| Code | Description | Claims | Beneficiaries | Total Paid |
| 90834 |
|
2,574 |
2,067 |
$52K |
| 90791 |
|
1,013 |
1,002 |
$34K |
| 98941 |
|
7,072 |
5,031 |
$30K |
| 99213 |
|
99,994 |
83,467 |
$22K |
| 59425 |
|
3,452 |
1,987 |
$22K |
| S9455 |
Diabetic management program, |
731 |
637 |
$22K |
| 90832 |
|
929 |
728 |
$15K |
| S9445 |
Pt education noc individ |
680 |
648 |
$13K |
| 99392 |
|
5,731 |
5,723 |
$9K |
| 99214 |
|
23,756 |
22,285 |
$6K |
| 99391 |
|
3,228 |
3,203 |
$4K |
| 99393 |
|
3,289 |
3,287 |
$4K |
| G9920 |
Scrning perf and negative |
1,235 |
1,193 |
$4K |
| 98940 |
|
1,570 |
1,115 |
$3K |
| 99401 |
|
3,738 |
3,198 |
$2K |
| H1003 |
Prenatal at risk education |
2,121 |
1,616 |
$2K |
| 99394 |
|
857 |
857 |
$2K |
| 90688 |
|
4,259 |
4,243 |
$1K |
| 99212 |
|
10,838 |
10,120 |
$1K |
| 90686 |
|
7,110 |
7,008 |
$1K |
| 85018 |
|
15,280 |
15,133 |
$1K |
| 90670 |
|
2,399 |
2,388 |
$1K |
| 92551 |
|
6,428 |
6,390 |
$1K |
| 90633 |
|
1,429 |
1,422 |
$900.00 |
| 90715 |
|
928 |
915 |
$856.86 |
| 86580 |
|
3,718 |
3,394 |
$713.04 |
| 81003 |
|
18,729 |
13,337 |
$703.98 |
| 97803 |
|
2,079 |
1,835 |
$691.02 |
| 90723 |
|
1,469 |
1,461 |
$675.00 |
| 96151 |
|
820 |
642 |
$674.54 |
| 59430 |
|
195 |
188 |
$582.90 |
| 90710 |
|
384 |
381 |
$540.00 |
| 90648 |
|
108 |
105 |
$486.00 |
| 90471 |
|
551 |
518 |
$459.00 |
| 90792 |
|
12 |
12 |
$456.00 |
| 90647 |
|
1,834 |
1,798 |
$423.00 |
| 99173 |
|
6,854 |
6,837 |
$347.67 |
| 99203 |
|
190 |
185 |
$326.29 |
| 90472 |
|
46 |
29 |
$315.00 |
| 96150 |
|
117 |
116 |
$300.42 |
| 90681 |
|
473 |
469 |
$297.00 |
| 90651 |
|
81 |
81 |
$279.00 |
| 71020 |
|
38 |
29 |
$192.39 |
| 99201 |
|
81 |
81 |
$172.71 |
| 90696 |
|
222 |
221 |
$171.00 |
| J3490 |
Drugs unclassified injection |
730 |
677 |
$156.00 |
| 97802 |
|
579 |
576 |
$147.79 |
| 96152 |
|
68 |
66 |
$138.93 |
| 90700 |
|
267 |
260 |
$126.00 |
| 81025 |
|
3,885 |
3,734 |
$111.54 |
| 59025 |
|
529 |
277 |
$109.90 |
| 90734 |
|
35 |
35 |
$99.00 |
| 82962 |
|
1,158 |
1,016 |
$81.69 |
| 90620 |
|
12 |
12 |
$54.00 |
| 92250 |
|
770 |
770 |
$42.13 |
| 96156 |
|
3,072 |
2,791 |
$25.23 |
| S9452 |
Nutrition class |
248 |
247 |
$8.41 |
| 87426 |
|
2,995 |
2,965 |
$0.11 |
| 87811 |
|
766 |
756 |
$0.08 |
| 87428 |
|
434 |
427 |
$0.03 |
| 3725F |
|
5,983 |
5,258 |
$0.00 |
| 90649 |
|
224 |
