| Code | Description | Claims | Beneficiaries | Total Paid |
| 00003 |
|
19,992 |
17,672 |
$2.68M |
| T1015 |
Clinic service |
22,670 |
18,687 |
$2.26M |
| G9012 |
Other specified case mgmt |
15,708 |
6,903 |
$1.19M |
| 99213 |
|
232,394 |
192,643 |
$1.08M |
| G9008 |
Mccd,phys coor-care ovrsght |
2,617 |
2,494 |
$719K |
| 99214 |
|
37,611 |
32,332 |
$583K |
| H1001 |
Antepartum management |
7,991 |
5,037 |
$281K |
| 99212 |
|
68,385 |
58,698 |
$216K |
| H0043 |
Supported housing, per diem |
1,580 |
431 |
$177K |
| 87635 |
|
16,094 |
15,300 |
$126K |
| 99396 |
|
3,533 |
3,426 |
$115K |
| 90832 |
|
7,471 |
6,085 |
$105K |
| 99395 |
|
3,770 |
3,672 |
$82K |
| 92004 |
|
2,190 |
1,989 |
$67K |
| 98940 |
|
5,246 |
3,684 |
$62K |
| 99394 |
|
5,694 |
5,538 |
$61K |
| 99393 |
|
6,169 |
5,980 |
$59K |
| 99392 |
|
5,356 |
5,196 |
$53K |
| G0467 |
Fqhc visit, estab pt |
14,437 |
11,497 |
$51K |
| 92014 |
|
2,005 |
1,802 |
$50K |
| 81003 |
|
44,620 |
39,241 |
$42K |
| V2020 |
Vision svcs frames purchases |
2,450 |
2,438 |
$33K |
| 92551 |
|
26,719 |
26,166 |
$30K |
| 99203 |
|
2,943 |
2,916 |
$28K |
| 99391 |
|
1,738 |
1,684 |
$27K |
| 99202 |
|
2,620 |
2,559 |
$22K |
| 92340 |
|
1,886 |
1,879 |
$21K |
| 96156 |
|
1,988 |
1,742 |
$20K |
| 92015 |
|
4,164 |
3,780 |
$20K |
| G9920 |
Scrning perf and negative |
4,168 |
4,160 |
$20K |
| 90791 |
|
713 |
712 |
$19K |
| 96372 |
|
10,965 |
9,108 |
$18K |
| 82962 |
|
29,297 |
25,047 |
$18K |
| 90471 |
|
31,544 |
30,789 |
$17K |
| 98941 |
|
8,212 |
5,452 |
$15K |
| H1000 |
Prenatal care atrisk assessm |
193 |
191 |
$14K |
| 99401 |
|
1,454 |
1,235 |
$13K |
| 90651 |
|
3,312 |
3,261 |
$13K |
| 81025 |
|
12,872 |
12,028 |
$12K |
| 99173 |
|
26,021 |
25,476 |
$12K |
| H1003 |
Prenatal at risk education |
1,295 |
1,179 |
$12K |
| 87811 |
|
2,172 |
2,122 |
$11K |
| 85018 |
|
37,670 |
35,912 |
$10K |
| S9445 |
Pt education noc individ |
660 |
541 |
$10K |
| 59425 |
|
2,962 |
1,962 |
$10K |
| 90834 |
|
1,157 |
904 |
$10K |
| 90715 |
|
4,304 |
4,213 |
$7K |
| 36415 |
|
10,998 |
10,694 |
$6K |
| 92341 |
|
348 |
348 |
$5K |
| 96110 |
|
1,500 |
1,496 |
$5K |
| 90686 |
|
8,689 |
8,490 |
$5K |
| 90472 |
|
10,375 |
10,161 |
$5K |
| 93000 |
|
1,776 |
1,739 |
$4K |
| 90670 |
|
2,105 |
2,027 |
$4K |
| 97803 |
|
326 |
323 |
$4K |
| J0696 |
Ceftriaxone sodium injection |
1,017 |
828 |
$4K |
| J3301 |
Triamcinolone acet inj nos |
782 |
679 |
$4K |
| 97802 |
|
367 |
235 |
$4K |
| 83036 |
|
2,496 |
2,479 |
$3K |
| 90837 |
|
95 |
67 |
$3K |
| 59409 |
|
13 |
13 |
$3K |
| 59430 |
|
132 |
131 |
$3K |
| 99204 |
|
98 |
97 |
$3K |
| 87804 |
|
4,344 |
4,179 |
$3K |
| J3420 |
Vitamin b12 injection |
837 |
664 |
$3K |
| G2025 |
Dis site tele svcs rhc/fqhc |
580 |
521 |
$3K |
| 94640 |
|
1,161 |
885 |
$3K |
| 87880 |
|
4,173 |
4,049 |
$2K |
| J7613 |
Albuterol non-comp unit |
802 |
651 |
$2K |
| 90756 |
|
1,199 |
1,179 |
$2K |
| 90460 |
|
216 |
215 |
$2K |
| J1100 |
Dexamethasone sodium phos |
302 |
283 |
$2K |
| 99211 |
|
423 |
406 |
$2K |
| 90750 |
|
56 |
56 |
$2K |
| 20552 |
|
99 |
71 |
$1K |
| 90674 |
|
1,197 |
1,184 |
$1K |
| 90620 |
|
900 |
882 |
$1K |
| 90734 |
|
2,055 |
2,001 |
$1K |
| 90656 |
|
578 |
577 |
$937.52 |
| 99383 |
|
39 |
39 |
$859.41 |
| 20550 |
|
82 |
70 |
$855.52 |
| 0011A |
|
207 |
203 |
