| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
2,044 |
1,669 |
$286K |
| 99213 |
|
491,806 |
453,771 |
$101K |
| 99214 |
|
239,016 |
228,409 |
$55K |
| U0002 |
Covid-19 lab test non-cdc |
5,248 |
5,137 |
$30K |
| 99393 |
|
35,741 |
35,656 |
$25K |
| 99212 |
|
100,940 |
95,049 |
$18K |
| 99392 |
|
36,257 |
36,186 |
$18K |
| 99394 |
|
27,776 |
27,741 |
$18K |
| 92551 |
|
60,087 |
59,921 |
$10K |
| 36415 |
|
132,997 |
129,957 |
$8K |
| 99460 |
|
373 |
373 |
$6K |
| T1003 |
Lpn/lvn services up to 15min |
71,377 |
67,232 |
$6K |
| 87491 |
|
36,392 |
35,711 |
$5K |
| 99391 |
|
16,427 |
16,359 |
$5K |
| 99403 |
|
4,815 |
4,697 |
$4K |
| 90471 |
|
112,845 |
112,355 |
$4K |
| 99404 |
|
1,979 |
1,896 |
$3K |
| 76805 |
|
3,074 |
3,025 |
$3K |
| 97802 |
|
13,501 |
13,337 |
$3K |
| 97803 |
|
14,670 |
14,506 |
$3K |
| 90832 |
|
843 |
758 |
$2K |
| 99402 |
|
9,569 |
9,065 |
$2K |
| 99462 |
|
161 |
122 |
$2K |
| T1002 |
Rn services up to 15 minutes |
13,742 |
13,114 |
$2K |
| 76801 |
|
3,194 |
3,054 |
$2K |
| T1004 |
Nsg aide service up to 15min |
21,555 |
21,135 |
$2K |
| 96110 |
|
9,960 |
9,943 |
$2K |
| 90791 |
|
276 |
274 |
$2K |
| 99401 |
|
19,865 |
19,413 |
$1K |
| 99395 |
|
2,447 |
2,446 |
$1K |
| 94010 |
|
1,684 |
1,681 |
$1K |
| 83036 |
|
31,498 |
31,377 |
$1K |
| 87536 |
|
1,000 |
989 |
$1K |
| 90670 |
|
12,223 |
12,213 |
$1K |
| 96151 |
|
1,831 |
1,825 |
$1K |
| 90734 |
|
8,542 |
8,532 |
$1K |
| G9920 |
Scrning perf and negative |
8,388 |
8,372 |
$1K |
| 87389 |
|
9,309 |
9,273 |
$1K |
| 99215 |
Prolong outpt/office vis |
27,328 |
26,518 |
$1K |
| 85018 |
|
22,714 |
22,423 |
$969.82 |
| 57454 |
|
613 |
310 |
$922.24 |
| 99211 |
|
15,517 |
14,498 |
$883.70 |
| 84443 |
|
31,445 |
31,325 |
$844.11 |
| 90715 |
|
6,812 |
6,808 |
$836.62 |
| 88175 |
|
18,912 |
18,878 |
$832.37 |
| 80061 |
|
23,340 |
23,252 |
$828.55 |
| 99381 |
|
956 |
953 |
$764.31 |
| 81002 |
|
63,206 |
48,402 |
$754.10 |
| 80053 |
|
23,841 |
23,699 |
$749.92 |
| 80055 |
|
3,347 |
3,341 |
$733.75 |
| T1016 |
Case management |
2,047 |
1,688 |
$704.23 |
| 90837 |
|
282 |
257 |
$686.14 |
| 90686 |
|
60,292 |
60,235 |
$666.13 |
| 96150 |
|
899 |
899 |
$605.71 |
| 99396 |
|
1,641 |
