| Code | Description | Claims | Beneficiaries | Total Paid |
| 47379 |
|
332 |
265 |
$12K |
| 43775 |
|
310 |
198 |
$12K |
| 99214 |
|
5,986 |
5,593 |
$6K |
| 99204 |
|
714 |
714 |
$6K |
| 99213 |
|
18,665 |
16,372 |
$5K |
| G2012 |
Brief check in by md/qhp |
3,352 |
3,279 |
$3K |
| 43235 |
|
200 |
197 |
$2K |
| 99244 |
|
664 |
664 |
$1K |
| 99212 |
|
1,713 |
1,594 |
$470.84 |
| 91200 |
|
183 |
182 |
$359.70 |
| 99203 |
|
217 |
217 |
$188.76 |
| 91010 |
|
75 |
75 |
$54.05 |
| 59425 |
|
1,392 |
928 |
$0.00 |
| 87660 |
|
208 |
180 |
$0.00 |
| E1390 |
Oxygen concentrator |
129 |
126 |
$0.00 |
| 99392 |
|
522 |
516 |
$0.00 |
| 87641 |
|
67 |
64 |
$0.00 |
| 99401 |
|
200 |
175 |
$0.00 |
| 86038 |
|
222 |
163 |
$0.00 |
| 80076 |
|
926 |
734 |
$0.00 |
| 87186 |
|
473 |
369 |
$0.00 |
| 87481 |
|
284 |
275 |
$0.00 |
| 87491 |
|
2,211 |
1,868 |
$0.00 |
| 81002 |
|
1,397 |
1,151 |
$0.00 |
| 90715 |
|
147 |
131 |
$0.00 |
| 90670 |
|
478 |
464 |
$0.00 |
| 90472 |
|
470 |
462 |
$0.00 |
| 99173 |
|
768 |
757 |
$0.00 |
| 85610 |
|
1,088 |
703 |
$0.00 |
| 80061 |
|
3,682 |
2,904 |
$0.00 |
| 83655 |
|
597 |
552 |
$0.00 |
| 80307 |
|
485 |
414 |
$0.00 |
| 84156 |
|
130 |
112 |
$0.00 |
| 87653 |
|
139 |
137 |
$0.00 |
| 81025 |
|
1,066 |
1,006 |
$0.00 |
| 80306 |
|
29 |
29 |
$0.00 |
| 83970 |
|
63 |
54 |
$0.00 |
| 84550 |
|
626 |
529 |
$0.00 |
| H1003 |
Prenatal at risk education |
423 |
350 |
$0.00 |
| 81003 |
|
1,455 |
1,104 |
$0.00 |
| 71046 |
|
91 |
90 |
$0.00 |
| 90648 |
|
289 |
281 |
$0.00 |
| 90734 |
|
16 |
16 |
$0.00 |
| 82776 |
|
177 |
174 |
$0.00 |
| 87880 |
|
13 |
13 |
$0.00 |
| T4541 |
Large disposable underpad |
65 |
65 |
$0.00 |
| 93010 |
|
467 |
372 |
$0.00 |
| 99391 |
|
297 |
295 |
$0.00 |
| 86696 |
|
193 |
159 |
$0.00 |
| 84100 |
|
835 |
294 |
$0.00 |
| 99382 |
|
68 |
68 |
$0.00 |
| 82947 |
|
352 |
347 |
$0.00 |
| 86923 |
|
74 |
59 |
$0.00 |
| 3078F |
|
157 |
142 |
$0.00 |
| 84450 |
|
125 |
96 |
$0.00 |
| 80074 |
|
200 |
149 |
$0.00 |
| 82565 |
|
164 |
105 |
$0.00 |
| 83013 |
|
107 |
86 |
$0.00 |
| 86480 |
|
262 |
228 |
$0.00 |
| 88175 |
|
539 |
501 |
$0.00 |
| 86787 |
|
66 |
45 |
$0.00 |
| 87210 |
