| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
|
100,600 |
66,506 |
$55.56M |
| T1015 |
Clinic service |
74,296 |
54,789 |
$41.94M |
| G0467 |
Fqhc visit, estab pt |
20,056 |
16,099 |
$4.97M |
| 99214 |
|
29,359 |
26,015 |
$1.73M |
| 99213 |
|
30,121 |
26,621 |
$974K |
| 92004 |
|
3,800 |
2,525 |
$880K |
| 90834 |
|
7,446 |
4,936 |
$562K |
| 92014 |
|
1,436 |
1,102 |
$458K |
| 98941 |
|
718 |
280 |
$230K |
| G0470 |
Fqhc visit, mh estab pt |
453 |
371 |
$205K |
| G0466 |
Fqhc visit new patient |
327 |
311 |
$95K |
| G0469 |
Fqhc visit, mh new pt |
1,390 |
901 |
$91K |
| 99396 |
|
2,266 |
2,222 |
$70K |
| 0900 |
|
1,064 |
608 |
$61K |
| 90837 |
|
544 |
423 |
$45K |
| G0468 |
Fqhc visit, ippe or awv |
114 |
99 |
$45K |
| 99212 |
|
3,680 |
3,438 |
$41K |
| 90791 |
|
491 |
476 |
$23K |
| 96372 |
|
2,280 |
2,016 |
$21K |
| S0620 |
Routine ophthalmological exa |
125 |
123 |
$20K |
| 99203 |
|
1,040 |
1,027 |
$19K |
| 0002A |
|
474 |
474 |
$17K |
| 90832 |
|
790 |
619 |
$14K |
| 0001A |
|
425 |
425 |
$13K |
| 99393 |
|
187 |
186 |
$12K |
| 90686 |
|
2,001 |
1,989 |
$11K |
| 99395 |
|
1,065 |
1,042 |
$10K |
| G9920 |
Scrning perf and negative |
925 |
920 |
$6K |
| 81002 |
|
3,467 |
3,145 |
$6K |
| 82962 |
|
1,699 |
1,525 |
$6K |
| 90471 |
|
3,765 |
3,699 |
$5K |
| 99392 |
|
12 |
12 |
$5K |
| G0439 |
Ppps, subseq visit |
28 |
27 |
$4K |
| 99215 |
Prolong outpt/office vis |
520 |
507 |
$4K |
| 99211 |
|
12 |
12 |
$4K |
| 0003A |
|
126 |
124 |
$3K |
| G2025 |
Dis site tele svcs rhc/fqhc |
950 |
811 |
$3K |
| V2020 |
Vision svcs frames purchases |
1,080 |
998 |
$3K |
| 99000 |
|
4,194 |
4,008 |
$2K |
| 88142 |
|
358 |
356 |
$2K |
| G9919 |
Scrn nd pos nd prov of rec |
192 |
191 |
$2K |
| 99173 |
|
762 |
757 |
$910.00 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
320 |
243 |
$772.52 |
| 92015 |
|
3,296 |
3,285 |
$727.80 |
| 87426 |
|
538 |
498 |
$671.00 |
| 0124A |
|
13 |
13 |
$468.00 |
| 36415 |
|
3,425 |
3,351 |
$443.98 |
| G0008 |
Admin influenza virus vac |
446 |
444 |
$325.39 |
| 99204 |
|
453 |
451 |
$257.00 |
| 87635 |
|
837 |
797 |
$220.95 |
| 90715 |
|
964 |
959 |
$47.00 |
| 90656 |
|
81 |
81 |
$31.05 |
| 87502 |
|
74 |
73 |
$27.00 |
| J1885 |
Ketorolac tromethamine inj |
27 |
25 |
$15.00 |
| 87880 |
|
110 |
105 |
$6.99 |
| 85018 |
|
655 |
643 |
$2.07 |
| 81025 |
|
865 |
843 |
$2.00 |
| H1001 |
Antepartum management |
369 |
219 |
$0.03 |
| 83036 |
|
147 |
144 |
$0.02 |
| 99205 |
Prolong outpt/office vis |
27 |
27 |
$0.01 |
| 3074F |
|
230 |
226 |
$0.00 |
| 99441 |
|
691 |
657 |
$0.00 |
| 99443 |
|
1,147 |
1,097 |
$0.00 |
| 98967 |
|
28 |
26 |
$0.00 |
| 0949 |
|
190 |
122 |
$0.00 |
| 3080F |
|
60 |
57 |
$0.00 |
| 3008F |
|
111 |
109 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
16 |
14 |
$0.00 |
| 3079F |
|
112 |
110 |
$0.00 |
| 92551 |
|
433 |
431 |
$0.00 |
| 99406 |
|
156 |
151 |
$0.00 |
| 87651 |
|
73 |
70 |
$0.00 |
| 99202 |
|
85 |
84 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 1126F |
|
60 |
60 |
$0.00 |
| 3075F |
|
16 |
16 |
$0.00 |
| 87428 |
|
53 |
53 |
$0.00 |
| 3351F |
|
72 |
72 |
$0.00 |
| 1125F |
|
48 |
47 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
15 |
13 |
$0.00 |
| 87807 |
|
33 |
33 |
$0.00 |
| 99394 |
|
192 |
192 |
$0.00 |
| 90472 |
|
598 |
441 |
$0.00 |
| 4004F |
|
37 |
37 |
$0.00 |
| 0521 |
|
280 |
215 |
$0.00 |
| 98968 |
|
1,317 |
883 |
$0.00 |
| 99442 |
|
433 |
416 |
$0.00 |
| 90833 |
|
13 |
13 |
$0.00 |
| 87804 |
|
90 |
88 |
$0.00 |
| 3078F |
|
129 |
126 |
$0.00 |
| 1159F |
|
140 |
136 |
$0.00 |
| 90662 |
|
178 |
177 |
$0.00 |
| 90750 |
|
61 |
60 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
80 |
79 |
$0.00 |
| 90460 |
|
112 |
71 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 3077F |
|
113 |
109 |
$0.00 |
| 90714 |
|
17 |
17 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
12 |
12 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90713 |
|
16 |
16 |
$0.00 |