| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
133,572 |
112,687 |
$17.46M |
| 00003 |
|
46,144 |
29,365 |
$7.22M |
| 90832 |
|
8,684 |
5,221 |
$146K |
| 99213 |
|
86,328 |
53,102 |
$115K |
| 99212 |
|
37,716 |
24,221 |
$68K |
| G0467 |
Fqhc visit, estab pt |
1,669 |
1,368 |
$57K |
| 90791 |
|
1,149 |
882 |
$40K |
| 0011A |
|
225 |
225 |
$15K |
| 90834 |
|
580 |
393 |
$15K |
| G9920 |
Scrning perf and negative |
7,394 |
4,763 |
$14K |
| 0012A |
|
151 |
151 |
$10K |
| 0001A |
|
134 |
106 |
$8K |
| 99460 |
|
689 |
482 |
$7K |
| 0002A |
|
93 |
74 |
$6K |
| 0031A |
|
69 |
69 |
$5K |
| 99238 |
|
528 |
334 |
$4K |
| J3490 |
Drugs unclassified injection |
728 |
531 |
$3K |
| 81025 |
|
13,266 |
8,714 |
$2K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
289 |
289 |
$2K |
| 99395 |
|
1,780 |
1,140 |
$2K |
| 99214 |
|
5,060 |
3,171 |
$1K |
| 99203 |
|
82 |
55 |
$1K |
| H1001 |
Antepartum management |
1,839 |
1,334 |
$1K |
| 99391 |
|
1,422 |
1,121 |
$1K |
| 99393 |
|
2,543 |
1,740 |
$594.50 |
| H1000 |
Prenatal care atrisk assessm |
68 |
68 |
$378.93 |
| 99392 |
|
2,203 |
1,594 |
$295.88 |
| 87635 |
|
120 |
82 |
$285.44 |
| 90686 |
|
2,796 |
2,245 |
$260.14 |
| 90715 |
|
972 |
670 |
$249.01 |
| 92551 |
|
6,839 |
4,731 |
$247.91 |
| 81002 |
|
13,593 |
8,249 |
$189.03 |
| G2025 |
Dis site tele svcs rhc/fqhc |
14 |
12 |
$155.60 |
| 90471 |
|
2,473 |
1,792 |
$141.93 |
| 85018 |
|
12,911 |
8,920 |
$138.18 |
| 99396 |
|
484 |
297 |
$135.99 |
| 87880 |
|
3,956 |
2,401 |
$127.56 |
| 99173 |
|
7,713 |
5,276 |
$123.43 |
| G9919 |
Scrn nd pos nd prov of rec |
110 |
60 |
$116.00 |
| 99394 |
|
1,538 |
1,044 |
$109.11 |
| 87804 |
|
2,701 |
1,737 |
$96.90 |
| 90670 |
|
1,175 |
906 |
$72.00 |
| 59425 |
|
943 |
697 |
$60.48 |
| 90734 |
|
471 |
325 |
$42.75 |
| 90647 |
|
650 |
525 |
$36.00 |
| 90651 |
|
787 |
573 |
$24.75 |
| 90688 |
|
711 |
395 |
$24.37 |
| 82962 |
|
3,972 |
2,538 |
$19.99 |
| 90716 |
|
29 |
26 |
$18.00 |
| 90633 |
|
458 |
328 |
$18.00 |
| 90707 |
|
25 |
24 |
$18.00 |
| 90677 |
|
103 |
67 |
$9.00 |
| 90700 |
|
669 |
481 |
$9.00 |
| J3301 |
Triamcinolone acet inj nos |
55 |
29 |
$8.00 |
| 83036 |
|
693 |
473 |
$7.76 |
| G8510 |
Scr dep neg, no plan reqd |
31,107 |
17,152 |
$1.42 |
| G2023 |
Specimen collect covid-19 |
4,284 |
2,696 |
$1.20 |
| G0439 |
Ppps, subseq visit |
2,724 |
2,496 |
$0.01 |
| 99202 |
|
26 |
25 |
$0.00 |
| 3079F |
|
3,193 |
1,851 |
$0.00 |
| 96372 |
|
1,094 |
706 |
$0.00 |
| 3074F |
|
3,566 |
2,043 |
$0.00 |
| Z1034 |
|
3,912 |
2,847 |
$0.00 |
| 93000 |
|
95 |
56 |
$0.00 |
| 86580 |
|
185 |
121 |
$0.00 |
| 3075F |
|
1,931 |
1,139 |
$0.00 |
| G9226 |
3 comp foot exam completed |
855 |
555 |
$0.00 |
| 90680 |
|
510 |
402 |
$0.00 |
| 3080F |
|
890 |
499 |
$0.00 |
| Z1032 |
|
220 |
220 |
$0.00 |
| Z1038 |
|
68 |
68 |
$0.00 |
| 90723 |
|
434 |
353 |
$0.00 |
| 59430 |
|
59 |
59 |
$0.00 |
| 96151 |
|
13 |
13 |
$0.00 |
| 90697 |
|
80 |
55 |
$0.00 |
| J0561 |
Penicillin g benzathine inj |
18 |
12 |
$0.00 |
| 99239 |
|
18 |
14 |
$0.00 |
| 11976 |
|
24 |
13 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
12 |
12 |
$0.00 |
| 88720 |
|
23 |
12 |
$0.00 |
| G8511 |
Scr dep pos, no plan doc rng |
962 |
599 |
$0.00 |
| 3078F |
|
3,666 |
2,106 |
$0.00 |
| 3077F |
|
2,235 |
1,253 |
$0.00 |
| G9357 |
Pp eval/edu perf |
115 |
84 |
$0.00 |
| 83655 |
|
337 |
230 |
$0.00 |
| 11981 |
|
22 |
12 |
$0.00 |
| 90713 |
|
197 |
139 |
$0.00 |
| Z6400 |
|
80 |
80 |
$0.00 |
| H1003 |
Prenatal at risk education |
12 |
12 |
$0.00 |
| 90710 |
|
115 |
80 |
$0.00 |
| 90685 |
|
13 |
12 |
$0.00 |
| J7307 |
Etonogestrel implant system |
22 |
12 |
$0.00 |
| 99401 |
|
14 |
14 |
$0.00 |
| 97803 |
|
13 |
13 |
$0.00 |
| 90678 |
|
27 |
15 |
$0.00 |
| 90472 |
|
17 |
13 |
$0.00 |
| G0438 |
Ppps, initial visit |
16 |
12 |
$0.00 |