| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
89,132 |
73,171 |
$15.31M |
| 99213 |
|
42,456 |
37,766 |
$163K |
| 90837 |
|
2,620 |
1,394 |
$126K |
| 99212 |
|
23,120 |
21,186 |
$105K |
| 99201 |
|
195 |
195 |
$26K |
| J3490 |
Drugs unclassified injection |
514 |
389 |
$26K |
| S4993 |
Contraceptive pills for bc |
401 |
397 |
$22K |
| 90834 |
|
613 |
338 |
$20K |
| 99202 |
|
471 |
470 |
$18K |
| A4267 |
Male condom |
1,212 |
1,207 |
$10K |
| 90832 |
|
4,481 |
2,197 |
$7K |
| 87806 |
|
93 |
93 |
$2K |
| 81025 |
|
945 |
924 |
$2K |
| S5001 |
Prescription drug,brand name |
133 |
120 |
$2K |
| 99211 |
|
1,301 |
1,247 |
$2K |
| 99000 |
|
4,370 |
4,293 |
$1K |
| 90658 |
|
155 |
155 |
$1K |
| 85018 |
|
2,797 |
2,769 |
$1K |
| 0134A |
|
14 |
14 |
$938.00 |
| S5000 |
Prescription drug, generic |
68 |
68 |
$834.00 |
| 0124A |
|
12 |
12 |
$804.00 |
| 87210 |
|
392 |
376 |
$663.90 |
| 99214 |
|
316 |
308 |
$663.37 |
| 99395 |
|
78 |
78 |
$275.96 |
| 91300 |
|
84 |
74 |
$222.54 |
| 99396 |
|
330 |
330 |
$162.06 |
| 91301 |
|
447 |
423 |
$132.00 |
| 92081 |
|
460 |
460 |
$130.48 |
| 99392 |
|
372 |
370 |
$74.04 |
| 81002 |
|
2,613 |
2,082 |
$62.76 |
| 96110 |
|
223 |
223 |
$59.90 |
| 92551 |
|
394 |
393 |
$44.08 |
| 90656 |
|
181 |
181 |
$40.00 |
| 83036 |
|
1,872 |
1,859 |
$33.80 |
| 87491 |
|
265 |
261 |
$20.47 |
| 87591 |
|
265 |
261 |
$20.29 |
| 90715 |
|
60 |
60 |
$18.06 |
| 3008F |
|
26,742 |
24,893 |
$0.00 |
| 00018 |
|
63,042 |
53,437 |
$0.00 |
| 87389 |
|
509 |
508 |
$0.00 |
| 90686 |
|
876 |
873 |
$0.00 |
| D0210 |
|
1,020 |
686 |
$0.00 |
| H1001 |
Antepartum management |
1,183 |
827 |
$0.00 |
| D0150 |
|
1,234 |
814 |
$0.00 |
| 88142 |
|
1,037 |
1,037 |
$0.00 |
| Z1034 |
|
16 |
12 |
$0.00 |
| D1330 |
|
786 |
526 |
$0.00 |
| 90688 |
|
74 |
74 |
$0.00 |
| 90677 |
|
82 |
82 |
$0.00 |
| D0140 |
|
1,567 |
901 |
$0.00 |
| D1206 |
|
1,002 |
956 |
$0.00 |
| D0603 |
|
557 |
556 |
$0.00 |
| 96161 |
|
74 |
73 |
$0.00 |
| 0012A |
|
257 |
257 |
$0.00 |
| 93000 |
|
13 |
13 |
$0.00 |
| 87661 |
|
134 |
132 |
$0.00 |
| 99386 |
|
14 |
14 |
$0.00 |
| 94200 |
|
83 |
72 |
$0.00 |
| 87624 |
|
18 |
18 |
$0.00 |
| 0011A |
|
274 |
271 |
$0.00 |
| D2330 |
|
17 |
12 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
30 |
30 |
$0.00 |
| 99385 |
|
24 |
24 |
$0.00 |
| D1120 |
|
652 |
388 |
$0.00 |
| 99391 |
|
87 |
84 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
360 |
319 |
$0.00 |
| 90670 |
|
82 |
77 |
$0.00 |
| D1110 |
|
1,779 |
1,154 |
$0.00 |
| 99393 |
|
81 |
81 |
$0.00 |
| D2391 |
|
179 |
105 |
$0.00 |
| 88175 |
|
295 |
293 |
$0.00 |
| 87481 |
|
133 |
131 |
$0.00 |
| 99394 |
|
15 |
15 |
$0.00 |
| G9920 |
Scrning perf and negative |
72 |
71 |
$0.00 |
| 90746 |
|
12 |
12 |
$0.00 |
| 99203 |
|
120 |
120 |
$0.00 |
| 82274 |
|
70 |
70 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
37 |
37 |
$0.00 |