| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
|
109,626 |
98,411 |
$3.78M |
| 99214 |
|
73,025 |
65,770 |
$3.60M |
| 99284 |
|
31,744 |
29,126 |
$2.02M |
| T2031 |
Assist living waiver/diem |
105,114 |
3,886 |
$1.54M |
| 99285 |
|
16,884 |
15,377 |
$1.53M |
| S0302 |
Completed epsdt |
25,764 |
25,135 |
$784K |
| X5622 |
|
11,864 |
10,832 |
$676K |
| 99215 |
Prolong outpt/office vis |
8,885 |
8,227 |
$565K |
| 99283 |
|
15,415 |
14,467 |
$545K |
| 99392 |
|
9,456 |
9,178 |
$463K |
| 92014 |
|
6,804 |
6,699 |
$313K |
| 99212 |
|
16,605 |
15,467 |
$297K |
| 99393 |
|
5,933 |
5,812 |
$297K |
| 99391 |
|
8,855 |
8,547 |
$278K |
| 99203 |
|
6,540 |
6,263 |
$276K |
| 92004 |
|
3,678 |
3,615 |
$215K |
| 99211 |
|
14,048 |
12,763 |
$205K |
| 99202 |
|
7,927 |
7,589 |
$205K |
| 74177 |
|
4,151 |
3,869 |
$198K |
| 99394 |
|
3,517 |
3,327 |
$197K |
| T1016 |
Case management |
9,855 |
3,047 |
$185K |
| 59400 |
|
166 |
155 |
$171K |
| 99204 |
|
2,312 |
2,171 |
$164K |
| 92015 |
|
13,357 |
13,126 |
$153K |
| 99232 |
|
3,448 |
1,252 |
$147K |
| 93010 |
|
32,535 |
27,323 |
$135K |
| 87651 |
|
4,418 |
4,288 |
$131K |
| 92340 |
|
6,100 |
5,700 |
$128K |
| 99291 |
|
834 |
706 |
$113K |
| 99395 |
|
2,030 |
1,984 |
$112K |
| T2028 |
Special supply, nos waiver |
12,343 |
350 |
$108K |
| V2020 |
Vision svcs frames purchases |
3,367 |
3,170 |
$106K |
| 99309 |
|
2,568 |
2,339 |
$104K |
| 90837 |
|
1,804 |
1,340 |
$96K |
| 90834 |
|
1,470 |
1,036 |
$94K |
| 99308 |
|
2,825 |
2,321 |
$90K |
| 99233 |
Prolong inpt eval add15 m |
1,252 |
511 |
$80K |
| 99396 |
|
1,268 |
1,246 |
$76K |
| 99223 |
Prolong inpt eval add15 m |
481 |
385 |
$70K |
| 99188 |
|
5,215 |
5,142 |
$70K |
| 99239 |
|
1,089 |
987 |
$69K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,361 |
1,447 |
$61K |
| S5130 |
Homaker service nos per 15m |
7,959 |
694 |
$60K |
| 77067 |
|
3,037 |
3,003 |
$59K |
| 70450 |
|
2,777 |
2,530 |
$55K |
| V2784 |
Lens polycarb or equal |
4,553 |
2,423 |
$48K |
| 99460 |
|
755 |
746 |
$45K |
| 77063 |
|
2,267 |
2,241 |
$42K |
| 71046 |
|
8,408 |
7,705 |
$40K |
| S5170 |
Homedelivered prepared meal |
25,195 |
1,171 |
$40K |
| 99442 |
|
1,179 |
1,103 |
$35K |
| 90471 |
|
2,723 |
2,683 |
$35K |
| 71045 |
|
7,387 |
6,406 |
$34K |
| 99310 |
Prolong nursin fac eval 15m |
514 |
467 |
$34K |
| 11721 |
|
3,588 |
3,438 |
$33K |
| U0003 |
Cov-19 amp prb hgh thruput |
530 |
501 |
$32K |
| 90832 |
|
811 |
728 |
$31K |
| 90791 |
|
340 |
325 |
$30K |
| 99245 |
|
147 |
144 |
$29K |
| 99238 |
|
687 |
665 |
$29K |
| 0002A |
|
1,474 |
1,465 |
$28K |
| 93306 |
|
638 |
628 |
$27K |
| 0001A |
|
1,574 |
1,564 |
$25K |
| 87631 |
|
224 |
218 |
$24K |
| 71275 |
|
414 |
401 |
$23K |
| 92341 |
|
884 |
819 |
$21K |
| 99243 |
|
394 |
387 |
$21K |
| 99443 |
|
539 |
481 |
$20K |
| 17110 |
|
392 |
359 |
$18K |
| 99205 |
Prolong outpt/office vis |
115 |
110 |
$18K |
| 76816 |
|
661 |
608 |
$17K |
| 76805 |
|
592 |
573 |
$17K |
| 20610 |
|
497 |
426 |
$14K |
| 92551 |
|
1,668 |
1,632 |
$13K |
| 96110 |
|
2,575 |
2,481 |
$12K |
| 36415 |
|
5,602 |
4,960 |
$12K |
| G2211 |
Complex e/m visit add on |
4,422 |
4,250 |
$12K |
| 11042 |
|
445 |
323 |
$11K |
| 90792 |
|
54 |
54 |
$11K |
| 99282 |
|
378 |
374 |
$10K |
| 73630 |
|
2,309 |
1,985 |
$10K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
293 |
185 |
$9K |
| U0005 |
Infec agen detec ampli probe |
454 |
435 |
$9K |
| 99222 |
|
112 |
97 |
$9K |
| 87880 |
|
978 |
927 |
$8K |
| 90686 |
|
2,444 |
2,416 |
$8K |
| 76830 |
|
313 |
307 |
$7K |
| 76801 |
|
218 |
211 |
$7K |
| 73610 |
|
1,389 |
1,198 |
$7K |
| 99441 |
|
417 |
398 |
$7K |
| 67028 |
|
104 |
93 |
$7K |
| 99231 |
|
265 |
127 |
$6K |
| 0004A |
|
272 |
251 |
$6K |
| 95004 |
|
52 |
52 |
$6K |
| 74176 |
|
95 |
92 |
$6K |
| 73130 |
|
1,129 |
887 |
$5K |
| 99417 |
Prolong home eval add 15m |
82 |
80 |
$5K |
| 72125 |
|
160 |
156 |
$5K |
| 90833 |
|
45 |
44 |
$5K |
| 99244 |
|
91 |
89 |
$5K |
| 76705 |
|
284 |
270 |
$5K |
| 0241U |
|
37 |
36 |
$4K |
| 73564 |
|
663 |
539 |
$4K |
| 99173 |
|
2,720 |
2,613 |
$4K |
| T2003 |
N-et; encounter/trip |
720 |
400 |
$4K |
| 85025 |
|
1,037 |
974 |
$4K |
| 84443 |
|
433 |
422 |
$4K |
| 73030 |
|
758 |
646 |
$4K |
| 96161 |
|
2,707 |
2,670 |
$4K |
| D1206 |
|
907 |
861 |
$4K |
| 0071A |
|
101 |
101 |
$4K |
| S5161 |
Emer rspns sys serv permonth |
319 |
315 |
$3K |
| 0764T |
|
319 |
290 |
$3K |
| 99381 |
|
136 |
133 |
$3K |
| 92133 |
|
184 |
183 |
$3K |
| 76819 |
|
97 |
51 |
$2K |
| 20553 |
|
115 |
115 |
$2K |
| 99201 |
|
184 |
175 |
$2K |
| 99242 |
|
53 |
53 |
$2K |
| 99463 |
|
32 |
31 |
$2K |
| 99462 |
|
80 |
64 |
$2K |
| 99383 |
|
80 |
80 |
$2K |
| 76856 |
|
88 |
86 |
$2K |
| 73110 |
|
318 |
260 |
$2K |
| 96132 |
|
14 |
13 |
$2K |
| 92134 |
|
114 |
107 |
$2K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
59 |
37 |
$2K |
| V5008 |
Hearing screening |
208 |
206 |
$2K |
| S5135 |
Adult companioncare per 15m |
588 |
147 |
$2K |
| 0064A |
|
55 |
55 |
$2K |
| 83036 |
|
270 |
256 |
$1K |
| 0072A |
|
36 |
36 |
$1K |
| 81003 |
|
724 |
713 |
$1K |
| 72100 |
|
177 |
175 |
$1K |
| 74018 |
|
229 |
204 |
$1K |
| 87070 |
|
255 |
242 |
$1K |
| 59025 |
|
137 |
81 |
$1K |
| 94060 |
|
194 |
190 |
$1K |
| 80053 |
|
190 |
172 |
$1K |
| 90460 |
|
60 |
53 |
$981.26 |
| 90662 |
|
32 |
31 |
$936.00 |
| 99341 |
|
28 |
27 |
$930.17 |
| 99384 |
|
29 |
28 |
$913.92 |
| 0011A |
|
43 |
43 |
$912.08 |
| 82728 |
|
102 |
101 |
$831.49 |
| 62326 |
|
27 |
25 |
$750.70 |
| 87086 |
|
117 |
114 |
$711.09 |
| 80048 |
|
147 |
136 |
$699.21 |
| 31575 |
|
18 |
18 |
$695.40 |
| Q3014 |
Telehealth facility fee |
29 |
28 |
$630.43 |
| 96136 |
|
13 |
12 |
$612.69 |
| 58300 |
|
13 |
13 |
$607.95 |
| 97813 |
|
28 |
12 |
$602.09 |
| 99217 |
|
13 |
12 |
$591.00 |
| 90473 |
|
29 |
29 |
$572.94 |
| 94726 |
|
89 |
87 |
$565.09 |
| 73721 |
|
12 |
12 |
$553.08 |
| 94729 |
|
116 |
113 |
$538.67 |
| 73502 |
|
77 |
75 |
$529.50 |
| S0215 |
Nonemerg transp mileage |
110 |
36 |
$513.32 |
| G0008 |
Admin influenza virus vac |
132 |
131 |
$505.04 |
| 71260 |
|
16 |
16 |
$491.92 |
| 99382 |
|
25 |
25 |
$396.00 |
| 12001 |
|
13 |
13 |
$357.60 |
| 80061 |
|
58 |
46 |
$346.74 |
| 81025 |
|
49 |
49 |
$316.93 |
| 86780 |
|
30 |
30 |
$310.08 |
| 87510 |
|
28 |
28 |
$308.11 |
| 73562 |
|
63 |
51 |
$299.18 |
| 87660 |
|
26 |
26 |
$290.01 |
| 87480 |
|
27 |
27 |
$290.01 |
| G0279 |
Tomosynthesis, mammo |
13 |
13 |
$289.38 |
| 82306 |
|
15 |
15 |
$270.83 |
| 73140 |
|
81 |
69 |
$270.47 |
| 87389 |
|
14 |
14 |
$237.60 |
| 69210 |
|
17 |
12 |
$225.49 |
| 85027 |
|
44 |
37 |
$207.86 |
| 86850 |
|
17 |
17 |
$117.12 |
| 99307 |
|
46 |
45 |
$114.43 |
| 81001 |
|
42 |
39 |
$91.97 |
| 0031A |
|
12 |
12 |
$52.20 |
| G1004 |
Cdsm ndsc |
2,746 |
1,711 |
$27.00 |
| 96127 |
|
18 |
18 |
$8.48 |
| 0502F |
|
5,720 |
4,765 |
$0.00 |
| 3078F |
|
28,816 |
26,429 |
$0.00 |
| 3077F |
|
2,052 |
1,883 |
$0.00 |
| 91300 |
|
2,510 |
2,404 |
$0.00 |
| 1159F |
|
242 |
224 |
$0.00 |
| 3051F |
|
372 |
268 |
$0.00 |
| 3046F |
|
415 |
284 |
$0.00 |
| 90672 |
|
17 |
17 |
$0.00 |
| 11981 |
|
13 |
12 |
$0.00 |
| 96101 |
|
15 |
13 |
$0.00 |
| 90734 |
|
22 |
18 |
$0.00 |
| 3074F |
|
34,303 |
31,635 |
$0.00 |
| 3075F |
|
3,040 |
2,893 |
$0.00 |
| 1111F |
|
428 |
309 |
$0.00 |
| 3079F |
|
6,842 |
6,519 |
$0.00 |
| 1123F |
|
782 |
548 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
1,928 |
1,909 |
$0.00 |
| 3044F |
|
3,184 |
2,581 |
$0.00 |
| 3080F |
|
1,123 |
1,056 |
$0.00 |
| 0503F |
|
12 |
12 |
$0.00 |
| G9717 |
Doc pt dx bipol |
15,181 |
10,925 |
$0.00 |
| 3008F |
|
759 |
758 |
$0.00 |
| 0500F |
|
58 |
57 |
$0.00 |
| 90660 |
|
29 |
29 |
$0.00 |
| 91307 |
|
154 |
149 |
$0.00 |
| 90656 |
|
270 |
270 |
$0.00 |
| 3052F |
|
129 |
84 |
$0.00 |
| 91301 |
|
78 |
65 |
$0.00 |
| G8432 |
Dep scr not doc, rng |
762 |
633 |
$0.00 |
| 1125F |
|
36 |
36 |
$0.00 |
| 91306 |
|
28 |
28 |
$0.00 |
| 90651 |
|
16 |
12 |
$0.00 |