| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
547,450 |
502,553 |
$85.81M |
| G0467 |
Fqhc visit, estab pt |
80,688 |
66,763 |
$1.69M |
| G0470 |
Fqhc visit, mh estab pt |
7,807 |
7,028 |
$1.48M |
| 59400 |
|
635 |
634 |
$1.37M |
| 59510 |
|
534 |
534 |
$1.28M |
| 99391 |
|
8,971 |
8,701 |
$1.14M |
| 99392 |
|
7,666 |
7,662 |
$1.05M |
| 99050 |
|
25,369 |
24,911 |
$962K |
| T1040 |
Comm bh clinic svc per diem |
6,837 |
4,674 |
$957K |
| 99393 |
|
6,707 |
6,702 |
$948K |
| 99213 |
|
32,425 |
27,922 |
$657K |
| J3490 |
Drugs unclassified injection |
429 |
403 |
$585K |
| 99394 |
|
4,702 |
4,690 |
$555K |
| 99214 |
|
42,373 |
39,389 |
$447K |
| 90471 |
|
21,127 |
21,004 |
$385K |
| 99232 |
|
10,376 |
4,165 |
$352K |
| 97802 |
|
7,129 |
7,104 |
$342K |
| 90834 |
|
4,039 |
3,013 |
$325K |
| 96110 |
|
29,206 |
28,585 |
$287K |
| 99381 |
|
1,059 |
1,054 |
$209K |
| 99238 |
|
4,645 |
4,548 |
$206K |
| 97803 |
|
5,320 |
4,997 |
$199K |
| 99395 |
|
1,896 |
1,889 |
$166K |
| 87804 |
|
11,128 |
10,975 |
$142K |
| 99460 |
|
2,089 |
2,047 |
$133K |
| 90460 |
|
4,864 |
4,829 |
$118K |
| G2023 |
Specimen collect covid-19 |
5,167 |
5,114 |
$117K |
| 87880 |
|
8,037 |
7,932 |
$102K |
| 90677 |
|
1,498 |
1,496 |
$99K |
| 90472 |
|
5,282 |
5,272 |
$95K |
| 59025 |
|
3,051 |
1,941 |
$93K |
| 0012A |
|
2,108 |
2,093 |
$90K |
| G0108 |
Diab manage trn per indiv |
2,057 |
1,872 |
$75K |
| 90791 |
|
580 |
575 |
$68K |
| 0011A |
|
1,799 |
1,764 |
$66K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
8,466 |
8,460 |
$63K |
| 90832 |
|
1,394 |
1,147 |
$58K |
| G2025 |
Dis site tele svcs rhc/fqhc |
4,389 |
4,045 |
$58K |
| 99462 |
|
1,588 |
1,259 |
$54K |
| 99222 |
|
541 |
523 |
$52K |
| 90715 |
|
1,982 |
1,978 |
$48K |
| 99397 |
|
287 |
287 |
$45K |
| 96127 |
|
4,937 |
4,103 |
$41K |
| 81025 |
|
5,328 |
5,220 |
$37K |
| 11981 |
|
317 |
317 |
$35K |
| 99233 |
Prolong inpt eval add15 m |
627 |
311 |
$34K |
| 99221 |
|
430 |
416 |
$31K |
| 96372 |
|
3,009 |
2,749 |
$30K |
| 90739 |
|
582 |
581 |
$29K |
| 99384 |
|
196 |
196 |
$28K |
| 90688 |
|
1,845 |
1,842 |
$27K |
| 0002A |
|
471 |
471 |
$22K |
| 90792 |
|
201 |
201 |
$20K |
| 90461 |
|
572 |
571 |
$20K |
| 93000 |
|
1,272 |
1,265 |
$19K |
| 0001A |
|
392 |
392 |
$17K |
| 91320 |
|
162 |
162 |
$17K |
| 90686 |
|
1,973 |
1,969 |
$17K |
| 81002 |
|
6,075 |
5,903 |
$17K |
| 99231 |
|
640 |
400 |
$15K |
| 82948 |
|
4,844 |
4,530 |
$14K |
| 99215 |
Prolong outpt/office vis |
2,284 |
2,235 |
$14K |
| 99423 |
|
17 |
17 |
$14K |
| 99443 |
|
424 |
406 |
$13K |
| 99239 |
|
182 |
181 |
$12K |
| 90662 |
|
1,264 |
1,264 |
$12K |
| 90837 |
|
138 |
120 |
$11K |
| 83037 |
