| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
1,241,179 |
957,066 |
$357.76M |
| 99214 |
|
398,770 |
343,100 |
$472K |
| 99238 |
|
5,622 |
5,509 |
$336K |
| 59409 |
|
288 |
282 |
$240K |
| 99213 |
|
406,359 |
349,683 |
$222K |
| 99460 |
|
3,303 |
3,208 |
$214K |
| T1016 |
Case management |
16,664 |
12,768 |
$194K |
| 99233 |
Prolong inpt eval add15 m |
3,403 |
1,295 |
$192K |
| 99231 |
|
3,999 |
3,145 |
$130K |
| 99232 |
|
2,644 |
1,067 |
$103K |
| 99239 |
|
750 |
701 |
$38K |
| 59514 |
|
26 |
26 |
$24K |
| 90471 |
|
123,559 |
111,285 |
$23K |
| 99204 |
|
5,310 |
5,123 |
$21K |
| H0031 |
Mh health assess by non-md |
6,058 |
5,820 |
$21K |
| 90837 |
|
14,251 |
9,373 |
$20K |
| 90750 |
|
7,338 |
6,982 |
$19K |
| 99215 |
Prolong outpt/office vis |
10,556 |
9,719 |
$14K |
| 90792 |
|
3,670 |
3,593 |
$14K |
| 99391 |
|
41,279 |
34,830 |
$14K |
| 96156 |
|
17,171 |
15,779 |
$12K |
| 90834 |
|
10,417 |
7,953 |
$10K |
| 99395 |
|
20,045 |
18,003 |
$10K |
| 99396 |
|
17,855 |
16,163 |
$9K |
| 99392 |
|
30,581 |
26,388 |
$9K |
| H0004 |
Alcohol and/or drug services |
11,359 |
6,470 |
$8K |
| 99385 |
|
2,845 |
2,523 |
$8K |
| 99203 |
|
6,320 |
5,854 |
$8K |
| 90686 |
|
60,336 |
52,774 |
$7K |
| 0124A |
|
5,989 |
5,552 |
$6K |
| 90670 |
|
20,883 |
17,834 |
$6K |
| 99212 |
|
43,272 |
32,757 |
$6K |
| 90460 |
|
60,332 |
55,545 |
$6K |
| 97110 |
|
13,165 |
7,703 |
$5K |
| 90715 |
|
19,562 |
18,002 |
$5K |
| 99000 |
|
2,829 |
2,732 |
$5K |
| 99393 |
|
30,169 |
26,052 |
$5K |
| 90461 |
|
30,795 |
27,672 |
$4K |
| 90791 |
|
1,734 |
1,683 |
$4K |
| G0467 |
Fqhc visit, estab pt |
14,600 |
11,610 |
$4K |
| 99221 |
|
68 |
64 |
$4K |
| 99394 |
|
20,464 |
17,261 |
$4K |
| 97803 |
|
5,833 |
5,115 |
$3K |
| 87491 |
|
4,687 |
4,474 |
$3K |
| 0072A |
|
2,964 |
2,740 |
$3K |
| 90472 |
|
40,371 |
35,581 |
$3K |
| 80061 |
|
6,751 |
6,576 |
$3K |
| 90651 |
|
11,414 |
9,965 |
$3K |
| 99381 |
|
3,945 |
3,620 |
$3K |
| 97802 |
|
5,851 |
5,654 |
$2K |
| 87389 |
|
3,354 |
3,218 |
$2K |
| 0071A |
|
1,379 |
1,273 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
26 |
25 |
$2K |
| 87591 |
|
3,353 |
3,188 |
$2K |
| 99462 |
|
76 |
67 |
$2K |
| G2025 |
Dis site tele svcs rhc/fqhc |
2,515 |
2,146 |
$2K |
| 77067 |
|
3,187 |
3,110 |
$2K |
| 99386 |
|
1,215 |
1,115 |
$2K |
| 36415 |
|
61,933 |
57,944 |
$2K |
| 80053 |
|
6,060 |
5,831 |
$2K |
| 76856 |
|
1,281 |
1,244 |
$2K |
| 0012A |
|
1,914 |
1,901 |
$2K |
| 90716 |
|
11,092 |
9,531 |
$2K |
| 76700 |
|
457 |
445 |
$2K |
| 99383 |
|
1,307 |
1,108 |
$2K |
| 90734 |
|
6,536 |
5,528 |
$2K |
| 90677 |
