| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
225,638 |
212,640 |
$99.61M |
| 00003 |
|
6,772 |
6,105 |
$4.30M |
| G0467 |
Fqhc visit, estab pt |
5,117 |
4,555 |
$961K |
| 99213 |
|
206,369 |
132,617 |
$542K |
| G9012 |
Other specified case mgmt |
3,641 |
2,616 |
$379K |
| 99214 |
|
60,142 |
40,141 |
$218K |
| G9008 |
Mccd,phys coor-care ovrsght |
582 |
353 |
$116K |
| 87635 |
|
2,191 |
2,051 |
$44K |
| 99203 |
|
5,085 |
4,064 |
$44K |
| 99309 |
|
3,656 |
3,501 |
$44K |
| 90750 |
|
1,429 |
1,074 |
$37K |
| 92014 |
|
3,770 |
2,667 |
$34K |
| 99212 |
|
21,228 |
13,027 |
$33K |
| 99202 |
|
4,274 |
4,083 |
$31K |
| 90677 |
|
936 |
645 |
$27K |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
4,050 |
3,578 |
$25K |
| 90686 |
|
5,543 |
4,329 |
$12K |
| 90834 |
|
1,356 |
688 |
$10K |
| 90792 |
|
496 |
305 |
$9K |
| 90471 |
|
12,029 |
8,980 |
$7K |
| 90837 |
|
881 |
361 |
$7K |
| 91320 |
|
51 |
51 |
$6K |
| 99215 |
Prolong outpt/office vis |
4,008 |
2,672 |
$6K |
| 99392 |
|
788 |
631 |
$6K |
| 99393 |
|
460 |
335 |
$6K |
| 99244 |
|
367 |
321 |
$5K |
| 90715 |
|
634 |
498 |
$4K |
| 91322 |
|
26 |
26 |
$4K |
| 90662 |
|
1,100 |
827 |
$4K |
| 99394 |
|
302 |
212 |
$4K |
| 90791 |
|
355 |
230 |
$4K |
| 99307 |
|
291 |
199 |
$3K |
| 90480 |
|
130 |
130 |
$3K |
| 77067 |
|
212 |
212 |
$3K |
| 81025 |
|
6,357 |
4,261 |
$3K |
| 90656 |
|
729 |
581 |
$2K |
| 99308 |
|
126 |
100 |
$2K |
| 90678 |
|
223 |
157 |
$2K |
| 90832 |
|
255 |
124 |
$2K |
| 99204 |
|
106 |
83 |
$1K |
| 81002 |
|
4,772 |
3,855 |
$990.28 |
| 99242 |
|
83 |
51 |
$874.61 |
| 92004 |
|
29 |
18 |
$668.86 |
| 90670 |
|
46 |
41 |
$650.98 |
| 0124A |
|
19 |
19 |
$640.00 |
| J1380 |
Estradiol valerate 10 mg inj |
60 |
38 |
$565.99 |
| 90746 |
|
42 |
40 |
$434.03 |
| J1885 |
Ketorolac tromethamine inj |
419 |
410 |
$409.47 |
| 82962 |
|
1,153 |
987 |
$376.10 |
| 71046 |
|
110 |
109 |
$374.67 |
| 99201 |
|
76 |
76 |
$360.18 |
| 82947 |
|
479 |
397 |
$322.04 |
| J3490 |
Drugs unclassified injection |
1,425 |
1,108 |
$312.37 |
| 96372 |
|
185 |
176 |
$279.38 |
| 99306 |
Prolong nursin fac eval 15m |
46 |
41 |
$200.44 |
| 90732 |
|
13 |
13 |
$190.76 |
| 93005 |
|
65 |
65 |
$157.30 |
| 90472 |
|
120 |
101 |
$149.82 |
| 99391 |
|
48 |
39 |
$101.29 |
| 90688 |
|
107 |
107 |
$91.80 |
| J0696 |
Ceftriaxone sodium injection |
114 |
109 |
$88.86 |
| 73630 |
|
12 |
12 |
$87.52 |
| 81001 |
|
92 |
91 |
$58.36 |
| 87880 |
|
31 |
31 |
$45.74 |
| 3080F |
|
7,739 |
5,642 |
$24.00 |
| 83036 |
|
85 |
64 |
$22.20 |
| 90698 |
|
14 |
14 |
$15.30 |
| J2001 |
Lidocaine injection |
65 |
61 |
$13.18 |
| J7613 |
Albuterol non-comp unit |
191 |
186 |
$1.32 |
| 3077F |
|
19,013 |
14,391 |
$0.00 |
| 3078F |
|
65,163 |
49,889 |
$0.00 |
| 1160F |
|
15,372 |
10,132 |
$0.00 |
| 1159F |
|
36,163 |
24,373 |
$0.00 |
| 99442 |
|
984 |
937 |
$0.00 |
| 3050F |
|
170 |
132 |
$0.00 |
| G8935 |
Rx ace or arb therapy |
330 |
311 |
$0.00 |
| 3046F |
|
166 |
136 |
$0.00 |
| 3051F |
|
183 |
159 |
$0.00 |
| 96113 |
|
86 |
50 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 99395 |
|
13 |
12 |
$0.00 |
| 99173 |
|
16 |
14 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 3044F |
|
9,003 |
7,723 |
$0.00 |
| 1126F |
|
8,036 |
7,349 |
$0.00 |
| 3075F |
|
16,304 |
12,326 |
$0.00 |
| 3074F |
|
59,731 |
45,431 |
$0.00 |
| 3079F |
|
21,803 |
16,437 |
$0.00 |
| 3048F |
|
895 |
651 |
$0.00 |
| 3049F |
|
291 |
238 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
111 |
107 |
$0.00 |
| 1125F |
|
6,397 |
5,912 |
$0.00 |
| 99443 |
|
263 |
257 |
$0.00 |
| G0008 |
Admin influenza virus vac |
418 |
309 |
$0.00 |
| 1123F |
|
77 |
73 |
$0.00 |
| 99441 |
|
1,466 |
1,228 |
$0.00 |
| G2025 |
Dis site tele svcs rhc/fqhc |
393 |
321 |
$0.00 |
| 4086F |
|
272 |
250 |
$0.00 |
| 3052F |
|
78 |
61 |
$0.00 |
| 96380 |
|
93 |
65 |
$0.00 |
| 2033F |
|
16 |
12 |
$0.00 |
| 96110 |
|
61 |
43 |
$0.00 |
| 99243 |
|
13 |
13 |
$0.00 |
| 96112 |
|
88 |
50 |
$0.00 |
| 00018 |
|
179 |
153 |
$0.00 |
| Q0162 |
Ondansetron oral |
95 |
95 |
$0.00 |