| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
278,580 |
219,074 |
$42.38M |
| T1040 |
Comm bh clinic svc per diem |
21,964 |
12,978 |
$3.03M |
| D9450 |
|
105,214 |
63,382 |
$2.53M |
| 90834 |
|
18,910 |
11,411 |
$1.49M |
| 99391 |
|
9,153 |
8,919 |
$1.38M |
| 99392 |
|
7,919 |
7,910 |
$1.22M |
| 99393 |
|
7,462 |
7,443 |
$1.14M |
| G0470 |
Fqhc visit, mh estab pt |
8,052 |
6,117 |
$1.10M |
| 99394 |
|
6,281 |
6,271 |
$938K |
| G0467 |
Fqhc visit, estab pt |
20,389 |
17,076 |
$848K |
| 99395 |
|
4,312 |
4,302 |
$702K |
| D1110 |
|
25,394 |
18,653 |
$701K |
| G2023 |
Specimen collect covid-19 |
18,413 |
17,339 |
$436K |
| D0210 |
|
10,674 |
7,821 |
$386K |
| D1120 |
|
7,627 |
7,313 |
$377K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
21,347 |
21,172 |
$374K |
| 90460 |
|
33,127 |
32,521 |
$366K |
| 90739 |
|
2,717 |
2,694 |
$342K |
| 87635 |
|
6,690 |
6,495 |
$339K |
| 90832 |
|
7,952 |
6,456 |
$322K |
| 59400 |
|
150 |
150 |
$321K |
| 90750 |
|
2,244 |
2,232 |
$318K |
| D7140 |
|
6,889 |
2,396 |
$306K |
| D2391 |
|
7,711 |
4,239 |
$304K |
| D2392 |
|
6,514 |
3,986 |
$292K |
| 87502 |
|
3,447 |
3,392 |
$289K |
| 99381 |
|
1,529 |
1,522 |
$280K |
| D9110 |
|
11,902 |
6,380 |
$270K |
| 96110 |
|
27,945 |
27,601 |
$269K |
| 87426 |
|
7,914 |
7,435 |
$262K |
| D0274 |
|
9,674 |
8,073 |
$261K |
| 99173 |
|
14,710 |
14,648 |
$258K |
| J7307 |
Etonogestrel implant system |
701 |
696 |
$245K |
| 90651 |
|
5,730 |
5,714 |
$242K |
| D7210 |
|
2,986 |
1,125 |
$227K |
| D0120 |
|
12,627 |
10,038 |
$193K |
| D0150 |
|
7,343 |
5,629 |
$185K |
| D0140 |
|
7,697 |
4,706 |
$181K |
| 90791 |
|
1,510 |
1,494 |
$173K |
| 99188 |
|
6,207 |
6,184 |
$160K |
| G2025 |
Dis site tele svcs rhc/fqhc |
8,048 |
6,598 |
$160K |
| D1206 |
|
6,295 |
6,054 |
$158K |
| 90686 |
|
22,045 |
21,967 |
$143K |
| 77067 |
|
2,873 |
1,488 |
$137K |
| D0180 |
|
7,611 |
5,596 |
$137K |
| 99213 |
|
11,185 |
9,927 |
$131K |
| D1351 |
|
3,148 |
970 |
$122K |
| 0012A |
|
2,611 |
2,604 |
$120K |
| 92014 |
|
2,425 |
2,424 |
$119K |
| 90471 |
|
24,426 |
23,913 |
$114K |
| 90715 |
|
6,847 |
6,839 |
$113K |
| 99460 |
|
1,765 |
1,755 |
$112K |
| 0011A |
|
2,507 |
2,504 |
$102K |
| D2150 |
|
1,906 |
1,311 |
$102K |
| 91320 |
|
896 |
896 |
$100K |
| 99214 |
|
10,342 |
9,664 |
$92K |
| D0220 |
|
9,706 |
5,998 |
$92K |
| D2331 |
|
2,171 |
1,169 |
$90K |
| 0001A |
|
1,954 |
1,922 |
$89K |
| D1208 |
|
2,852 |
2,735 |
$79K |
| 0004A |
|
1,699 |
1,695 |
$77K |
| D2393 |
|
1,719 |
1,126 |
$75K |
| D0330 |
|
2,114 |
1,263 |
$72K |
| 99232 |
|
1,518 |
1,372 |
$72K |
| 87634 |
|
1,152 |
1,135 |
$71K |
| 99462 |
|
2,135 |
1,447 |
$67K |
| 87651 |
|
2,081 |
2,047 |
$64K |
| 90746 |
|
1,167 |
1,166 |
$60K |
| 59025 |
|
2,030 |
1,482 |
$59K |
| 83036 |
|
6,794 |
6,759 |
