| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
325,293 |
264,047 |
$84.85M |
| 00003 |
|
12,210 |
10,500 |
$3.80M |
| G9012 |
Other specified case mgmt |
18,703 |
7,861 |
$1.20M |
| G0467 |
Fqhc visit, estab pt |
14,197 |
10,736 |
$1.17M |
| 90837 |
|
19,882 |
8,241 |
$771K |
| 90832 |
|
23,334 |
9,830 |
$422K |
| G9008 |
Mccd,phys coor-care ovrsght |
1,353 |
1,296 |
$393K |
| 90834 |
|
11,175 |
5,978 |
$324K |
| 99213 |
|
147,540 |
88,547 |
$246K |
| G0470 |
Fqhc visit, mh estab pt |
2,035 |
1,288 |
$237K |
| D2392 |
|
12,272 |
6,970 |
$152K |
| 99214 |
|
82,370 |
49,731 |
$148K |
| 92014 |
|
4,859 |
3,691 |
$133K |
| 90791 |
|
2,007 |
1,294 |
$106K |
| D0150 |
|
13,478 |
8,883 |
$96K |
| D1206 |
|
19,823 |
12,767 |
$95K |
| D4341 |
|
8,052 |
4,177 |
$93K |
| D1120 |
|
7,403 |
4,735 |
$89K |
| D0210 |
|
9,372 |
6,109 |
$73K |
| D0120 |
|
16,779 |
10,574 |
$70K |
| D9430 |
|
19,811 |
12,029 |
$68K |
| D2391 |
|
6,441 |
3,354 |
$67K |
| D0220 |
|
27,686 |
16,623 |
$64K |
| 98940 |
|
13,005 |
6,233 |
$56K |
| D7140 |
|
5,764 |
2,271 |
$54K |
| D1110 |
|
6,216 |
3,984 |
$49K |
| 92004 |
|
3,202 |
2,094 |
$46K |
| D0274 |
|
12,914 |
8,035 |
$37K |
| V2020 |
Vision svcs frames purchases |
2,092 |
2,037 |
$26K |
| D0230 |
|
24,219 |
11,414 |
$23K |
| 99215 |
Prolong outpt/office vis |
763 |
469 |
$16K |
| G2025 |
Dis site tele svcs rhc/fqhc |
2,850 |
1,997 |
$15K |
| 92015 |
|
7,002 |
4,997 |
$13K |
| D2393 |
|
786 |
469 |
$12K |
| D4910 |
|
635 |
422 |
$11K |
| 99212 |
|
28,769 |
16,381 |
$11K |
| 92341 |
|
591 |
580 |
$10K |
| 92340 |
|
881 |
864 |
$10K |
| 90792 |
|
281 |
178 |
$6K |
| D0270 |
|
7,719 |
4,559 |
$5K |
| D0330 |
|
1,489 |
988 |
$5K |
| D4342 |
|
565 |
224 |
$4K |
| V2200 |
Lens spher bifoc plano 4.00d |
242 |
120 |
$4K |
| D9999 |
|
31 |
30 |
$4K |
| D1351 |
|
513 |
91 |
$3K |
| D7210 |
|
244 |
128 |
$2K |
| 99204 |
|
804 |
525 |
$2K |
| D0603 |
|
17,432 |
11,619 |
$2K |
| G0466 |
Fqhc visit new patient |
15 |
15 |
$2K |
| 90471 |
|
6,202 |
4,598 |
$2K |
| 0134A |
|
63 |
40 |
$2K |
| D2331 |
|
97 |
66 |
$1K |
| 99202 |
|
1,460 |
1,179 |
$1K |
| 92133 |
|
155 |
105 |
$1K |
| 90715 |
|
631 |
432 |
$1K |
| D0140 |
|
1,288 |
775 |
$1K |
| 90651 |
|
68 |
40 |
$981.17 |
| 99203 |
|
1,599 |
1,137 |
$958.20 |
| 0011A |
|
15 |
15 |
$938.00 |
| D2330 |
|
48 |
25 |
$710.00 |
| 90674 |
|
552 |
391 |
$571.65 |
| D1999 |
|
621 |
316 |
$500.00 |
| 92250 |
|
1,051 |
1,010 |
$470.11 |
| D0601 |
|
2,257 |
1,368 |
$384.00 |
| G8510 |
Scr dep neg, no plan reqd |
18,901 |
10,897 |
$343.37 |
| 92551 |
|
1,516 |
1,066 |
$281.94 |
| G8431 |
Pos clin depres scrn f/u doc |
2,430 |
1,443 |
$246.83 |
| 92012 |
|
71 |
52 |
$223.63 |
| D3999 |
|
49 |
45 |
$210.00 |
| 96127 |
|
3,694 |
2,235 |
$204.29 |
| 92083 |
|
58 |
43 |
$199.30 |