1,640 |
$543.80 |
| 92250 |
|
11,524 |
11,450 |
$523.35 |
| 99238 |
|
84 |
84 |
$451.22 |
| 90698 |
|
4,654 |
4,652 |
$450.00 |
| S9445 |
Pt education noc individ |
11,550 |
9,307 |
$445.82 |
| 82306 |
|
13,149 |
13,121 |
$439.49 |
| 81025 |
|
31,167 |
30,344 |
$437.81 |
| 90792 |
|
379 |
368 |
$413.00 |
| H1003 |
Prenatal at risk education |
6,663 |
5,210 |
$410.70 |
| H1000 |
Prenatal care atrisk assessm |
1,144 |
1,096 |
$383.10 |
| 99203 |
|
1,721 |
1,716 |
$360.42 |
| 90472 |
|
41,527 |
41,366 |
$356.47 |
| 88304 |
|
490 |
484 |
$344.76 |
| H1002 |
Carecoordination prenatal |
743 |
743 |
$341.39 |
| 90834 |
|
252 |
195 |
$335.80 |
| 90710 |
|
3,408 |
3,408 |
$333.00 |
| 90744 |
|
2,494 |
2,492 |
$333.00 |
| 90696 |
|
3,243 |
3,242 |
$315.00 |
| 82274 |
|
3,455 |
3,438 |
$299.31 |
| 90716 |
|
3,521 |
3,516 |
$288.00 |
| 85025 |
|
35,822 |
35,615 |
$284.56 |
| 83655 |
|
4,620 |
4,602 |
$269.11 |
| 86803 |
|
2,307 |
2,302 |
$256.31 |
| 93000 |
|
1,281 |
1,277 |
$255.69 |
| 97804 |
|
48 |
32 |
$247.86 |
| 83718 |
|
4,425 |
4,410 |
$212.00 |
| 90707 |
|
2,797 |
2,790 |
$207.00 |
| 99173 |
|
53,765 |
53,728 |
$206.62 |
| 87081 |
|
3,172 |
3,149 |
$174.22 |
| G2025 |
Dis site tele svcs rhc/fqhc |
1,258 |
1,096 |
$172.77 |
| 82948 |
|
889 |
871 |
$170.32 |
| 86592 |
|
22,115 |
22,055 |
$169.09 |
| 76810 |
|
119 |
118 |
$167.68 |
| 90750 |
|
896 |
895 |
$164.81 |
| 86580 |
|
3,759 |
3,669 |
$163.12 |
| 82043 |
|
7,594 |
7,537 |
$161.01 |
| 86361 |
|
321 |
320 |
$157.43 |
| J3490 |
Drugs unclassified injection |
356 |
355 |
$156.44 |
| 90700 |
|
2,359 |
2,359 |
$153.00 |
| 87661 |
|
80 |
79 |
$151.15 |
| 99204 |
|
1,177 |
1,174 |
$137.11 |
| 81001 |
|
16,939 |
16,605 |
$119.14 |
| 82465 |
|
4,905 |
4,891 |
$110.00 |
| G0467 |
Fqhc visit, estab pt |
1,670 |
1,511 |
$108.77 |
| 99383 |
|
125 |
124 |
$108.56 |
| G9012 |
Other specified case mgmt |
3,754 |
2,679 |
$105.00 |
| 90688 |
|
6,514 |
6,502 |
$103.31 |
| 90674 |
|
799 |
799 |
$103.31 |
| 86765 |
|
75 |
74 |
$102.06 |
| 87070 |
|
1,408 |
1,401 |
$88.13 |
| 80076 |
|
895 |
887 |
$76.50 |
| G0109 |
Diab manage trn ind/group |
27 |
14 |
$73.56 |
| 73562 |
|
188 |
172 |
$69.44 |
| 99202 |
|
464 |
