| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
289,243 |
254,943 |
$58.24M |
| H0019 |
Alcohol and/or drug services |
9,474 |
618 |
$1.45M |
| G0467 |
Fqhc visit, estab pt |
25,960 |
23,761 |
$811K |
| H0004 |
Alcohol and/or drug services |
8,847 |
4,229 |
$364K |
| 99213 |
|
6,026 |
5,740 |
$321K |
| V2100 |
Lens spher single plano 4.00 |
5,087 |
5,081 |
$140K |
| D9999 |
|
416 |
370 |
$112K |
| D7210 |
|
910 |
511 |
$112K |
| 92340 |
|
3,472 |
3,471 |
$105K |
| D2392 |
|
954 |
625 |
$103K |
| 99214 |
|
1,419 |
1,390 |
$102K |
| D0140 |
|
3,316 |
3,258 |
$99K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
6,705 |
6,640 |
$90K |
| 92015 |
|
4,211 |
4,210 |
$73K |
| H0010 |
Alcohol and/or drug services |
244 |
87 |
$73K |
| D7140 |
|
1,011 |
595 |
$71K |
| D0220 |
|
3,447 |
3,341 |
$53K |
| V2020 |
Vision svcs frames purchases |
4,787 |
4,785 |
$48K |
| H2017 |
Psysoc rehab svc, per 15 min |
2,321 |
690 |
$44K |
| G2025 |
Dis site tele svcs rhc/fqhc |
1,235 |
1,196 |
$24K |
| D2393 |
|
127 |
85 |
$18K |
| D2391 |
|
275 |
187 |
$17K |
| H0031 |
Mh health assess by non-md |
180 |
180 |
$16K |
| D2150 |
|
117 |
87 |
$15K |
| H2015 |
Comp comm supp svc, 15 min |
822 |
312 |
$12K |
| 99212 |
|
305 |
300 |
$11K |
| D4341 |
|
60 |
26 |
$10K |
| G0470 |
Fqhc visit, mh estab pt |
276 |
143 |
$8K |
| D2140 |
|
81 |
59 |
$5K |
| G0179 |
Md recertification hha pt |
454 |
451 |
$4K |
| D1110 |
|
281 |
222 |
$4K |
| H0002 |
Alcohol and/or drug screenin |
130 |
130 |
$3K |
| D0230 |
|
297 |
171 |
$2K |
| 90832 |
|
85 |
45 |
$2K |
| D1120 |
|
326 |
290 |
$1K |
| 92250 |
|
37 |
37 |
$1K |
| 90471 |
|
119 |
114 |
$1K |
| D2330 |
|
17 |
12 |
$1K |
| Q3014 |
Telehealth facility fee |
55 |
53 |
$804.83 |
| 99231 |
|
40 |
24 |
$654.02 |
| 0012A |
|
23 |
23 |
$577.77 |
| T1017 |
Targeted case management |
23 |
13 |
$505.96 |
| 80305 |
|
56 |
55 |
$392.35 |
| 90834 |
|
17 |
12 |
$297.28 |
| 99238 |
|
13 |
13 |
$250.93 |
| 87811 |
|
106 |
105 |
$220.86 |
| 87880 |
|
13 |
13 |
$191.10 |
| 83036 |
|
13 |
13 |
$112.32 |
| 36415 |
|
42 |
41 |
$85.00 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
19 |
16 |
$83.62 |
| 87804 |
|
27 |
27 |
$29.44 |
| 96160 |
|
4,731 |
4,606 |
$0.00 |
| D0330 |
|
184 |
184 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
105 |
104 |
$0.00 |
| D0274 |
|
206 |
206 |
$0.00 |
| V2784 |
Lens polycarb or equal |
4,977 |
4,972 |
$0.00 |
| 87635 |
|
561 |
549 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
322 |
318 |
$0.00 |
| D1206 |
|
1,788 |
1,783 |
$0.00 |
| 1036F |
|
419 |
414 |
$0.00 |
| D0272 |
|
75 |
75 |
$0.00 |
| D0120 |
|
154 |
154 |
$0.00 |
| D1208 |
|
463 |
463 |
$0.00 |
| D0150 |
|
249 |
249 |
$0.00 |
| G9902 |
Pt scrn tbco and id as user |
14 |
14 |
$0.00 |
| D1351 |
|
40 |
12 |
$0.00 |
| 96161 |
|
13 |
13 |
$0.00 |