| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
98,203 |
80,617 |
$13.84M |
| D9450 |
|
34,720 |
22,459 |
$1.19M |
| T1040 |
Comm bh clinic svc per diem |
6,027 |
3,767 |
$830K |
| G0470 |
Fqhc visit, mh estab pt |
5,454 |
4,060 |
$708K |
| 99050 |
|
15,267 |
14,312 |
$584K |
| 90834 |
|
8,081 |
4,155 |
$557K |
| 99393 |
|
3,717 |
3,697 |
$555K |
| 99392 |
|
3,232 |
3,223 |
$504K |
| 99394 |
|
3,285 |
3,269 |
$492K |
| 99395 |
|
3,381 |
3,355 |
$470K |
| G0467 |
Fqhc visit, estab pt |
11,040 |
9,058 |
$418K |
| 99391 |
|
2,626 |
2,446 |
$411K |
| D1110 |
|
9,770 |
7,581 |
$264K |
| G2023 |
Specimen collect covid-19 |
6,539 |
5,971 |
$263K |
| 92340 |
|
7,984 |
6,888 |
$216K |
| 92014 |
|
3,477 |
3,454 |
$163K |
| D0210 |
|
4,598 |
3,515 |
$154K |
| D2391 |
|
4,696 |
2,765 |
$139K |
| D0120 |
|
9,552 |
7,678 |
$133K |
| D0274 |
|
5,451 |
4,485 |
$120K |
| D0220 |
|
11,162 |
7,215 |
$116K |
| 90832 |
|
2,848 |
2,315 |
$115K |
| D1120 |
|
2,256 |
2,209 |
$115K |
| 90471 |
|
14,014 |
13,745 |
$103K |
| D9110 |
|
3,968 |
2,322 |
$97K |
| D0150 |
|
4,072 |
3,171 |
$97K |
| 97802 |
|
2,514 |
2,077 |
$93K |
| D2392 |
|
2,014 |
1,466 |
$90K |
| D0140 |
|
3,114 |
2,115 |
$85K |
| 92015 |
|
7,661 |
7,488 |
$84K |
| 99213 |
|
7,335 |
6,720 |
$77K |
| 90460 |
|
4,994 |
4,938 |
$76K |
| D0230 |
|
8,229 |
4,357 |
$71K |
| D1206 |
|
2,660 |
2,565 |
$68K |
| 83036 |
|
9,877 |
9,674 |
$64K |
| 90686 |
|
8,686 |
8,608 |
$64K |
| D0180 |
|
3,514 |
2,804 |
$63K |
| D7140 |
|
1,257 |
486 |
$58K |
| 90677 |
|
488 |
486 |
$57K |
| 97803 |
|
1,833 |
1,326 |
$57K |
| 99441 |
|
2,469 |
2,335 |
$54K |
| 90715 |
|
2,795 |
2,768 |
$49K |
| 90651 |
|
2,571 |
2,553 |
$45K |
| 99173 |
|
2,484 |
2,467 |
$44K |
| 90472 |
|
4,797 |
4,746 |
$44K |
| 99214 |
|
7,371 |
6,782 |
$43K |
| 99442 |
|
1,438 |
1,226 |
$41K |
| 92250 |
|
2,936 |
2,879 |
$40K |
| V2020 |
Vision svcs frames purchases |
439 |
376 |
$40K |
| G2025 |
Dis site tele svcs rhc/fqhc |
2,430 |
1,737 |
$38K |
| 90739 |
|
322 |
318 |
$37K |
| 90746 |
|
702 |
695 |
$37K |
| 99443 |
|
1,205 |
1,027 |
$35K |
| 92341 |
|
933 |
909 |
$30K |
| 90461 |
|
2,772 |
2,745 |
$27K |
| 90837 |
|
309 |
183 |
$27K |
| 96110 |
|
2,429 |
2,396 |
$23K |
| 84703 |
|
3,350 |
3,244 |
$22K |
| 87880 |
|
1,684 |
1,658 |
$22K |
| 0064A |
|
511 |
502 |
$21K |
| 92551 |
|
2,205 |
2,187 |
$20K |
| 90791 |
|
150 |
142 |
$17K |
| 99381 |
|
83 |
82 |
$16K |
| 90670 |
|
1,981 |
1,957 |
$16K |
| V2750 |
Anti-reflective coating |
483 |
419 |
$15K |
| 81003 |
|
6,523 |
5,596 |
$13K |
| 0124A |
|
313 |
300 |
$13K |
| 99385 |
|
66 |
66 |
$12K |
| 0004A |
|
269 |
265 |
$12K |
| D2330 |
|
298 |
195 |
$12K |
| 90473 |
|
712 |
709 |
$12K |
| 99211 |
|
3,284 |
3,137 |
$11K |
| 96372 |
|
2,302 |
2,217 |
$11K |
| 99396 |
|
181 |
147 |
$10K |
| V2760 |
Scratch resistant coating |
450 |
387 |
$10K |
| 0001A |
|
210 |
209 |
$10K |
| 90732 |
|
103 |
102 |
$10K |
| 0134A |
|
242 |
235 |
$9K |
| D0272 |
|
279 |
264 |
$8K |
| D1351 |
|
222 |
58 |
$8K |
| 90662 |
|
