| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
119,287 |
105,847 |
$22.71M |
| 00003 |
|
27,741 |
23,798 |
$6.72M |
| 99213 |
|
100,362 |
63,803 |
$315K |
| G9012 |
Other specified case mgmt |
893 |
653 |
$247K |
| 90832 |
|
11,010 |
5,631 |
$174K |
| 99214 |
|
16,551 |
10,852 |
$159K |
| H1001 |
Antepartum management |
2,377 |
1,812 |
$144K |
| 97803 |
|
1,828 |
1,495 |
$113K |
| 97802 |
|
1,022 |
976 |
$84K |
| 90791 |
|
1,668 |
1,020 |
$76K |
| 90651 |
|
1,216 |
1,127 |
$71K |
| 90834 |
|
1,619 |
842 |
$46K |
| 90686 |
|
4,214 |
3,877 |
$46K |
| 59425 |
|
715 |
547 |
$42K |
| 99212 |
|
4,131 |
3,017 |
$38K |
| 90792 |
|
2,085 |
1,317 |
$38K |
| J7307 |
Etonogestrel implant system |
48 |
48 |
$35K |
| 90670 |
|
4,142 |
3,130 |
$33K |
| 90648 |
|
4,771 |
3,677 |
$33K |
| 99391 |
|
5,819 |
3,496 |
$31K |
| H0050 |
Alcohol/drug service 15 min |
1,130 |
1,056 |
$26K |
| 90688 |
|
2,413 |
1,765 |
$24K |
| 90723 |
|
3,529 |
2,685 |
$24K |
| 0124A |
|
354 |
354 |
$24K |
| 90677 |
|
879 |
736 |
$21K |
| 90715 |
|
979 |
821 |
$17K |
| 90633 |
|
2,315 |
1,848 |
$17K |
| 80305 |
|
2,137 |
1,618 |
$17K |
| 83655 |
|
1,921 |
1,404 |
$15K |
| 99392 |
|
7,412 |
4,313 |
$14K |
| 99211 |
|
3,075 |
2,501 |
$14K |
| 0154A |
|
185 |
185 |
$12K |
| 90680 |
|
1,901 |
1,399 |
$12K |
| 90710 |
|
1,470 |
1,183 |
$11K |
| 99393 |
|
5,031 |
2,922 |
$10K |
| 92250 |
|
209 |
198 |
$9K |
| J7298 |
Mirena, 52 mg |
12 |
12 |
$9K |
| 99381 |
|
503 |
369 |
$8K |
| 99394 |
|
3,023 |
1,706 |
$7K |
| J3490 |
Drugs unclassified injection |
139 |
119 |
$7K |
| 90750 |
|
70 |
53 |
$6K |
| 90734 |
|
705 |
591 |
$6K |
| 81025 |
|
2,378 |
2,173 |
$6K |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
887 |
639 |
$6K |
| 90685 |
|
934 |
645 |
$6K |
| 90733 |
|
257 |
243 |
$5K |
| 0073A |
|
79 |
79 |
$5K |
| 92551 |
|
7,449 |
6,093 |
$5K |
| 90681 |
|
542 |
463 |
$4K |
| 90746 |
|
109 |
100 |
$4K |
| 0134A |
|
67 |
67 |
$4K |
| 90480 |
|
213 |
212 |
$4K |
| 0072A |
|
66 |
66 |
$4K |
| 99215 |
Prolong outpt/office vis |
162 |
122 |
$4K |
| 99203 |
|
328 |
244 |
$4K |
| 0003A |
|
75 |
75 |
$4K |
| H1003 |
Prenatal at risk education |
195 |
174 |
$4K |
| 0082A |
|
50 |
50 |
$3K |
| 58300 |
|
50 |
25 |
$3K |
| 90649 |
|
492 |
313 |
$3K |
| 76815 |
|
96 |
90 |
$3K |
| 90656 |
|
609 |
465 |
$3K |
| 11981 |
|
13 |
13 |
$3K |
| 90700 |
|
326 |
270 |
$2K |
| 0173A |
|
38 |
38 |
$2K |
| 0071A |
|
36 |
36 |
$2K |
| H1000 |
Prenatal care atrisk assessm |
13 |
13 |
$2K |
| 0083A |
|
33 |
33 |
$2K |
| 92004 |
|
4,369 |
4,052 |
$2K |
| 0081A |
|
27 |
27 |
$2K |
| 90696 |
|
193 |
170 |
$2K |
| Z7500 |
|
71 |
71 |
$2K |
| 90662 |
|
58 |
52 |
$1K |
| 0004A |
|
16 |
16 |
$1K |
| H2000 |
Comp multidisipln evaluation |
55 |
42 |
$1K |
| 0064A |
|
13 |
13 |
$820.75 |
| 92014 |
|
569 |
567 |
$762.87 |
| 96372 |
|
50 |
41 |
$750.00 |
| 94640 |
|
47 |
44 |
$551.80 |
| J1885 |
Ketorolac tromethamine inj |
100 |
67 |
$426.69 |
| 99283 |
|
3,006 |
2,618 |
$417.11 |
| 99202 |
|
71 |
56 |
$297.71 |
| 90716 |
|
27 |
25 |
$243.00 |
| 99385 |
|
51 |
36 |
$233.68 |
| 85018 |
|
3,940 |
3,094 |
$165.47 |
| 90471 |
|
278 |
276 |
$160.56 |
| 90707 |
|
14 |
12 |
$126.00 |
| 81003 |
|
182 |
158 |
$97.63 |
| 86710 |
|
197 |
194 |
$48.60 |
| 91322 |
|
12 |
12 |
$36.00 |
| 83036 |
|
148 |
146 |
$34.16 |
| 92015 |
|
5,435 |
4,977 |
$16.02 |
| 81002 |
|
54 |
38 |
$12.47 |
| 86580 |
|
24 |
24 |
$10.08 |
| 88720 |
|
16 |
14 |
$4.30 |
| 82948 |
|
28 |
25 |
$2.17 |
| 99173 |
|
1,277 |
1,276 |
$0.08 |
| Z6400 |
|
368 |
333 |
$0.00 |
| 92340 |
|
2,687 |
2,687 |
$0.00 |
| V2020 |
Vision svcs frames purchases |
291 |
291 |
$0.00 |
| Z6414 |
|
75 |
59 |
$0.00 |
| 87804 |
|
13 |
13 |
$0.00 |
| 90472 |
|
94 |
94 |
$0.00 |
| G0470 |
Fqhc visit, mh estab pt |
113 |
84 |
$0.00 |
| 92341 |
|
13 |
13 |
$0.00 |
| 99395 |
|
69 |
47 |
$0.00 |
| 99396 |
|
16 |
14 |
$0.00 |
| G0467 |
Fqhc visit, estab pt |
6,035 |
5,493 |
$0.00 |
| Z1034 |
|
2,927 |
2,413 |
$0.00 |
| G2025 |
Dis site tele svcs rhc/fqhc |
935 |
886 |
$0.00 |
| Z6204 |
|
433 |
240 |
$0.00 |
| Z6406 |
|
86 |
79 |
$0.00 |
| Z1032 |
|
240 |
237 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
16 |
16 |
$0.00 |
| 87426 |
|
29 |
29 |
$0.00 |
| Z6410 |
|
15 |
14 |
$0.00 |