462 |
$67.92 |
| 84999 |
|
21,392 |
21,264 |
$66.84 |
| 87086 |
|
874 |
789 |
$66.50 |
| 90713 |
|
113 |
113 |
$54.00 |
| 85027 |
|
5,892 |
5,854 |
$34.61 |
| 87400 |
|
664 |
661 |
$34.38 |
| 82105 |
|
101 |
101 |
$34.29 |
| 96156 |
|
10,098 |
10,050 |
$33.49 |
| 96127 |
|
8,251 |
8,205 |
$28.66 |
| 87210 |
|
138 |
138 |
$27.90 |
| 90680 |
|
140 |
140 |
$27.00 |
| 90633 |
|
10,023 |
10,010 |
$24.02 |
| 1123F |
|
25,565 |
24,806 |
$23.76 |
| 80305 |
|
1,272 |
998 |
$20.06 |
| 92081 |
|
8,540 |
8,415 |
$20.00 |
| 84439 |
|
868 |
867 |
$12.82 |
| 1159F |
|
524,268 |
480,434 |
$12.13 |
| 3078F |
|
281,998 |
265,744 |
$12.13 |
| 3046F |
|
22,206 |
20,665 |
$12.13 |
| 3044F |
|
8,146 |
7,536 |
$12.13 |
| 99441 |
|
160 |
157 |
$10.26 |
| 82947 |
|
227 |
224 |
$8.88 |
| 85652 |
|
129 |
127 |
$7.15 |
| 83735 |
|
326 |
325 |
$5.90 |
| 87340 |
|
1,592 |
1,591 |
$4.75 |
| 84460 |
|
3,660 |
3,655 |
$3.33 |
| 84450 |
|
171 |
170 |
$3.33 |
| 84550 |
|
339 |
339 |
$3.30 |
| 80048 |
|
670 |
664 |
$2.92 |
| 82950 |
|
129 |
129 |
$2.46 |
| 83540 |
|
838 |
823 |
$2.14 |
| 1160F |
|
249,289 |
230,304 |
$0.00 |
| 3077F |
|
21,711 |
21,198 |
$0.00 |
| 90460 |
|
7,519 |
7,482 |
$0.00 |
| 99605 |
|
785 |
784 |
$0.00 |
| 90648 |
|
1,561 |
1,558 |
$0.00 |
| 80074 |
|
66 |
66 |
$0.00 |
| 1158F |
|
16,202 |
15,691 |
$0.00 |
| 90681 |
|
1,967 |
1,963 |
$0.00 |
| 84403 |
|
112 |
112 |
$0.00 |
| 71046 |
|
608 |
606 |
$0.00 |
| 87481 |
|
2,519 |
2,505 |
$0.00 |
| 91300 |
|
6,004 |
5,502 |
$0.00 |
| 98966 |
|
6,529 |
5,837 |
$0.00 |
| 91313 |
|
654 |
654 |
$0.00 |
| 88164 |
|
965 |
962 |
$0.00 |
| 99453 |
|
245 |
243 |
$0.00 |
| 90687 |
|
650 |
647 |
$0.00 |
| 90461 |
|
1,545 |
1,197 |
$0.00 |
| 90671 |
|
615 |
614 |
$0.00 |
| 90473 |
|
1,209 |
1,208 |
$0.00 |
| 84702 |
|
456 |
417 |
$0.00 |
| 90746 |
|
244 |
244 |
$0.00 |
| 91312 |
|
986 |
986 |
$0.00 |
| 77067 |
|
344 |
344 |
$0.00 |
| A4550 |
Surgical trays |
264 |
264 |
$0.00 |
| 0054A |
|
853 |
852 |
$0.00 |
| 3051F |
|
126 |
117 |
$0.00 |
| 92552 |
|
962 |
960 |
$0.00 |
| 0071A |
|
1,588 |
1,581 |
$0.00 |
| 86480 |
|
328 |
323 |
$0.00 |
| 0002A |
|
2,455 |
2,454 |
$0.00 |
| 80307 |
|
162 |
162 |
$0.00 |
| G0101 |