224 |
$0.00 |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
382 |
382 |
$0.00 |
| 1159F |
|
6,134 |
5,421 |
$0.00 |
| S3000 |
Bilat dil retinal exam |
470 |
470 |
$0.00 |
| 99499 |
|
575 |
575 |
$0.00 |
| 1160F |
|
6,134 |
5,421 |
$0.00 |
| 3078F |
|
7,046 |
6,274 |
$0.00 |
| 87880 |
|
679 |
672 |
$0.00 |
| 90707 |
|
180 |
179 |
$0.00 |
| 92015 |
|
161 |
161 |
$0.00 |
| 0004A |
|
39 |
39 |
$0.00 |
| 99395 |
|
40 |
40 |
$0.00 |
| 71046 |
|
127 |
127 |
$0.00 |
| 0071A |
|
107 |
107 |
$0.00 |
| 90644 |
|
100 |
100 |
$0.00 |
| 91300 |
|
66 |
65 |
$0.00 |
| 0034A |
|
17 |
17 |
$0.00 |
| 99204 |
|
82 |
82 |
$0.00 |
| 3077F |
|
227 |
214 |
$0.00 |
| 90630 |
|
137 |
137 |
$0.00 |
| 92340 |
|
54 |
54 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
40 |
39 |
$0.00 |
| 92014 |
|
41 |
41 |
$0.00 |
| 90685 |
|
53 |
51 |
$0.00 |
| H1000 |
Prenatal care atrisk assessm |
24 |
24 |
$0.00 |
| 90621 |
|
13 |
13 |
$0.00 |
| 0002A |
|
12 |
12 |
$0.00 |
| V2020 |
Vision svcs frames purchases |
47 |
47 |
$0.00 |
| 3074F |
|
7,057 |
6,275 |
$0.00 |
| 90677 |
|
27 |
27 |
$0.00 |
| G2025 |
Dis site tele svcs rhc/fqhc |
53 |
44 |
$0.00 |
| 1126F |
|
3,152 |
2,966 |
$0.00 |
| 3008F |
|
8,643 |
7,692 |
$0.00 |
| 3079F |
|
953 |
915 |
$0.00 |
| H1001 |
Antepartum management |
9,138 |
5,536 |
$0.00 |
| 93000 |
|
109 |
106 |
$0.00 |
| 90716 |
|
357 |
343 |
$0.00 |
| H2000 |
Comp multidisipln evaluation |
662 |
597 |
$0.00 |
| 3075F |
|
814 |
785 |
$0.00 |
| 1036F |
|
6,569 |
5,590 |
$0.00 |
| 96372 |
|
197 |
197 |
$0.00 |
| 0064A |
|
73 |
73 |
$0.00 |
| 92227 |
|
26 |
26 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
12 |
12 |
$0.00 |
| 90732 |
|
67 |
67 |
$0.00 |
| 99202 |
|
114 |
114 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
75 |
69 |
$0.00 |
| 99381 |
|
93 |
93 |
$0.00 |
| 0031A |
|
118 |
118 |
$0.00 |
| G9226 |
3 comp foot exam completed |
77 |
77 |
$0.00 |
| 1125F |
|
132 |
130 |
$0.00 |
| 0072A |
|
199 |
199 |
$0.00 |
| 36415 |
|
368 |
361 |
$0.00 |
| 91306 |
|
73 |
73 |
$0.00 |
| 1034F |
|
18 |
15 |
$0.00 |
| 90697 |
|
24 |
24 |
$0.00 |
| 91307 |
|
312 |
295 |
$0.00 |
| 90674 |
|
13 |
13 |
$0.00 |
| 3080F |
|
82 |
78 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
13 |
12 |
$0.00 |
| 99384 |
|
13 |
12 |
$0.00 |
| 91303 |
|
118 |
118 |
$0.00 |
| 90733 |
|
12 |
12 |
$0.00 |