|
5,291 |
5,028 |
$2K |
| 76830 |
|
1,068 |
1,038 |
$2K |
| 85025 |
|
7,212 |
6,943 |
$1K |
| 97140 |
|
10,964 |
6,209 |
$1K |
| 96158 |
|
3,200 |
2,900 |
$1K |
| 97530 |
|
3,653 |
2,740 |
$1K |
| 90688 |
|
16,595 |
13,975 |
$1K |
| 90620 |
|
5,900 |
5,029 |
$1K |
| 96152 |
|
6,139 |
4,939 |
$1K |
| 90732 |
|
827 |
709 |
$1K |
| H0038 |
Self-help/peer svc per 15min |
735 |
398 |
$1K |
| 83036 |
|
6,944 |
6,779 |
$1K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
3,182 |
3,093 |
$1K |
| 0011A |
|
1,914 |
1,871 |
$1K |
| 99382 |
|
189 |
167 |
$1K |
| 90723 |
|
15,250 |
13,078 |
$1K |
| 99463 |
|
14 |
14 |
$1K |
| 99384 |
|
644 |
544 |
$1K |
| 96372 |
|
8,552 |
7,712 |
$1K |
| 97112 |
|
5,198 |
3,325 |
$1K |
| 98927 |
|
373 |
332 |
$974.43 |
| 90707 |
|
10,687 |
9,176 |
$972.65 |
| 0001A |
|
3,719 |
3,545 |
$880.00 |
| 90746 |
|
1,211 |
1,111 |
$866.89 |
| 76642 |
|
1,099 |
1,067 |
$842.90 |
| 0054A |
|
1,008 |
919 |
$840.00 |
| 99202 |
|
938 |
824 |
$828.71 |
| 90681 |
|
9,489 |
8,128 |
$815.56 |
| 76815 |
|
377 |
260 |
$783.91 |
| 84443 |
|
2,738 |
2,662 |
$696.97 |
| 77066 |
Tomosynthesis, mammo |
256 |
251 |
$690.05 |
| 0051A |
|
868 |
788 |
$680.00 |
| 80050 |
|
1,194 |
1,177 |
$666.36 |
| 71046 |
|
4,036 |
3,879 |
$630.28 |
| 0004A |
|
4,590 |
4,143 |
$588.60 |
| 90647 |
|
20,192 |
17,322 |
$558.56 |
| 0002A |
|
3,530 |
3,427 |
$520.00 |
| 0052A |
|
19 |
18 |
$520.00 |
| 0031A |
|
514 |
509 |
$517.95 |
| 99441 |
|
106 |
101 |
$501.20 |
| 99442 |
|
186 |
165 |
$490.26 |
| 90632 |
|
424 |
386 |
$465.96 |
| 86803 |
|
1,946 |
1,888 |
$423.13 |
| 92227 |
|
1,470 |
1,409 |
$390.24 |
| 76536 |
|
37 |
36 |
$388.10 |
| 59025 |
|
2,949 |
1,298 |
$378.57 |
| J1050 |
Medroxyprogesterone acetate |
3,287 |
3,130 |
$363.14 |
| 81003 |
|
23,438 |
19,083 |
$350.79 |
| H2011 |
Crisis interven svc, 15 min |
155 |
138 |
$347.40 |
| 76817 |
|
712 |
624 |
$331.74 |
| 94640 |
|
2,210 |
1,801 |
$325.96 |
| 91303 |
|
204 |
200 |
$317.95 |
| 77063 |
|
3,379 |
3,157 |
$312.38 |
| 96167 |
|
92 |
79 |
$303.62 |
| 99244 |
|
139 |
130 |
$288.42 |
| 1159F |
|
95,217 |
80,373 |
$284.24 |
| G0008 |
Admin influenza virus vac |
4,245 |
3,890 |
$265.33 |
| 99177 |
|
27,810 |
24,014 |
$263.40 |
| D7210 |
|
2,003 |
1,204 |
$232.88 |
| 90633 |
|
11,262 |
9,692 |
$219.00 |
| 76705 |
|
70 |
68 |
$218.04 |
| 92551 |
|
30,468 |
26,336 |
$216.58 |
| 96154 |
|
4,813 |
3,877 |
$179.31 |
| G0438 |
Ppps, initial visit |
29 |
27 |
$171.98 |
| 82247 |
|
569 |
454 |
$169.69 |
| D0140 |
|
16,152 |
13,364 |
$162.00 |
| 90832 |
|
2,886 |
2,355 |
$161.58 |