|
188 |
177 |
$0.00 |
| 77067 |
|
143 |
143 |
$0.00 |
| 86431 |
|
130 |
88 |
$0.00 |
| 86200 |
|
24 |
14 |
$0.00 |
| 82274 |
|
339 |
324 |
$0.00 |
| 82977 |
|
18 |
14 |
$0.00 |
| 93880 |
|
44 |
44 |
$0.00 |
| 99393 |
|
84 |
84 |
$0.00 |
| 2022F |
|
31 |
25 |
$0.00 |
| 87798 |
|
298 |
262 |
$0.00 |
| 82248 |
|
435 |
365 |
$0.00 |
| 90685 |
|
71 |
69 |
$0.00 |
| 90700 |
|
331 |
323 |
$0.00 |
| 84466 |
|
163 |
160 |
$0.00 |
| 90633 |
|
243 |
239 |
$0.00 |
| 82570 |
|
928 |
688 |
$0.00 |
| 83516 |
|
174 |
172 |
$0.00 |
| 90707 |
|
68 |
67 |
$0.00 |
| 84460 |
|
152 |
120 |
$0.00 |
| 90681 |
|
14 |
14 |
$0.00 |
| 86900 |
|
612 |
533 |
$0.00 |
| 82785 |
|
59 |
52 |
$0.00 |
| 3077F |
|
108 |
98 |
$0.00 |
| 82247 |
|
242 |
146 |
$0.00 |
| 83540 |
|
436 |
364 |
$0.00 |
| 82140 |
|
34 |
29 |
$0.00 |
| 90713 |
|
183 |
175 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
79 |
70 |
$0.00 |
| 99396 |
|
17 |
17 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90461 |
|
304 |
279 |
$0.00 |
| 90460 |
|
765 |
345 |
$0.00 |
| 97110 |
|
249 |
78 |
$0.00 |
| 87806 |
|
61 |
61 |
$0.00 |
| 92552 |
|
99 |
99 |
$0.00 |
| 84702 |
|
598 |
485 |
$0.00 |
| 82172 |
|
12 |
12 |
$0.00 |
| 87075 |
|
51 |
42 |
$0.00 |
| 84439 |
|
1,276 |
893 |
$0.00 |
| 99211 |
|
221 |
218 |
$0.00 |
| 76805 |
|
27 |
27 |
$0.00 |
| 83695 |
|
12 |
12 |
$0.00 |
| 99394 |
|
51 |
51 |
$0.00 |
| A7003 |
Nebulizer administration set |
70 |
65 |
$0.00 |
| 87502 |
|
19 |
19 |
$0.00 |
| 99284 |
|
25 |
25 |
$0.00 |
| 93015 |
|
12 |
12 |
$0.00 |
| 84146 |
|
29 |
25 |
$0.00 |
| 87338 |
|
14 |
13 |
$0.00 |
| T1013 |
Sign lang/oral interpreter |
44 |
39 |
$0.00 |
| 83698 |
|
12 |
12 |
$0.00 |
| L0643 |
Lso sag ctr rigi pos pre ots |
14 |
14 |
$0.00 |
| 97803 |
|
41 |
38 |
$0.00 |
| S9470 |
Nutritional counseling, diet |
13 |
13 |
$0.00 |
| 69210 |
|
17 |
17 |
$0.00 |
| 84403 |
|
22 |
17 |
$0.00 |
| 99497 |
|
12 |
12 |
$0.00 |
| 76642 |
|
12 |
12 |
$0.00 |
| 84520 |
|
27 |
13 |
$0.00 |
| 73562 |
|
15 |
15 |
$0.00 |
| 43239 |
|
30 |
30 |
$0.00 |
| 43644 |
|
20 |
12 |
$0.00 |
| 90471 |
|
898 |
882 |
$0.00 |
| 85025 |
|
7,378 |
4,900 |
$0.00 |
| 3008F |