$57K |
| D4341 |
|
1,658 |
800 |
$56K |
| 90837 |
|
648 |
493 |
$54K |
| D2140 |
|
1,160 |
777 |
$54K |
| 99238 |
|
1,024 |
1,019 |
$51K |
| 90887 |
|
992 |
814 |
$50K |
| 90670 |
|
5,901 |
5,878 |
$50K |
| D2335 |
|
817 |
449 |
$49K |
| 90632 |
|
876 |
876 |
$49K |
| D4342 |
|
1,253 |
686 |
$48K |
| 90480 |
|
1,121 |
1,120 |
$47K |
| 0002A |
|
1,035 |
1,030 |
$47K |
| 90688 |
|
4,542 |
4,537 |
$47K |
| 92340 |
|
1,608 |
1,466 |
$45K |
| D2330 |
|
1,327 |
674 |
$44K |
| 0124A |
|
1,176 |
1,160 |
$43K |
| 81025 |
|
6,505 |
6,366 |
$43K |
| D2332 |
|
816 |
472 |
$41K |
| 11981 |
|
379 |
378 |
$40K |
| D0230 |
|
5,357 |
2,204 |
$40K |
| D5212 |
|
188 |
127 |
$39K |
| 90707 |
|
3,190 |
3,178 |
$37K |
| 99050 |
|
1,978 |
1,922 |
$37K |
| 90732 |
|
414 |
412 |
$36K |
| 99383 |
|
201 |
200 |
$33K |
| 92015 |
|
2,579 |
2,565 |
$30K |
| 96372 |
|
5,570 |
5,263 |
$30K |
| 90461 |
|
15,512 |
15,201 |
$30K |
| 87880 |
|
2,191 |
2,143 |
$29K |
| 90882 |
|
672 |
453 |
$28K |
| 99219 |
|
392 |
346 |
$27K |
| 96127 |
|
2,832 |
2,804 |
$26K |
| 97802 |
|
372 |
372 |
$24K |
| 99384 |
|
136 |
136 |
$23K |
| 93000 |
|
1,578 |
1,560 |
$23K |
| 92341 |
|
664 |
662 |
$23K |
| 71046 |
|
1,883 |
958 |
$22K |
| 0071A |
|
485 |
483 |
$22K |
| 90472 |
|
7,020 |
6,946 |
$20K |
| 99211 |
|
590 |
526 |
$19K |
| 99212 |
|
893 |
856 |
$19K |
| 11982 |
|
155 |
155 |
$18K |
| 0072A |
|
370 |
368 |
$17K |
| 88142 |
|
1,056 |
1,054 |
$16K |
| D5211 |
|
90 |
56 |
$16K |
| D2160 |
|
368 |
233 |
$16K |
| 90682 |
|
270 |
268 |
$15K |
| 99222 |
|
127 |
126 |
$12K |
| 91319 |
|
144 |
144 |
$12K |
| D0270 |
|
1,947 |
1,298 |
$11K |
| 90674 |
|
4,175 |
4,165 |
$11K |
| 97803 |
|
264 |
252 |
$11K |
| 90714 |
|
741 |
733 |
$11K |
| S3005 |
Eval self-assess depression |
1,251 |
1,230 |
$10K |
| 59409 |
|
12 |
12 |
$10K |
| 91318 |
|
112 |
112 |
$7K |
| H0046 |
Mental health service, nos |
216 |
178 |
$7K |
| 99215 |
Prolong outpt/office vis |
193 |
165 |
$7K |
| 98966 |
|
578 |
505 |
$6K |
| 98967 |
|
274 |
262 |
$6K |
| G0469 |
Fqhc visit, mh new pt |
26 |
26 |
$6K |
| S4989 |
Contracept iud |
24 |
24 |
$6K |
| 0081A |
|
105 |
102 |
$5K |
| 90716 |
|
3,165 |
3,153 |
$4K |
| 82948 |
|
986 |
921 |
$4K |
| 87501 |
|
103 |
100 |
$4K |
| 86580 |
|
624 |
610 |
$4K |
| 99382 |
|
42 |
42 |
$4K |
| 90713 |
|
2,324 |
2,312 |
$3K |
| 90662 |
|
223 |
223 |
$3K |
| J7298 |
Mirena, 52 mg |
14 |
14 |
$3K |
| 72100 |
|
199 |
99 |
$3K |
| 58300 |
|
108 |
108 |
$2K |
| 73562 |
|
164 |
77 |
$2K |
| 98968 |
|
74 |
69 |
$2K |
| 90734 |
|
2,857 |
2,847 |
$2K |
| 54150 |
|
12 |
12 |
$2K |
| J1050 |
Medroxyprogesterone acetate |
2,881 |
2,874 |
$2K |
| 99442 |
|
70 |
68 |
$1K |
| 99396 |
|
13 |
13 |
$1K |
| D0272 |
|
63 |
50 |
$1K |
| 77065 |
Tomosynthesis, mammo |
28 |
14 |
$1K |
| 81002 |
