| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
86,779 |
68,944 |
$13.12M |
| 00003 |
|
33,644 |
24,319 |
$8.21M |
| G9012 |
Other specified case mgmt |
1,819 |
827 |
$265K |
| H1001 |
Antepartum management |
2,868 |
2,110 |
$206K |
| 59425 |
|
2,136 |
1,563 |
$136K |
| 90832 |
|
6,465 |
2,471 |
$116K |
| 99213 |
|
44,563 |
28,192 |
$99K |
| 99214 |
|
24,778 |
16,129 |
$74K |
| G0442 |
Annual alcohol screen 15 min |
6,109 |
4,150 |
$50K |
| 90686 |
|
4,224 |
2,977 |
$37K |
| 76811 |
|
253 |
141 |
$26K |
| 90791 |
|
461 |
287 |
$25K |
| 90834 |
|
967 |
431 |
$25K |
| 90688 |
|
1,359 |
1,027 |
$23K |
| 99391 |
|
2,595 |
1,721 |
$21K |
| 90837 |
|
427 |
134 |
$19K |
| S9445 |
Pt education noc individ |
639 |
497 |
$11K |
| 97803 |
|
961 |
809 |
$11K |
| G8510 |
Scr dep neg, no plan reqd |
2,209 |
1,421 |
$10K |
| 96156 |
|
749 |
628 |
$10K |
| 90670 |
|
1,502 |
996 |
$9K |
| 99392 |
|
3,293 |
2,085 |
$9K |
| 76801 |
|
127 |
85 |
$8K |
| H1003 |
Prenatal at risk education |
738 |
644 |
$8K |
| 0064A |
|
112 |
111 |
$7K |
| H1002 |
Carecoordination prenatal |
54 |
54 |
$7K |
| 97802 |
|
57 |
53 |
$6K |
| 90715 |
|
291 |
216 |
$6K |
| 90647 |
|
1,193 |
812 |
$6K |
| 0012A |
|
92 |
91 |
$6K |
| 0124A |
|
82 |
82 |
$5K |
| 90723 |
|
1,071 |
724 |
$5K |
| 99393 |
|
1,924 |
1,185 |
$5K |
| 0004A |
|
70 |
70 |
$5K |
| 0011A |
|
52 |
52 |
$3K |
| 99212 |
|
1,443 |
937 |
$3K |
| 99394 |
|
863 |
515 |
$3K |
| 90633 |
|
459 |
330 |
$3K |
| 92551 |
|
4,546 |
2,816 |
$3K |
| 99401 |
|
217 |
207 |
$3K |
| 99203 |
|
546 |
444 |
$3K |
| S9452 |
Nutrition class |
207 |
178 |
$2K |
| 96127 |
|
852 |
498 |
$2K |
| 0001A |
|
33 |
33 |
$2K |
| 90656 |
|
348 |
269 |
$2K |
| 96110 |
|
56 |
39 |
$2K |
| 0134A |
|
28 |
28 |
$2K |
| G2023 |
Specimen collect covid-19 |
66 |
61 |
$2K |
| 90671 |
|
313 |
208 |
$1K |
| 0071A |
|
19 |
19 |
$1K |
| 99202 |
|
300 |
190 |
$1K |
| 0002A |
|
15 |
15 |
$1K |
| 90680 |
|
109 |
109 |
$972.00 |
| 99000 |
|
335 |
323 |
$903.87 |
| 90662 |
|
17 |
12 |
$870.58 |
| 90681 |
|
198 |
130 |
$765.00 |
| 99211 |
|
671 |
528 |
$762.43 |
| H0049 |
Alcohol/drug screening |
32 |
31 |
$744.00 |
| 96160 |
|
416 |
328 |
$613.47 |
| 99283 |
|
3,343 |
2,930 |
$529.84 |
| G2025 |
Dis site tele svcs rhc/fqhc |
421 |
378 |
$515.36 |
| 83036 |
|
921 |
896 |
$286.01 |
| 99406 |
|
41 |
29 |
$277.16 |
| 90685 |
|
28 |
28 |
$269.27 |
| 85018 |
|
2,387 |
2,269 |
$264.64 |
| 99188 |
|
16 |
16 |
$258.02 |
| G0467 |
Fqhc visit, estab pt |
1,773 |
1,637 |
$192.80 |
| 90651 |
|
21 |
18 |
$162.00 |
| 81025 |
|
79 |
52 |
$148.40 |
| 86703 |
|
15 |
12 |
$143.52 |
| 82947 |
|
870 |
824 |
$140.60 |
| 90471 |
|
195 |
178 |
$115.96 |
| 90700 |
|
12 |
12 |
$108.00 |
| 90716 |
|
12 |
12 |
$108.00 |
| 86580 |
|
143 |
130 |
$50.40 |
| 81002 |
|
114 |
100 |
$45.15 |
| 86592 |
|
16 |
12 |
$31.80 |
| 82948 |
|
82 |
80 |
$5.42 |
| Z6304 |
|
464 |
421 |
$0.00 |
| Z6400 |
|
375 |
370 |
$0.00 |
| Z6300 |
|
16 |
16 |
$0.00 |
| Z6208 |
|
145 |
135 |
$0.00 |
| Z6500 |
|
118 |
118 |
$0.00 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
36 |
36 |
$0.00 |
| Z6200 |
|
16 |
16 |
$0.00 |
| 99173 |
|
41 |
41 |
$0.00 |
| 99395 |
|
26 |
13 |
$0.00 |
| 87804 |
|
15 |
15 |
$0.00 |
| Z6204 |
|
741 |
687 |
$0.00 |
| Z6410 |
|
760 |
630 |
$0.00 |
| Z1034 |
|
3,340 |
2,553 |
$0.00 |
| Z6406 |
|
71 |
71 |
$0.00 |
| 88720 |
|
37 |
26 |
$0.00 |
| Z6402 |
|
17 |
17 |
$0.00 |
| 87426 |
|
13 |
13 |
$0.00 |
| G0008 |
Admin influenza virus vac |
36 |
36 |
$0.00 |