| Code | Description | Claims | Beneficiaries | Total Paid |
| J3490 |
Drugs unclassified injection |
2,974 |
2,495 |
$237K |
| 99213 |
|
26,279 |
24,043 |
$177K |
| 99214 |
|
9,445 |
8,781 |
$87K |
| 90715 |
|
2,466 |
2,398 |
$79K |
| 90686 |
|
4,684 |
4,547 |
$76K |
| 90746 |
|
749 |
745 |
$50K |
| 90732 |
|
314 |
312 |
$24K |
| 90688 |
|
1,276 |
1,273 |
$14K |
| 99211 |
|
892 |
811 |
$9K |
| 90674 |
|
287 |
285 |
$8K |
| 99392 |
|
2,625 |
2,129 |
$8K |
| 87491 |
|
2,940 |
2,825 |
$8K |
| 99490 |
Ccm add 20min |
284 |
283 |
$8K |
| J3301 |
Triamcinolone acet inj nos |
1,488 |
1,447 |
$7K |
| Q3014 |
Telehealth facility fee |
302 |
242 |
$7K |
| 99204 |
|
504 |
499 |
$6K |
| 59425 |
|
1,253 |
905 |
$6K |
| A4267 |
Male condom |
310 |
221 |
$6K |
| 99212 |
|
3,602 |
3,324 |
$6K |
| 92551 |
|
3,851 |
2,913 |
$6K |
| 92552 |
|
2,258 |
2,224 |
$6K |
| 90739 |
|
39 |
39 |
$5K |
| H1003 |
Prenatal at risk education |
1,839 |
1,120 |
$5K |
| 99215 |
Prolong outpt/office vis |
1,215 |
1,138 |
$5K |
| 90670 |
|
1,846 |
1,536 |
$4K |
| 99393 |
|
2,145 |
1,733 |
$4K |
| 90658 |
|
295 |
295 |
$4K |
| 99394 |
|
1,181 |
1,034 |
$4K |
| 69210 |
|
64 |
64 |
$4K |
| 90677 |
|
12 |
12 |
$3K |
| 90471 |
|
1,794 |
1,769 |
$3K |
| 90662 |
|
57 |
57 |
$3K |
| J2785 |
Regadenoson injection |
14 |
14 |
$3K |
| 95117 |
|
701 |
292 |
$2K |
| 99284 |
|
37 |
28 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
1,025 |
953 |
$2K |
| 99173 |
|
3,701 |
3,517 |
$2K |
| 87880 |
|
257 |
248 |
$1K |
| 97803 |
|
2,448 |
1,523 |
$1K |
| 83013 |
|
206 |
206 |
$1K |
| 99401 |
|
5,316 |
3,443 |
$1K |
| 93010 |
|
290 |
245 |
$1K |
| 81220 |
|
29 |
29 |
$990.00 |
| 99203 |
|
200 |
198 |
$984.24 |
| 90656 |
|
47 |
47 |
$854.30 |
| D1206 |
|
733 |
375 |
$815.76 |
| J0696 |
Ceftriaxone sodium injection |
438 |
402 |
$767.40 |
| 90682 |
|
12 |
12 |
$725.64 |
| 99283 |
|
117 |
117 |
$717.60 |
| 99391 |
|
1,622 |
1,296 |
$714.60 |
| J1100 |
Dexamethasone sodium phos |
670 |
435 |
$660.31 |
| G9920 |
Scrning perf and negative |
13 |
13 |
$657.14 |
| J1050 |
Medroxyprogesterone acetate |
13 |
13 |
$578.03 |
| 80307 |
|
1,022 |
948 |
$555.68 |
| 99201 |
|
17 |
12 |
$545.28 |
| 88175 |
|
778 |
776 |
$536.86 |
| 90756 |
|
27 |
27 |
$505.53 |
| 87591 |
|
2,934 |
2,818 |
$466.22 |
| 94760 |
|
70 |
64 |
$328.32 |
| J3420 |
Vitamin b12 injection |
162 |
143 |
$283.88 |
| G8510 |
Scr dep neg, no plan reqd |
14 |
14 |
$275.50 |
| 36415 |
|
15,225 |
14,283 |
