| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
78,254 |
39,929 |
$44.89M |
| G0467 |
Fqhc visit, estab pt |
32,765 |
17,757 |
$8.14M |
| 97140 |
|
33,526 |
6,815 |
$2.31M |
| 99213 |
|
28,792 |
24,185 |
$1.85M |
| 99214 |
|
17,442 |
14,841 |
$1.27M |
| G0470 |
Fqhc visit, mh estab pt |
1,635 |
1,142 |
$474K |
| A0120 |
Noner transport mini-bus |
13,044 |
4,091 |
$352K |
| A0390 |
Advanced life support mileag |
6,353 |
2,237 |
$290K |
| 97750 |
|
3,384 |
2,369 |
$206K |
| A0130 |
Noner transport wheelch van |
3,053 |
989 |
$203K |
| 97110 |
|
33,831 |
6,862 |
$162K |
| A0380 |
Basic life support mileage |
3,059 |
989 |
$124K |
| 0900 |
|
1,024 |
549 |
$60K |
| G0469 |
Fqhc visit, mh new pt |
103 |
87 |
$51K |
| 99212 |
|
2,545 |
2,380 |
$49K |
| 99202 |
|
401 |
398 |
$29K |
| 90832 |
|
2,152 |
2,023 |
$19K |
| G0466 |
Fqhc visit new patient |
28 |
28 |
$12K |
| T2007 |
Non-emer transport wait time |
106 |
88 |
$8K |
| 97035 |
|
31,270 |
6,424 |
$2K |
| 97014 |
|
31,544 |
6,449 |
$1K |
| 82962 |
|
309 |
299 |
$913.86 |
| G2025 |
Dis site tele svcs rhc/fqhc |
613 |
501 |
$895.05 |
| 87426 |
|
386 |
376 |
$495.87 |
| 99215 |
Prolong outpt/office vis |
1,028 |
914 |
$495.87 |
| J1885 |
Ketorolac tromethamine inj |
654 |
620 |
$427.00 |
| J3301 |
Triamcinolone acet inj nos |
68 |
68 |
$19.00 |
| 90792 |
|
412 |
395 |
$0.00 |
| 96372 |
|
27 |
25 |
$0.00 |
| 83036 |
|
422 |
406 |
$0.00 |
| 90686 |
|
399 |
390 |
$0.00 |
| 90834 |
|
417 |
350 |
$0.00 |
| 001 |
Comm hlth intg svs add 30 m |
46 |
30 |
$0.00 |
| G0008 |
Admin influenza virus vac |
134 |
130 |
$0.00 |
| 92551 |
|
48 |
48 |
$0.00 |
| 90688 |
|
31 |
31 |
$0.00 |
| 90471 |
|
26 |
26 |
$0.00 |
| 88142 |
|
13 |
13 |
$0.00 |
| 90694 |
|
14 |
13 |
$0.00 |
| 88738 |
|
73 |
72 |
$0.00 |
| 99173 |
|
108 |
107 |
$0.00 |
| 90662 |
|
41 |
41 |
$0.00 |
| 99203 |
|
141 |
138 |
$0.00 |
| 90837 |
|
436 |
322 |
$0.00 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
285 |
236 |
$0.00 |
| 90791 |
|
80 |
79 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 87880 |
|
33 |
31 |
$0.00 |
| 99204 |
|
117 |
117 |
$0.00 |
| 87804 |
|
130 |
128 |
$0.00 |
| 90460 |
|
34 |
31 |
$0.00 |
| 81003 |
|
16 |
15 |
$0.00 |
| 97164 |
|
20 |
20 |
$0.00 |