| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
25,396 |
21,800 |
$4.75M |
| 00003 |
Internal/system code - not a standard HCPCS code |
9,540 |
7,627 |
$2.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,133 |
8,534 |
$34K |
| 59425 |
|
1,187 |
890 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,441 |
4,403 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,916 |
2,019 |
$12K |
| 97802 |
|
7,058 |
4,585 |
$9K |
| 94760 |
|
26,393 |
16,532 |
$7K |
| 92551 |
|
3,461 |
2,457 |
$4K |
| 96156 |
|
5,573 |
3,959 |
$4K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
208 |
172 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
61 |
48 |
$2K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
889 |
622 |
$1K |
| 97803 |
|
588 |
374 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
241 |
161 |
$823.20 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
2,692 |
1,925 |
$803.76 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
279 |
242 |
$674.48 |
| 99215 |
Prolong outpt/office vis |
93 |
86 |
$581.15 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
195 |
178 |
$504.60 |
| 99401 |
|
367 |
285 |
$477.49 |
| 90686 |
|
986 |
728 |
$374.00 |
| 90651 |
|
640 |
457 |
$230.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
933 |
654 |
$175.40 |
| 99000 |
|
2,165 |
1,562 |
$119.79 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
98 |
76 |
$109.90 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
841 |
581 |
$109.66 |
| 81025 |
|
77 |
65 |
$75.60 |
| 85018 |
|
3,523 |
2,465 |
$60.03 |
| 96127 |
|
614 |
443 |
$57.72 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
128 |
83 |
$51.42 |
| 81002 |
|
550 |
384 |
$49.86 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
588 |
386 |
$37.39 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
221 |
148 |
$34.69 |
| 90677 |
|
91 |
59 |
$18.00 |
| 82962 |
|
254 |
180 |
$16.00 |
| 90633 |
|
304 |
233 |
$12.00 |
| 90619 |
|
169 |
114 |
$9.00 |
| 90715 |
|
88 |
64 |
$9.00 |
| 90710 |
|
117 |
83 |
$6.00 |
| 99173 |
|
5,851 |
4,163 |
$4.03 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
278 |
230 |
$0.00 |
| 3008F |
|
29,646 |
18,831 |
$0.00 |
| 3079F |
|
1,029 |
707 |
$0.00 |
| Z6410 |
|
879 |
750 |
$0.00 |
| Z6204 |
|
182 |
181 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,380 |
1,379 |
$0.00 |
| 1036F |
|
5,283 |
3,498 |
$0.00 |
| Z6406 |
|
274 |
259 |
$0.00 |
| 1031F |
|
2,165 |
1,374 |
$0.00 |
| 86803 |
|
54 |
40 |
$0.00 |
| Z1034 |
|
1,994 |
1,525 |
$0.00 |
| 96161 |
|
2,881 |
2,014 |
$0.00 |
| 1000F |
|
3,343 |
2,243 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,660 |
1,718 |
$0.00 |
| D0603 |
|
1,546 |
1,546 |
$0.00 |
| D9995 |
|
171 |
171 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
1,321 |
1,318 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,571 |
1,568 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
306 |
236 |
$0.00 |
| 90688 |
|
79 |
64 |
$0.00 |
| 3074F |
|
7,864 |
4,889 |
$0.00 |
| 3075F |
|
552 |
375 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
184 |
115 |
$0.00 |
| D1351 |
Sealant - per tooth |
416 |
114 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,073 |
450 |
$0.00 |
| 3044F |
|
36 |
29 |
$0.00 |
| 86580 |
|
36 |
30 |
$0.00 |
| Z1032 |
|
81 |
81 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
171 |
171 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
462 |
322 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
402 |
338 |
$0.00 |
| Z6402 |
|
13 |
13 |
$0.00 |
| D0602 |
|
363 |
363 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
904 |
649 |
$0.00 |
| 3080F |
|
443 |
295 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
907 |
907 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
83 |
52 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
4,144 |
2,797 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
14 |
$0.00 |
| 90674 |
|
162 |
125 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
282 |
201 |
$0.00 |
| 1126F |
|
34 |
22 |
$0.00 |
| 90697 |
|
197 |
138 |
$0.00 |
| 99402 |
|
77 |
77 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
102 |
65 |
$0.00 |
| 99383 |
|
40 |
26 |
$0.00 |
| 99384 |
|
16 |
12 |
$0.00 |
| 0501F |
|
50 |
27 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
56 |
43 |
$0.00 |
| Z1038 |
|
12 |
12 |
$0.00 |
| M1207 |
Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
26 |
19 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
17 |
12 |
$0.00 |
| 90620 |
|
26 |
19 |
$0.00 |
| 90716 |
|
13 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,613 |
1,140 |
$0.00 |
| D9430 |
|
647 |
630 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
121 |
86 |
$0.00 |
| Z6304 |
|
182 |
182 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
965 |
878 |
$0.00 |
| 90461 |
|
1,252 |
910 |
$0.00 |
| 3078F |
|
7,520 |
4,733 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,973 |
1,298 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
450 |
447 |
$0.00 |
| 1159F |
|
6,033 |
3,848 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
213 |
175 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,224 |
1,454 |
$0.00 |
| G9920 |
Screening performed and negative |
1,580 |
1,100 |
$0.00 |
| 3077F |
|
728 |
495 |
$0.00 |
| G0445 |
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes |
68 |
50 |
$0.00 |
| Z6400 |
|
673 |
661 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
199 |
132 |
$0.00 |
| 90670 |
|
98 |
90 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,017 |
1,016 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
163 |
126 |
$0.00 |
| D4341 |
|
381 |
301 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,676 |
1,105 |
$0.00 |
| 96160 |
|
3,120 |
2,127 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
54 |
34 |
$0.00 |
| 1160F |
|
6,444 |
4,240 |
$0.00 |
| D1110 |
Prophylaxis - adult |
70 |
70 |
$0.00 |
| 90671 |
|
105 |
71 |
$0.00 |
| 80061 |
Lipid panel |
170 |
123 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
364 |
277 |
$0.00 |
| Z6500 |
|
86 |
86 |
$0.00 |
| 90681 |
|
35 |
25 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
85 |
85 |
$0.00 |
| Z6300 |
|
13 |
13 |
$0.00 |
| D2140 |
|
51 |
38 |
$0.00 |
| 0502F |
|
50 |
27 |
$0.00 |
| 83655 |
|
27 |
20 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
30 |
25 |
$0.00 |
| Z6200 |
|
13 |
13 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
47 |
31 |
$0.00 |
| 90734 |
|
59 |
42 |
$0.00 |
| 98960 |
|
50 |
48 |
$0.00 |
| D4910 |
|
13 |
13 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
16 |
14 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
12 |
12 |
$0.00 |