| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
653,401 |
561,473 |
$196.48M |
| 00003 |
|
53,586 |
35,263 |
$19.46M |
| G0467 |
Fqhc visit, estab pt |
25,789 |
22,911 |
$933K |
| 99213 |
|
474,634 |
302,833 |
$345K |
| 98940 |
|
1,063 |
426 |
$314K |
| 99214 |
|
87,214 |
59,484 |
$281K |
| 92014 |
|
5,573 |
5,403 |
$133K |
| G0466 |
Fqhc visit new patient |
1,648 |
1,637 |
$83K |
| 99203 |
|
24,691 |
18,338 |
$54K |
| 99212 |
|
147,093 |
96,414 |
$47K |
| 99204 |
|
2,230 |
1,856 |
$37K |
| G8510 |
Scr dep neg, no plan reqd |
194,260 |
103,184 |
$30K |
| 90791 |
|
540 |
379 |
$19K |
| G9012 |
Other specified case mgmt |
622 |
590 |
$16K |
| 99202 |
|
12,877 |
10,993 |
$9K |
| 96372 |
|
6,621 |
3,939 |
$8K |
| G9920 |
Scrning perf and negative |
6,449 |
4,436 |
$8K |
| 90832 |
|
379 |
246 |
$5K |
| 90686 |
|
30,441 |
23,256 |
$4K |
| H1001 |
Antepartum management |
3,428 |
2,837 |
$3K |
| 99395 |
|
6,946 |
4,323 |
$2K |
| 99460 |
|
236 |
192 |
$2K |
| J3490 |
Drugs unclassified injection |
1,171 |
1,057 |
$2K |
| 99381 |
|
4,595 |
3,813 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
382 |
218 |
$2K |
| 99391 |
|
18,801 |
14,802 |
$2K |
| 90834 |
|
87 |
61 |
$2K |
| 99396 |
|
2,823 |
1,848 |
$1K |
| 0071A |
|
18 |
18 |
$1K |
| 0011A |
|
18 |
18 |
$1K |
| 0012A |
|
17 |
17 |
$1K |
| 99238 |
|
199 |
131 |
$1K |
| 90651 |
|
5,015 |
3,539 |
$1K |
| G2025 |
Dis site tele svcs rhc/fqhc |
481 |
430 |
$1K |
| 99385 |
|
893 |
583 |
$981.78 |
| 93000 |
|
464 |
367 |
$941.02 |
| 99392 |
|
22,695 |
16,032 |
$785.41 |
| 99201 |
|
1,805 |
1,580 |
$650.24 |
| 81025 |
|
17,473 |
11,303 |
$636.98 |
| 81002 |
|
30,735 |
20,533 |
$464.55 |
| 99215 |
Prolong outpt/office vis |
969 |
702 |
$442.39 |
| 90715 |
|
4,064 |
2,855 |
$423.71 |
| 87880 |
|
14,595 |
8,681 |
$398.16 |
| 99386 |
|
128 |
83 |
$319.84 |
| 99393 |
|
17,172 |
11,200 |
$305.65 |
| J1885 |
Ketorolac tromethamine inj |
2,008 |
1,194 |
$299.43 |
| 99394 |
|
9,572 |
6,048 |
$290.65 |
| 90471 |
|
22,205 |
16,219 |
$281.27 |
| 90677 |
|
3,359 |
2,444 |
$269.28 |
| 92551 |
|
40,749 |
26,875 |
$238.84 |
| 58300 |
|
15 |
13 |
$181.69 |
| 87804 |
|
4,611 |
2,935 |
$170.34 |
| 90670 |
|
15,645 |
12,523 |
$142.30 |
| 85018 |
|
50,180 |
32,463 |
$140.08 |
| 88720 |
|
5,188 |
3,536 |
$128.11 |
| 92133 |
|
389 |
294 |
$126.84 |
| 83036 |
|
11,981 |
8,497 |
$120.51 |
| 99173 |
|
43,553 |
28,604 |
$81.73 |
| 90698 |
|
9,857 |
7,978 |
$78.40 |
| 3078F |
|
14,087 |
8,579 |
$72.04 |
| 3074F |
|
13,869 |
8,190 |
$72.01 |
| 90744 |
|
5,435 |
4,502 |
$58.50 |
| 82962 |
|
9,052 |
5,962 |
$57.69 |
| 90633 |
|
6,624 |
4,879 |
$55.90 |
| 90746 |
|
297 |
214 |
$52.00 |
| 99382 |
|
621 |
615 |
$51.33 |
| 92004 |
|
1,223 |
1,220 |
$49.78 |
| 87635 |
|
67 |
50 |
$48.00 |
| 58100 |
|
14 |
13 |
$41.04 |
