
| 90710 |
|
5,624 |
5,616 |
$138.48 |
| 87210 |
|
25 |
25 |
$110.00 |
| D1330 |
|
1,817 |
1,044 |
$56.00 |
| 90619 |
|
1,654 |
1,649 |
$30.00 |
| 90674 |
|
499 |
498 |
$29.23 |
| J1885 |
Ketorolac tromethamine inj |
1,415 |
1,351 |
$17.20 |
| J1815 |
Insulin injection |
126 |
105 |
$7.90 |
| J7620 |
Albuterol ipratrop non-comp |
930 |
832 |
$1.56 |
| J3535 |
Metered dose inhaler drug |
23 |
22 |
$0.10 |
| J7613 |
Albuterol non-comp unit |
48 |
47 |
$0.01 |
| 91305 |
|
1,519 |
1,482 |
$0.01 |
| Q0144 |
Azithromycin dihydrate, oral |
419 |
417 |
$0.00 |
| 90633 |
|
8,564 |
8,554 |
$0.00 |
| G0468 |
Fqhc visit, ippe or awv |
505 |
503 |
$0.00 |
| 90681 |
|
5,976 |
5,961 |
$0.00 |
| 99177 |
|
2,871 |
2,844 |
$0.00 |
| 0502F |
|
2,974 |
2,094 |
$0.00 |
| G0101 |
Ca screen;pelvic/breast exam |
728 |
727 |
$0.00 |
| 90648 |
|
3,169 |
3,159 |
$0.00 |
| 90651X |
|
36 |
36 |
$0.00 |
| 91313 |
|
210 |
210 |
$0.00 |
| 90685 |
|
1,082 |
1,079 |
$0.00 |
| 90700 |
|
932 |
932 |
$0.00 |
| 99072 |
|
154 |
139 |
$0.00 |
| 91311 |
|
261 |
256 |
$0.00 |
| 91312 |
|
512 |
511 |
$0.00 |
| D5411 |
|
22 |
12 |
$0.00 |
| X5410 |
|
78 |
52 |
$0.00 |
| D5610 |
|
71 |
25 |
$0.00 |
| J2315 |
Naltrexone, depot form |
12 |
12 |
$0.00 |
| 90655 |
|
51 |
51 |
$0.00 |
| A4550 |
Surgical trays |
28 |
28 |
$0.00 |
| D2940 |
|
44 |
12 |
$0.00 |
| 91308 |
|
90 |
90 |
$0.00 |
| 96160 |
|
28 |
28 |
$0.00 |
| 2700B |
|
21 |
16 |
$0.00 |
| 2700A |
|
15 |
15 |
$0.00 |
| 90698 |
|
4,039 |
4,037 |
$0.00 |
| 90744 |
|
3,166 |
3,160 |
$0.00 |
| S0302 |
Completed epsdt |
573 |
570 |
$0.00 |
| 92558 |
|
2,791 |
2,765 |
$0.00 |
| 90697 |
|
4,650 |
4,635 |
$0.00 |
| 90696 |
|
2,164 |
2,161 |
$0.00 |
| D0603 |
|
269 |
256 |
$0.00 |
| 91306 |
|
492 |
492 |
$0.00 |
| 5000E |
|
338 |
177 |
$0.00 |
| 5000B |
|
287 |
178 |
$0.00 |
| 91303 |
|
297 |
297 |
$0.00 |
| 91307 |
|
983 |
965 |
$0.00 |
| 0503F |
|
307 |
300 |
$0.00 |
| D0601 |
|
70 |
55 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
57 |
57 |
$0.00 |
| G0439 |
Ppps, subseq visit |
497 |
495 |
$0.00 |
| J2001 |
Lidocaine injection |
149 |
139 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
203 |
198 |
$0.00 |
| 5000F |
|
275 |
154 |
$0.00 |
| 90723 |
|
2,377 |
2,370 |
$0.00 |
| 5000D |
|
199 |
118 |
$0.00 |
| 90792 |
|
28 |
28 |
$0.00 |
| D0171 |
|
51 |
12 |
$0.00 |
| D9999 |
|
866 |
387 |
$0.00 |
| D4355 |
|
176 |
64 |
$0.00 |
| 0501F |
|
47 |
47 |
$0.00 |
| D1310 |
|
164 |
141 |
$0.00 |
| 99459 |
|
67 |
67 |
$0.00 |
| 96112 |
|
16 |
12 |
$0.00 |
| 91317 |
|
29 |
29 |
$0.00 |
| 96380 |
|
147 |
145 |
$0.00 |
| J0456 |
Azithromycin |
37 |
36 |
$0.00 |
| 91316 |
|
44 |
44 |
$0.00 |
| 90381 |
|
82 |
82 |
$0.00 |
| 91315 |
|
35 |
35 |
$0.00 |
| 0500F |
|
16 |
16 |
$0.00 |