| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0467 |
Fqhc visit, estab pt |
66,422 |
57,449 |
$4.77M |
| 59426 |
|
1,667 |
1,661 |
$1.54M |
| G0470 |
Fqhc visit, mh estab pt |
6,070 |
3,599 |
$428K |
| G0466 |
Fqhc visit new patient |
3,385 |
3,370 |
$285K |
| D1110 |
|
2,519 |
2,494 |
$206K |
| D0150 |
|
2,282 |
2,262 |
$190K |
| D0140 |
|
1,643 |
1,603 |
$161K |
| D7140 |
|
1,644 |
888 |
$155K |
| D2392 |
|
1,125 |
980 |
$150K |
| J1050 |
Medroxyprogesterone acetate |
1,901 |
1,893 |
$139K |
| D2391 |
|
995 |
793 |
$107K |
| D0120 |
|
2,445 |
2,431 |
$98K |
| D1120 |
|
1,690 |
1,687 |
$64K |
| 99213 |
|
32,962 |
29,372 |
$57K |
| D0210 |
|
1,795 |
1,663 |
$55K |
| 59425 |
|
83 |
83 |
$45K |
| D1206 |
|
1,896 |
1,881 |
$43K |
| 99402 |
|
551 |
506 |
$42K |
| 99214 |
|
15,879 |
14,911 |
$37K |
| D0274 |
|
1,203 |
1,196 |
$20K |
| D2331 |
|
158 |
127 |
$19K |
| 59430 |
|
1,688 |
1,679 |
$17K |
| D0330 |
|
750 |
745 |
$16K |
| D0220 |
|
1,739 |
1,695 |
$12K |
| D1351 |
|
393 |
121 |
$10K |
| D2393 |
|
60 |
56 |
$9K |
| 90837 |
|
3,710 |
2,320 |
$9K |
| 96372 |
|
1,505 |
1,468 |
$8K |
| 0012A |
|
176 |
176 |
$7K |
| 0011A |
|
184 |
184 |
$7K |
| 87635 |
|
1,124 |
1,106 |
$6K |
| D4355 |
|
37 |
37 |
$5K |
| 99395 |
|
1,762 |
1,757 |
$4K |
| 99396 |
|
1,600 |
1,594 |
$4K |
| 90715 |
|
1,242 |
1,240 |
$4K |
| 99203 |
|
1,039 |
1,032 |
$4K |
| 90471 |
|
3,669 |
3,643 |
$3K |
| H2000 |
Comp multidisipln evaluation |
31 |
31 |
$3K |
| D0999 |
|
16 |
15 |
$2K |
| D7210 |
|
14 |
12 |
$2K |
| 99393 |
|
425 |
423 |
$2K |
| D0272 |
|
109 |
108 |
$2K |
| 90651 |
|
125 |
125 |
$2K |
| D0270 |
|
323 |
320 |
$2K |
| H1000 |
Prenatal care atrisk assessm |
23 |
23 |
$2K |
| 81025 |
|
2,605 |
2,555 |
$2K |
| 99204 |
|
429 |
428 |
$2K |
| 90472 |
|
1,318 |
1,313 |
$2K |
| 90480 |
|
54 |
54 |
$2K |
| 0064A |
|
75 |
75 |
$1K |
| 99212 |
|
1,931 |
1,863 |
$1K |
| 99394 |
|
444 |
441 |
$1K |
| 90688 |
|
1,789 |
1,770 |
$1K |
| D0230 |
|
546 |
280 |
$1K |
| D2330 |
|
14 |
12 |
$1K |
| 99392 |
|
420 |
419 |
$1K |
| 87804 |
|
1,796 |
941 |
$1K |
| 59025 |
|
628 |
356 |
$1K |
| 99202 |
|
558 |
556 |
$1K |
| 87880 |
|
1,350 |
1,328 |
$934.19 |
| 90834 |
|
524 |
457 |
$927.37 |
| G0008 |
Admin influenza virus vac |
2,153 |
2,140 |
$909.59 |
| 91322 |
|
52 |
52 |
$840.00 |
| 90658 |
|
86 |
86 |
$721.38 |
| 81003 |
|
2,019 |
1,954 |
$600.51 |
| H0004 |
Alcohol and/or drug services |
66 |
37 |
$536.88 |
| 0134A |
|
13 |
13 |
$435.39 |
| 81002 |
|
1,633 |
1,622 |
$427.54 |
| 98960 |
|
80 |
80 |
$400.14 |
| 83036 |
|
411 |
411 |
$380.97 |
| 99391 |
|
181 |
167 |
$375.24 |
| 90792 |
|
191 |
178 |
$335.96 |
| 85018 |
|
1,160 |
1,157 |
$265.10 |
| 99406 |
|
713 |
700 |
$172.30 |
| 90460 |
|
77 |
77 |
$161.30 |
| 90746 |
|
12 |
12 |
$69.65 |
| 96102 |
|
15 |
12 |
$68.94 |
| 93000 |
|
337 |
336 |
$56.07 |
| 90707 |
|
29 |
29 |
$53.17 |
| 99307 |
|
2,437 |
2,184 |
$49.12 |
| G0009 |
Admin pneumococcal vaccine |
204 |
204 |
$48.76 |
| 90832 |
|
12 |
12 |
$37.64 |
| 80305 |
|
49 |
40 |
$31.29 |
| J1885 |
Ketorolac tromethamine inj |
16 |
14 |
$28.06 |
| Q0091 |
Obtaining screen pap smear |
64 |
64 |
$23.36 |
| 90686 |
|
412 |
411 |
$22.35 |
| 96127 |
|
899 |
870 |
$0.49 |
| G8431 |
Pos clin depres scrn f/u doc |
2,094 |
2,011 |
$0.00 |
| 90734 |
|
74 |
74 |
$0.00 |
| 82075 |
|
46 |
39 |
$0.00 |
| 90670 |
|
191 |
191 |
$0.00 |
| 91313 |
|
16 |
16 |
$0.00 |
| 96160 |
|
37 |
37 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
3,901 |
3,842 |
$0.00 |
| 91301 |
|
339 |
326 |
$0.00 |
| 91306 |
|
71 |
71 |
$0.00 |
| 99308 |
|
408 |
407 |
$0.00 |
| G2025 |
Dis site tele svcs rhc/fqhc |
236 |
196 |
$0.00 |
| 90716 |
|
42 |
42 |
$0.00 |
| 99304 |
|
25 |
25 |
$0.00 |
| 58300 |
|
12 |
12 |
$0.00 |
| 90656 |
|
21 |
21 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 90723 |
|
17 |
17 |
$0.00 |
| 90647 |
|
26 |
26 |
$0.00 |
| 99495 |
|
12 |
12 |
$0.00 |