| 81025 |
|
16,194 |
14,879 |
$154.44 |
| 90853 |
|
38 |
12 |
$148.96 |
| 73564 |
|
197 |
181 |
$140.56 |
| 86592 |
|
2,009 |
1,915 |
$139.95 |
| G0439 |
Ppps, subseq visit |
1,119 |
1,019 |
$134.60 |
| 82248 |
|
459 |
394 |
$129.87 |
| 90662 |
|
2,618 |
2,379 |
$124.00 |
| 99051 |
|
28,737 |
25,915 |
$115.22 |
| 36416 |
|
1,171 |
1,143 |
$104.10 |
| 73030 |
|
395 |
355 |
$103.88 |
| 92014 |
|
307 |
283 |
$97.41 |
| 90696 |
|
3,345 |
2,803 |
$88.88 |
| 80048 |
|
2,285 |
2,201 |
$87.60 |
| 81001 |
|
2,312 |
2,215 |
$84.84 |
| 99173 |
|
23,113 |
19,897 |
$71.50 |
| H0002 |
Alcohol and/or drug screenin |
228 |
221 |
$68.07 |
| 87088 |
|
1,671 |
1,603 |
$66.23 |
| 73630 |
|
128 |
119 |
$66.13 |
| 99397 |
|
511 |
403 |
$64.94 |
| 96150 |
|
2,132 |
1,823 |
$64.85 |
| 73610 |
|
31 |
28 |
$63.86 |
| D0220 |
|
18,483 |
15,606 |
$62.00 |
| 85610 |
|
2,052 |
1,261 |
$61.64 |
| 82962 |
|
2,915 |
2,543 |
$61.64 |
| 58300 |
|
1,359 |
1,295 |
$58.26 |
| 96110 |
|
3,359 |
2,974 |
$53.42 |
| 86580 |
|
1,677 |
1,430 |
$46.18 |
| 87800 |
|
526 |
507 |
$45.57 |
| 93000 |
|
1,757 |
1,644 |
$44.70 |
| 20610 |
|
185 |
166 |
$34.30 |
| 90474 |
|
3,421 |
3,035 |
$31.07 |
| 82043 |
|
1,667 |
1,625 |
$26.80 |
| 86706 |
|
392 |
378 |
$25.40 |
| 84436 |
|
600 |
588 |
$23.81 |
| 87480 |
|
874 |
863 |
$23.71 |
| 87340 |
|
619 |
603 |
$22.50 |
| G0108 |
Diab manage trn per indiv |
346 |
322 |
$22.14 |
| 87070 |
|
1,155 |
1,126 |
$21.04 |
| 87186 |
|
480 |
459 |
$20.04 |
| 80076 |
|
387 |
365 |
$19.32 |
| 82728 |
|
477 |
468 |
$15.48 |
| 87880 |
|
9,603 |
8,955 |
$14.88 |
| 85652 |
|
475 |
460 |
$9.63 |
| 83540 |
|
482 |
475 |
$7.35 |
| 82950 |
|
399 |
392 |
$5.61 |
| J1885 |
Ketorolac tromethamine inj |
1,205 |
1,105 |
$4.88 |
| J1100 |
Dexamethasone sodium phos |
490 |
415 |
$1.35 |
| J7620 |
Albuterol ipratrop non-comp |
916 |
778 |
$0.14 |
| 1036F |
|
311,568 |
258,607 |
$0.09 |
| 1220F |
|
134,296 |
118,185 |
$0.06 |
| J7613 |
Albuterol non-comp unit |
412 |
343 |
$0.04 |
| 96127 |
|
11,052 |
9,498 |
$0.02 |
| 1158F |
|
14,019 |
12,518 |
$0.01 |
| 1003F |
|
1,585 |
1,429 |
$0.01 |
| 91300 |
|
7,635 |
6,894 |
$0.01 |
| 1125F |
|
27,478 |
23,892 |
$0.01 |
| 1101F |
|
5,375 |
4,781 |
$0.01 |
| 1126F |
|
30,272 |
25,901 |
$0.01 |
| 1157F |
|
7,926 |
6,746 |
$0.01 |
| 91320 |
|
5,659 |
5,520 |
$0.00 |
| 90682 |
|
332 |
268 |
$0.00 |
| 3077F |
|
11,715 |
10,829 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
989 |
917 |
$0.00 |
| D2930 |
|
1,524 |
699 |
$0.00 |
| 90713 |
|
1,835 |
1,647 |
$0.00 |
| 87481 |
|
138 |
134 |
$0.00 |
| 84460 |
