| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
194,353 |
177,516 |
$28.83M |
| D9450 |
|
52,003 |
34,539 |
$1.60M |
| 99392 |
|
8,527 |
8,366 |
$1.21M |
| 99391 |
|
6,646 |
6,495 |
$976K |
| G0467 |
Fqhc visit, estab pt |
30,695 |
26,236 |
$961K |
| 99395 |
|
4,995 |
4,973 |
$660K |
| T1040 |
Comm bh clinic svc per diem |
4,611 |
3,163 |
$636K |
| 99393 |
|
4,636 |
4,508 |
$621K |
| 90460 |
|
21,173 |
20,980 |
$478K |
| D1110 |
|
16,965 |
13,022 |
$434K |
| 99394 |
|
3,184 |
3,108 |
$409K |
| 99213 |
|
52,044 |
48,616 |
$283K |
| G0470 |
Fqhc visit, mh estab pt |
1,397 |
1,285 |
$268K |
| 96110 |
|
25,282 |
24,590 |
$256K |
| 99188 |
|
9,619 |
9,577 |
$243K |
| D7140 |
|
5,389 |
2,002 |
$241K |
| 90471 |
|
16,474 |
16,172 |
$204K |
| D1120 |
|
3,782 |
3,699 |
$191K |
| S0302 |
Completed epsdt |
27,924 |
26,940 |
$188K |
| 99401 |
|
6,543 |
6,198 |
$184K |
| D0140 |
|
7,350 |
4,403 |
$178K |
| G2023 |
Specimen collect covid-19 |
7,654 |
7,222 |
$177K |
| D0120 |
|
11,716 |
9,304 |
$159K |
| 99173 |
|
10,124 |
9,854 |
$150K |
| D0210 |
|
4,916 |
3,755 |
$149K |
| 99050 |
|
4,217 |
4,155 |
$149K |
| D1206 |
|
6,103 |
5,876 |
$141K |
| D0274 |
|
6,540 |
5,205 |
$133K |
| 90686 |
|
11,517 |
11,095 |
$127K |
| 87502 |
|
1,792 |
1,772 |
$122K |
| 99381 |
|
627 |
625 |
$117K |
| 99396 |
|
1,714 |
1,709 |
$102K |
| D2150 |
|
2,742 |
1,809 |
$98K |
| G2025 |
Dis site tele svcs rhc/fqhc |
5,242 |
4,735 |
$85K |
| 92551 |
|
8,041 |
7,775 |
$76K |
| D2391 |
|
2,024 |
1,299 |
$76K |
| 97802 |
|
1,408 |
1,400 |
$74K |
| D0150 |
|
2,477 |
2,065 |
$70K |
| 87651 |
|
2,467 |
2,414 |
$69K |
| 90834 |
|
805 |
601 |
$69K |
| 97803 |
|
1,619 |
1,590 |
$66K |
| 90746 |
|
957 |
952 |
$63K |
| 90739 |
|
341 |
338 |
$54K |
| 90715 |
|
1,843 |
1,829 |
$51K |
| D7210 |
|
526 |
261 |
$50K |
| D0330 |
|
1,213 |
807 |
$49K |
| J1050 |
Medroxyprogesterone acetate |
962 |
947 |
$48K |
| D0220 |
|
5,301 |
3,209 |
$48K |
| D2392 |
|
844 |
627 |
$48K |
| 83655 |
|
4,254 |
4,141 |
$47K |
| D2140 |
|
1,653 |
943 |
$44K |
| D4341 |
|
1,488 |
587 |
$44K |
| 90750 |
|
359 |
359 |
$42K |
| T1502 |
Medication admin visit |
654 |
180 |
$39K |
| 90671 |
|
419 |
414 |
$38K |
| 87880 |
|
3,268 |
3,216 |
$37K |
| 83036 |
|
6,419 |
6,168 |
$36K |
| 90832 |
|
915 |
644 |
$35K |
| 96372 |
|
3,109 |
2,974 |
$34K |
| 98966 |
|
3,472 |
3,170 |
$34K |
| 90651 |
|
715 |
714 |
$33K |
| 91320 |
|
309 |
309 |
$33K |
| 84703 |
|
4,609 |
4,459 |
$30K |
| 99214 |
|
3,801 |
3,639 |
$28K |
| 96127 |
|
2,651 |
2,624 |
$26K |
| 93000 |
|
1,846 |
1,809 |
$23K |
| D0272 |
|
776 |
732 |
$21K |
| D2331 |
|
569 |
311 |
$21K |
| 99402 |
|
429 |
348 |
$21K |
| 87635 |
|
405 |
399 |
$21K |
| 81025 |
|
2,378 |
2,274 |
$18K |
| D1351 |
|
430 |
131 |
$17K |
| D2160 |
|
447 |
296 |
$16K |
| 90472 |
|
1,915 |
1,901 |
$16K |
| 81002 |
|
6,325 |
6,170 |
$15K |
| 90792 |
|
135 |
126 |
$12K |
| 90632 |
|
176 |
175 |
$11K |
| 90837 |
|
113 |
90 |
$10K |
| 99212 |
|
5,579 |
5,343 |
$9K |
| G0299 |
Hhs/hospice of rn ea 15 min |
120 |
93 |
$9K |
| D9110 |
|
333 |
193 |
$8K |
| 90480 |
|
216 |
215 |
$7K |
| D2330 |
|
231 |
111 |
$7K |
| 90674 |
|
1,223 |
1,215 |
$7K |
| D2332 |
|
133 |
83 |
$6K |
| 90732 |
|
150 |
149 |
$6K |
| 99211 |
|
3,047 |
2,911 |
$4K |
| D0230 |
|
550 |
275 |
$4K |
