| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97124 |
|
294 |
142 |
$0.00 |
| 90686 |
|
929 |
926 |
$0.00 |
| 90471 |
|
3,808 |
3,757 |
$0.00 |
| 99213 |
|
14,642 |
13,111 |
$0.00 |
| 97162 |
|
78 |
78 |
$0.00 |
| 85025 |
|
3,877 |
3,734 |
$0.00 |
| 99214 |
|
7,683 |
7,167 |
$0.00 |
| 86580 |
|
944 |
925 |
$0.00 |
| 82306 |
|
1,538 |
1,523 |
$0.00 |
| 3074F |
|
201 |
185 |
$0.00 |
| 76700 |
|
606 |
583 |
$0.00 |
| 87517 |
|
334 |
327 |
$0.00 |
| 85027 |
|
314 |
303 |
$0.00 |
| 86803 |
|
251 |
245 |
$0.00 |
| 82270 |
|
779 |
777 |
$0.00 |
| 87389 |
|
155 |
153 |
$0.00 |
| 82043 |
|
867 |
849 |
$0.00 |
| 80053 |
|
4,624 |
4,501 |
$0.00 |
| 1157F |
|
133 |
133 |
$0.00 |
| 76830 |
|
768 |
756 |
$0.00 |
| 84443 |
|
2,193 |
2,163 |
$0.00 |
| 99000 |
|
68 |
68 |
$0.00 |
| 1125F |
|
12 |
12 |
$0.00 |
| 97035 |
|
671 |
309 |
$0.00 |
| 81001 |
|
795 |
776 |
$0.00 |
| 88305 |
|
224 |
224 |
$0.00 |
| 97010 |
|
47 |
12 |
$0.00 |
| 82105 |
|
322 |
316 |
$0.00 |
| 90688 |
|
446 |
445 |
$0.00 |
| 87624 |
|
162 |
161 |
$0.00 |
| 85018 |
|
557 |
557 |
$0.00 |
| 92250 |
|
189 |
189 |
$0.00 |
| 36415 |
|
6,565 |
6,306 |
$0.00 |
| T4535 |
Disposable liner/shield/pad |
547 |
546 |
$0.00 |
| 20610 |
|
71 |
29 |
$0.00 |
| 77063 |
|
120 |
119 |
$0.00 |
| 97014 |
|
597 |
284 |
$0.00 |
| 81000 |
|
336 |
322 |
$0.00 |
| 86762 |
|
49 |
49 |
$0.00 |
| 86706 |
|
765 |
755 |
$0.00 |
| 86317 |
|
13 |
13 |
$0.00 |
| 82728 |
|
63 |
60 |
$0.00 |
| 83036 |
|
2,980 |
2,943 |
$0.00 |
| 85651 |
|
40 |
37 |
$0.00 |
| 87340 |
|
886 |
876 |
$0.00 |
| 85652 |
|
12 |
12 |
$0.00 |
| 84153 |
|
467 |
458 |
$0.00 |
| 1036F |
|
278 |
268 |
$0.00 |
| 92551 |
|
152 |
152 |
$0.00 |
| 83735 |
|
48 |
44 |
$0.00 |
| 90651 |
|
75 |
74 |
$0.00 |
| 1123F |
|
13 |
13 |
$0.00 |
| 94640 |
|
33 |
27 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
26 |
25 |
$0.00 |
| 80050 |
|
329 |
322 |
$0.00 |
| 77081 |
|
26 |
26 |
$0.00 |
| G8754 |
Dias bp less 90 |
31 |
26 |
$0.00 |
| 3008F |
|
134 |
127 |
$0.00 |
| 90674 |
|
30 |
30 |
$0.00 |
| 87086 |
|
13 |
13 |
$0.00 |
| T4536 |
Reusable pull-on any size |
197 |
196 |
$0.00 |
| 92004 |
|
28 |
28 |
$0.00 |
| 1170F |
|
39 |
36 |
$0.00 |
| 80048 |
|
106 |
100 |
$0.00 |
| 97140 |
|
89 |
26 |
$0.00 |
| 83921 |
|
24 |
24 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
26 |
25 |
$0.00 |
| 86592 |
|
36 |
36 |
$0.00 |
| 0250 |
|
92 |
62 |
$0.00 |
| 86704 |
|
47 |
43 |
$0.00 |
| 83550 |
|
42 |
40 |
$0.00 |
| 93000 |
|
62 |
59 |
$0.00 |
| G8420 |
Calc bmi norm parameters |
105 |
102 |
$0.00 |
| 99406 |
|
20 |
20 |
$0.00 |
| 87591 |
|
53 |
53 |
$0.00 |
| 99202 |
|
26 |
26 |
$0.00 |
| 99386 |
|
12 |
12 |
$0.00 |
| T1999 |
Noc retail items andsupplies |
36 |
13 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
14 |
