| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0467 |
Fqhc visit, estab pt |
56,547 |
48,025 |
$3.99M |
| 59426 |
|
750 |
741 |
$1.11M |
| G0470 |
Fqhc visit, mh estab pt |
6,583 |
4,359 |
$439K |
| D0140 |
|
2,539 |
2,486 |
$250K |
| D7140 |
|
3,112 |
1,759 |
$229K |
| D2392 |
|
1,588 |
1,251 |
$203K |
| G0466 |
Fqhc visit new patient |
2,149 |
2,123 |
$184K |
| D0120 |
|
2,894 |
2,891 |
$175K |
| D1110 |
|
2,043 |
2,042 |
$163K |
| D2391 |
|
1,609 |
1,185 |
$161K |
| D0150 |
|
1,575 |
1,571 |
$130K |
| 99214 |
|
18,989 |
17,216 |
$115K |
| 99213 |
|
20,319 |
18,381 |
$87K |
| J1050 |
Medroxyprogesterone acetate |
1,312 |
1,276 |
$72K |
| D1120 |
|
1,637 |
1,637 |
$64K |
| D1206 |
|
2,576 |
2,575 |
$58K |
| D0210 |
|
1,190 |
1,180 |
$52K |
| D0274 |
|
1,519 |
1,517 |
$36K |
| D0220 |
|
2,756 |
2,688 |
$24K |
| 99395 |
|
1,261 |
1,224 |
$12K |
| 99392 |
|
1,617 |
1,600 |
$11K |
| 90471 |
|
8,653 |
8,403 |
$11K |
| 90834 |
|
1,654 |
1,142 |
$11K |
| D2393 |
|
67 |
66 |
$11K |
| 99393 |
|
1,674 |
1,656 |
$11K |
| D4355 |
|
96 |
96 |
$10K |
| G9007 |
Mccd, sch team conf |
1,259 |
924 |
$10K |
| 99212 |
|
3,962 |
3,688 |
$10K |
| D0272 |
|
466 |
466 |
$9K |
| 90472 |
|
3,150 |
3,090 |
$9K |
| G9002 |
Mccd,maintenance rate |
703 |
623 |
$9K |
| 59430 |
|
206 |
206 |
$9K |
| 99394 |
|
1,125 |
1,116 |
$8K |
| 99391 |
|
1,226 |
1,196 |
$7K |
| 90686 |
|
6,036 |
5,927 |
$6K |
| 96127 |
|
12,092 |
11,171 |
$5K |
| 99215 |
Prolong outpt/office vis |
441 |
424 |
$5K |
| 0001A |
|
141 |
141 |
$5K |
| 99396 |
|
401 |
393 |
$4K |
| 90832 |
|
1,034 |
845 |
$4K |
| 96372 |
|
2,531 |
2,234 |
$4K |
| 0002A |
|
124 |
124 |
$4K |
| 0124A |
|
179 |
179 |
$4K |
| 90791 |
|
531 |
506 |
$4K |
| 59025 |
|
1,734 |
632 |
$4K |
| D2330 |
|
39 |
26 |
$3K |
| 90715 |
|
748 |
747 |
$3K |
| Q0091 |
Obtaining screen pap smear |
1,365 |
1,347 |
$3K |
| 83036 |
|
2,665 |
2,570 |
$3K |
| 99487 |
Ccm add 20min |
74 |
51 |
$3K |
| 98966 |
|
2,280 |
1,788 |
$3K |
| 0004A |
|
93 |
93 |
$3K |
| 99204 |
|
154 |
154 |
$2K |
| 0054A |
|
80 |
79 |
$2K |
| 90837 |
|
302 |
222 |
$2K |
| 81025 |
|
1,831 |
1,766 |
$2K |
| 90656 |
|
112 |
112 |
$2K |
| G0101 |
Ca screen;pelvic/breast exam |
910 |
901 |
$2K |
| 96110 |
|
1,873 |
1,599 |
$1K |
| H0004 |
Alcohol and/or drug services |
1,214 |
805 |
$1K |
| 99203 |
|
84 |
83 |
$1K |
| D0240 |
|
49 |
25 |
$1K |
| 90651 |
|
654 |
652 |
$1K |
| 98967 |
|
244 |
202 |
$944.46 |
| 90707 |
|
242 |
241 |
$942.05 |
