| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
230,680 |
198,227 |
$53.55M |
| 00003 |
|
4,890 |
4,262 |
$1.77M |
| D4341 |
|
11,259 |
4,836 |
$242K |
| D2392 |
|
9,180 |
5,875 |
$231K |
| D1120 |
|
12,374 |
8,521 |
$224K |
| 90832 |
|
10,668 |
6,663 |
$213K |
| 90791 |
|
4,050 |
2,825 |
$196K |
| D0150 |
|
13,747 |
9,781 |
$179K |
| D1206 |
|
19,869 |
14,210 |
$174K |
| D0120 |
|
11,356 |
7,689 |
$127K |
| D4910 |
|
5,044 |
3,457 |
$124K |
| D0210 |
|
10,178 |
7,327 |
$114K |
| D2391 |
|
5,603 |
3,448 |
$112K |
| D1310 |
|
11,601 |
8,831 |
$92K |
| D9430 |
|
14,014 |
10,067 |
$79K |
| D0220 |
|
24,671 |
17,021 |
$69K |
| D1351 |
|
2,630 |
928 |
$64K |
| D1110 |
|
3,160 |
2,350 |
$63K |
| D0230 |
|
24,936 |
8,845 |
$62K |
| D9999 |
|
514 |
408 |
$54K |
| D7140 |
|
2,379 |
1,405 |
$48K |
| 99213 |
|
86,556 |
69,497 |
$45K |
| D0274 |
|
9,183 |
6,236 |
$43K |
| 90834 |
|
1,290 |
799 |
$35K |
| D2393 |
|
944 |
646 |
$33K |
| D2740 |
|
190 |
143 |
$27K |
| G0467 |
Fqhc visit, estab pt |
701 |
638 |
$23K |
| D0603 |
|
8,523 |
6,117 |
$22K |
| 99214 |
|
17,032 |
13,752 |
$15K |
| 90792 |
|
1,368 |
1,083 |
$15K |
| D4342 |
|
831 |
388 |
$13K |
| 99212 |
|
32,181 |
25,911 |
$12K |
| D0330 |
|
4,879 |
4,031 |
$12K |
| 92014 |
|
512 |
434 |
$9K |
| D0270 |
|
8,553 |
6,043 |
$9K |
| 90480 |
|
1,192 |
1,051 |
$8K |
| G2025 |
Dis site tele svcs rhc/fqhc |
328 |
303 |
$7K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
554 |
554 |
$7K |
| D0240 |
|
1,249 |
697 |
$6K |
| D0145 |
|
458 |
328 |
$6K |
| 99203 |
|
4,152 |
3,378 |
$6K |
| 99391 |
|
2,115 |
1,772 |
$6K |
| D2331 |
|
160 |
96 |
$5K |
| D0272 |
|
1,098 |
741 |
$4K |
| 99393 |
|
2,696 |
2,260 |
$4K |
| 99394 |
|
1,268 |
1,060 |
$4K |
| D0602 |
|
890 |
615 |
$3K |
| 99392 |
|
3,188 |
2,639 |
$3K |
| D9110 |
|
694 |
605 |
$3K |
| D9230 |
|
349 |
251 |
$3K |
| 99395 |
|
383 |
324 |
$3K |
| 96127 |
|
3,083 |
2,811 |
$3K |
| 97802 |
|
910 |
776 |
$2K |
| 99396 |
|
287 |
228 |
$2K |
| 99204 |
|
332 |
273 |
$2K |
| D7210 |
|
27 |
18 |
$2K |
| 90471 |
|
17,484 |
14,546 |
$2K |
| 90677 |
|
1,063 |
935 |
$1K |
| 97803 |
|
705 |
566 |
$1K |
| D2335 |
|
36 |
26 |
$1K |
| 83036 |
|
6,146 |
5,204 |
$1K |
| 90472 |
|
8,294 |
7,012 |
$1K |
| 92587 |
|
680 |
574 |
$1K |
| 92015 |
|
499 |
432 |
$944.58 |
| D0350 |
|
3,287 |
2,767 |
$919.00 |
| D1354 |
|
83 |
17 |
$918.00 |
| 99383 |
|
628 |
540 |
$827.86 |
| 99381 |
|
119 |
110 |
$745.72 |
| 90739 |
|
215 |
176 |
$709.00 |
| D0601 |
|
271 |
203 |
$702.00 |
| V2020 |
Vision svcs frames purchases |
135 |
114 |
$675.37 |
| 93000 |
|
622 |
497 |
$641.40 |
| 99202 |
|
805 |
664 |
$607.87 |
| 92250 |
|
430 |
379 |
$474.77 |
| 85018 |
|
5,330 |
4,411 |
$437.27 |
| G9920 |
Scrning perf and negative |
40 |
27 |
$377.00 |
| 99215 |
Prolong outpt/office vis |
1,029 |
872 |
$373.02 |
| 90686 |
|
4,928 |
3,887 |
$371.68 |
| 83655 |
|
630 |
513 |
$315.32 |
| 90697 |
|
426 |
365 |
$279.56 |
| 90656 |
|
1,277 |
1,159 |
$261.27 |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
89 |
74 |
$232.50 |
| 99188 |
|
236 |
184 |
$219.42 |
| 90715 |
|
583 |
502 |
$216.19 |
| D2930 |
|
14 |
12 |
$210.00 |
| V2100 |
Lens spher single plano 4.00 |
70 |
56 |
$200.00 |
| 99401 |
|
632 |
534 |
$140.64 |
| D0140 |
|
20 |
12 |
$140.00 |
| 99384 |
|
317 |
248 |
$138.64 |
| V2200 |
