| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
|
68,046 |
54,717 |
$678K |
| S9542 |
Ht inj noc per diem |
318 |
300 |
$323K |
| 99214 |
|
5,903 |
5,384 |
$111K |
| J3490 |
Drugs unclassified injection |
287 |
276 |
$71K |
| 59425 |
|
2,086 |
1,423 |
$58K |
| 99283 |
|
2,331 |
2,280 |
$48K |
| 81025 |
|
2,311 |
2,191 |
$48K |
| 81002 |
|
3,588 |
3,114 |
$44K |
| 85018 |
|
6,976 |
6,815 |
$43K |
| 99173 |
|
3,935 |
3,913 |
$40K |
| 81003 |
|
6,177 |
5,715 |
$40K |
| 93306 |
|
252 |
248 |
$38K |
| 99243 |
|
530 |
526 |
$33K |
| 99212 |
|
5,820 |
5,385 |
$32K |
| 92551 |
|
3,303 |
3,293 |
$32K |
| 96372 |
|
2,173 |
1,878 |
$30K |
| 94760 |
|
2,923 |
2,396 |
$28K |
| 97110 |
|
1,432 |
829 |
$27K |
| 99204 |
|
787 |
761 |
$24K |
| 99392 |
|
2,305 |
2,290 |
$23K |
| 99284 |
|
647 |
632 |
$21K |
| 92552 |
|
1,620 |
1,612 |
$21K |
| 99393 |
|
1,626 |
1,623 |
$21K |
| 77067 |
|
417 |
407 |
$20K |
| 99285 |
|
311 |
305 |
$18K |
| 71046 |
|
1,343 |
1,272 |
$18K |
| 93015 |
|
158 |
152 |
$17K |
| 3074F |
|
2,452 |
2,047 |
$16K |
| 88305 |
|
358 |
351 |
$16K |
| 3078F |
|
2,171 |
1,822 |
$15K |
| 36415 |
|
9,550 |
9,106 |
$15K |
| 99203 |
|
574 |
564 |
$14K |
| 99215 |
Prolong outpt/office vis |
334 |
318 |
$12K |
| 78452 |
|
71 |
71 |
$12K |
| 92081 |
|
946 |
944 |
$12K |
| 93000 |
|
520 |
499 |
$11K |
| J7050 |
Normal saline solution infus |
156 |
152 |
$11K |
| 97014 |
|
809 |
395 |
$11K |
| 99051 |
|
556 |
496 |
$11K |
| 99394 |
|
648 |
648 |
$11K |
| J0153 |
Adenosine inj 1mg |
103 |
99 |
$10K |
| 82947 |
|
1,406 |
1,193 |
$10K |
| 78492 |
|
58 |
52 |
$9K |
| 99395 |
|
277 |
270 |
$9K |
| H1003 |
Prenatal at risk education |
569 |
379 |
$9K |
| 76815 |
|
182 |
181 |
$9K |
| J3420 |
Vitamin b12 injection |
1,034 |
943 |
$9K |
| T4541 |
Large disposable underpad |
268 |
256 |
$8K |
| J1100 |
Dexamethasone sodium phos |
378 |
326 |
$8K |
| 77063 |
|
277 |
270 |
$8K |
| A9500 |
Tc99m sestamibi |
72 |
72 |
$8K |
| 59514 |
|
15 |
14 |
$7K |
| 86580 |
|
1,133 |
1,109 |
$7K |
| D1206 |
|
441 |
440 |
$7K |
| J1885 |
Ketorolac tromethamine inj |
584 |
501 |
$7K |
| 85014 |
|
546 |
544 |
$7K |
| 43239 |
|
41 |
40 |
$7K |
| 90670 |
|
914 |
901 |
$7K |
| 82962 |
|
843 |
658 |
$7K |
| 94200 |
|
740 |
307 |
$7K |
| 81005 |
|
370 |
368 |
$7K |
| 99000 |
|
956 |
899 |
$6K |
| 99391 |
|
663 |
654 |
$6K |
| 76700 |
|
113 |
107 |
$6K |
| 3079F |
