| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
154,333 |
133,820 |
$21.08M |
| 00003 |
Internal/system code - not a standard HCPCS code |
9,965 |
5,992 |
$1.67M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82,775 |
53,793 |
$982K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,390 |
16,452 |
$417K |
| 90832 |
Psychotherapy, 30 minutes with patient |
14,338 |
7,196 |
$358K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
18,655 |
16,583 |
$338K |
| 90791 |
Psychiatric diagnostic evaluation |
3,256 |
2,175 |
$207K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
19,926 |
17,105 |
$192K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
12,302 |
8,202 |
$187K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16,563 |
13,254 |
$173K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,235 |
1,883 |
$87K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,809 |
1,836 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,095 |
2,111 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,015 |
1,874 |
$49K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,693 |
1,084 |
$43K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,101 |
5,191 |
$40K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,170 |
734 |
$39K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,847 |
1,333 |
$26K |
| 0002A |
|
459 |
258 |
$25K |
| 92551 |
|
4,316 |
2,703 |
$21K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,829 |
3,300 |
$20K |
| 0001A |
|
331 |
215 |
$19K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
882 |
707 |
$15K |
| 0012A |
|
249 |
183 |
$15K |
| 90686 |
|
4,266 |
3,279 |
$15K |
| 0013A |
|
269 |
144 |
$14K |
| 92552 |
|
1,182 |
1,034 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
261 |
205 |
$12K |
| 0011A |
|
151 |
115 |
$9K |
| 0071A |
|
149 |
76 |
$8K |
| 92002 |
|
867 |
811 |
$8K |
| 0072A |
|
139 |
72 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,788 |
1,361 |
$7K |
| 99215 |
Prolong outpt/office vis |
149 |
124 |
$7K |
| 90694 |
|
232 |
185 |
$6K |
| 81002 |
|
6,017 |
3,821 |
$5K |
| 90671 |
|
539 |
346 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
585 |
539 |
$5K |
| 81025 |
|
3,112 |
2,031 |
$5K |
| 90651 |
|
1,143 |
794 |
$5K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit |
235 |
152 |
$5K |
| 90715 |
|
466 |
368 |
$4K |
| 82962 |
|
3,694 |
2,712 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
581 |
407 |
$4K |
| 80305 |
|
844 |
419 |
$4K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
55 |
39 |
$3K |
| 90461 |
|
3,564 |
2,481 |
$3K |
| 0003A |
|
50 |
27 |
$3K |
| 90633 |
|
968 |
679 |
$3K |
| 90656 |
|
592 |
408 |
$3K |
| 97813 |
|
627 |
386 |
$2K |
| J3490 |
Unclassified drugs |
129 |
80 |
$2K |
| 97814 |
|
610 |
381 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
48 |
37 |
$2K |
| 99173 |
|
2,092 |
1,493 |
$2K |
| 90670 |
|
866 |
708 |
$2K |
| 90677 |
|
273 |
172 |
$2K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
284 |
180 |
$1K |
| 93000 |
|
125 |
96 |
$1K |
| 90697 |
|
461 |
290 |
$1K |
| 90746 |
|
32 |
24 |
$1K |
| 90647 |
|
635 |
539 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,271 |
2,103 |
$1K |
| 87420 |
|
885 |
506 |
$1K |
| 90756 |
|
90 |
87 |
$1K |
| 90680 |
|
563 |
430 |
$1K |
| 90723 |
|
562 |
475 |
$981.63 |
| 90619 |
|
329 |
196 |
$873.33 |
| 85018 |
|
956 |
820 |
$758.30 |
| 90716 |
|
122 |
91 |
$752.06 |
| 98940 |
|
211 |
151 |
$735.68 |
| 90688 |
|
95 |
84 |
$712.75 |
| 90734 |
|
227 |
183 |
$675.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
496 |
462 |
$625.53 |
| 99381 |
|
74 |
71 |
$609.71 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
285 |
238 |
$598.87 |
| 99460 |
|
37 |
29 |
$457.80 |
| 99188 |
|
44 |
26 |
$414.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
38 |
32 |
$400.04 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
59 |
53 |
$389.10 |
| 90710 |
|
135 |
117 |
$351.00 |
| 86580 |
|
179 |
163 |
$342.72 |
| 90696 |
|
122 |
109 |
$324.00 |
| 90707 |
|
77 |
53 |
$225.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16 |
12 |
$206.01 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
137 |
137 |
$187.08 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
58 |
36 |
$182.90 |
| 1036F |
|
25,342 |
19,772 |
$161.95 |
| 90700 |
|
67 |
44 |
$108.00 |
| 96127 |
|
239 |
224 |
$101.01 |
| 90713 |
|
16 |
16 |
$90.00 |
| 90674 |
|
225 |
225 |
$45.74 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
276 |
267 |
$24.26 |
| 90620 |
|
17 |
12 |
$18.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
5,046 |
3,293 |
$3.66 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
4,819 |
3,117 |
$3.54 |
| 1159F |
|
25,862 |
21,018 |
$2.12 |
| 96146 |
|
119 |
91 |
$1.84 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
550 |
379 |
$0.34 |
| 4004F |
|
3,143 |
2,166 |
$0.24 |
| 2022F |
|
4,269 |
3,284 |
$0.22 |
| 1034F |
|
1,486 |
1,150 |
$0.16 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
342 |
234 |
$0.14 |
| 3051F |
|
43 |
30 |
$0.10 |
| 1111F |
|
1,319 |
1,124 |
$0.02 |
| 3074F |
|
20,619 |
16,724 |
$0.01 |
| 3008F |
|
27,950 |
22,865 |
$0.01 |
| 2001F |
|
27,986 |
22,897 |
$0.01 |
| 3078F |
|
19,168 |
15,611 |
$0.01 |
| 1126F |
|
2,629 |
2,174 |
$0.00 |
| 3075F |
|
3,291 |
2,808 |
$0.00 |
| 1125F |
|
799 |
621 |
$0.00 |
| 3080F |
|
1,232 |
1,042 |
$0.00 |
| 3044F |
|
240 |
198 |
$0.00 |
| 3079F |
|
5,890 |
4,955 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
50 |
50 |
$0.00 |
| 3052F |
|
15 |
14 |
$0.00 |
| 3077F |
|
2,341 |
1,977 |
$0.00 |
| 90661 |
|
15 |
15 |
$0.00 |
| 3046F |
|
116 |
90 |
$0.00 |
| Z6500 |
|
46 |
46 |
$0.00 |
| S0197 |
Prenatal vitamins, 30-day supply |
45 |
45 |
$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 |
89 |
62 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
16 |
16 |
$0.00 |
| A4550 |
Surgical trays |
73 |
50 |
$0.00 |
| 92015 |
Determination of refractive state |
139 |
138 |
$0.00 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
72 |
72 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| 0502F |
|
34 |
28 |
$0.00 |