$269.43 |
| 88305 |
|
51 |
51 |
$262.32 |
| H2000 |
Comp multidisipln evaluation |
165 |
163 |
$235.17 |
| 71046 |
|
153 |
140 |
$233.50 |
| 97802 |
|
2,981 |
2,106 |
$226.52 |
| 86592 |
|
1,029 |
1,019 |
$225.60 |
| 59426 |
|
95 |
74 |
$221.51 |
| 59430 |
|
14 |
14 |
$219.40 |
| 3074F |
|
767 |
714 |
$202.35 |
| 96127 |
|
1,522 |
1,365 |
$201.96 |
| 83690 |
|
117 |
116 |
$200.34 |
| 80061 |
|
7,796 |
7,605 |
$199.37 |
| 85018 |
|
4,677 |
3,503 |
$190.98 |
| 90633 |
|
860 |
697 |
$164.80 |
| 99285 |
|
15 |
15 |
$150.00 |
| 86038 |
|
356 |
349 |
$138.90 |
| 81025 |
|
459 |
440 |
$125.23 |
| 87624 |
|
849 |
841 |
$122.44 |
| 92004 |
|
13 |
13 |
$115.58 |
| 85025 |
|
4,505 |
4,272 |
$113.48 |
| 87088 |
|
921 |
884 |
$109.66 |
| 90655 |
|
97 |
97 |
$101.43 |
| 83036 |
|
5,890 |
5,823 |
$99.15 |
| 87806 |
|
107 |
95 |
$95.79 |
| 96151 |
|
591 |
438 |
$95.29 |
| 93000 |
|
68 |
66 |
$92.25 |
| 90649 |
|
31 |
31 |
$90.64 |
| 3078F |
|
764 |
706 |
$74.32 |
| 87086 |
|
1,264 |
1,201 |
$73.93 |
| 88142 |
|
587 |
584 |
$71.67 |
| 82947 |
|
119 |
115 |
$70.18 |
| 81001 |
|
2,426 |
2,358 |
$66.78 |
| 82728 |
|
559 |
552 |
$66.78 |
| 84443 |
|
2,756 |
2,707 |
$66.78 |
| 87340 |
|
740 |
735 |
$66.78 |
| 82746 |
|
458 |
457 |
$66.78 |
| 97014 |
|
21 |
13 |
$66.72 |
| S9445 |
Pt education noc individ |
43 |
40 |
$60.63 |
| 83655 |
|
648 |
644 |
$54.75 |
| 92567 |
|
29 |
29 |
$51.08 |
| 90744 |
|
438 |
383 |
$41.20 |
| J7050 |
Normal saline solution infus |
54 |
39 |
$38.13 |
| 90700 |
|
822 |
712 |
$37.08 |
| 97750 |
|
15 |
14 |
$35.89 |
| S4993 |
Contraceptive pills for bc |
25 |
12 |
$31.08 |
| 2010F |
|
446 |
395 |
$30.32 |
| 90698 |
|
212 |
212 |
$28.84 |
| 80053 |
|
5,619 |
5,346 |
$13.97 |
| 84439 |
|
1,220 |
1,207 |
$5.33 |
| 86140 |
|
806 |
800 |
$4.63 |
| J2001 |
Lidocaine injection |
94 |
94 |
$2.14 |
| 87046 |
|
16 |
16 |
$0.00 |
| 82306 |
|
2,076 |
2,066 |
$0.00 |
| 86580 |
|
2,856 |
2,328 |
$0.00 |
| 96110 |
|
5,267 |
3,595 |
$0.00 |
| 90680 |
|
735 |
605 |
$0.00 |
| 90651 |
|
597 |
478 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
117 |
111 |
$0.00 |
| D0120 |
|
4,740 |
2,976 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
681 |
635 |
$0.00 |
| 86706 |
|
298 |
291 |
$0.00 |
| 3008F |
|
535 |
423 |
$0.00 |
| 82043 |
|
968 |
958 |
$0.00 |
| 83735 |
|
179 |
136 |
$0.00 |
| 84436 |
|
230 |
229 |
$0.00 |
| H0049 |
Alcohol/drug screening |
205 |
181 |
$0.00 |
| 86317 |
|
421 |
420 |
$0.00 |
