| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
565,265 |
494,406 |
$120.39M |
| H1001 |
Antepartum management |
17,371 |
10,618 |
$1.46M |
| G9012 |
Other specified case mgmt |
6,923 |
3,150 |
$1.14M |
| T2033 |
Res, nos waiver per diem |
5,458 |
299 |
$1.11M |
| 99213 |
|
390,037 |
238,221 |
$1.10M |
| H0044 |
Supported housing, per month |
7,630 |
319 |
$836K |
| 99214 |
|
159,977 |
96,838 |
$593K |
| 90832 |
|
47,075 |
23,042 |
$422K |
| 00003 |
|
1,522 |
1,248 |
$392K |
| 98941 |
|
32,288 |
13,552 |
$381K |
| H1000 |
Prenatal care atrisk assessm |
1,565 |
1,556 |
$285K |
| 59425 |
|
3,389 |
2,152 |
$280K |
| 99391 |
|
24,192 |
15,630 |
$217K |
| 59430 |
|
2,415 |
2,256 |
$207K |
| H0043 |
Supported housing, per diem |
408 |
407 |
$157K |
| 59025 |
|
8,188 |
2,183 |
$135K |
| 99215 |
Prolong outpt/office vis |
5,576 |
3,399 |
$133K |
| 90686 |
|
17,496 |
12,007 |
$100K |
| G0467 |
Fqhc visit, estab pt |
1,236 |
1,046 |
$96K |
| 99392 |
|
26,358 |
16,193 |
$87K |
| 90670 |
|
15,237 |
10,168 |
$85K |
| 90834 |
|
4,269 |
1,801 |
$81K |
| 99203 |
|
3,643 |
2,440 |
$80K |
| 83068 |
|
17,116 |
10,627 |
$80K |
| 96110 |
|
2,945 |
1,746 |
$79K |
| 99393 |
|
19,256 |
11,432 |
$75K |
| 99212 |
|
19,002 |
11,713 |
$70K |
| 11721 |
|
6,284 |
4,720 |
$69K |
| 80305 |
|
9,798 |
4,945 |
$68K |
| G0442 |
Annual alcohol screen 15 min |
8,549 |
5,481 |
$66K |
| 83036 |
|
19,455 |
13,922 |
$66K |
| 90715 |
|
4,125 |
2,807 |
$63K |
| 81002 |
|
65,091 |
29,682 |
$63K |
| 96156 |
|
3,294 |
2,870 |
$57K |
| 87635 |
|
2,709 |
1,968 |
$52K |
| 90791 |
|
905 |
535 |
$49K |
| 90633 |
|
8,613 |
5,571 |
$48K |
| 90837 |
|
1,239 |
499 |
$45K |
| 99238 |
|
1,659 |
1,207 |
$44K |
| 99394 |
|
7,830 |
4,462 |
$42K |
| 99202 |
|
1,726 |
1,308 |
$40K |
| 90723 |
|
7,104 |
4,875 |
$39K |
| 90697 |
|
7,626 |
4,791 |
$39K |
| 92014 |
|
8,005 |
7,855 |
$39K |
| 90647 |
|
6,990 |
4,767 |
$38K |
| 97802 |
|
1,932 |
1,698 |
$36K |
| 90680 |
|
5,857 |
4,032 |
$32K |
| 99401 |
|
2,774 |
2,267 |
$31K |
| 93010 |
|
1,755 |
1,745 |
$31K |
| 99188 |
|
3,281 |
1,954 |
$31K |
| 92551 |
|
30,211 |
18,029 |
$29K |
| 83655 |
|
4,159 |
2,352 |
$24K |
| 99460 |
|
666 |
484 |
$23K |
| 90651 |
|
2,397 |
1,835 |
$23K |
| 90710 |
|
3,269 |
2,407 |
$22K |
| 90677 |
|
3,754 |
2,208 |
$21K |
| 11056 |
|
2,083 |
1,394 |
$21K |
| 99402 |
|
963 |
955 |
$19K |
| 99283 |
|
27,028 |
25,654 |
$19K |
| 97597 |
|
1,274 |
673 |
$18K |
| 54150 |
|
179 |
178 |
$18K |
| 99204 |
|
828 |
495 |
$18K |
| 87426 |
|
799 |
535 |
$16K |
| 97803 |
|
1,507 |
1,423 |
$16K |
| 90792 |
|
448 |
263 |
$15K |
| H1003 |
Prenatal at risk education |
1,344 |
1,323 |
$14K |
| 92004 |
|
1,057 |
1,022 |
$13K |
| 90681 |
|
2,678 |
1,646 |
$13K |
| 90700 |
|
1,804 |
1,289 |
$12K |
| 99462 |
|
641 |
395 |
$11K |
| 87804 |
|
1,012 |
666 |
$11K |
| S9445 |
Pt education noc individ |
554 |
460 |
$10K |
| 81025 |
|
5,995 |
3,793 |
$10K |
| 99335 |
|
1,649 |
1,055 |
$10K |
| 90696 |
|
1,468 |
1,103 |
$10K |
| 96372 |
|
496 |
390 |
$9K |
| 90716 |
|
1,484 |
960 |
$9K |
| 90707 |
|