Ca screen;pelvic/breast exam |
527 |
527 |
$0.00 |
| 72100 |
|
25 |
25 |
$0.00 |
| 85610 |
|
396 |
368 |
$0.00 |
| 11721 |
|
533 |
533 |
$0.00 |
| 82397 |
|
234 |
232 |
$0.00 |
| 90672 |
|
469 |
468 |
$0.00 |
| 96158 |
|
915 |
910 |
$0.00 |
| 0124A |
|
658 |
658 |
$0.00 |
| 83525 |
|
122 |
120 |
$0.00 |
| 76813 |
|
132 |
132 |
$0.00 |
| 76802 |
|
13 |
13 |
$0.00 |
| 90685 |
|
112 |
112 |
$0.00 |
| 99382 |
|
12 |
12 |
$0.00 |
| 73630 |
|
289 |
248 |
$0.00 |
| 83721 |
|
14 |
14 |
$0.00 |
| 99201 |
|
67 |
56 |
$0.00 |
| 91322 |
|
176 |
176 |
$0.00 |
| 96152 |
|
158 |
158 |
$0.00 |
| 0004A |
|
370 |
369 |
$0.00 |
| 69210 |
|
12 |
12 |
$0.00 |
| 91321 |
|
45 |
45 |
$0.00 |
| 0013A |
|
97 |
97 |
$0.00 |
| 82565 |
|
88 |
88 |
$0.00 |
| 11981 |
|
24 |
12 |
$0.00 |
| H2015 |
Comp comm supp svc, 15 min |
13 |
13 |
$0.00 |
| 99442 |
|
134 |
133 |
$0.00 |
| 81003 |
|
130 |
130 |
$0.00 |
| 0003A |
|
24 |
24 |
$0.00 |
| 91311 |
|
195 |
194 |
$0.00 |
| 84146 |
|
165 |
164 |
$0.00 |
| 90999 |
|
24 |
23 |
$0.00 |
| 86787 |
|
17 |
17 |
$0.00 |
| 98968 |
|
140 |
136 |
$0.00 |
| T1017 |
Targeted case management |
16 |
13 |
$0.00 |
| 82627 |
|
51 |
51 |
$0.00 |
| 90611 |
|
25 |
25 |
$0.00 |
| 91320 |
|
103 |
103 |
$0.00 |
| 87798 |
|
12 |
12 |
$0.00 |
| 86708 |
|
12 |
12 |
$0.00 |
| 86003 |
|
12 |
12 |
$0.00 |
| 82785 |
|
25 |
25 |
$0.00 |
| 11720 |
|
12 |
12 |
$0.00 |
| J7307 |
Etonogestrel implant system |
12 |
12 |
$0.00 |
| 84481 |
|
12 |
12 |
$0.00 |
| 96159 |
|
19 |
19 |
$0.00 |
| 73030 |
|
17 |
16 |
$0.00 |
| 86705 |
|
25 |
25 |
$0.00 |
| 90651 |
|
13,856 |
13,838 |
$0.00 |
| 1126F |
|
319,768 |
297,849 |
$0.00 |
| 3075F |
|
31,917 |
31,511 |
$0.00 |
| 3074F |
|
257,060 |
241,654 |
$0.00 |
| 86706 |
|
409 |
409 |
$0.00 |
| 3079F |
|
50,947 |
49,805 |
$0.00 |
| 3080F |
|
4,628 |
4,525 |
$0.00 |
| 90656 |
|
4,650 |
4,650 |
$0.00 |
| 1125F |
|
60,033 |
58,525 |
$0.00 |
| 1170F |
|
91,052 |
86,158 |
$0.00 |
| H2000 |
Comp multidisipln evaluation |
2,417 |
2,412 |
$0.00 |
| 36416 |
|
3,636 |
3,599 |
$0.00 |
| 0052A |
|
221 |
221 |
$0.00 |
| 82607 |
|
1,064 |
1,058 |
$0.00 |
| H1001 |
Antepartum management |
18,207 |
12,368 |
$0.00 |
| S9452 |
Nutrition class |
2,706 |