|
289 |
256 |
$0.00 |
| 87503 |
|
17 |
17 |
$0.00 |
| 83498 |
|
180 |
177 |
$0.00 |
| Q0111 |
Wet mounts/ w preparations |
42 |
42 |
$0.00 |
| 87086 |
|
863 |
682 |
$0.00 |
| 92551 |
|
551 |
540 |
$0.00 |
| A7016 |
Nebulizer dome & mouthpiece |
70 |
65 |
$0.00 |
| 84436 |
|
93 |
82 |
$0.00 |
| 83550 |
|
205 |
149 |
$0.00 |
| 83735 |
|
1,133 |
378 |
$0.00 |
| 87070 |
|
216 |
190 |
$0.00 |
| 86850 |
|
538 |
491 |
$0.00 |
| 80048 |
|
1,689 |
768 |
$0.00 |
| 90686 |
|
355 |
354 |
$0.00 |
| 76816 |
|
147 |
136 |
$0.00 |
| 87081 |
|
104 |
102 |
$0.00 |
| 87661 |
|
389 |
362 |
$0.00 |
| 80055 |
|
82 |
64 |
$0.00 |
| 83690 |
|
687 |
582 |
$0.00 |
| D1206 |
|
326 |
320 |
$0.00 |
| 98941 |
|
276 |
205 |
$0.00 |
| 83021 |
|
177 |
174 |
$0.00 |
| 82607 |
|
590 |
476 |
$0.00 |
| 90651 |
|
39 |
38 |
$0.00 |
| 96110 |
|
688 |
678 |
$0.00 |
| 87340 |
|
190 |
178 |
$0.00 |
| 85018 |
|
2,142 |
2,078 |
$0.00 |
| 87389 |
|
1,266 |
966 |
$0.00 |
| 83001 |
|
54 |
41 |
$0.00 |
| 85652 |
|
357 |
254 |
$0.00 |
| 76811 |
|
61 |
61 |
$0.00 |
| 84443 |
|
2,984 |
2,668 |
$0.00 |
| 84153 |
|
156 |
131 |
$0.00 |
| 80053 |
|
4,946 |
3,877 |
$0.00 |
| 87591 |
|
2,203 |
1,866 |
$0.00 |
| 87624 |
|
302 |
263 |
$0.00 |
| 82962 |
|
324 |
286 |
$0.00 |
| 86580 |
|
184 |
183 |
$0.00 |
| 83036 |
|
4,135 |
3,239 |
$0.00 |
| 87040 |
|
219 |
182 |
$0.00 |
| 83704 |
|
12 |
12 |
$0.00 |
| 3080F |
|
37 |
32 |
$0.00 |
| 81001 |
|
2,582 |
2,228 |
$0.00 |
| 90688 |
|
444 |
444 |
$0.00 |
| 97802 |
|
38 |
38 |
$0.00 |
| 90680 |
|
159 |
149 |
$0.00 |
| 83605 |
|
257 |
203 |
$0.00 |
| 96372 |
|
34 |
27 |
$0.00 |
| 80050 |
|
966 |
936 |
$0.00 |
| 86592 |
|
671 |
531 |
$0.00 |
| 82803 |
|
156 |
101 |
$0.00 |
| 87205 |
|
133 |
111 |
$0.00 |
| 90698 |
|
105 |
104 |
$0.00 |
| 87511 |
|
242 |
242 |
$0.00 |
| 94760 |
|
37 |
37 |
$0.00 |
| 90744 |
|
168 |
166 |
$0.00 |
| 82728 |
|
417 |
334 |
$0.00 |
| 80320 |
|
95 |
85 |
$0.00 |
| 85027 |
|
1,404 |
1,110 |
$0.00 |
| 83002 |
|
35 |
27 |
$0.00 |
| 86141 |
|
30 |
30 |
$0.00 |
| 83880 |
|
271 |
207 |
$0.00 |
| 99000 |
|
14 |
14 |
$0.00 |
| 36416 |
|
88 |
88 |
$0.00 |
| 86361 |
|
152 |
149 |
$0.00 |
