| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0018 |
Alcohol and/or drug services |
20,616 |
3,769 |
$4.08M |
| 99213 |
|
80,174 |
74,004 |
$2.44M |
| 99214 |
|
30,575 |
28,856 |
$1.14M |
| 96165 |
|
16,745 |
5,055 |
$814K |
| H0019 |
Alcohol and/or drug services |
2,469 |
247 |
$456K |
| H2036 |
A/d tx program, per diem |
26,515 |
4,478 |
$294K |
| H0004 |
Alcohol and/or drug services |
3,773 |
2,846 |
$266K |
| 96164 |
|
16,568 |
5,058 |
$232K |
| 99442 |
|
11,727 |
11,167 |
$223K |
| 99443 |
|
3,053 |
2,292 |
$151K |
| 90832 |
|
3,137 |
2,368 |
$146K |
| 99441 |
|
12,263 |
11,704 |
$122K |
| 80305 |
|
12,870 |
9,819 |
$88K |
| 99212 |
|
5,635 |
5,392 |
$84K |
| 90471 |
|
8,204 |
8,057 |
$58K |
| H0001 |
Alcohol and/or drug assess |
355 |
353 |
$45K |
| 99211 |
|
5,171 |
3,581 |
$42K |
| 90686 |
|
5,829 |
5,768 |
$38K |
| 99203 |
|
741 |
732 |
$29K |
| 83036 |
|
3,665 |
3,630 |
$21K |
| J1050 |
Medroxyprogesterone acetate |
831 |
827 |
$20K |
| 36415 |
|
8,333 |
7,950 |
$16K |
| 99396 |
|
185 |
179 |
$15K |
| 99348 |
|
281 |
185 |
$14K |
| 99215 |
Prolong outpt/office vis |
291 |
281 |
$13K |
| G9149 |
Medical home level ii |
74 |
74 |
$13K |
| 81025 |
|
1,761 |
1,714 |
$12K |
| 0031A |
|
323 |
322 |
$11K |
| 99202 |
|
435 |
427 |
$11K |
| 90834 |
|
203 |
179 |
$11K |
| 90677 |
|
39 |
38 |
$11K |
| 99395 |
|
109 |
109 |
$10K |
| 90746 |
|
249 |
246 |
$10K |
| 0012A |
|
231 |
231 |
$9K |
| 99204 |
|
132 |
131 |
$8K |
| 0011A |
|
216 |
216 |
$8K |
| 0064A |
|
193 |
191 |
$8K |
| 87880 |
|
558 |
549 |
$7K |
| J7307 |
Etonogestrel implant system |
12 |
12 |
$5K |
| 90837 |
|
65 |
58 |
$4K |
| 96372 |
|
396 |
364 |
$4K |
| 90715 |
|
425 |
419 |
$4K |
| 99422 |
|
103 |
101 |
$4K |
| 99394 |
|
58 |
58 |
$4K |
| 81002 |
|
1,606 |
1,562 |
$3K |
| 99393 |
|
60 |
60 |
$3K |
| 90619 |
|
42 |
42 |
$3K |
| 87804 |
|
169 |
167 |
$2K |
| 90651 |
|
161 |
161 |
$2K |
| 90472 |
|
322 |
316 |
$2K |
| 36416 |
|
2,109 |
2,082 |
$1K |
| 90732 |
|
13 |
13 |
$1K |
| 99423 |
|
17 |
16 |
$988.04 |
| 99421 |
|
49 |
48 |
$937.34 |
| 3074F |
|
72,996 |
66,545 |
$906.32 |
| 90656 |
|
80 |
80 |
$674.30 |
| 99205 |
Prolong outpt/office vis |
14 |
14 |
$667.71 |
| 90707 |
|
25 |
25 |
$579.72 |
| G2025 |
Dis site tele svcs rhc/fqhc |
820 |
701 |
$574.57 |
| 0034A |
|
14 |
14 |
$560.00 |
| 90688 |
|
62 |
62 |
$481.74 |
| 0134A |
|
49 |
49 |
$400.38 |
| 99499 |
|
18 |
18 |
$365.00 |
| 99201 |
|
14 |
13 |
$207.84 |
| 90658 |
|
29 |
29 |
$200.00 |
| 86580 |
|
75 |
69 |
$178.31 |
| 83037 |
|
15 |
15 |
$153.44 |
| G2012 |
Brief check in by md/qhp |
21 |
21 |
$149.11 |
| 90734 |
|
82 |
79 |
$134.41 |
| 3044F |
|
646 |
640 |
$100.00 |
| 93005 |
|
26 |
25 |
$57.06 |
| J1885 |
Ketorolac tromethamine inj |
16 |
14 |
$33.64 |
| 85018 |
|
17 |
15 |
$28.32 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
242 |
209 |
$8.60 |
| 3078F |
|
66,069 |
60,282 |
$0.23 |
| 3079F |
|
16,819 |
15,816 |
$0.03 |
| 91313 |
|
183 |
182 |
$0.01 |
| 3077F |
|
2,630 |
2,454 |
$0.00 |
| T1017 |
Targeted case management |
103 |
44 |
$0.00 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
100 |
100 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90633 |
|
50 |
48 |
$0.00 |
| 90710 |
|
27 |
27 |
$0.00 |
| T1015 |
Clinic service |
89 |
43 |
$0.00 |
| 3075F |
|
6,419 |
5,998 |
$0.00 |
| 3080F |
|
1,992 |
1,893 |
$0.00 |
| 99402 |
|
188 |
139 |
$0.00 |
| 91301 |
|
551 |
547 |
$0.00 |
| 91306 |
|
254 |
250 |
$0.00 |
| G0467 |
Fqhc visit, estab pt |
3,752 |
3,350 |
$0.00 |
| 91303 |
|
373 |
372 |
$0.00 |
| 99309 |
|
26 |
26 |
$0.00 |
| 99406 |
|
12 |
12 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |