| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
161,347 |
136,788 |
$25.96M |
| 00003 |
|
113,357 |
61,144 |
$21.42M |
| 0521 |
|
361,025 |
146,594 |
$3.13M |
| 0636 |
|
20,418 |
12,325 |
$422K |
| 0761 |
|
5,471 |
5,099 |
$102K |
| 99214 |
|
15,683 |
15,193 |
$87K |
| 92340 |
|
8,829 |
6,731 |
$84K |
| 99213 |
|
28,470 |
26,892 |
$81K |
| V2020 |
Vision svcs frames purchases |
9,526 |
7,388 |
$77K |
| 92014 |
|
9,913 |
9,637 |
$35K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
2,925 |
2,901 |
$29K |
| H1001 |
Antepartum management |
1,314 |
732 |
$27K |
| 59409 |
|
41 |
41 |
$26K |
| 0771 |
|
4,416 |
4,170 |
$17K |
| 0770 |
|
5,637 |
5,608 |
$16K |
| 98941 |
|
16,369 |
9,709 |
$13K |
| 0301 |
|
7,408 |
7,290 |
$12K |
| 87635 |
|
296 |
183 |
$10K |
| 92250 |
|
492 |
473 |
$7K |
| 0307 |
|
2,436 |
2,195 |
$7K |
| S9445 |
Pt education noc individ |
1,586 |
948 |
$5K |
| 0309 |
|
763 |
728 |
$5K |
| 99396 |
|
1,638 |
1,615 |
$5K |
| 90750 |
|
211 |
194 |
$4K |
| 92015 |
|
10,913 |
10,376 |
$4K |
| 0306 |
|
303 |
300 |
$3K |
| 0270 |
|
194 |
184 |
$3K |
| 99395 |
|
2,495 |
2,473 |
$2K |
| 0124A |
|
59 |
43 |
$2K |
| 87804 |
|
358 |
265 |
$1K |
| G0442 |
Annual alcohol screen 15 min |
800 |
775 |
$1K |
| 99283 |
|
28 |
25 |
$1K |
| 92004 |
|
335 |
334 |
$1K |
| 90651 |
|
760 |
678 |
$1K |
| 0500 |
|
58 |
40 |
$1K |
| 83036 |
|
1,166 |
1,076 |
$1K |
| 0900 |
|
4,746 |
3,520 |
$891.17 |
| 0051A |
|
26 |
13 |
$871.00 |
| 0929 |
|
59 |
59 |
$864.00 |
| 99188 |
|
2,123 |
2,088 |
$840.48 |
| 99212 |
|
16,730 |
15,103 |
$761.57 |
| 0412 |
|
40 |
38 |
$755.74 |
| 99238 |
|
39 |
39 |
$560.41 |
| 0300 |
|
48 |
47 |
$540.68 |
| 90677 |
|
409 |
314 |
$522.00 |
| 0271 |
|
32 |
30 |
$490.73 |
| 82947 |
|
477 |
396 |
$489.82 |
| 81025 |
|
1,060 |
1,037 |
$474.55 |
| 0064A |
|
31 |
21 |
$440.00 |
| G9919 |
Scrn nd pos nd prov of rec |
24 |
13 |
$428.04 |
| 0011A |
|
45 |
28 |
$408.00 |
| 0003A |
|
23 |
13 |
$400.00 |
| 90619 |
|
389 |
288 |
$360.00 |
| 0004A |
|
23 |
14 |
$360.00 |
| 90662 |
|
126 |
126 |
$318.40 |
| 85018 |
|
7,633 |
6,655 |
$255.34 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
18 |
17 |
$246.42 |
| 11721 |
|
573 |
566 |
$244.56 |
| 99392 |
|
1,955 |
1,896 |
$209.59 |
| 11720 |
|
208 |
201 |
$194.16 |
| 81003 |
|
660 |
581 |
$190.89 |
| 90834 |
|
4,262 |
2,791 |
$160.00 |
| H1003 |
Prenatal at risk education |
26 |
12 |
$154.73 |
| 99401 |
|
209 |
186 |
$145.05 |
| 99393 |
|
1,809 |
1,780 |
$143.60 |
| 99385 |
|
89 |
89 |
$117.33 |
| 99233 |
Prolong inpt eval add15 m |
13 |
13 |
$105.34 |
| 90656 |
|
325 |
313 |
$105.00 |
| 99394 |
|
1,970 |
1,919 |
$104.73 |
| 87426 |
|
29 |
26 |
$86.92 |
| 92552 |
|
4,783 |
4,727 |
$79.34 |
| 99381 |
|
527 |
526 |
$55.75 |
| 99051 |
|
558 |
553 |
$50.00 |
| 83655 |
|
391 |
263 |
$47.68 |
| 99173 |
|
4,789 |
4,716 |
$33.09 |
| G0008 |
Admin influenza virus vac |
286 |
286 |
$26.38 |
| 87210 |
|
117 |
115 |
$25.65 |
| 82962 |
|
13 |
12 |
$3.28 |
| G8510 |
Scr dep neg, no plan reqd |
8,771 |
8,353 |
$0.00 |
| 90723 |
|
1,348 |
1,151 |
$0.00 |
| 90716 |
|
687 |
594 |
$0.00 |
| G0439 |
Ppps, subseq visit |
173 |
173 |
$0.00 |
| H0001 |
Alcohol and/or drug assess |
744 |
743 |
$0.00 |
| G2025 |
Dis site tele svcs rhc/fqhc |
1,242 |
1,225 |
$0.00 |
| 99384 |
|
25 |
25 |
$0.00 |
| 90686 |
|
4,327 |
3,931 |
$0.00 |
| 90680 |
|
897 |
759 |
$0.00 |
| V2784 |
Lens polycarb or equal |
520 |
519 |
$0.00 |
| 90647 |
|
1,228 |
1,037 |
$0.00 |
| 96127 |
|
103 |
100 |
$0.00 |
| 90471 |
|
1,602 |
1,575 |
$0.00 |
| 99368 |
|
22 |
13 |
$0.00 |
| G0467 |
Fqhc visit, estab pt |
41 |
41 |
$0.00 |
| 88720 |
|
30 |
27 |
$0.00 |
| 90620 |
|
303 |
274 |
$0.00 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
524 |
524 |
$0.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
47 |
47 |
$0.00 |
| G0396 |
Alcohol/subs interv 15-30mn |
144 |
139 |
$0.00 |
| 96372 |
|
12 |
12 |
$0.00 |
| V2100 |
Lens spher single plano 4.00 |
153 |
153 |
$0.00 |
| 90696 |
|
95 |
78 |
$0.00 |
| 81000 |
|
66 |
66 |
$0.00 |
| 99383 |
|
30 |
30 |
$0.00 |
| Z1034 |
|
15 |
13 |
$0.00 |
| 90715 |
|
206 |
188 |
$0.00 |
| 90734 |
|
330 |
330 |
$0.00 |
| 2028F |
|
894 |
868 |
$0.00 |
| 99391 |
|
1,726 |
1,671 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
541 |
469 |
$0.00 |
| 90837 |
|
771 |
509 |
$0.00 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
49 |
49 |
$0.00 |
| 90633 |
|
651 |
545 |
$0.00 |
| 90832 |
|
1,418 |
1,032 |
$0.00 |
| 95251 |
|
136 |
132 |
$0.00 |
| 90670 |
|
1,277 |
1,127 |
$0.00 |
| 90791 |
|
500 |
370 |
$0.00 |
| 90707 |
|
554 |
468 |
$0.00 |
| 96160 |
|
223 |
212 |
$0.00 |
| 99442 |
|
110 |
109 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
89 |
89 |
$0.00 |
| 11056 |
|
12 |
12 |
$0.00 |
| 90679 |
|
13 |
13 |
$0.00 |
| 0524 |
|
30 |
13 |
$0.00 |
| 94375 |
|
12 |
12 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 87880 |
|
13 |
13 |
$0.00 |