|
1,432 |
1,416 |
$11K |
| 99383 |
|
102 |
102 |
$11K |
| 90707 |
|
743 |
741 |
$8K |
| 99442 |
|
308 |
303 |
$7K |
| 0072A |
|
141 |
141 |
$6K |
| 90656 |
|
1,094 |
1,091 |
$6K |
| A0429 |
Bls-emergency |
25 |
25 |
$6K |
| 87210 |
|
1,124 |
1,109 |
$6K |
| 99385 |
|
25 |
25 |
$6K |
| J7307 |
Etonogestrel implant system |
13 |
13 |
$6K |
| 0013A |
|
118 |
118 |
$5K |
| 99188 |
|
207 |
205 |
$5K |
| G0008 |
Admin influenza virus vac |
1,170 |
1,170 |
$5K |
| 90480 |
|
106 |
106 |
$5K |
| A0425 |
Ground mileage |
213 |
203 |
$5K |
| 90649 |
|
506 |
506 |
$4K |
| A0427 |
Als1-emergency |
13 |
13 |
$4K |
| 86580 |
|
547 |
530 |
$3K |
| 0071A |
|
62 |
62 |
$3K |
| 0031A |
|
59 |
59 |
$3K |
| 90716 |
|
888 |
886 |
$2K |
| 97810 |
|
87 |
84 |
$2K |
| 90620 |
|
124 |
123 |
$2K |
| 54160 |
|
12 |
12 |
$2K |
| 99218 |
|
31 |
27 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| G0009 |
Admin pneumococcal vaccine |
294 |
294 |
$2K |
| 90651 |
|
238 |
237 |
$2K |
| 90473 |
|
73 |
73 |
$1K |
| 90474 |
|
148 |
147 |
$1K |
| 98928 |
|
30 |
27 |
$1K |
| 92551 |
|
120 |
118 |
$1K |
| 0054A |
|
20 |
20 |
$913.12 |
| 90713 |
|
142 |
142 |
$900.48 |
| 99211 |
|
183 |
166 |
$897.97 |
| 91301 |
|
653 |
618 |
$833.09 |
| 90670 |
|
422 |
422 |
$750.00 |
| 0134A |
|
84 |
83 |
$730.12 |
| 90632 |
|
12 |
12 |
$705.12 |
| G0468 |
Fqhc visit, ippe or awv |
56 |
56 |
$504.00 |
| 88142 |
|
23 |
23 |
$480.47 |
| 90674 |
|
145 |
145 |
$479.27 |
| 0124A |
|
35 |
35 |
$320.71 |
| 85610 |
|
87 |
53 |
$263.07 |
| 90658 |
|
15 |
15 |
$170.55 |
| G0439 |
Ppps, subseq visit |
55 |
55 |
$148.81 |
| 90734 |
|
153 |
153 |
$89.05 |
| 83036 |
|
12 |
12 |
$79.74 |
| J0561 |
Penicillin g benzathine inj |
97 |
73 |
$2.46 |
| J1885 |
Ketorolac tromethamine inj |
563 |
545 |
$0.17 |
| 91300 |
|
52 |
50 |
$0.10 |
| 90697 |
|
276 |
275 |
$0.00 |
| 90619 |
|
652 |
647 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
126 |
120 |
$0.00 |
| 94640 |
|
18 |
18 |
$0.00 |
| 90723 |
|
1,337 |
1,336 |
$0.00 |
| 90696 |
|
139 |
139 |
$0.00 |
| 92558 |
|
1,865 |
1,825 |
$0.00 |
| 90680 |
|
1,474 |
1,473 |
$0.00 |
| 90744 |
|
17 |
17 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
12 |
12 |
$0.00 |
| 82947 |
|
1,633 |
1,530 |
$0.00 |
| 90633 |
|
970 |
967 |
$0.00 |
| 99051 |
|
418 |
400 |
$0.00 |
| 90700 |
|
307 |
307 |
$0.00 |
| 90648 |
|
1,737 |
1,735 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
1,053 |
1,014 |
$0.00 |
| 90710 |
|
175 |
175 |
$0.00 |
| 90671 |
|
584 |
583 |
$0.00 |
| 90661 |
|
73 |
73 |
$0.00 |
| 90655 |
|
15 |
15 |
$0.00 |
| 90678 |
|
41 |
41 |
$0.00 |
| 99212 |
|
12 |
12 |
$0.00 |
| 91312 |
|
12 |
12 |
$0.00 |