| 83021 |
|
171 |
170 |
$0.00 |
| 90696 |
|
136 |
93 |
$0.00 |
| 20610 |
|
19 |
13 |
$0.00 |
| 85027 |
|
1,506 |
1,483 |
$0.00 |
| 87430 |
|
169 |
168 |
$0.00 |
| 83550 |
|
414 |
410 |
$0.00 |
| 82550 |
|
99 |
83 |
$0.00 |
| 97140 |
|
107 |
37 |
$0.00 |
| 99383 |
|
223 |
158 |
$0.00 |
| 86704 |
|
601 |
597 |
$0.00 |
| 80048 |
|
1,261 |
1,222 |
$0.00 |
| 87077 |
|
238 |
233 |
$0.00 |
| 3075F |
|
21 |
21 |
$0.00 |
| 82105 |
|
36 |
34 |
$0.00 |
| 90716 |
|
449 |
416 |
$0.00 |
| 81005 |
|
1,431 |
1,414 |
$0.00 |
| 81000 |
|
1,912 |
1,183 |
$0.00 |
| 87389 |
|
1,045 |
1,038 |
$0.00 |
| 96111 |
|
128 |
44 |
$0.00 |
| 86803 |
|
934 |
927 |
$0.00 |
| 96150 |
|
1,307 |
1,161 |
$0.00 |
| 84153 |
|
369 |
363 |
$0.00 |
| 87661 |
|
588 |
564 |
$0.00 |
| 80050 |
|
2,316 |
2,300 |
$0.00 |
| 82607 |
|
754 |
752 |
$0.00 |
| G0447 |
Behavior counsel obesity 15m |
4,529 |
3,048 |
$0.00 |
| 80069 |
|
201 |
191 |
$0.00 |
| 86695 |
|
80 |
79 |
$0.00 |
| 87070 |
|
265 |
260 |
$0.00 |
| 90723 |
|
708 |
548 |
$0.00 |
| G0467 |
Fqhc visit, estab pt |
80 |
72 |
$0.00 |
| 87801 |
|
423 |
418 |
$0.00 |
| 87081 |
|
169 |
168 |
$0.00 |
| 3079F |
|
108 |
106 |
$0.00 |
| 87147 |
|
84 |
81 |
$0.00 |
| 87110 |
|
135 |
78 |
$0.00 |
| S9088 |
Services provided in urgent |
347 |
326 |
$0.00 |
| 85652 |
|
626 |
613 |
$0.00 |
| 99000 |
|
104 |
95 |
$0.00 |
| 82150 |
|
60 |
60 |
$0.00 |
| 82950 |
|
129 |
129 |
$0.00 |
| 83014 |
|
78 |
78 |
$0.00 |
| 90647 |
|
350 |
328 |
$0.00 |
| 99384 |
|
20 |
14 |
$0.00 |
| B4160 |
Ef ped caloric dense>/=0.7kc |
95 |
76 |
$0.00 |
| G0439 |
Ppps, subseq visit |
13 |
13 |
$0.00 |
| 2000F |
|
189 |
184 |
$0.00 |
| 86762 |
|
45 |
45 |
$0.00 |
| 82951 |
|
73 |
73 |
$0.00 |
| 85730 |
|
210 |
207 |
$0.00 |
| 2001F |
|
189 |
184 |
$0.00 |
| 83001 |
|
108 |
106 |
$0.00 |
| R0070 |
Transport portable x-ray |
19 |
18 |
$0.00 |
| 86376 |
|
43 |
43 |
$0.00 |
| 84479 |
|
109 |
109 |
$0.00 |
| 96372 |
|
129 |
120 |
$0.00 |
| 80081 |
|
184 |
182 |
$0.00 |
| 82784 |
|
56 |
51 |
$0.00 |
| 83002 |
|
73 |
71 |
$0.00 |
| 97124 |
|
22 |
13 |
$0.00 |
| 88141 |
|
42 |
41 |
$0.00 |
| 99058 |
|
29 |
26 |
$0.00 |
| G8419 |
Calc bmi out nrm param nof/u |
29 |
25 |
$0.00 |
| Q0092 |
Set up port xray equipment |
20 |
19 |
$0.00 |
| S9452 |
Nutrition class |
28 |
28 |
$0.00 |
| 84402 |
|
16 |
16 |
$0.00 |
| G8420 |
Calc bmi norm parameters |
33 |
13 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
16 |
15 |
$0.00 |
| 0072A |
|
16 |