1,382 |
896 |
$8K |
| 90471 |
|
5,586 |
4,769 |
$8K |
| 90734 |
|
859 |
623 |
$6K |
| 87634 |
|
171 |
101 |
$6K |
| 99403 |
|
482 |
308 |
$6K |
| 99211 |
|
4,438 |
3,169 |
$5K |
| 90656 |
|
936 |
601 |
$5K |
| 11055 |
|
862 |
581 |
$5K |
| 98925 |
|
373 |
238 |
$5K |
| 87880 |
|
8,920 |
5,483 |
$4K |
| 90756 |
|
161 |
161 |
$4K |
| 88720 |
|
1,337 |
876 |
$3K |
| 92250 |
|
117 |
97 |
$3K |
| 90619 |
|
461 |
310 |
$3K |
| 98926 |
|
119 |
90 |
$3K |
| 96150 |
|
170 |
141 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
797 |
511 |
$2K |
| 99336 |
|
506 |
337 |
$2K |
| 99381 |
|
112 |
66 |
$2K |
| 90678 |
|
38 |
31 |
$2K |
| 17110 |
|
43 |
26 |
$2K |
| 96151 |
|
201 |
185 |
$2K |
| 99395 |
|
334 |
191 |
$2K |
| 99308 |
|
355 |
197 |
$2K |
| 93005 |
|
2,508 |
1,613 |
$1K |
| J3490 |
Drugs unclassified injection |
17 |
13 |
$1K |
| 90688 |
|
475 |
464 |
$1K |
| 97810 |
|
613 |
432 |
$1K |
| 99309 |
|
291 |
167 |
$1K |
| 87811 |
|
68 |
48 |
$1K |
| 90685 |
|
129 |
128 |
$1K |
| 90713 |
|
138 |
123 |
$1K |
| 20550 |
|
47 |
27 |
$961.59 |
| 90744 |
|
115 |
99 |
$891.00 |
| 99222 |
|
24 |
13 |
$885.06 |
| 11750 |
|
21 |
12 |
$845.10 |
| 92227 |
|
147 |
96 |
$728.96 |
| H2000 |
Comp multidisipln evaluation |
56 |
56 |
$665.06 |
| 99383 |
|
22 |
12 |
$438.64 |
| 90381 |
|
92 |
54 |
$405.00 |
| 11730 |
|
29 |
12 |
$384.24 |
| 90662 |
|
220 |
213 |
$370.00 |
| 82948 |
|
2,953 |
2,159 |
$358.35 |
| 90746 |
|
18 |
13 |
$357.60 |
| S9452 |
Nutrition class |
28 |
28 |
$337.54 |
| 90380 |
|
79 |
58 |
$333.00 |
| 99348 |
|
58 |
30 |
$240.10 |
| 95251 |
|
20 |
12 |
$236.72 |
| 92012 |
|
2,723 |
2,583 |
$227.82 |
| 88142 |
|
51 |
41 |
$210.60 |
| 86703 |
|
49 |
31 |
$205.01 |
| 99201 |
|
56 |
41 |
$188.16 |
| 99382 |
|
19 |
12 |
$94.26 |
| 90472 |
|
111 |
103 |
$91.46 |
| 92134 |
|
600 |
598 |
$64.50 |
| 86580 |
|
69 |
63 |
$63.84 |
| 99349 |
|
30 |
15 |
$51.60 |
| 92015 |
|
6,919 |
6,900 |
$48.06 |
| 92133 |
|
300 |
297 |
$32.25 |
| 99173 |
|
9,236 |
9,232 |
$2.54 |
| Z6400 |
|
1,449 |
1,434 |
$0.00 |
| Z6300 |
|
1,418 |
1,409 |
$0.00 |
| 4004F |
|
1,372 |
1,353 |
$0.00 |
| Z6304 |
|
1,448 |
1,382 |
$0.00 |
| 99177 |
|
1,823 |
1,820 |
$0.00 |
| 90785 |
|
30 |
29 |
$0.00 |
| Z6200 |
|
1,533 |
1,525 |
$0.00 |
| Z6202 |
|
128 |
112 |
$0.00 |
| 99396 |
|
20 |
12 |
$0.00 |
| Z6208 |
|
63 |
63 |
$0.00 |
| 92083 |
|
43 |
43 |
$0.00 |
| 91300 |
|
14 |
14 |
$0.00 |
| Z6308 |
|
53 |
52 |
$0.00 |
| Z6302 |
|
81 |
79 |
$0.00 |
| Z6414 |
|
82 |
81 |
$0.00 |
| 76514 |
|
12 |
12 |
$0.00 |
| 90750 |
|
12 |
12 |
$0.00 |
| 87428 |
|
3,499 |
3,490 |
$0.00 |
| Z6204 |
|
1,428 |
1,360 |
$0.00 |
| Z6406 |
|
2,151 |
1,744 |
$0.00 |
| Z6402 |
|
1,456 |
1,449 |
$0.00 |
| Z1038 |
|
2,080 |
1,977 |
$0.00 |
| Z1032 |
|
2,120 |
2,104 |
$0.00 |
| Z1034 |
|
20,402 |
12,990 |
$0.00 |
| Z6410 |
|
552 |
460 |
$0.00 |
| Z6404 |
|
639 |
410 |
$0.00 |
| G0008 |
Admin influenza virus vac |
985 |
985 |
$0.00 |
| G2025 |
Dis site tele svcs rhc/fqhc |
39 |
32 |
$0.00 |
| G0439 |
Ppps, subseq visit |
92 |
92 |
$0.00 |
| 0001A |
|
13 |
13 |
$0.00 |