|
907 |
798 |
$6K |
| 76856 |
|
148 |
137 |
$6K |
| S9088 |
Services provided in urgent |
271 |
262 |
$6K |
| 99211 |
|
536 |
196 |
$6K |
| 92012 |
|
70 |
49 |
$6K |
| 59409 |
|
12 |
12 |
$6K |
| 95117 |
|
576 |
210 |
$5K |
| 88307 |
|
84 |
83 |
$5K |
| 81000 |
|
859 |
796 |
$5K |
| 97140 |
|
656 |
359 |
$5K |
| G9637 |
Doc >1 dose reduc tech |
273 |
194 |
$4K |
| 90460 |
|
344 |
337 |
$4K |
| 87491 |
|
3,562 |
3,466 |
$4K |
| J0696 |
Ceftriaxone sodium injection |
331 |
282 |
$4K |
| 3044F |
|
240 |
238 |
$4K |
| G9318 |
Image std nomenclature |
272 |
190 |
$4K |
| T4535 |
Disposable liner/shield/pad |
141 |
136 |
$4K |
| 87591 |
|
3,560 |
3,465 |
$4K |
| A9555 |
Rb82 rubidium |
62 |
53 |
$4K |
| 96151 |
|
320 |
192 |
$4K |
| 36410 |
|
418 |
402 |
$3K |
| 87510 |
|
196 |
188 |
$3K |
| 88304 |
|
135 |
135 |
$3K |
| 92250 |
|
81 |
81 |
$3K |
| 00170 |
|
102 |
102 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
154 |
140 |
$3K |
| 90633 |
|
475 |
467 |
$3K |
| 74177 |
|
115 |
102 |
$3K |
| 45378 |
|
12 |
12 |
$3K |
| 76830 |
|
76 |
73 |
$3K |
| 90700 |
|
251 |
250 |
$3K |
| 87880 |
|
806 |
783 |
$3K |
| 73562 |
|
200 |
170 |
$3K |
| 96110 |
|
292 |
291 |
$3K |
| 99401 |
|
173 |
133 |
$3K |
| 96127 |
|
234 |
234 |
$3K |
| 87480 |
|
200 |
186 |
$3K |
| 88175 |
|
1,067 |
1,067 |
$3K |
| 3075F |
|
375 |
340 |
$3K |
| 93010 |
|
150 |
132 |
$2K |
| 90471 |
|
419 |
414 |
$2K |
| 99202 |
|
103 |
102 |
$2K |
| 87624 |
|
476 |
476 |
$2K |
| 90686 |
|
584 |
575 |
$2K |
| 87797 |
|
168 |
163 |
$2K |
| J2405 |
Ondansetron hcl injection |
138 |
124 |
$2K |
| 71045 |
|
374 |
269 |
$2K |
| 70450 |
|
155 |
122 |
$2K |
| 88312 |
|
80 |
80 |
$2K |
| 94640 |
|
251 |
188 |
$2K |
| 76805 |
|
25 |
25 |
$2K |
| 76642 |
|
58 |
33 |
$2K |
| 87430 |
|
130 |
127 |
$2K |
| 90648 |
|
415 |
405 |
$2K |
| 90680 |
|
251 |
247 |
$2K |
| J1050 |
Medroxyprogesterone acetate |
70 |
69 |
$2K |
| 98940 |
|
264 |
209 |
$2K |
| 85025 |
|
12,633 |
11,502 |
$2K |
| 90651 |
|
160 |
159 |
$2K |
| 88342 |
|
28 |
26 |
$2K |
| 3077F |
|
335 |
295 |
$2K |
| S0020 |
Injection, bupivicaine hydro |
35 |
27 |
$2K |
| J2001 |
Lidocaine injection |
49 |
40 |
$2K |
| 97139 |
|
322 |
132 |
$2K |
| 90461 |
|
176 |
174 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
48 |
40 |
$2K |
| 93880 |
|
12 |
12 |
$2K |
| T4522 |
Adult size brief/diaper med |
41 |
39 |
$2K |