| 0031A |
|
30 |
29 |
$870.55 |
| 90632 |
|
82 |
73 |
$821.23 |
| D4910 |
|
13 |
13 |
$802.01 |
| G2025 |
Dis site tele svcs rhc/fqhc |
114 |
99 |
$729.05 |
| 99202 |
|
164 |
163 |
$723.43 |
| 90620 |
|
389 |
387 |
$710.20 |
| 90746 |
|
89 |
85 |
$678.37 |
| 92551 |
|
1,069 |
1,055 |
$588.39 |
| 87880 |
|
318 |
308 |
$553.88 |
| 0003A |
|
16 |
16 |
$454.20 |
| 0051A |
|
13 |
13 |
$413.15 |
| 81002 |
|
1,473 |
1,382 |
$392.42 |
| 0052A |
|
12 |
12 |
$375.30 |
| D0145 |
|
12 |
12 |
$336.00 |
| 90473 |
|
613 |
602 |
$264.00 |
| 99442 |
|
34 |
18 |
$249.22 |
| 85018 |
|
850 |
831 |
$243.19 |
| 96152 |
|
969 |
823 |
$208.38 |
| 99381 |
|
53 |
53 |
$173.44 |
| 90670 |
|
1,045 |
1,032 |
$161.00 |
| 90732 |
|
17 |
17 |
$114.21 |
| 99382 |
|
15 |
14 |
$93.36 |
| 90682 |
|
41 |
32 |
$84.00 |
| 11982 |
|
13 |
13 |
$66.76 |
| J1885 |
Ketorolac tromethamine inj |
58 |
50 |
$62.31 |
| 86580 |
|
42 |
38 |
$59.28 |
| 82962 |
|
83 |
57 |
$40.65 |
| 87811 |
|
13 |
13 |
$34.26 |
| D0230 |
|
55 |
13 |
$25.00 |
| 96158 |
|
44 |
40 |
$24.05 |
| 93000 |
|
12 |
12 |
$19.02 |
| 90688 |
|
17 |
17 |
$18.20 |
| 92552 |
|
12 |
12 |
$17.83 |
| G0008 |
Admin influenza virus vac |
210 |
209 |
$7.00 |
| G0444 |
Depression screen annual |
183 |
182 |
$0.00 |
| 91300 |
|
406 |
384 |
$0.00 |
| 91312 |
|
160 |
160 |
$0.00 |
| 90633 |
|
358 |
358 |
$0.00 |
| 90700 |
|
171 |
171 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
494 |
457 |
$0.00 |
| 3077F |
|
2,067 |
1,928 |
$0.00 |
| 3078F |
|
918 |
899 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 90734 |
|
498 |
497 |
$0.00 |
| 90710 |
|
175 |
173 |
$0.00 |
| G8511 |
Scr dep pos, no plan doc rng |
60 |
60 |
$0.00 |
| 99173 |
|
14 |
12 |
$0.00 |
| 90681 |
|
173 |
172 |
$0.00 |
| 3045F |
|
44 |
41 |
$0.00 |
| 3051F |
|
12 |
12 |
$0.00 |
| 96160 |
|
14 |
14 |
$0.00 |
| 99605 |
|
13 |
13 |
$0.00 |
| 90671 |
|
15 |
15 |
$0.00 |
| 3044F |
|
1,059 |
1,026 |
$0.00 |
| 3080F |
|
1,584 |
1,485 |
$0.00 |
| 3075F |
|
1,033 |
996 |
$0.00 |
| 3079F |
|
2,020 |
1,908 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
3,203 |
2,980 |
$0.00 |
| 3074F |
|
1,385 |
1,342 |
$0.00 |
| 90723 |
|
721 |
713 |
$0.00 |
| 90647 |
|
752 |
747 |
$0.00 |
| 90680 |
|
380 |
375 |
$0.00 |
| 90696 |
|
147 |
145 |
$0.00 |
| 91305 |
|
172 |
169 |
$0.00 |
| 94010 |
|
12 |
12 |
$0.00 |
| 94760 |
|
324 |
305 |
$0.00 |
| 90716 |
|
110 |
110 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |
| 91303 |
|
27 |
27 |
$0.00 |