| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
90,028 |
77,706 |
$22.00M |
| G0467 |
Fqhc visit, estab pt |
10,282 |
9,113 |
$1.65M |
| 99214 |
|
77,065 |
61,527 |
$252K |
| 99213 |
|
50,070 |
36,980 |
$123K |
| 98940 |
|
2,410 |
1,550 |
$21K |
| 99212 |
|
9,661 |
6,763 |
$16K |
| 87635 |
|
1,533 |
1,443 |
$11K |
| 90686 |
|
6,731 |
5,330 |
$10K |
| 83036 |
|
18,241 |
15,358 |
$8K |
| 87502 |
|
528 |
506 |
$5K |
| 99393 |
|
1,037 |
759 |
$4K |
| 99394 |
|
650 |
458 |
$4K |
| 90670 |
|
241 |
199 |
$4K |
| 0241U |
|
207 |
175 |
$3K |
| 99395 |
|
524 |
332 |
$3K |
| 90715 |
|
994 |
797 |
$3K |
| 99392 |
|
501 |
382 |
$2K |
| 90471 |
|
6,048 |
4,447 |
$2K |
| G0466 |
Fqhc visit new patient |
13 |
13 |
$2K |
| 99203 |
|
233 |
210 |
$2K |
| 0064A |
|
244 |
219 |
$2K |
| 90677 |
|
228 |
154 |
$2K |
| 0012A |
|
128 |
103 |
$2K |
| 99396 |
|
314 |
260 |
$2K |
| 96372 |
|
12,338 |
9,434 |
$2K |
| G2025 |
Dis site tele svcs rhc/fqhc |
320 |
296 |
$1K |
| 99204 |
|
161 |
158 |
$1K |
| J3420 |
Vitamin b12 injection |
6,531 |
5,598 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
2,558 |
2,032 |
$1K |
| 82948 |
|
9,838 |
9,148 |
$892.79 |
| 90688 |
|
304 |
304 |
$790.24 |
| 82962 |
|
7,255 |
4,951 |
$719.88 |
| 87651 |
|
180 |
150 |
$712.70 |
| 0011A |
|
150 |
136 |
$695.00 |
| 99442 |
|
601 |
539 |
$559.19 |
| 0013A |
|
19 |
13 |
$535.00 |
| 81025 |
|
1,974 |
1,561 |
$492.66 |
| C9803 |
Hopd covid-19 spec collect |
150 |
140 |
$479.35 |
| 91322 |
|
288 |
258 |
$437.76 |
| 0004A |
|
123 |
115 |
$321.00 |
| 87634 |
|
14 |
14 |
$258.92 |
| 20610 |
|
14 |
14 |
$240.40 |
| 85018 |
|
1,720 |
1,382 |
$234.34 |
| 90656 |
|
706 |
549 |
$226.69 |
| J3490 |
Drugs unclassified injection |
91 |
78 |
$196.58 |
| 1159F |
|
34,463 |
29,736 |
$185.68 |
| 99202 |
|
14 |
14 |
$180.10 |
| 99391 |
|
64 |
54 |
$178.64 |
| 90734 |
|
153 |
105 |
$151.80 |
| 0124A |
|
186 |
173 |
$134.00 |
| 92552 |
|
168 |
121 |
$120.98 |
| 90480 |
|
316 |
286 |
$120.00 |
| 81002 |
|
408 |
389 |
$107.38 |
| 81003 |
|
3,666 |
3,148 |
$91.87 |
| 90694 |
|
35 |
20 |
$76.00 |
| 94640 |
|
49 |
48 |
$68.56 |
| 90657 |
|
26 |
19 |
$63.90 |
| 90662 |
|
91 |
89 |
$60.72 |
| 90658 |
|
39 |
39 |
$56.70 |
| 86580 |
|
203 |
151 |
$52.16 |
| 98967 |
|
103 |
94 |
$47.25 |
| 90649 |
|
84 |
55 |
$46.80 |
| J1040 |
Methylprednisolone 80 mg inj |
17 |
17 |
$43.60 |
| J3301 |
Triamcinolone acet inj nos |
92 |
90 |
$42.78 |
| 90472 |
|
107 |
75 |
$28.09 |
| 93000 |
|
16 |
16 |
$27.12 |
| 90723 |
|
19 |
12 |
$18.90 |
| J0696 |
Ceftriaxone sodium injection |
27 |
26 |
$13.62 |
| 90716 |
|
15 |
15 |
$9.45 |
| 90685 |
|
21 |
15 |
$9.45 |
| 90707 |
|
14 |
14 |
$9.45 |
| 90633 |
|
12 |
12 |
$9.00 |
| J7613 |
Albuterol non-comp unit |
26 |
26 |
$0.20 |
| 3075F |
|
2,385 |
2,327 |
$0.00 |
| 3079F |
|
3,386 |
3,303 |
$0.00 |
| 91301 |
|
272 |
255 |
$0.00 |
| 3008F |
|
16,878 |
15,327 |
$0.00 |
| 3044F |
|
2,358 |
2,318 |
$0.00 |
| 3074F |
|
5,698 |
5,456 |
$0.00 |
| 3080F |
|
876 |
837 |
$0.00 |
| 91306 |
|
199 |
190 |
$0.00 |
| 0134A |
|
134 |
127 |
$0.00 |
| G0008 |
Admin influenza virus vac |
47 |
47 |
$0.00 |
| 3052F |
|
282 |
278 |
$0.00 |
| 97140 |
|
116 |
77 |
$0.00 |
| 97014 |
|
40 |
31 |
$0.00 |
| 90674 |
|
156 |
156 |
$0.00 |
| 99441 |
|
88 |
86 |
$0.00 |
| 97124 |
|
16 |
14 |
$0.00 |
| 92250 |
|
45 |
40 |
$0.00 |
| 3051F |
|
673 |
662 |
$0.00 |
| 3078F |
|
5,988 |
5,705 |
$0.00 |
| 1160F |
|
25,470 |
22,255 |
$0.00 |
| 3077F |
|
2,029 |
1,951 |
$0.00 |
| 91312 |
|
157 |
148 |
$0.00 |
| 3046F |
|
771 |
748 |
$0.00 |
| 91300 |
|
163 |
151 |
$0.00 |
| G9774 |
Pt had hyst |
12 |
12 |
$0.00 |
| 91321 |
|
14 |
14 |
$0.00 |
| G0101 |
Ca screen;pelvic/breast exam |
16 |
12 |
$0.00 |
| G0438 |
Ppps, initial visit |
95 |
95 |
$0.00 |
| 99201 |
|
18 |
18 |
$0.00 |
| 91313 |
|
129 |
124 |
$0.00 |
| 90653 |
|
84 |
84 |
$0.00 |
| Z7500 |
|
13 |
13 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
15 |
12 |
$0.00 |