| 92015 |
|
6,618 |
6,592 |
$39.79 |
| 90680 |
|
5,310 |
4,482 |
$36.00 |
| 90688 |
|
7,251 |
4,155 |
$33.37 |
| 11721 |
|
454 |
301 |
$32.57 |
| 90697 |
|
3,200 |
2,313 |
$29.55 |
| H1003 |
Prenatal at risk education |
122 |
122 |
$25.23 |
| 90472 |
|
1,175 |
846 |
$21.39 |
| 90681 |
|
1,210 |
920 |
$18.00 |
| 90648 |
|
300 |
299 |
$9.90 |
| 90707 |
|
1,643 |
1,218 |
$9.00 |
| 90710 |
|
679 |
438 |
$9.00 |
| 90716 |
|
1,655 |
1,230 |
$9.00 |
| 90647 |
|
805 |
644 |
$9.00 |
| 90696 |
|
579 |
400 |
$9.00 |
| 86580 |
|
109 |
77 |
$3.67 |
| G2023 |
Specimen collect covid-19 |
13,049 |
8,200 |
$0.71 |
| 99406 |
|
4,555 |
2,634 |
$0.25 |
| 3077F |
|
9,559 |
5,639 |
$0.00 |
| 90734 |
|
2,909 |
2,060 |
$0.00 |
| 90380 |
|
222 |
169 |
$0.00 |
| 83655 |
|
2,217 |
1,567 |
$0.00 |
| G8511 |
Scr dep pos, no plan doc rng |
6,224 |
3,540 |
$0.00 |
| 0124A |
|
269 |
172 |
$0.00 |
| 3046F |
|
430 |
264 |
$0.00 |
| G0438 |
Ppps, initial visit |
843 |
754 |
$0.00 |
| 59425 |
|
777 |
581 |
$0.00 |
| 90700 |
|
1,182 |
915 |
$0.00 |
| 91320 |
|
220 |
134 |
$0.00 |
| Z6400 |
|
124 |
124 |
$0.00 |
| 90685 |
|
31 |
31 |
$0.00 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
747 |
745 |
$0.00 |
| 90713 |
|
175 |
168 |
$0.00 |
| 92134 |
|
424 |
305 |
$0.00 |
| 86703 |
|
70 |
43 |
$0.00 |
| 11056 |
|
68 |
40 |
$0.00 |
| G9919 |
Scrn nd pos nd prov of rec |
289 |
187 |
$0.00 |
| 91321 |
|
34 |
19 |
$0.00 |
| 3051F |
|
100 |
57 |
$0.00 |
| 0004A |
|
60 |
39 |
$0.00 |
| 2022F |
|
16 |
12 |
$0.00 |
| H1000 |
Prenatal care atrisk assessm |
27 |
27 |
$0.00 |
| G0439 |
Ppps, subseq visit |
6,071 |
5,768 |
$0.00 |
| 3079F |
|
11,862 |
6,967 |
$0.00 |
| Z1034 |
|
5,847 |
5,098 |
$0.00 |
| 3080F |
|
3,795 |
2,194 |
$0.00 |
| 3075F |
|
6,229 |
3,774 |
$0.00 |
| Z1038 |
|
152 |
152 |
$0.00 |
| 90620 |
|
260 |
208 |
$0.00 |
| G9226 |
3 comp foot exam completed |
2,494 |
1,658 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
22 |
18 |
$0.00 |
| 2023F |
|
470 |
343 |
$0.00 |
| G0008 |
Admin influenza virus vac |
725 |
724 |
$0.00 |
| 99383 |
|
725 |
684 |
$0.00 |
| 99384 |
|
454 |
402 |
$0.00 |
| 3044F |
|
1,068 |
655 |
$0.00 |
| 92250 |
|
640 |
477 |
$0.00 |
| 90381 |
|
132 |
103 |
$0.00 |
| 90656 |
|
1,577 |
1,040 |
$0.00 |
| Z6410 |
|
16 |
15 |
$0.00 |
| 90723 |
|
535 |
531 |
$0.00 |
| 90480 |
|
41 |
28 |
$0.00 |
| 90732 |
|
115 |
115 |
$0.00 |
| J3420 |
Vitamin b12 injection |
64 |
42 |
$0.00 |
| Z1032 |
|
494 |
494 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
40 |
25 |
$0.00 |
| 96110 |
|
85 |
81 |
$0.00 |
| 59430 |
|
67 |
62 |
$0.00 |
| 96156 |
|
25 |
25 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
51 |
51 |
$0.00 |
| 94640 |
|
45 |
30 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
22 |
15 |
$0.00 |
| 0111A |
|
20 |
13 |
$0.00 |