|
413 |
349 |
$1K |
| G0466 |
Fqhc visit new patient |
27 |
27 |
$1K |
| 87210 |
|
238 |
236 |
$1K |
| 73030 |
|
81 |
41 |
$945.20 |
| 92004 |
|
12 |
12 |
$816.48 |
| 90473 |
|
74 |
74 |
$656.28 |
| 0003A |
|
14 |
14 |
$642.18 |
| 82947 |
|
196 |
192 |
$624.60 |
| 90694 |
|
312 |
308 |
$600.52 |
| 0073A |
|
13 |
13 |
$596.31 |
| 90661 |
|
698 |
698 |
$589.60 |
| 87804 |
|
20 |
19 |
$244.60 |
| 90474 |
|
364 |
362 |
$167.77 |
| 90620 |
|
252 |
250 |
$120.21 |
| 92551 |
|
12 |
12 |
$112.56 |
| 90833 |
|
12 |
12 |
$109.11 |
| 85610 |
|
26 |
12 |
$89.50 |
| 90658 |
|
30 |
30 |
$56.00 |
| 91312 |
|
1,247 |
1,236 |
$55.00 |
| 90653 |
|
39 |
39 |
$52.00 |
| 91301 |
|
3,975 |
3,924 |
$45.34 |
| 90633 |
|
5,663 |
5,646 |
$36.00 |
| 94640 |
|
609 |
535 |
$13.00 |
| 82962 |
|
13 |
12 |
$7.06 |
| 90677 |
|
1,705 |
1,702 |
$2.99 |
| 0154A |
|
24 |
23 |
$0.22 |
| 98926 |
|
612 |
546 |
$0.00 |
| 90648 |
|
5,892 |
5,867 |
$0.00 |
| 90700 |
|
2,870 |
2,852 |
$0.00 |
| 90681 |
|
3,103 |
3,094 |
$0.00 |
| 69210 |
|
336 |
314 |
$0.00 |
| 91308 |
|
209 |
201 |
$0.00 |
| L3908 |
Who cock-up nonmolde pre ots |
24 |
24 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
306 |
306 |
$0.00 |
| 91300 |
|
4,519 |
4,342 |
$0.00 |
| 90672 |
|
81 |
81 |
$0.00 |
| 90710 |
|
1,625 |
1,620 |
$0.00 |
| J2315 |
Naltrexone, depot form |
188 |
170 |
$0.00 |
| 0502F |
|
231 |
185 |
$0.00 |
| 99408 |
|
12 |
12 |
$0.00 |
| 99051 |
|
173 |
173 |
$0.00 |
| 90685 |
|
101 |
101 |
$0.00 |
| 90671 |
|
768 |
766 |
$0.00 |
| 90678 |
|
39 |
39 |
$0.00 |
| V2020 |
Vision svcs frames purchases |
14 |
14 |
$0.00 |
| 90723 |
|
3,404 |
3,387 |
$0.00 |
| 90696 |
|
1,708 |
1,704 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
507 |
480 |
$0.00 |
| 90619 |
|
1,169 |
1,168 |
$0.00 |
| G0008 |
Admin influenza virus vac |
1,132 |
1,121 |
$0.00 |
| 90744 |
|
964 |
963 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
635 |
624 |
$0.00 |
| 90680 |
|
1,046 |
1,046 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
364 |
324 |
$0.00 |
| 98925 |
|
180 |
162 |
$0.00 |
| 99000 |
|
61 |
61 |
$0.00 |
| 90697 |
|
690 |
689 |
$0.00 |
| 91307 |
|
1,131 |
1,080 |
$0.00 |
| 91317 |
|
32 |
30 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
40 |
40 |
$0.00 |
| G0010 |
Admin hepatitis b vaccine |
13 |
13 |
$0.00 |
| D9995 |
|
1,211 |
677 |
$0.00 |
| D0170 |
|
51 |
39 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 91305 |
|
113 |
109 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
42 |
39 |
$0.00 |
| 36416 |
|
286 |
265 |
$0.00 |
| 96380 |
|
40 |
40 |
$0.00 |
| Q9992 |
Buprenorphine xr over 100 mg |
28 |
25 |
$0.00 |
| G0442 |
Annual alcohol screen 15 min |
15 |
15 |
$0.00 |
| Q2036 |
Flulaval vacc, 3 yrs & >, im |
241 |
241 |
$0.00 |
| 91315 |
|
23 |
22 |
$0.00 |