| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0467 |
Fqhc visit, estab pt |
129,623 |
111,504 |
$6.27M |
| G0470 |
Fqhc visit, mh estab pt |
16,762 |
12,177 |
$824K |
| 99213 |
|
54,309 |
49,201 |
$718K |
| 99214 |
|
29,972 |
28,578 |
$542K |
| G0466 |
Fqhc visit new patient |
5,428 |
5,351 |
$327K |
| 99392 |
|
4,851 |
4,793 |
$133K |
| J1050 |
Medroxyprogesterone acetate |
1,871 |
1,869 |
$131K |
| 92014 |
|
7,028 |
6,989 |
$131K |
| 99212 |
|
15,791 |
14,875 |
$122K |
| 99393 |
|
3,767 |
3,723 |
$96K |
| 90834 |
|
4,721 |
3,585 |
$86K |
| 90832 |
|
6,024 |
5,130 |
$84K |
| 99391 |
|
3,781 |
3,675 |
$80K |
| S0621 |
Routine ophthalmological exa |
3,858 |
3,839 |
$79K |
| 99215 |
Prolong outpt/office vis |
2,685 |
2,636 |
$66K |
| 99394 |
|
2,088 |
2,073 |
$57K |
| 77067 |
|
1,460 |
1,445 |
$56K |
| 90471 |
|
9,837 |
9,745 |
$41K |
| 90472 |
|
5,189 |
5,157 |
$40K |
| 90791 |
|
1,296 |
1,281 |
$35K |
| 92015 |
|
7,348 |
7,277 |
$29K |
| V2020 |
Vision svcs frames purchases |
2,050 |
2,040 |
$29K |
| 99204 |
|
1,008 |
998 |
$24K |
| 96372 |
|
4,522 |
4,284 |
$19K |
| 99203 |
|
1,019 |
992 |
$18K |
| 92340 |
|
1,477 |
1,473 |
$17K |
| H0004 |
Alcohol and/or drug services |
2,117 |
2,032 |
$16K |
| 83036 |
|
4,448 |
4,415 |
$15K |
| 77063 |
|
1,230 |
1,216 |
$14K |
| 99000 |
|
2,259 |
2,184 |
$14K |
| 90460 |
|
4,013 |
3,973 |
$14K |
| 99395 |
|
551 |
545 |
$13K |
| 90686 |
|
6,489 |
6,453 |
$13K |
| 90651 |
|
1,277 |
1,268 |
$13K |
| 90847 |
|
343 |
306 |
$11K |
| 96110 |
|
2,607 |
1,855 |
$11K |
| H0001 |
Alcohol and/or drug assess |
1,360 |
1,293 |
$9K |
| 92341 |
|
638 |
637 |
$8K |
| 92083 |
|
637 |
635 |
$8K |
| S0620 |
Routine ophthalmological exa |
337 |
337 |
$7K |
| 81025 |
|
2,908 |
2,845 |
$7K |
| 36415 |
|
5,322 |
5,157 |
$7K |
| 96127 |
|
5,477 |
5,380 |
$6K |
| 82962 |
|
5,913 |
5,460 |
$6K |
| 96160 |
|
1,745 |
1,722 |
$6K |
| 90792 |
|
482 |
477 |
$6K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
877 |
873 |
$6K |
| 87636 |
|
314 |
309 |
$6K |
| 90837 |
|
201 |
164 |
$5K |
| 99381 |
|
139 |
139 |
$5K |
| 91320 |
|
56 |
56 |
$4K |
| 90480 |
|
190 |
188 |
$4K |
| 99188 |
|
1,390 |
1,362 |
$4K |
| 90715 |
|
891 |
888 |
$4K |
| 90677 |
|
230 |
229 |
$4K |
| 90734 |
|
956 |
951 |
$4K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
452 |
450 |
$4K |
| 87637 |
|
223 |
220 |
$3K |
| 87880 |
|
824 |
811 |
$3K |
| 72110 |
|
249 |
244 |
$3K |
| 71046 |
|
423 |
407 |
$3K |
| 90670 |
|
3,178 |
3,164 |
$3K |
| 73564 |
|
248 |
193 |
$3K |
| V2100 |
Lens spher single plano 4.00 |
422 |
420 |
$2K |
| 90746 |
|
97 |
96 |
$2K |
| 90656 |
|
271 |
269 |
$2K |
| 99496 |
|
58 |
57 |
$2K |
| 92133 |
|
1,034 |
1,022 |
$2K |
| D0190 |
|
320 |
317 |
$2K |
| 99202 |
|
289 |
285 |
$2K |
| 81003 |
|
3,188 |
3,095 |
$2K |
| 92250 |
|
280 |
276 |
$2K |
| 99408 |
|
691 |
470 |
$2K |
| S0581 |
Nonstnd lens |
608 |
601 |
$2K |
| 99396 |
|
51 |
51 |
$2K |
| 92004 |
|
63 |
63 |
$1K |
| 92134 |
|
517 |
510 |
$1K |
| 99211 |
|
211 |
206 |
$1K |
| 90632 |
|
60 |
60 |
$1K |
| 99383 |
|
24 |
24 |
$1K |
| 90473 |
|
527 |
526 |
$1K |
| 85610 |
|
479 |
264 |
$1K |
| 99409 |
|
380 |
220 |
$1K |
| 91322 |
|
41 |
40 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
927 |
864 |
$858.26 |
| V2200 |
Lens spher bifoc plano 4.00d |
163 |
163 |