|
131 |
130 |
$0.00 |
| 91312 |
|
3,585 |
3,413 |
$0.00 |
| D0190 |
|
15,379 |
13,590 |
$0.00 |
| D0330 |
|
2,968 |
2,721 |
$0.00 |
| 3078F |
|
24,738 |
22,691 |
$0.00 |
| 90473 |
|
1,620 |
1,285 |
$0.00 |
| 1160F |
|
26,721 |
23,396 |
$0.00 |
| D0274 |
|
3,114 |
2,912 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
113 |
105 |
$0.00 |
| 11982 |
|
167 |
158 |
$0.00 |
| 2028F |
|
750 |
696 |
$0.00 |
| 87804 |
|
2,638 |
2,576 |
$0.00 |
| D1120 |
|
11,859 |
10,855 |
$0.00 |
| 86705 |
|
182 |
176 |
$0.00 |
| G0470 |
Fqhc visit, mh estab pt |
477 |
289 |
$0.00 |
| 98968 |
|
538 |
488 |
$0.00 |
| 97161 |
|
1,121 |
1,115 |
$0.00 |
| 90700 |
|
5,459 |
4,745 |
$0.00 |
| D0270 |
|
4,054 |
3,216 |
$0.00 |
| 91308 |
|
660 |
590 |
$0.00 |
| 4004F |
|
1,264 |
1,130 |
$0.00 |
| 80305 |
|
207 |
155 |
$0.00 |
| J7307 |
Etonogestrel implant system |
726 |
679 |
$0.00 |
| 81002 |
|
7,019 |
5,201 |
$0.00 |
| 2024F |
|
1,348 |
1,314 |
$0.00 |
| 96153 |
|
632 |
287 |
$0.00 |
| D9230 |
|
2,275 |
1,810 |
$0.00 |
| D1110 |
|
2,479 |
2,290 |
$0.00 |
| 90678 |
|
77 |
77 |
$0.00 |
| 87660 |
|
789 |
779 |
$0.00 |
| 1090F |
|
95 |
76 |
$0.00 |
| G0468 |
Fqhc visit, ippe or awv |
357 |
314 |
$0.00 |
| D2391 |
|
2,078 |
1,311 |
$0.00 |
| D0145 |
|
946 |
875 |
$0.00 |
| D1354 |
|
4,384 |
1,381 |
$0.00 |
| 11981 |
|
498 |
476 |
$0.00 |
| 0003A |
|
180 |
154 |
$0.00 |
| 1100F |
|
152 |
125 |
$0.00 |
| 72100 |
|
258 |
248 |
$0.00 |
| 90685 |
|
1,175 |
1,161 |
$0.00 |
| 70355 |
|
53 |
53 |
$0.00 |
| 90648 |
|
103 |
86 |
$0.00 |
| 3046F |
|
140 |
104 |
$0.00 |
| 77062 |
|
132 |
125 |
$0.00 |
| 3051F |
|
76 |
68 |
$0.00 |
| 84450 |
|
118 |
117 |
$0.00 |
| 73130 |
|
28 |
26 |
$0.00 |
| 0073A |
|
35 |
32 |
$0.00 |
| 0502F |
|
212 |
161 |
$0.00 |
| G0466 |
Fqhc visit new patient |
61 |
58 |
$0.00 |
| 82947 |
|
74 |
72 |
$0.00 |
| 73562 |
|
45 |
40 |
$0.00 |
| J7297 |
Liletta, 52 mg |
51 |
50 |
$0.00 |
| 77065 |
Tomosynthesis, mammo |
59 |
57 |
$0.00 |
| 99201 |
|
85 |
77 |
$0.00 |
| 80074 |
|
13 |
13 |
$0.00 |
| 0053A |
|
147 |
134 |
$0.00 |
| 76805 |
|
27 |
27 |
$0.00 |
| 99211 |
|
124 |
105 |
$0.00 |
| 87210 |
|
32 |
31 |
$0.00 |
| 86431 |
|
174 |
171 |
$0.00 |
| 82565 |
|
12 |
12 |
$0.00 |
| S0119 |
Ondansetron 4 mg |
13 |
13 |
$0.00 |
| 4040F |
|
17 |
17 |
$0.00 |
| 73110 |
|
14 |
12 |
$0.00 |
| 95004 |
|
49 |
33 |
$0.00 |
| 76770 |
|
16 |
15 |
$0.00 |
| 84550 |
|
14 |
14 |
$0.00 |
| 82570 |
|
14 |
12 |
$0.00 |
| 98926 |
|
30 |
26 |
$0.00 |
| D2740 |
|
23 |
13 |
$0.00 |
| 97039 |
|
19 |
18 |
$0.00 |
| 92228 |
|
671 |
637 |
$0.00 |
| D0272 |