16 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
50 |
50 |
$0.00 |
| 87209 |
|
31 |
29 |
$0.00 |
| 86696 |
|
85 |
84 |
$0.00 |
| 90707 |
|
480 |
426 |
$0.00 |
| 92081 |
|
1,968 |
1,261 |
$0.00 |
| 90685 |
|
230 |
223 |
$0.00 |
| 90734 |
|
467 |
395 |
$0.00 |
| 87799 |
|
477 |
432 |
$0.00 |
| 87186 |
|
264 |
258 |
$0.00 |
| 1159F |
|
488 |
460 |
$0.00 |
| 90648 |
|
1,050 |
778 |
$0.00 |
| 90710 |
|
149 |
108 |
$0.00 |
| 99051 |
|
990 |
967 |
$0.00 |
| 85610 |
|
583 |
460 |
$0.00 |
| 90713 |
|
648 |
526 |
$0.00 |
| 83525 |
|
689 |
674 |
$0.00 |
| 84460 |
|
551 |
542 |
$0.00 |
| 84550 |
|
459 |
452 |
$0.00 |
| 86735 |
|
29 |
29 |
$0.00 |
| 86480 |
|
213 |
211 |
$0.00 |
| 86709 |
|
176 |
174 |
$0.00 |
| 82570 |
|
1,053 |
1,011 |
$0.00 |
| 1160F |
|
88 |
85 |
$0.00 |
| 92012 |
|
72 |
64 |
$0.00 |
| 82274 |
|
460 |
456 |
$0.00 |
| 86708 |
|
586 |
582 |
$0.00 |
| 85014 |
|
1,300 |
1,299 |
$0.00 |
| 83540 |
|
520 |
512 |
$0.00 |
| 84450 |
|
181 |
172 |
$0.00 |
| 99188 |
|
300 |
251 |
$0.00 |
| 99001 |
|
47 |
42 |
$0.00 |
| 96160 |
|
237 |
228 |
$0.00 |
| 84702 |
|
80 |
69 |
$0.00 |
| 90460 |
|
417 |
232 |
$0.00 |
| 83970 |
|
44 |
42 |
$0.00 |
| 87338 |
|
82 |
81 |
$0.00 |
| 96152 |
|
28 |
28 |
$0.00 |
| 92083 |
|
37 |
37 |
$0.00 |
| 82465 |
|
24 |
24 |
$0.00 |
| 86431 |
|
221 |
218 |
$0.00 |
| 82652 |
|
107 |
106 |
$0.00 |
| 90621 |
|
229 |
229 |
$0.00 |
| 87512 |
|
428 |
415 |
$0.00 |
| 81003 |
|
174 |
165 |
$0.00 |
| 86787 |
|
65 |
65 |
$0.00 |
| 84403 |
|
123 |
123 |
$0.00 |
| 83516 |
|
66 |
66 |
$0.00 |
| 81002 |
|
882 |
763 |
$0.00 |
| 86200 |
|
39 |
39 |
$0.00 |
| 86003 |
|
266 |
258 |
$0.00 |
| 77067 |
|
12 |
12 |
$0.00 |
| 84146 |
|
74 |
73 |
$0.00 |
| 84481 |
|
89 |
86 |
$0.00 |
| 82977 |
|
44 |
41 |
$0.00 |
| 80074 |
|
163 |
163 |
$0.00 |
| 92014 |
|
235 |
231 |
$0.00 |
| 80076 |
|
150 |
148 |
$0.00 |
| 82785 |
|
199 |
197 |
$0.00 |
| 84100 |
|
15 |
15 |
$0.00 |
| J2930 |
Methylprednisolone injection |
12 |
12 |
$0.00 |
| 92133 |
|
27 |
27 |
$0.00 |
| 92015 |
|
12 |
12 |
$0.00 |
| 82565 |
|
63 |
61 |
$0.00 |
| 86765 |
|
29 |
29 |
$0.00 |
| 90472 |
|
67 |
67 |
$0.00 |
| 90461 |
|
42 |
39 |
$0.00 |
| 99382 |
|
83 |
59 |
$0.00 |
| 97110 |
|
21 |
13 |
$0.00 |
| 87045 |
|
16 |
16 |
$0.00 |
| 82248 |
|
151 |
144 |
$0.00 |
| 86235 |
|
12 |
12 |
$0.00 |
| 87427 |
|
16 |
16 |
$0.00 |
| 87177 |
|
31 |
29 |
$0.00 |
| 92020 |
|
12 |
12 |
$0.00 |
| 99199 |
|
14 |
13 |
$0.00 |
| 82247 |
|
17 |
15 |
$0.00 |