447 |
444 |
$8K |
| 92133 |
|
486 |
482 |
$8K |
| 81025 |
|
1,097 |
1,053 |
$7K |
| J1050 |
Medroxyprogesterone acetate |
1,126 |
1,125 |
$7K |
| 91320 |
|
109 |
109 |
$6K |
| 90480 |
|
137 |
137 |
$6K |
| 0071A |
|
132 |
131 |
$6K |
| 90734 |
|
1,730 |
1,716 |
$5K |
| 92004 |
|
82 |
82 |
$5K |
| 87650 |
|
242 |
238 |
$5K |
| 90716 |
|
711 |
708 |
$5K |
| 99349 |
|
480 |
470 |
$4K |
| 99212 |
|
187 |
180 |
$4K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
48 |
46 |
$4K |
| 87804 |
|
357 |
349 |
$4K |
| 86580 |
|
640 |
622 |
$4K |
| 99051 |
|
751 |
695 |
$4K |
| 0011A |
|
321 |
310 |
$4K |
| 90707 |
|
656 |
655 |
$3K |
| G0008 |
Admin influenza virus vac |
490 |
484 |
$3K |
| 99215 |
Prolong outpt/office vis |
125 |
122 |
$3K |
| 91322 |
|
36 |
36 |
$3K |
| 99606 |
|
110 |
99 |
$3K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
50 |
41 |
$3K |
| D2331 |
|
68 |
43 |
$3K |
| 93000 |
|
170 |
165 |
$3K |
| 0012A |
|
299 |
287 |
$2K |
| 99383 |
|
13 |
13 |
$2K |
| D1330 |
|
3,456 |
2,319 |
$2K |
| 92225 |
|
42 |
25 |
$2K |
| 92552 |
|
77 |
77 |
$2K |
| 0002A |
|
28 |
28 |
$1K |
| 85014 |
|
520 |
520 |
$1K |
| D1208 |
|
42 |
39 |
$1K |
| 85018 |
|
414 |
413 |
$909.44 |
| D2393 |
|
12 |
12 |
$875.00 |
| D0145 |
|
30 |
30 |
$810.00 |
| 0094A |
|
21 |
21 |
$806.55 |
| 99397 |
|
30 |
30 |
$789.58 |
| 92012 |
|
17 |
17 |
$748.51 |
| 87210 |
|
170 |
167 |
$708.40 |
| 0073A |
|
14 |
13 |
$596.31 |
| 87220 |
|
140 |
137 |
$572.93 |
| 92083 |
|
28 |
28 |
$492.94 |
| T1001 |
Nursing assessment/evaluatn |
375 |
361 |
$216.58 |
| 90710 |
|
456 |
453 |
$179.25 |
| 82962 |
|
2,216 |
2,036 |
$178.72 |
| 90714 |
|
12 |
12 |
$175.70 |
| 94010 |
|
75 |
74 |
$94.79 |
| 81002 |
|
30 |
30 |
$79.20 |
| 82948 |
|
14 |
14 |
$34.19 |
| 90713 |
|
166 |
165 |
$28.14 |
| 11719 |
|
13 |
13 |
$16.21 |
| 91301 |
|
2,841 |
2,698 |
$0.00 |
| 91305 |
|
90 |
83 |
$0.00 |
| 90680 |
|
1,227 |
1,219 |
$0.00 |
| 90723 |
|
1,087 |
1,082 |
$0.00 |
| 90744 |
|
96 |
96 |
$0.00 |
| 0241U |
|
552 |
544 |
$0.00 |
| 91307 |
|
677 |
618 |
$0.00 |
| 91306 |
|
838 |
815 |
$0.00 |
| 90697 |
|
342 |
338 |
$0.00 |
| 96127 |
|
43 |
43 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
91 |
91 |
$0.00 |
| S0302 |
Completed epsdt |
144 |
142 |
$0.00 |
| 90696 |
|
244 |
243 |
$0.00 |
| 94760 |
|
25 |
24 |
$0.00 |
| J2001 |
Lidocaine injection |
120 |
106 |
$0.00 |
| A9150 |
Misc/exper non-prescript dru |
47 |
46 |
$0.00 |
| 91303 |
|
61 |
61 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |
| J3490 |
Drugs unclassified injection |
53 |
52 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
17 |
14 |
$0.00 |
| 91309 |
|
24 |
24 |
$0.00 |
| 90648 |
|
1,530 |
1,524 |
$0.00 |
| 90700 |
|
214 |
213 |
$0.00 |
| 90633 |
|
1,919 |
1,913 |
$0.00 |
| 90750 |
|
86 |
86 |
$0.00 |
| 91312 |
|
409 |
395 |
$0.00 |
| 91313 |
|
313 |
304 |
$0.00 |
| 91300 |
|
2,023 |
1,856 |
$0.00 |
| 91308 |
|
16 |
14 |
$0.00 |
| 90685 |
|
287 |
287 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
16 |
16 |
$0.00 |