| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
55,624 |
48,719 |
$6.30M |
| 00003 |
|
3,914 |
2,384 |
$980K |
| 99213 |
|
44,182 |
30,351 |
$235K |
| J3490 |
Drugs unclassified injection |
340 |
256 |
$28K |
| 90715 |
|
499 |
457 |
$19K |
| 90732 |
|
190 |
181 |
$16K |
| 99212 |
|
4,862 |
2,814 |
$15K |
| 92250 |
|
437 |
379 |
$15K |
| 90837 |
|
214 |
104 |
$14K |
| 0011A |
|
131 |
131 |
$9K |
| 0012A |
|
126 |
126 |
$8K |
| 99214 |
|
14,547 |
10,192 |
$5K |
| 99202 |
|
361 |
321 |
$4K |
| 99000 |
|
8,998 |
8,606 |
$3K |
| 90688 |
|
225 |
225 |
$2K |
| 81025 |
|
1,360 |
1,351 |
$2K |
| 0031A |
|
32 |
32 |
$2K |
| 90677 |
|
40 |
40 |
$1K |
| 90834 |
|
794 |
599 |
$1K |
| 99203 |
|
314 |
216 |
$800.10 |
| A4267 |
Male condom |
80 |
79 |
$666.00 |
| 99204 |
|
847 |
661 |
$618.03 |
| G8510 |
Scr dep neg, no plan reqd |
16,293 |
15,035 |
$328.62 |
| 99391 |
|
441 |
318 |
$309.76 |
| 90686 |
|
38 |
38 |
$278.08 |
| 90656 |
|
46 |
46 |
$272.05 |
| 99396 |
|
186 |
125 |
$218.70 |
| 83036 |
|
2,724 |
2,682 |
$201.35 |
| 92552 |
|
12 |
12 |
$193.05 |
| 99392 |
|
768 |
457 |
$185.47 |
| G9919 |
Scrn nd pos nd prov of rec |
101 |
101 |
$144.13 |
| 96372 |
|
114 |
106 |
$130.30 |
| 90791 |
|
386 |
329 |
$128.08 |
| 90832 |
|
223 |
171 |
$120.17 |
| G9920 |
Scrning perf and negative |
32 |
32 |
$86.13 |
| 99215 |
Prolong outpt/office vis |
143 |
83 |
$56.63 |
| 90471 |
|
3,041 |
2,981 |
$51.38 |
| 85018 |
|
1,060 |
1,051 |
$44.89 |
| 83655 |
|
15 |
15 |
$31.56 |
| 81003 |
|
151 |
149 |
$20.77 |
| 99173 |
|
30 |
30 |
$15.38 |
| 86580 |
|
25 |
24 |
$9.99 |
| 90633 |
|
41 |
41 |
$9.90 |
| 81002 |
|
29 |
29 |
$6.65 |
| 82962 |
|
47 |
45 |
$1.98 |
| 99385 |
|
78 |
48 |
$0.00 |
| 3079F |
|
886 |
872 |
$0.00 |
| H0049 |
Alcohol/drug screening |
4,721 |
4,393 |
$0.00 |
| 3074F |
|
3,708 |
3,526 |
$0.00 |
| 3044F |
|
477 |
475 |
$0.00 |
| G9008 |
Mccd,phys coor-care ovrsght |
1,557 |
809 |
$0.00 |
| 3075F |
|
211 |
209 |
$0.00 |
| 3080F |
|
13 |
13 |
$0.00 |
| G9012 |
Other specified case mgmt |
12 |
12 |
$0.00 |
| 36415 |
|
13 |
13 |
$0.00 |
| 3077F |
|
315 |
302 |
$0.00 |
| 3078F |
|
3,463 |
3,289 |
$0.00 |
| 90472 |
|
453 |
437 |
$0.00 |
| 99393 |
|
278 |
179 |
$0.00 |
| 99395 |
|
195 |
113 |
$0.00 |
| 99394 |
|
273 |
184 |
$0.00 |
| G8511 |
Scr dep pos, no plan doc rng |
258 |
247 |
$0.00 |
| 3045F |
|
150 |
147 |
$0.00 |
| 96160 |
|
104 |
104 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
200 |
190 |
$0.00 |
| 90473 |
|
22 |
22 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| 90671 |
|
26 |
26 |
$0.00 |
| 83013 |
|
16 |
15 |
$0.00 |
| 3046F |
|
15 |
15 |
$0.00 |
| 91312 |
|
13 |
13 |
$0.00 |