| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
482,656 |
405,024 |
$66.49M |
| 00003 |
|
139,743 |
94,428 |
$23.06M |
| 92014 |
|
32,358 |
27,288 |
$756K |
| V2020 |
Vision svcs frames purchases |
21,385 |
21,334 |
$392K |
| 90791 |
|
10,109 |
7,583 |
$386K |
| 99213 |
|
224,876 |
146,372 |
$356K |
| 92340 |
|
16,489 |
16,449 |
$298K |
| 99212 |
|
118,100 |
80,535 |
$282K |
| G9008 |
Mccd,phys coor-care ovrsght |
794 |
779 |
$278K |
| G9012 |
Other specified case mgmt |
1,130 |
1,050 |
$244K |
| 90832 |
|
13,354 |
8,416 |
$221K |
| 92015 |
|
34,239 |
29,243 |
$151K |
| G0467 |
Fqhc visit, estab pt |
3,542 |
3,069 |
$99K |
| 92341 |
|
3,080 |
3,080 |
$85K |
| 92004 |
|
517 |
382 |
$47K |
| G9920 |
Scrning perf and negative |
14,869 |
10,578 |
$41K |
| 99391 |
|
16,997 |
13,278 |
$29K |
| J7307 |
Etonogestrel implant system |
362 |
281 |
$25K |
| 59409 |
|
78 |
76 |
$23K |
| J3490 |
Drugs unclassified injection |
4,498 |
3,447 |
$22K |
| H1001 |
Antepartum management |
12,983 |
10,063 |
$14K |
| 0011A |
|
198 |
198 |
$13K |
| 92250 |
|
3,209 |
2,247 |
$12K |
| 99460 |
|
986 |
732 |
$12K |
| 99238 |
|
1,378 |
1,022 |
$11K |
| 99381 |
|
1,343 |
1,177 |
$11K |
| 81025 |
|
39,384 |
28,790 |
$11K |
| 11976 |
|
574 |
352 |
$10K |
| 99214 |
|
8,293 |
5,208 |
$9K |
| 99239 |
|
684 |
462 |
$8K |
| 0072A |
|
111 |
111 |
$7K |
| 11981 |
|
309 |
241 |
$7K |
| 99395 |
|
4,573 |
2,951 |
$6K |
| 0071A |
|
65 |
65 |
$4K |
| 0002A |
|
64 |
64 |
$4K |
| 76811 |
|
288 |
281 |
$4K |
| 99392 |
|
15,297 |
11,019 |
$3K |
| 0004A |
|
52 |
52 |
$3K |
| 0001A |
|
49 |
49 |
$3K |
| 59514 |
|
12 |
12 |
$3K |
| 0012A |
|
44 |
44 |
$3K |
| H1000 |
Prenatal care atrisk assessm |
671 |
670 |
$3K |
| G8511 |
Scr dep pos, no plan doc rng |
6,454 |
3,843 |
$2K |
| 92133 |
|
647 |
469 |
$2K |
| G2025 |
Dis site tele svcs rhc/fqhc |
119 |
113 |
$2K |
| 99393 |
|
9,671 |
6,539 |
$2K |
| 99203 |
|
146 |
95 |
$2K |
| 90670 |
|
10,024 |
7,915 |
$1K |
| 99394 |
|
5,078 |
3,256 |
$1K |
| 90680 |
|
8,082 |
6,280 |
$1K |
| G9919 |
Scrn nd pos nd prov of rec |
118 |
104 |
$1K |
| 59425 |
|
10,211 |
7,867 |
$1K |
| 90715 |
|
4,686 |
3,039 |
$1K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
96 |
96 |
$1K |
| 88720 |
|
2,151 |
1,546 |
$1K |
| 99396 |
|
1,514 |
934 |
$995.15 |
| 90686 |
|
13,470 |
11,090 |
$958.44 |
| 90723 |
|
5,969 |
4,800 |
$924.75 |
| 76813 |
|
103 |
102 |
$911.88 |
| 90647 |
|
5,916 |
4,759 |
$873.59 |
| 81002 |
|
67,921 |
43,143 |
$873.12 |
| 90651 |
|
1,544 |
1,040 |
$817.34 |
| 99232 |
|
41 |
14 |
$646.38 |
| 92551 |
|
19,906 |
13,915 |
$640.84 |
| 99241 |
|
27 |
26 |
$632.64 |
| 90697 |
|
3,149 |
2,257 |
$590.86 |
| 92285 |
|
226 |
142 |
$494.00 |
| 76816 |
|
205 |
201 |
$477.02 |
| H1003 |
Prenatal at risk education |
1,983 |
1,962 |
$448.22 |
| 87880 |
|
7,262 |
4,236 |
$429.72 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
19 |
19 |
$426.56 |
| 90471 |
|
11,276 |
7,974 |
$416.55 |
| H1002 |
Carecoordination prenatal |
263 |
263 |
$403.86 |
| 83036 |
|
5,260 |
3,608 |
$374.80 |
| 90677 |
|
2,809 |
1,974 |
