| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
117,911 |
93,029 |
$24.40M |
| G0467 |
Fqhc visit, estab pt |
802 |
733 |
$41K |
| S0280 |
Medical home, initial plan |
1,013 |
967 |
$39K |
| 99213 |
|
50,120 |
43,150 |
$3K |
| 90750 |
|
470 |
410 |
$3K |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
287 |
269 |
$988.20 |
| 90715 |
|
2,015 |
1,932 |
$730.36 |
| J1050 |
Medroxyprogesterone acetate |
1,833 |
1,704 |
$694.55 |
| 90651 |
|
2,562 |
2,446 |
$484.46 |
| 90460 |
|
49,315 |
19,258 |
$295.37 |
| 96127 |
|
3,916 |
3,421 |
$248.02 |
| G0008 |
Admin influenza virus vac |
384 |
356 |
$245.90 |
| 3075F |
|
39 |
39 |
$240.00 |
| 3077F |
|
52 |
50 |
$220.00 |
| 90632 |
|
91 |
82 |
$217.77 |
| 90670 |
|
6,296 |
5,993 |
$214.45 |
| 3079F |
|
40 |
40 |
$200.00 |
| 90716 |
|
2,371 |
2,247 |
$87.87 |
| 90792 |
|
55 |
51 |
$85.86 |
| 3074F |
|
52 |
51 |
$80.00 |
| 99392 |
|
8,650 |
8,276 |
$79.93 |
| 90471 |
|
6,438 |
6,185 |
$77.47 |
| 99214 |
|
13,291 |
11,825 |
$66.80 |
| 90686 |
|
8,342 |
8,023 |
$65.16 |
| 90732 |
|
176 |
169 |
$56.56 |
| T1013 |
Sign lang/oral interpreter |
3,641 |
3,178 |
$43.17 |
| 3078F |
|
14 |
14 |
$40.00 |
| 86403 |
|
545 |
510 |
$28.96 |
| 80305 |
|
1,737 |
1,195 |
$28.70 |
| Q2036 |
Flulaval vacc, 3 yrs & >, im |
40 |
38 |
$26.50 |
| 90472 |
|
1,870 |
1,191 |
$21.41 |
| 96372 |
|
2,633 |
2,311 |
$20.84 |
| 90734 |
|
728 |
711 |
$18.32 |
| 83036 |
|
369 |
341 |
$17.85 |
| 81002 |
|
1,538 |
1,446 |
$14.56 |
| 81000 |
|
415 |
407 |
$12.58 |
| 81025 |
|
2,433 |
2,282 |
$10.87 |
| 81015 |
|
716 |
685 |
$4.32 |
| 90461 |
|
48,378 |
12,056 |
$0.00 |
| 94150 |
|
315 |
302 |
$0.00 |
| 99395 |
|
2,165 |
2,033 |
$0.00 |
| 90633 |
|
4,560 |
4,353 |
$0.00 |
| 90710 |
|
1,511 |
1,457 |
$0.00 |
| 99394 |
|
2,473 |
2,354 |
$0.00 |
| 99212 |
|
5,456 |
5,049 |
$0.00 |
| 99391 |
|
10,457 |
9,168 |
$0.00 |
| 90791 |
|
349 |
325 |
$0.00 |
| 99203 |
|
1,889 |
1,818 |
$0.00 |
| 87210 |
|
1,759 |
1,674 |
$0.00 |
| 99396 |
|
2,282 |
2,212 |
$0.00 |
| 99393 |
|
4,681 |
4,469 |
$0.00 |
| 90621 |
|
312 |
293 |
$0.00 |
| 90837 |
|
1,399 |
971 |
$0.00 |
| 99204 |
|
470 |
437 |
$0.00 |
| 90707 |
|
2,092 |
1,971 |
$0.00 |
| 90832 |
|
1,916 |
1,380 |
$0.00 |
| 90700 |
|
1,794 |
1,717 |
$0.00 |
| 90685 |
|
55 |
55 |
$0.00 |
| 99382 |
|
171 |
167 |
$0.00 |
| 99442 |
|
211 |
197 |
$0.00 |
| 90713 |
|
501 |
477 |
$0.00 |
| 90682 |
|
566 |
553 |
$0.00 |
| 87400 |
|
372 |
354 |
$0.00 |
| 91322 |
|
73 |
71 |
$0.00 |
| 90746 |
|
132 |
112 |
$0.00 |
| 91313 |
|
85 |
83 |
$0.00 |
| 99408 |
|
91 |
85 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
135 |
125 |
$0.00 |
| 91321 |
|
28 |
28 |
$0.00 |
| 99177 |
|
18 |
18 |
$0.00 |
| 90723 |
|
3,198 |
3,107 |
$0.00 |
| 90647 |
|
3,790 |
3,654 |
$0.00 |
| 99381 |
|
2,348 |
2,067 |
$0.00 |
| 90834 |
|
4,384 |
2,854 |
$0.00 |
| 90680 |
|
5,382 |
5,059 |
$0.00 |
| 90674 |
|
138 |
137 |
$0.00 |
| 90677 |
|
1,137 |
1,114 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
16 |
12 |
$0.00 |
| 99383 |
|
427 |
407 |
$0.00 |
| 0134A |
|
85 |
83 |
$0.00 |
| 82962 |
|
457 |
432 |
$0.00 |
| 99384 |
|
272 |
264 |
$0.00 |
| 90697 |
|
2,857 |
2,688 |
$0.00 |
| 99441 |
|
379 |
357 |
$0.00 |
| Q3014 |
Telehealth facility fee |
104 |
97 |
$0.00 |
| 96110 |
|
218 |
195 |
$0.00 |
| 90656 |
|
855 |
846 |
$0.00 |
| 90696 |
|
1,368 |
1,317 |
$0.00 |
| 99385 |
|
175 |
173 |
$0.00 |
| 90744 |
|
119 |
106 |
$0.00 |
| 88720 |
|
169 |
132 |
$0.00 |
| 3008F |
|
1,191 |
1,101 |
$0.00 |
| G9008 |
Mccd,phys coor-care ovrsght |
414 |
392 |
$0.00 |
| 0064A |
|
102 |
95 |
$0.00 |
| 90619 |
|
821 |
783 |
$0.00 |
| 90480 |
|
107 |
104 |
$0.00 |
| Q2039 |
Influenza virus vaccine, nos |
21 |
17 |
$0.00 |
| 91306 |
|
65 |
60 |
$0.00 |
| 3080F |
|
49 |
47 |
$0.00 |
| 99202 |
|
148 |
142 |
$0.00 |
| 87807 |
|
63 |
60 |
$0.00 |
| 93000 |
|
12 |
12 |
$0.00 |
| G0506 |
Comp asses care plan ccm svc |
205 |
201 |
$0.00 |
| 96380 |
|
47 |
47 |
$0.00 |
| 0011A |
|
12 |
12 |
$0.00 |
| 91301 |
|
29 |
27 |
$0.00 |
| 90381 |
|
12 |
12 |
$0.00 |