| D0602 |
|
1,010 |
617 |
$195.00 |
| 90686 |
|
1,790 |
1,333 |
$193.52 |
| D2954 |
|
16 |
12 |
$175.00 |
| 90480 |
|
34 |
30 |
$160.00 |
| 92132 |
|
19 |
13 |
$158.64 |
| 90472 |
|
492 |
356 |
$141.77 |
| 99396 |
|
388 |
224 |
$131.88 |
| V2744 |
Tint photochromatic lens/es |
24 |
12 |
$126.68 |
| 90636 |
|
105 |
87 |
$111.42 |
| D0272 |
|
49 |
27 |
$110.00 |
| 36416 |
|
334 |
311 |
$108.42 |
| D1330 |
|
10,149 |
7,225 |
$106.00 |
| 98941 |
|
271 |
164 |
$83.60 |
| 90661 |
|
519 |
338 |
$82.62 |
| 99393 |
|
138 |
110 |
$43.85 |
| 99392 |
|
63 |
38 |
$37.39 |
| 92082 |
|
28 |
16 |
$34.88 |
| 76514 |
|
16 |
12 |
$18.22 |
| 99173 |
|
1,264 |
908 |
$12.70 |
| 80305 |
|
715 |
477 |
$10.08 |
| 90460 |
|
2,375 |
1,616 |
$9.00 |
| 83036 |
|
2,289 |
1,553 |
$8.54 |
| 81025 |
|
374 |
242 |
$8.40 |
| 82962 |
|
2,491 |
1,682 |
$8.00 |
| 86580 |
|
38 |
27 |
$3.36 |
| 3074F |
|
21,664 |
12,990 |
$0.01 |
| 3079F |
|
8,452 |
5,186 |
$0.01 |
| 2001F |
|
6,887 |
4,307 |
$0.00 |
| D5899 |
|
3,646 |
1,620 |
$0.00 |
| 96372 |
|
727 |
386 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
148 |
76 |
$0.00 |
| D1310 |
|
4,935 |
4,022 |
$0.00 |
| 3075F |
|
4,988 |
3,143 |
$0.00 |
| 3048F |
|
1,213 |
767 |
$0.00 |
| 1126F |
|
1,757 |
1,023 |
$0.00 |
| 1034F |
|
1,788 |
1,078 |
$0.00 |
| 3044F |
|
10,645 |
5,831 |
$0.00 |
| 2023F |
|
209 |
146 |
$0.00 |
| D1320 |
|
60 |
53 |
$0.00 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
49 |
26 |
$0.00 |
| 1036F |
|
3,867 |
2,361 |
$0.00 |
| 1170F |
|
5,775 |
3,214 |
$0.00 |
| 3080F |
|
2,408 |
1,440 |
$0.00 |
| V2100 |
Lens spher single plano 4.00 |
62 |
31 |
$0.00 |
| 3008F |
|
6,889 |
4,308 |
$0.00 |
| 1125F |
|
992 |
573 |
$0.00 |
| 90656 |
|
37 |
26 |
$0.00 |
| 1123F |
|
231 |
150 |
$0.00 |
| 85018 |
|
40 |
36 |
$0.00 |
| 3049F |
|
55 |
33 |
$0.00 |
| 3052F |
|
22 |
14 |
$0.00 |
| 90732 |
|
21 |
19 |
$0.00 |
| 3078F |
|
21,437 |
13,077 |
$0.00 |
| 1160F |
|
28,932 |
16,567 |
$0.00 |
| 3077F |
|
5,730 |
3,531 |
$0.00 |
| D9993 |
|
2,909 |
2,004 |
$0.00 |
| 1159F |
|
5,370 |
3,307 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
740 |
496 |
$0.00 |
| 90746 |
|
185 |
150 |
$0.00 |
| 99395 |
|
451 |
244 |
$0.00 |
| 81002 |
|
1,381 |
919 |
$0.00 |
| 90750 |
|
170 |
109 |
$0.00 |
| 3051F |
|
406 |
243 |
$0.00 |
| 90461 |
|
757 |
533 |
$0.00 |
| 3046F |
|
424 |
213 |
$0.00 |
| 88164 |
|
521 |
319 |
$0.00 |
| 2028F |
|
140 |
89 |
$0.00 |
| 1158F |
|
231 |
150 |
$0.00 |
| 11721 |
|
146 |
122 |
$0.00 |
| 0521 |
|
19 |
18 |
$0.00 |
| 90687 |
|
94 |
69 |
$0.00 |
| 3050F |
|
320 |
182 |
$0.00 |
| 99442 |
|
64 |
36 |
$0.00 |
| 90749 |
|
42 |
26 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
24 |
12 |
$0.00 |
| 90756 |
|
23 |
14 |
$0.00 |
| 99382 |
|
15 |
14 |
$0.00 |
| 90653 |
|
14 |
12 |
$0.00 |