| 90716 |
|
237 |
234 |
$1K |
| 72100 |
|
72 |
67 |
$1K |
| 97010 |
|
403 |
155 |
$1K |
| 87661 |
|
839 |
833 |
$1K |
| 90715 |
|
92 |
92 |
$1K |
| 90713 |
|
106 |
106 |
$1K |
| G0483 |
Drug test def 22+ classes |
13 |
13 |
$1K |
| J7613 |
Albuterol non-comp unit |
150 |
115 |
$1K |
| 80053 |
|
10,304 |
9,733 |
$1K |
| A4267 |
Male condom |
40 |
38 |
$1K |
| Q0091 |
Obtaining screen pap smear |
145 |
127 |
$1K |
| 90707 |
|
250 |
247 |
$1K |
| 92134 |
|
13 |
12 |
$1K |
| 90723 |
|
198 |
193 |
$1K |
| 94010 |
|
61 |
58 |
$1K |
| 99242 |
|
12 |
12 |
$1K |
| 87804 |
|
218 |
146 |
$967.55 |
| 95115 |
|
185 |
74 |
$843.73 |
| 73030 |
|
55 |
52 |
$792.14 |
| G0467 |
Fqhc visit, estab pt |
403 |
347 |
$732.79 |
| 81220 |
|
17 |
17 |
$720.00 |
| 81001 |
|
1,973 |
1,901 |
$707.40 |
| 90734 |
|
77 |
77 |
$707.02 |
| T1015 |
Clinic service |
13 |
13 |
$661.49 |
| 3080F |
|
101 |
82 |
$624.88 |
| 90688 |
|
184 |
177 |
$617.23 |
| 90647 |
|
140 |
140 |
$602.74 |
| 99396 |
|
45 |
44 |
$594.16 |
| 87086 |
|
2,205 |
2,096 |
$570.26 |
| 90620 |
|
32 |
32 |
$486.08 |
| 76705 |
|
33 |
24 |
$473.51 |
| 83735 |
|
611 |
357 |
$460.36 |
| 90656 |
|
23 |
23 |
$457.36 |
| 90472 |
|
74 |
74 |
$447.38 |
| 76641 |
|
15 |
12 |
$437.64 |
| 73630 |
|
38 |
38 |
$429.15 |
| 72110 |
|
17 |
16 |
$426.84 |
| 97035 |
|
120 |
57 |
$420.00 |
| 11721 |
|
15 |
14 |
$405.55 |
| A6250 |
Skin seal protect moisturizr |
55 |
54 |
$385.98 |
| A4927 |
Non-sterile gloves |
27 |
25 |
$385.87 |
| 97530 |
|
36 |
25 |
$385.00 |
| 99238 |
|
13 |
12 |
$379.16 |
| 72081 |
|
12 |
12 |
$375.50 |
| 84484 |
|
354 |
313 |
$374.82 |
| 80048 |
|
808 |
637 |
$371.39 |
| 90696 |
|
14 |
14 |
$359.01 |
| 83690 |
|
744 |
681 |
$344.31 |
| 80061 |
|
7,311 |
7,272 |
$331.40 |
| J1030 |
Methylprednisolone 40 mg inj |
41 |
28 |
$329.26 |
| 90658 |
|
53 |
50 |
$322.25 |
| 88142 |
|
170 |
170 |
$321.80 |
| 97161 |
|
46 |
38 |
$315.00 |
| 83036 |
|
7,464 |
7,417 |
$307.43 |
| 85730 |
|
525 |
477 |
$300.30 |
| A9150 |
Misc/exper non-prescript dru |
30 |
30 |
$280.00 |
| 74176 |
|
14 |
14 |
$279.32 |
| G0101 |
Ca screen;pelvic/breast exam |
16 |
15 |
$273.20 |
| 20550 |
|
12 |
12 |
$255.00 |
| 85610 |
|
810 |
702 |
$253.66 |
| 97164 |
|
14 |
14 |
$250.00 |
| 99223 |
Prolong inpt eval add15 m |
16 |
16 |
$240.30 |
| 87081 |
|
511 |
506 |
$232.09 |
| 90685 |
|
85 |
80 |
$230.19 |
| 99174 |
|
127 |