$853.87 |
| 90648 |
|
1,198 |
1,145 |
$818.61 |
| 90688 |
|
1,827 |
1,774 |
$811.10 |
| 97110 |
|
5,792 |
3,843 |
$803.50 |
| J2001 |
Lidocaine injection |
73 |
69 |
$707.79 |
| J1050 |
Medroxyprogesterone acetate |
17 |
13 |
$545.52 |
| 90723 |
|
460 |
440 |
$539.09 |
| 99201 |
|
40 |
40 |
$528.04 |
| 90746 |
|
14 |
14 |
$523.88 |
| 96150 |
|
89 |
55 |
$513.18 |
| 90698 |
|
257 |
257 |
$476.22 |
| 99384 |
|
30 |
30 |
$420.68 |
| 91301 |
|
341 |
330 |
$420.17 |
| 99215 |
Prolong outpt/office vis |
26 |
26 |
$380.89 |
| 90633 |
|
1,062 |
1,022 |
$362.64 |
| 99382 |
|
27 |
27 |
$351.65 |
| 96158 |
|
65 |
47 |
$345.78 |
| 97012 |
|
5,767 |
3,840 |
$297.91 |
| 99403 |
|
58 |
57 |
$252.30 |
| M1016 |
Pt dx meop or sur steri |
8,331 |
6,439 |
$247.62 |
| 90461 |
|
65 |
65 |
$241.18 |
| 97032 |
|
5,769 |
3,841 |
$233.61 |
| 83655 |
|
758 |
737 |
$231.64 |
| 96151 |
|
82 |
79 |
$214.46 |
| 86580 |
|
552 |
537 |
$167.16 |
| J3490 |
Drugs unclassified injection |
43 |
37 |
$164.92 |
| J1885 |
Ketorolac tromethamine inj |
1,264 |
974 |
$157.87 |
| 90680 |
|
235 |
234 |
$126.00 |
| 92012 |
|
159 |
156 |
$98.95 |
| 1159F |
|
56,087 |
48,389 |
$98.39 |
| 90653 |
|
13 |
13 |
$94.61 |
| 11721 |
|
198 |
198 |
$93.31 |
| 90621 |
|
13 |
13 |
$91.53 |
| 90661 |
|
167 |
166 |
$83.00 |
| 90677 |
|
211 |
210 |
$66.00 |
| 99441 |
|
13 |
12 |
$60.96 |
| 90744 |
|
53 |
53 |
$54.00 |
| 69209 |
|
115 |
99 |
$40.13 |
| Q0091 |
Obtaining screen pap smear |
70 |
69 |
$36.88 |
| 90707 |
|
44 |
43 |
$27.00 |
| 3077F |
|
4,801 |
4,422 |
$24.00 |
| 0012A |
|
77 |
73 |
$23.76 |
| 90696 |
|
172 |
169 |
$18.00 |
| G0008 |
Admin influenza virus vac |
113 |
110 |
$16.49 |
| 99188 |
|
131 |
131 |
$16.16 |
| 3074F |
|
39,812 |
35,633 |
$11.75 |
| 87420 |
|
36 |
36 |
$11.68 |
| 90474 |
|
77 |
77 |
$9.86 |
| 90716 |
|
44 |
43 |
$9.00 |
| 90473 |
|
234 |
233 |
$8.91 |
| 90710 |
|
288 |
275 |
$6.00 |
| 81001 |
|
84 |
83 |
$5.39 |
| 3078F |
|
35,404 |
31,897 |
$0.90 |
| 1126F |
|
19,366 |
17,985 |
$0.60 |
| 1125F |
|
5,746 |
5,286 |
$0.30 |
| 3075F |
|
6,952 |
6,633 |
$0.20 |
| 3079F |
|
14,004 |
12,935 |
$0.00 |
| 3044F |
|
980 |
979 |
$0.00 |
| 1123F |
|
1,111 |
1,091 |
$0.00 |
| 3080F |
|
1,994 |
1,872 |
$0.00 |
| 98967 |
|
28 |
24 |
$0.00 |
| A4670 |
Automatic bp monitor, dial |
108 |
108 |
$0.00 |
| Z1034 |
|
135 |
104 |
$0.00 |
| 99474 |
|
140 |
135 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
35 |
34 |
$0.00 |
| Z6410 |
|
71 |
55 |
$0.00 |
| 90694 |
|
47 |
47 |
$0.00 |
| 90847 |
|
90 |
53 |
$0.00 |
| 1170F |
|
724 |
679 |
$0.00 |
| 90697 |
|
111 |
110 |
$0.00 |
| 0503F |
|
80 |
75 |
$0.00 |
| 87807 |
|
33 |
33 |
$0.00 |
| 0501F |
|
190 |
160 |
$0.00 |
| 90732 |
|
13 |
13 |
$0.00 |
| 1158F |
|
1,072 |
1,056 |
$0.00 |
| 1160F |
|
6,251 |
5,677 |
$0.00 |
| A4550 |
Surgical trays |
58 |
58 |
$0.00 |
| 90700 |
|
68 |
66 |
$0.00 |
| 0502F |
|
316 |
278 |
$0.00 |
| 98968 |
|
105 |
87 |
$0.00 |
| 90662 |
|
14 |
14 |
$0.00 |
| 90672 |
|
88 |
88 |
$0.00 |
| 99473 |
|
71 |
71 |
$0.00 |
| Z6304 |
|
12 |
12 |
$0.00 |
| 99408 |
|
12 |
12 |
$0.00 |
| 90736 |
|
38 |
38 |
$0.00 |
| 3051F |
|
24 |
24 |
$0.00 |
| 99453 |
|
44 |
44 |
$0.00 |
| 90649 |
|
29 |
29 |
$0.00 |
| 69210 |
|
13 |
13 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
21 |
16 |
$0.00 |