13 |
$0.00 |
| 0258 |
|
25 |
25 |
$0.00 |
| 93306 |
|
20 |
17 |
$0.00 |
| G0463 |
Hospital outpt clinic visit |
33 |
30 |
$0.00 |
| 86140 |
|
17 |
13 |
$0.00 |
| 90657 |
|
20 |
20 |
$0.00 |
| 99156 |
|
12 |
12 |
$0.00 |
| 92552 |
|
2,242 |
2,238 |
$0.00 |
| 88175 |
|
486 |
485 |
$0.00 |
| 1159F |
|
210 |
198 |
$0.00 |
| 80061 |
|
4,336 |
4,292 |
$0.00 |
| 93005 |
|
486 |
464 |
$0.00 |
| 81002 |
|
1,076 |
1,062 |
$0.00 |
| 92081 |
|
2,112 |
2,110 |
$0.00 |
| 99396 |
|
476 |
476 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
576 |
564 |
$0.00 |
| 99394 |
|
578 |
578 |
$0.00 |
| 2022F |
|
14 |
12 |
$0.00 |
| 87880 |
|
353 |
353 |
$0.00 |
| 97110 |
|
784 |
350 |
$0.00 |
| 84439 |
|
744 |
731 |
$0.00 |
| 80076 |
|
12 |
12 |
$0.00 |
| 82570 |
|
803 |
778 |
$0.00 |
| 92012 |
|
285 |
282 |
$0.00 |
| 77067 |
|
1,025 |
999 |
$0.00 |
| 93010 |
|
308 |
288 |
$0.00 |
| 90472 |
|
706 |
673 |
$0.00 |
| 99188 |
|
38 |
38 |
$0.00 |
| 82274 |
|
1,058 |
1,052 |
$0.00 |
| 99212 |
|
507 |
502 |
$0.00 |
| T4522 |
Adult size brief/diaper med |
24 |
24 |
$0.00 |
| 69210 |
|
405 |
401 |
$0.00 |
| T4526 |
Adult size pull-on med |
618 |
618 |
$0.00 |
| 86708 |
|
113 |
111 |
$0.00 |
| 99393 |
|
546 |
545 |
$0.00 |
| 81003 |
|
2,029 |
2,004 |
$0.00 |
| G9622 |
No unheal etoh user |
27 |
27 |
$0.00 |
| 71046 |
|
994 |
937 |
$0.00 |
| 84100 |
|
12 |
12 |
$0.00 |
| 84550 |
|
436 |
427 |
$0.00 |
| 99173 |
|
252 |
252 |
$0.00 |
| T4541 |
Large disposable underpad |
584 |
583 |
$0.00 |
| 83540 |
|
155 |
149 |
$0.00 |
| 86480 |
|
254 |
244 |
$0.00 |
| 99211 |
|
172 |
132 |
$0.00 |
| 90756 |
|
153 |
153 |
$0.00 |
| 85610 |
|
31 |
27 |
$0.00 |
| 1160F |
|
41 |
36 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
30 |
29 |
$0.00 |
| 93017 |
|
26 |
24 |
$0.00 |
| 99204 |
|
62 |
62 |
$0.00 |
| 3078F |
|
203 |
188 |
$0.00 |
| 99392 |
|
28 |
28 |
$0.00 |
| 92014 |
|
24 |
24 |
$0.00 |
| G8731 |
Pain neg no plan |
104 |
100 |
$0.00 |
| 73562 |
|
115 |
83 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
52 |
51 |
$0.00 |
| 99203 |
|
62 |
62 |
$0.00 |
| 86735 |
|
48 |
48 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
44 |
39 |
$0.00 |
| 99395 |
|
68 |
68 |
$0.00 |
| 84466 |
|
34 |
34 |
$0.00 |
| 1158F |
|
13 |
13 |
$0.00 |
| 72050 |
|
42 |
40 |
$0.00 |
| 90685 |
|
41 |
41 |
$0.00 |
| 99281 |
|
16 |
12 |
$0.00 |
| 90734 |
|
57 |
56 |
$0.00 |
| 87491 |
|
54 |
54 |
$0.00 |
| 86787 |
|
38 |
38 |
$0.00 |
| G8730 |
Pain doc pos and plan |
24 |
24 |
$0.00 |
| 72110 |
|
13 |
13 |
$0.00 |
| 86765 |
|
52 |
52 |
$0.00 |
| 83721 |
|
55 |
53 |
$0.00 |
| G8482 |
Flu immunize order/admin |
18 |
18 |
$0.00 |
| 97161 |
|
12 |
12 |
$0.00 |
| 92134 |
|
15 |
15 |
$0.00 |
| G8752 |
Sys bp less 140 |
31 |
26 |
$0.00 |
| 99411 |
|
33 |
33 |
$0.00 |