127 |
$219.30 |
| 36400 |
|
117 |
112 |
$219.06 |
| 80307 |
|
611 |
601 |
$217.64 |
| 73130 |
|
14 |
13 |
$215.71 |
| 84703 |
|
495 |
482 |
$209.51 |
| 87040 |
|
128 |
116 |
$191.57 |
| 82306 |
|
4,200 |
4,174 |
$177.37 |
| 87798 |
|
523 |
500 |
$173.47 |
| 97803 |
|
19 |
12 |
$159.79 |
| 87070 |
|
442 |
432 |
$158.76 |
| 90756 |
|
14 |
13 |
$157.00 |
| 87660 |
|
30 |
30 |
$148.63 |
| 86901 |
|
629 |
610 |
$139.17 |
| 88141 |
|
123 |
123 |
$136.12 |
| 83655 |
|
1,067 |
1,061 |
$134.21 |
| 36416 |
|
12 |
12 |
$128.48 |
| Q3014 |
Telehealth facility fee |
13 |
13 |
$128.08 |
| 84702 |
|
539 |
447 |
$126.10 |
| 90674 |
|
37 |
37 |
$124.62 |
| 83605 |
|
93 |
78 |
$121.99 |
| 90649 |
|
16 |
16 |
$114.39 |
| 92227 |
|
13 |
12 |
$112.66 |
| 87186 |
|
796 |
769 |
$105.58 |
| 3015F |
|
13 |
13 |
$100.03 |
| 80069 |
|
260 |
212 |
$99.72 |
| 83051 |
|
26 |
26 |
$97.24 |
| T1014 |
Telehealth transmit, per min |
13 |
13 |
$95.96 |
| 80076 |
|
579 |
562 |
$89.80 |
| S0302 |
Completed epsdt |
13 |
13 |
$89.66 |
| 83970 |
|
142 |
138 |
$78.95 |
| 83880 |
|
163 |
153 |
$75.53 |
| G8510 |
Scr dep neg, no plan reqd |
12 |
12 |
$72.00 |
| 86900 |
|
615 |
598 |
$71.92 |
| 84100 |
|
377 |
269 |
$69.57 |
| 83550 |
|
772 |
762 |
$60.99 |
| 86850 |
|
617 |
604 |
$54.95 |
| 82550 |
|
88 |
78 |
$53.06 |
| 87077 |
|
199 |
192 |
$46.97 |
| 84443 |
|
7,438 |
7,361 |
$34.33 |
| 82150 |
|
198 |
194 |
$32.28 |
| 86592 |
|
1,665 |
1,644 |
$30.21 |
| 87340 |
|
590 |
587 |
$25.91 |
| 86141 |
|
102 |
102 |
$23.39 |
| 83615 |
|
121 |
104 |
$23.20 |
| 86140 |
|
740 |
716 |
$20.07 |
| 80306 |
|
49 |
44 |
$19.48 |
| 80074 |
|
608 |
603 |
$15.35 |
| 84550 |
|
773 |
757 |
$14.17 |
| 84436 |
|
1,322 |
1,312 |
$12.57 |
| 82607 |
|
1,030 |
1,027 |
$11.67 |
| 87088 |
|
200 |
195 |
$9.90 |
| 82247 |
|
57 |
53 |
$9.11 |
| 82310 |
|
52 |
43 |
$7.93 |
| 83540 |
|
840 |
827 |
$7.54 |
| 82728 |
|
497 |
491 |
$7.52 |
| 84520 |
|
83 |
74 |
$7.46 |
| 82565 |
|
253 |
243 |
$3.81 |
| 84153 |
|
498 |
497 |
$3.29 |
| 87205 |
|
12 |
12 |
$2.19 |
| 87046 |
|
151 |
151 |
$2.18 |
| 85027 |
|
604 |
595 |
$1.14 |
| 84132 |
|
43 |
42 |
$0.69 |
| 82105 |
|
50 |
48 |
$0.00 |
| 85652 |
|
966 |
948 |
$0.00 |
| 82043 |
|
1,143 |
1,134 |
$0.00 |
| 83001 |
|
225 |
225 |
$0.00 |
| 88738 |
|
18 |
18 |
$0.00 |
| 82378 |
|
24 |
24 |
$0.00 |
| 86803 |
|
260 |
259 |
$0.00 |
| 86171 |
|
177 |
144 |
$0.00 |