Lens spher bifoc plano 4.00d |
46 |
40 |
$135.00 |
| 0124A |
|
20 |
17 |
$134.00 |
| 92551 |
|
39 |
27 |
$133.62 |
| 81025 |
|
494 |
414 |
$129.65 |
| 92552 |
|
1,315 |
1,124 |
$128.52 |
| G9919 |
Scrn nd pos nd prov of rec |
21 |
13 |
$116.00 |
| 96372 |
|
163 |
132 |
$114.18 |
| 99382 |
|
174 |
151 |
$107.34 |
| 17110 |
|
43 |
38 |
$102.77 |
| 80305 |
|
181 |
136 |
$72.00 |
| 81002 |
|
1,110 |
929 |
$62.35 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
18 |
16 |
$60.00 |
| 96160 |
|
485 |
419 |
$46.73 |
| 87880 |
|
124 |
114 |
$42.78 |
| 90633 |
|
1,542 |
1,322 |
$40.54 |
| 82962 |
|
1,036 |
888 |
$38.77 |
| 90653 |
|
66 |
62 |
$20.00 |
| 99211 |
|
14 |
14 |
$10.80 |
| V2784 |
Lens polycarb or equal |
17 |
15 |
$10.50 |
| 83026 |
|
116 |
91 |
$7.74 |
| 99442 |
|
1,649 |
1,415 |
$4.95 |
| 99173 |
|
1,567 |
1,348 |
$3.20 |
| J3301 |
Triamcinolone acet inj nos |
15 |
12 |
$2.30 |
| 99177 |
|
1,133 |
977 |
$1.87 |
| 3074F |
|
34,920 |
28,872 |
$0.00 |
| 99441 |
|
941 |
789 |
$0.00 |
| 3080F |
|
2,493 |
2,030 |
$0.00 |
| 90723 |
|
496 |
415 |
$0.00 |
| D1330 |
|
16,238 |
13,682 |
$0.00 |
| 3008F |
|
41,766 |
34,833 |
$0.00 |
| 3075F |
|
4,994 |
4,234 |
$0.00 |
| D5899 |
|
831 |
693 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
57 |
55 |
$0.00 |
| 3079F |
|
10,156 |
8,575 |
$0.00 |
| 90696 |
|
68 |
63 |
$0.00 |
| 90716 |
|
462 |
407 |
$0.00 |
| 99443 |
|
961 |
799 |
$0.00 |
| 99403 |
|
132 |
100 |
$0.00 |
| 90651 |
|
703 |
620 |
$0.00 |
| 90744 |
|
50 |
45 |
$0.00 |
| 3044F |
|
520 |
450 |
$0.00 |
| 96161 |
|
15 |
12 |
$0.00 |
| 99402 |
|
29 |
28 |
$0.00 |
| G0008 |
Admin influenza virus vac |
214 |
205 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
49 |
35 |
$0.00 |
| 1170F |
|
14 |
12 |
$0.00 |
| 90619 |
|
17 |
13 |
$0.00 |
| 90620 |
|
13 |
13 |
$0.00 |
| 87635 |
|
55 |
54 |
$0.00 |
| G0439 |
Ppps, subseq visit |
336 |
330 |
$0.00 |
| 90474 |
|
14 |
12 |
$0.00 |
| G0442 |
Annual alcohol screen 15 min |
14 |
12 |
$0.00 |
| 90694 |
|
56 |
45 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
40 |
37 |
$0.00 |
| D0171 |
|
43 |
28 |
$0.00 |
| 0134A |
|
20 |
16 |
$0.00 |
| D0170 |
|
19 |
14 |
$0.00 |
| D9993 |
|
6,419 |
6,255 |
$0.00 |
| 3078F |
|
34,192 |
28,317 |
$0.00 |
| 1159F |
|
6,303 |
5,423 |
$0.00 |
| 4004F |
|
539 |
521 |
$0.00 |
| D2950 |
|
176 |
156 |
$0.00 |
| 3077F |
|
7,370 |
6,132 |
$0.00 |
| 90670 |
|
481 |
397 |
$0.00 |
| 1160F |
|
6,305 |
5,424 |
$0.00 |
| G0438 |
Ppps, initial visit |
446 |
438 |
$0.00 |
| 91320 |
|
33 |
31 |
$0.00 |
| 90671 |
|
127 |
103 |
$0.00 |
| 90648 |
|
725 |
603 |
$0.00 |
| 90460 |
|
164 |
140 |
$0.00 |
| 90713 |
|
234 |
209 |
$0.00 |
| 90681 |
|
38 |
32 |
$0.00 |
| 90710 |
|
187 |
155 |
$0.00 |
| 90734 |
|
357 |
310 |
$0.00 |
| 90707 |
|
75 |
61 |
$0.00 |
| 91321 |
|
387 |
326 |
$0.00 |
| D2999 |
|
222 |
195 |
$0.00 |
| 90700 |
|
59 |
54 |
$0.00 |
| 90672 |
|
91 |
57 |
$0.00 |
| D9996 |
|
97 |
96 |
$0.00 |
| D9990 |
|
204 |
191 |
$0.00 |
| 3046F |
|
42 |
37 |
$0.00 |
| D0191 |
|
433 |
330 |
$0.00 |
| 87804 |
|
73 |
52 |
$0.00 |
| 90746 |
|
17 |
14 |
$0.00 |
| 91322 |
|
41 |
33 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
58 |
51 |
$0.00 |
| 3051F |
|
12 |
12 |
$0.00 |
| 87811 |
|
29 |
28 |
$0.00 |
| 91313 |
|
36 |
29 |
$0.00 |
| 90662 |
|
16 |
16 |
$0.00 |
| 91312 |
|
21 |
17 |
$0.00 |