|
6,941 |
6,334 |
$0.00 |
| D1206 |
|
24,664 |
22,140 |
$0.00 |
| D0230 |
|
3,798 |
2,592 |
$0.00 |
| 3075F |
|
12,972 |
12,378 |
$0.00 |
| 3074F |
|
24,588 |
22,690 |
$0.00 |
| 92004 |
|
99 |
93 |
$0.00 |
| 90480 |
|
8,378 |
8,194 |
$0.00 |
| 58100 |
|
360 |
349 |
$0.00 |
| D0150 |
|
2,910 |
2,617 |
$0.00 |
| 0154A |
|
559 |
516 |
$0.00 |
| 3079F |
|
18,447 |
17,356 |
$0.00 |
| D0120 |
|
9,929 |
9,128 |
$0.00 |
| D0603 |
|
1,529 |
1,482 |
$0.00 |
| 91301 |
|
997 |
968 |
$0.00 |
| 90619 |
|
1,080 |
1,035 |
$0.00 |
| 90656 |
|
5,092 |
4,999 |
$0.00 |
| D0240 |
|
5,010 |
1,727 |
$0.00 |
| 3080F |
|
5,203 |
4,865 |
$0.00 |
| D2392 |
|
1,980 |
1,246 |
$0.00 |
| D7140 |
|
8,285 |
4,510 |
$0.00 |
| 0081A |
|
579 |
492 |
$0.00 |
| 91319 |
|
147 |
144 |
$0.00 |
| 87081 |
|
1,149 |
1,116 |
$0.00 |
| D1351 |
|
6,346 |
1,691 |
$0.00 |
| 99417 |
Prolong home eval add 15m |
241 |
223 |
$0.00 |
| 88720 |
|
609 |
488 |
$0.00 |
| D1310 |
|
2,125 |
1,991 |
$0.00 |
| 96151 |
|
130 |
98 |
$0.00 |
| 98967 |
|
56 |
54 |
$0.00 |
| 90674 |
|
15 |
14 |
$0.00 |
| 91315 |
|
187 |
177 |
$0.00 |
| 91307 |
|
2,901 |
2,573 |
$0.00 |
| D1330 |
|
2,182 |
2,043 |
$0.00 |
| 97162 |
|
151 |
145 |
$0.00 |
| 87807 |
|
125 |
118 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
331 |
275 |
$0.00 |
| 58301 |
|
265 |
257 |
$0.00 |
| 0082A |
|
397 |
365 |
$0.00 |
| 91305 |
|
718 |
673 |
$0.00 |
| 87510 |
|
765 |
756 |
$0.00 |
| 3044F |
|
186 |
154 |
$0.00 |
| J7298 |
Mirena, 52 mg |
38 |
37 |
$0.00 |
| 83735 |
|
220 |
216 |
$0.00 |
| 94010 |
|
47 |
32 |
$0.00 |
| 76801 |
|
398 |
383 |
$0.00 |
| 85027 |
|
93 |
92 |
$0.00 |
| 84153 |
|
104 |
103 |
$0.00 |
| 96164 |
|
87 |
77 |
$0.00 |
| 3008F |
|
399 |
345 |
$0.00 |
| 90739 |
|
302 |
297 |
$0.00 |
| 83550 |
|
185 |
177 |
$0.00 |
| 80055 |
|
177 |
172 |
$0.00 |
| 4037F |
|
92 |
82 |
$0.00 |
| 87511 |
|
152 |
148 |
$0.00 |
| 83001 |
|
51 |
51 |
$0.00 |
| 90744 |
|
30 |
25 |
$0.00 |
| 87661 |
|
568 |
539 |
$0.00 |
| 0173A |
|
124 |
119 |
$0.00 |
| 57454 |
|
96 |
88 |
$0.00 |
| 80081 |
|
175 |
175 |
$0.00 |
| D0602 |
|
197 |
196 |
$0.00 |
| J2001 |
Lidocaine injection |
39 |
39 |
$0.00 |
| 91318 |
|
72 |
69 |
$0.00 |
| 90847 |
|
33 |
30 |
$0.00 |
| 3052F |
|
17 |
16 |
$0.00 |
| D0210 |
|
104 |
95 |
$0.00 |
| 82550 |
|
14 |
14 |
$0.00 |
| D0601 |
|
198 |
193 |
$0.00 |
| 97016 |
|
12 |
12 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
31 |
26 |
$0.00 |
| 82150 |
|
12 |
12 |
$0.00 |
| 96161 |
|
12 |
12 |
$0.00 |
| 73502 |
|
15 |
15 |
$0.00 |
| 97014 |
|
19 |
12 |
$0.00 |
| 82040 |
|
13 |
12 |
$0.00 |