| 98967 |
|
250 |
237 |
$4K |
| H2015 |
Comp comm supp svc, 15 min |
35 |
32 |
$4K |
| 90734 |
|
237 |
234 |
$3K |
| 0012A |
|
66 |
66 |
$3K |
| 0011A |
|
114 |
113 |
$3K |
| 99442 |
|
126 |
124 |
$2K |
| 90707 |
|
270 |
270 |
$2K |
| 81003 |
|
1,062 |
1,026 |
$2K |
| G0466 |
Fqhc visit new patient |
74 |
74 |
$2K |
| 91322 |
|
12 |
12 |
$2K |
| 92558 |
|
347 |
346 |
$2K |
| 82947 |
|
469 |
458 |
$2K |
| 90670 |
|
613 |
610 |
$1K |
| 90662 |
|
400 |
397 |
$1K |
| 90887 |
|
82 |
70 |
$1K |
| 80307 |
|
29 |
27 |
$1K |
| 98968 |
|
40 |
40 |
$1K |
| 99203 |
|
76 |
76 |
$1K |
| 0124A |
|
20 |
20 |
$917.40 |
| 90658 |
|
253 |
252 |
$769.60 |
| G0136 |
Adm of pa/n assess 5-15 m |
1,118 |
1,110 |
$740.28 |
| 0001A |
|
16 |
16 |
$734.08 |
| D2335 |
|
14 |
12 |
$730.00 |
| G0480 |
Drug test def 1-7 classes |
12 |
12 |
$656.60 |
| G0108 |
Diab manage trn per indiv |
12 |
12 |
$616.80 |
| 82948 |
|
202 |
202 |
$595.04 |
| 92015 |
|
39 |
39 |
$561.21 |
| 90461 |
|
1,987 |
1,979 |
$403.44 |
| 91301 |
|
1,953 |
1,861 |
$305.29 |
| 90649 |
|
361 |
361 |
$300.83 |
| 0013A |
|
53 |
50 |
$294.23 |
| 86701 |
|
42 |
42 |
$288.58 |
| 99441 |
|
26 |
26 |
$280.02 |
| G0008 |
Admin influenza virus vac |
2,332 |
2,312 |
$273.61 |
| G0439 |
Ppps, subseq visit |
2,999 |
2,976 |
$265.07 |
| 94760 |
|
387 |
368 |
$186.05 |
| 94664 |
|
13 |
13 |
$184.78 |
| 88720 |
|
39 |
29 |
$172.77 |
| 90710 |
|
151 |
150 |
$162.10 |
| D0270 |
|
20 |
12 |
$121.00 |
| 90713 |
|
14 |
14 |
$112.56 |
| 11719 |
|
12 |
12 |
$91.22 |
| G0468 |
Fqhc visit, ippe or awv |
3,061 |
3,039 |
$90.24 |
| 90620 |
|
235 |
235 |
$34.21 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
23 |
21 |
$29.73 |
| G0444 |
Depression screen annual |
386 |
373 |
$19.46 |
| J1885 |
Ketorolac tromethamine inj |
547 |
533 |
$12.32 |
| 0064A |
|
83 |
83 |
$0.00 |
| 90619 |
|
526 |
525 |
$0.00 |
| 90680 |
|
898 |
895 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
62 |
58 |
$0.00 |
| 90677 |
|
679 |
678 |
$0.00 |
| 90698 |
|
679 |
672 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
395 |
393 |
$0.00 |
| 94640 |
|
122 |
115 |
$0.00 |
| 99172 |
|
469 |
468 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
12 |
12 |
$0.00 |
| 90697 |
|
699 |
697 |
$0.00 |
| 91303 |
|
146 |
145 |
$0.00 |
| 90716 |
|
232 |
231 |
$0.00 |
| Q0162 |
Ondansetron oral |
17 |
13 |
$0.00 |
| 36416 |
|
457 |
446 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
270 |
269 |
$0.00 |
| 91305 |
|
88 |
86 |
$0.00 |
| V5008 |
Hearing screening |
2,532 |
2,519 |
$0.00 |
| 90696 |
|
95 |
93 |
$0.00 |
| 90744 |
|
174 |
174 |
$0.00 |
| 96380 |
|
17 |
17 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 2010F |
|
28 |
26 |
$0.00 |
| 90633 |
|
1,128 |
1,123 |
$0.00 |
| D1999 |
|
15,111 |
8,254 |
$0.00 |
| J2315 |
Naltrexone, depot form |
66 |
63 |
$0.00 |
| 91312 |
|
113 |
112 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
289 |
286 |
$0.00 |
| J7030 |
Normal saline solution infus |
12 |
12 |
$0.00 |
| 91311 |
|
75 |
75 |
$0.00 |
| G9920 |
Scrning perf and negative |
548 |
543 |
$0.00 |
| 96360 |
|
12 |
12 |
$0.00 |
| 90691 |
|
28 |
28 |
$0.00 |
| 90473 |
|
30 |
29 |
$0.00 |
| 91300 |
|
660 |
605 |
$0.00 |
| 96160 |
|
40 |
40 |
$0.00 |
| 90661 |
|
345 |
345 |
$0.00 |
| 90833 |
|
12 |
12 |
$0.00 |