| 83615 |
|
180 |
115 |
$0.00 |
| 87077 |
|
293 |
245 |
$0.00 |
| 97014 |
|
122 |
42 |
$0.00 |
| 82306 |
|
1,475 |
1,202 |
$0.00 |
| 82150 |
|
34 |
25 |
$0.00 |
| 99283 |
|
227 |
226 |
$0.00 |
| 36415 |
|
3,358 |
3,099 |
$0.00 |
| 82746 |
|
296 |
226 |
$0.00 |
| 82950 |
|
225 |
193 |
$0.00 |
| 82261 |
|
178 |
175 |
$0.00 |
| J3490 |
Drugs unclassified injection |
121 |
77 |
$0.00 |
| 85730 |
|
221 |
157 |
$0.00 |
| 96127 |
|
105 |
84 |
$0.00 |
| 87510 |
|
208 |
180 |
$0.00 |
| 93306 |
|
133 |
133 |
$0.00 |
| 3014F |
|
19 |
13 |
$0.00 |
| 76815 |
|
61 |
47 |
$0.00 |
| 85013 |
|
26 |
21 |
$0.00 |
| 80047 |
|
1,306 |
1,095 |
$0.00 |
| 86780 |
|
597 |
578 |
$0.00 |
| 86901 |
|
612 |
534 |
$0.00 |
| 80081 |
|
82 |
82 |
$0.00 |
| 86762 |
|
75 |
74 |
$0.00 |
| 87088 |
|
825 |
689 |
$0.00 |
| 93000 |
|
108 |
108 |
$0.00 |
| 83789 |
|
177 |
174 |
$0.00 |
| 1220F |
|
29 |
26 |
$0.00 |
| 96151 |
|
55 |
52 |
$0.00 |
| 3074F |
|
143 |
127 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 86695 |
|
112 |
93 |
$0.00 |
| 85651 |
|
119 |
112 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
14 |
14 |
$0.00 |
| 3075F |
|
48 |
43 |
$0.00 |
| J3420 |
Vitamin b12 injection |
12 |
12 |
$0.00 |
| 3079F |
|
93 |
84 |
$0.00 |
| 90716 |
|
78 |
77 |
$0.00 |
| 87480 |
|
208 |
180 |
$0.00 |
| 85379 |
|
30 |
29 |
$0.00 |
| 82951 |
|
16 |
12 |
$0.00 |
| 88142 |
|
444 |
312 |
$0.00 |
| 86803 |
|
113 |
79 |
$0.00 |
| 82043 |
|
885 |
648 |
$0.00 |
| 94640 |
|
70 |
65 |
$0.00 |
| 3044F |
|
18 |
15 |
$0.00 |
| 86140 |
|
310 |
246 |
$0.00 |
| 87801 |
|
24 |
24 |
$0.00 |
| 84703 |
|
128 |
120 |
$0.00 |
| E0431 |
Portable gaseous 02 |
42 |
39 |
$0.00 |
| 84484 |
|
606 |
438 |
$0.00 |
| 82550 |
|
28 |
25 |
$0.00 |
| 99383 |
|
25 |
25 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
69 |
64 |
$0.00 |
| E0562 |
Humidifier heated used w pap |
14 |
12 |
$0.00 |
| 97112 |
|
30 |
12 |
$0.00 |
| 84479 |
|
36 |
31 |
$0.00 |
| 3061F |
|
25 |
24 |
$0.00 |
| 83986 |
|
13 |
13 |
$0.00 |
| 88141 |
|
43 |
31 |
$0.00 |
| 99202 |
|
58 |
58 |
$0.00 |
| 84300 |
|
15 |
14 |
$0.00 |
| 97140 |
|
114 |
38 |
$0.00 |
| 76700 |
|
15 |
15 |
$0.00 |