| 83002 |
|
207 |
207 |
$0.00 |
| 82746 |
|
877 |
875 |
$0.00 |
| 86706 |
|
123 |
123 |
$0.00 |
| 84479 |
|
855 |
849 |
$0.00 |
| 82670 |
|
97 |
97 |
$0.00 |
| 87389 |
|
1,521 |
1,511 |
$0.00 |
| 86695 |
|
123 |
122 |
$0.00 |
| 80047 |
|
33 |
27 |
$0.00 |
| 86376 |
|
137 |
137 |
$0.00 |
| 84480 |
|
394 |
394 |
$0.00 |
| 82950 |
|
393 |
391 |
$0.00 |
| 84144 |
|
45 |
44 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
13 |
13 |
$0.00 |
| 82951 |
|
33 |
33 |
$0.00 |
| 99383 |
|
34 |
34 |
$0.00 |
| A4253 |
Blood glucose/reagent strips |
136 |
135 |
$0.00 |
| 82784 |
|
33 |
33 |
$0.00 |
| 86762 |
|
447 |
444 |
$0.00 |
| 87801 |
|
194 |
193 |
$0.00 |
| 86780 |
|
37 |
37 |
$0.00 |
| 82952 |
|
31 |
31 |
$0.00 |
| 86160 |
|
31 |
30 |
$0.00 |
| 86635 |
|
93 |
87 |
$0.00 |
| 99024 |
|
42 |
25 |
$0.00 |
| 83021 |
|
31 |
30 |
$0.00 |
| 86255 |
|
13 |
13 |
$0.00 |
| 86225 |
|
42 |
42 |
$0.00 |
| 82465 |
|
205 |
205 |
$0.00 |
| 84481 |
|
235 |
235 |
$0.00 |
| A4259 |
Lancets per box |
32 |
31 |
$0.00 |
| 82274 |
|
574 |
564 |
$0.00 |
| 86709 |
|
26 |
26 |
$0.00 |
| 84439 |
|
1,931 |
1,926 |
$0.00 |
| 86003 |
|
432 |
427 |
$0.00 |
| 86431 |
|
408 |
407 |
$0.00 |
| 82785 |
|
273 |
272 |
$0.00 |
| 87150 |
|
141 |
141 |
$0.00 |
| 87338 |
|
192 |
192 |
$0.00 |
| 85060 |
|
15 |
14 |
$0.00 |
| 82570 |
|
862 |
848 |
$0.00 |
| 87177 |
|
86 |
83 |
$0.00 |
| 84156 |
|
186 |
173 |
$0.00 |
| 84146 |
|
196 |
194 |
$0.00 |
| 87427 |
|
148 |
148 |
$0.00 |
| 85045 |
|
299 |
298 |
$0.00 |
| 82140 |
|
52 |
40 |
$0.00 |
| 86677 |
|
64 |
64 |
$0.00 |
| 87209 |
|
85 |
82 |
$0.00 |
| 86038 |
|
458 |
455 |
$0.00 |
| 84403 |
|
247 |
244 |
$0.00 |
| 83516 |
|
103 |
102 |
$0.00 |
| 82248 |
|
14 |
12 |
$0.00 |
| 83013 |
|
90 |
90 |
$0.00 |
| 84460 |
|
269 |
263 |
$0.00 |
| 84450 |
|
249 |
241 |
$0.00 |
| 83721 |
|
30 |
30 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 87481 |
|
271 |
267 |
$0.00 |
| 82977 |
|
106 |
105 |
$0.00 |
| 86200 |
|
161 |
161 |
$0.00 |
| 86696 |
|
131 |
130 |
$0.00 |
| 86480 |
|
30 |
30 |
$0.00 |
| 86331 |
|
168 |
136 |
$0.00 |
| 87045 |
|
152 |
152 |
$0.00 |
| 87400 |
|
17 |
17 |
$0.00 |
| 90473 |
|
13 |
13 |
$0.00 |
| 83525 |
|
29 |
29 |
$0.00 |
| 82652 |
|
15 |
15 |
$0.00 |
| 86235 |
|
63 |
63 |
$0.00 |
| 87420 |
|
17 |
16 |
$0.00 |
| 87075 |
|
13 |
13 |
$0.00 |
| 80164 |
|
13 |
13 |
$0.00 |
| 83718 |
|
15 |
15 |
$0.00 |