$847.98 |
| G2025 |
Dis site tele svcs rhc/fqhc |
1,437 |
1,334 |
$780.01 |
| 90750 |
|
12 |
12 |
$742.00 |
| 0064A |
|
48 |
48 |
$724.68 |
| 93000 |
|
277 |
271 |
$660.22 |
| 90620 |
|
144 |
142 |
$560.94 |
| 90707 |
|
125 |
124 |
$555.40 |
| 99495 |
|
12 |
12 |
$449.95 |
| 81001 |
|
311 |
301 |
$448.70 |
| 73030 |
|
47 |
38 |
$364.88 |
| 0001A |
|
27 |
26 |
$311.92 |
| 36416 |
|
2,731 |
2,567 |
$275.34 |
| 0071A |
|
25 |
25 |
$263.03 |
| 0134A |
|
35 |
35 |
$225.18 |
| 0124A |
|
13 |
13 |
$187.65 |
| 90716 |
|
119 |
117 |
$176.20 |
| 85018 |
|
169 |
167 |
$174.32 |
| 82044 |
|
63 |
63 |
$154.92 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
14 |
14 |
$149.72 |
| 73565 |
|
13 |
13 |
$140.07 |
| 76514 |
|
65 |
64 |
$134.39 |
| 98926 |
|
22 |
18 |
$103.00 |
| 99382 |
|
12 |
12 |
$93.36 |
| J0696 |
Ceftriaxone sodium injection |
97 |
95 |
$88.26 |
| G0468 |
Fqhc visit, ippe or awv |
41 |
41 |
$72.76 |
| 94640 |
|
24 |
24 |
$63.00 |
| 81002 |
|
24 |
24 |
$31.68 |
| G0008 |
Admin influenza virus vac |
534 |
530 |
$29.12 |
| 82948 |
|
18 |
17 |
$8.36 |
| G8417 |
Calc bmi abv up param f/u |
446 |
441 |
$0.01 |
| 1160F |
|
3,539 |
3,143 |
$0.00 |
| 90710 |
|
1,704 |
1,694 |
$0.00 |
| 3051F |
|
244 |
244 |
$0.00 |
| 90700 |
|
856 |
853 |
$0.00 |
| 3046F |
|
957 |
947 |
$0.00 |
| 3077F |
|
1,448 |
1,346 |
$0.00 |
| 90681 |
|
1,146 |
1,144 |
$0.00 |
| 90633 |
|
2,048 |
2,030 |
$0.00 |
| 90648 |
|
1,292 |
1,291 |
$0.00 |
| G0444 |
Depression screen annual |
4,087 |
3,935 |
$0.00 |
| 90713 |
|
75 |
75 |
$0.00 |
| 3078F |
|
7,115 |
6,646 |
$0.00 |
| 3045F |
|
396 |
391 |
$0.00 |
| 91300 |
|
27 |
27 |
$0.00 |
| 2022F |
|
1,550 |
1,530 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
460 |
454 |
$0.00 |
| 91313 |
|
33 |
33 |
$0.00 |
| 90461 |
|
2,480 |
2,463 |
$0.00 |
| 91312 |
|
57 |
56 |
$0.00 |
| 1159F |
|
449 |
424 |
$0.00 |
| G0270 |
Mnt subs tx for change dx |
43 |
43 |
$0.00 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
15 |
15 |
$0.00 |
| 90662 |
|
25 |
25 |
$0.00 |
| 1158F |
|
14 |
14 |
$0.00 |
| 94760 |
|
372 |
353 |
$0.00 |
| 3072F |
|
1,241 |
1,229 |
$0.00 |
| 3044F |
|
2,024 |
2,008 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
505 |
502 |
$0.00 |
| 90647 |
|
1,466 |
1,454 |
$0.00 |
| 3080F |
|
1,052 |
980 |
$0.00 |
| S0281 |
Medical home, maintenance |
7,401 |
6,311 |
$0.00 |
| 3079F |
|
3,337 |
3,166 |
$0.00 |
| 3351F |
|
2,646 |
2,624 |
$0.00 |
| 90723 |
|
2,547 |
2,533 |
$0.00 |
| 90696 |
|
597 |
594 |
$0.00 |
| 90744 |
|
21 |
21 |
$0.00 |
| 91306 |
|
54 |
53 |
$0.00 |
| 2023F |
|
155 |
153 |
$0.00 |
| 1125F |
|
422 |
415 |
$0.00 |
| 3008F |
|
9,962 |
9,149 |
$0.00 |
| 2000F |
|
85 |
83 |
$0.00 |
| 3074F |
|
7,913 |
7,362 |
$0.00 |
| 3075F |
|
2,147 |
2,069 |
$0.00 |
| S0280 |
Medical home, initial plan |
39 |
39 |
$0.00 |
| 91301 |
|
32 |
32 |
$0.00 |
| G0477 |
Drug test presump optical |
16 |
14 |
$0.00 |
| 3052F |
|
13 |
13 |
$0.00 |
| H0049 |
Alcohol/drug screening |
282 |
282 |
$0.00 |
| G0447 |
Behavior counsel obesity 15m |
86 |
84 |
$0.00 |
| 91307 |
|
15 |
15 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 1170F |
|
14 |
14 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
12 |
12 |
$0.00 |
| G0442 |
Annual alcohol screen 15 min |
13 |
13 |
$0.00 |
| 1126F |
|
17 |
17 |
$0.00 |