$363.20 |
| 59430 |
|
839 |
835 |
$356.83 |
| 85018 |
|
36,763 |
25,611 |
$351.15 |
| 87804 |
|
4,791 |
3,090 |
$328.36 |
| 92012 |
|
26 |
26 |
$321.40 |
| 99233 |
Prolong inpt eval add15 m |
24 |
14 |
$288.54 |
| 90633 |
|
4,657 |
3,331 |
$236.25 |
| 83655 |
|
4,172 |
3,089 |
$225.93 |
| 99173 |
|
17,818 |
12,308 |
$207.23 |
| 90734 |
|
1,138 |
740 |
$206.00 |
| 58300 |
|
19 |
12 |
$176.69 |
| 96372 |
|
3,055 |
1,963 |
$170.16 |
| H2000 |
Comp multidisipln evaluation |
319 |
319 |
$135.83 |
| 99215 |
Prolong outpt/office vis |
339 |
338 |
$124.19 |
| 82962 |
|
9,306 |
6,179 |
$121.93 |
| 90732 |
|
25 |
25 |
$110.00 |
| 90716 |
|
1,002 |
725 |
$94.50 |
| 90707 |
|
791 |
558 |
$81.00 |
| 99222 |
|
19 |
13 |
$79.86 |
| 90700 |
|
2,578 |
1,854 |
$76.50 |
| 96110 |
|
185 |
114 |
$59.30 |
| 99401 |
|
569 |
568 |
$52.99 |
| 90746 |
|
64 |
56 |
$52.00 |
| 87635 |
|
20 |
16 |
$48.00 |
| J1885 |
Ketorolac tromethamine inj |
499 |
319 |
$30.42 |
| 96156 |
|
793 |
792 |
$30.28 |
| S9445 |
Pt education noc individ |
318 |
297 |
$22.71 |
| 97803 |
|
473 |
472 |
$22.71 |
| G8510 |
Scr dep neg, no plan reqd |
113,709 |
62,026 |
$18.70 |
| 90710 |
|
189 |
115 |
$18.00 |
| 90688 |
|
3,554 |
1,992 |
$9.00 |
| 90713 |
|
242 |
148 |
$9.00 |
| 90380 |
|
26 |
23 |
$9.00 |
| 90472 |
|
411 |
279 |
$8.88 |
| J3301 |
Triamcinolone acet inj nos |
114 |
64 |
$8.00 |
| 90381 |
|
14 |
13 |
$2.55 |
| G2023 |
Specimen collect covid-19 |
1,044 |
721 |
$0.32 |
| G0439 |
Ppps, subseq visit |
12,224 |
11,672 |
$0.10 |
| 2023F |
|
1,548 |
1,054 |
$0.06 |
| 99406 |
|
100 |
61 |
$0.02 |
| G9226 |
3 comp foot exam completed |
1,740 |
1,211 |
$0.00 |
| Z1034 |
|
30,651 |
24,085 |
$0.00 |
| Z1032 |
|
2,518 |
2,509 |
$0.00 |
| 3074F |
|
8,815 |
5,243 |
$0.00 |
| 3079F |
|
5,032 |
3,050 |
$0.00 |
| 90834 |
|
26 |
25 |
$0.00 |
| Z6410 |
|
395 |
374 |
$0.00 |
| Z1038 |
|
992 |
978 |
$0.00 |
| 3044F |
|
882 |
529 |
$0.00 |
| Z6406 |
|
544 |
542 |
$0.00 |
| 99383 |
|
50 |
50 |
$0.00 |
| Z6204 |
|
465 |
464 |
$0.00 |
| 3075F |
|
2,356 |
1,426 |
$0.00 |
| S9452 |
Nutrition class |
149 |
143 |
$0.00 |
| 86580 |
|
185 |
125 |
$0.00 |
| 96151 |
|
27 |
27 |
$0.00 |
| 99202 |
|
80 |
80 |
$0.00 |
| 3080F |
|
342 |
204 |
$0.00 |
| 90632 |
|
18 |
12 |
$0.00 |
| G0008 |
Admin influenza virus vac |
22 |
22 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
50 |
26 |
$0.00 |
| 3078F |
|
9,011 |
5,367 |
$0.00 |
| Z6304 |
|
450 |
450 |
$0.00 |
| 3077F |
|
2,752 |
1,674 |
$0.00 |
| Z6500 |
|
1,244 |
1,240 |
$0.00 |
| Z6400 |
|
1,992 |
1,989 |
$0.00 |
| G9357 |
Pp eval/edu perf |
898 |
620 |
$0.00 |
| G0438 |
Ppps, initial visit |
188 |
188 |
$0.00 |
| 99382 |
|
18 |
18 |
$0.00 |
| 90678 |
|
150 |
96 |
$0.00 |
| 98940 |
|
19 |
19 |
$0.00 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
22 |
22 |
$0.00 |
| Z6208 |
|
92 |
88 |
$0.00 |
| 11042 |
|
31 |
12 |
$0.00 |
| 11721 |
|
482 |
259 |
$0.00 |
| Z6308 |
|
28 |
28 |
$0.00 |
| 90621 |
|
60 |
49 |
$0.00 |
| 2022F |
|
19 |
13 |
$0.00 |
| Z6414 |
|
33 |
33 |
$0.00 |
| 3046F |
|
25 |
25 |
$0.00 |
| 59025 |
|
36 |
14 |
$0.00 |