| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
76,064 |
53,835 |
$14.21M |
| G0467 |
Fqhc visit, estab pt |
19,654 |
15,389 |
$1.04M |
| G2025 |
Dis site tele svcs rhc/fqhc |
1,655 |
1,278 |
$182K |
| G0470 |
Fqhc visit, mh estab pt |
2,596 |
1,447 |
$143K |
| 99213 |
|
36,674 |
31,675 |
$112K |
| 99214 |
|
26,333 |
23,411 |
$71K |
| 90834 |
|
6,731 |
3,863 |
$32K |
| G0008 |
Admin influenza virus vac |
3,420 |
3,328 |
$31K |
| 99212 |
|
4,913 |
4,323 |
$29K |
| 80305 |
|
2,122 |
1,498 |
$13K |
| 90832 |
|
2,151 |
1,470 |
$10K |
| 99215 |
Prolong outpt/office vis |
1,515 |
1,367 |
$9K |
| 99395 |
|
616 |
574 |
$8K |
| 99203 |
|
2,368 |
2,273 |
$8K |
| 87880 |
|
677 |
657 |
$7K |
| 98941 |
|
1,664 |
889 |
$5K |
| 90837 |
|
1,278 |
806 |
$5K |
| 90472 |
|
1,872 |
1,830 |
$5K |
| 99396 |
|
163 |
152 |
$4K |
| 99394 |
|
1,002 |
991 |
$3K |
| 99393 |
|
1,664 |
1,639 |
$3K |
| 11721 |
|
1,230 |
1,205 |
$3K |
| 96127 |
|
1,219 |
1,148 |
$3K |
| G0009 |
Admin pneumococcal vaccine |
403 |
392 |
$3K |
| 98940 |
|
870 |
431 |
$3K |
| 90471 |
|
1,872 |
1,815 |
$3K |
| 98943 |
|
101 |
38 |
$3K |
| 99392 |
|
1,153 |
1,126 |
$2K |
| 71046 |
|
282 |
260 |
$2K |
| 73630 |
|
171 |
159 |
$2K |
| 99391 |
|
746 |
683 |
$2K |
| 99202 |
|
299 |
288 |
$2K |
| 96372 |
|
1,082 |
1,007 |
$2K |
| 90792 |
|
67 |
67 |
$1K |
| 90686 |
|
2,258 |
2,215 |
$1K |
| G0466 |
Fqhc visit new patient |
37 |
37 |
$1K |
| 96160 |
|
1,558 |
1,466 |
$1K |
| 90480 |
|
26 |
26 |
$997.33 |
| 90853 |
|
409 |
205 |
$904.43 |
| 94760 |
|
2,792 |
2,602 |
$755.88 |
| 97140 |
|
243 |
106 |
$590.02 |
| G0468 |
Fqhc visit, ippe or awv |
27 |
27 |
$499.97 |
| 99173 |
|
1,123 |
1,101 |
$430.64 |
| 90715 |
|
694 |
677 |
$377.77 |
| 97110 |
|
392 |
185 |
$304.03 |
| 69209 |
|
101 |
98 |
$270.13 |
| 96110 |
|
1,687 |
1,650 |
$172.90 |
| 81003 |
|
88 |
83 |
$136.35 |
| 99204 |
|
17 |
15 |
$23.79 |
| 83036 |
|
39 |
39 |
$12.32 |
| J1885 |
Ketorolac tromethamine inj |
152 |
140 |
$10.83 |
| 98929 |
|
41 |
39 |
$8.84 |
| 90656 |
|
180 |
179 |
$1.07 |
| 80061 |
|
241 |
241 |
$0.00 |
| 17110 |
|
12 |
12 |
$0.00 |
| 90734 |
|
69 |
66 |
$0.00 |
| 90670 |
|
149 |
146 |
$0.00 |
| 90633 |
|
24 |
24 |
$0.00 |
| 90785 |
|
227 |
171 |
$0.00 |
| 90658 |
|
18 |
18 |
$0.00 |
| 90671 |
|
38 |
38 |
$0.00 |
| Q2037 |
Fluvirin vacc, 3 yrs & >, im |
13 |
13 |
$0.00 |
| 90791 |
|
12 |
12 |
$0.00 |
| 99177 |
|
27 |
27 |
$0.00 |
| 90685 |
|
17 |
17 |
$0.00 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
31 |
30 |
$0.00 |
| 80053 |
|
702 |
678 |
$0.00 |
| 90688 |
|
215 |
206 |
$0.00 |
| 85025 |
|
155 |
149 |
$0.00 |
| 84443 |
|
149 |
148 |
$0.00 |
| 90651 |
|
45 |
45 |
$0.00 |
| Q2036 |
Flulaval vacc, 3 yrs & >, im |
155 |
142 |
$0.00 |
| 94640 |
|
79 |
74 |
$0.00 |
| 11055 |
|
12 |
12 |
$0.00 |
| 85027 |
|
14 |
13 |
$0.00 |
| 82306 |
|
13 |
13 |
$0.00 |
| 90619 |
|
15 |
15 |
$0.00 |