2,701 |
$0.00 |
| 99606 |
|
6,614 |
6,117 |
$0.00 |
| 90697 |
|
3,504 |
3,498 |
$0.00 |
| 76811 |
|
846 |
845 |
$0.00 |
| 90677 |
|
2,608 |
2,603 |
$0.00 |
| 84153 |
|
439 |
438 |
$0.00 |
| G9008 |
Mccd,phys coor-care ovrsght |
2,267 |
1,510 |
$0.00 |
| 59430 |
|
27 |
27 |
$0.00 |
| 83001 |
|
558 |
556 |
$0.00 |
| 91301 |
|
6,078 |
5,984 |
$0.00 |
| 84436 |
|
272 |
251 |
$0.00 |
| 91319 |
|
33 |
33 |
$0.00 |
| 91307 |
|
4,167 |
3,903 |
$0.00 |
| T1023 |
Program intake assessment |
140 |
140 |
$0.00 |
| 90620 |
|
2,234 |
2,230 |
$0.00 |
| 99607 |
|
728 |
727 |
$0.00 |
| 11730 |
|
88 |
87 |
$0.00 |
| 76815 |
|
334 |
326 |
$0.00 |
| 82670 |
|
463 |
462 |
$0.00 |
| 0011A |
|
2,075 |
2,072 |
$0.00 |
| 91315 |
|
58 |
58 |
$0.00 |
| 90480 |
|
248 |
247 |
$0.00 |
| 82728 |
|
346 |
346 |
$0.00 |
| 0064A |
|
1,532 |
1,531 |
$0.00 |
| 99412 |
|
2,679 |
2,115 |
$0.00 |
| 0112A |
|
70 |
70 |
$0.00 |
| 98967 |
|
569 |
561 |
$0.00 |
| G9007 |
Mccd, sch team conf |
13 |
13 |
$0.00 |
| 88142 |
|
962 |
961 |
$0.00 |
| 58100 |
|
158 |
79 |
$0.00 |
| 94012 |
|
68 |
68 |
$0.00 |
| 91305 |
|
1,605 |
1,581 |
$0.00 |
| 0072A |
|
1,593 |
1,592 |
$0.00 |
| 0051A |
|
153 |
153 |
$0.00 |
| 76816 |
|
438 |
433 |
$0.00 |
| 0134A |
|
602 |
602 |
$0.00 |
| 85730 |
|
56 |
56 |
$0.00 |
| 90619 |
|
185 |
185 |
$0.00 |
| 99454 |
|
729 |
719 |
$0.00 |
| 87490 |
|
31 |
31 |
$0.00 |
| 3052F |
|
15 |
14 |
$0.00 |
| 0012A |
|
2,077 |
2,077 |
$0.00 |
| 82951 |
|
24 |
24 |
$0.00 |
| 0001A |
|
2,765 |
2,758 |
$0.00 |
| 57455 |
|
112 |
55 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
69 |
61 |
$0.00 |
| 86317 |
|
143 |
142 |
$0.00 |
| 0074A |
|
94 |
94 |
$0.00 |
| J0456 |
Azithromycin |
18 |
18 |
$0.00 |
| 0154A |
|
12 |
12 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
90 |
90 |
$0.00 |
| 84402 |
|
44 |
44 |
$0.00 |
| 20550 |
|
12 |
12 |
$0.00 |
| 0111A |
|
61 |
61 |
$0.00 |
| 80051 |
|
42 |
41 |
$0.00 |
| 83002 |
|
86 |
86 |
$0.00 |
| 59400 |
|
77 |
77 |
$0.00 |
| 81015 |
|
137 |
135 |
$0.00 |
| 99385 |
|
16 |
16 |
$0.00 |
| 86704 |
|
12 |
12 |
$0.00 |
| 82040 |
|
42 |
42 |
$0.00 |
| 80320 |
|
25 |
13 |
$0.00 |
| 99384 |
|
12 |
12 |
$0.00 |
| 90660 |
|
61 |
60 |
$0.00 |