| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
75,596 |
63,543 |
$15.11M |
| 00003 |
Internal/system code - not a standard HCPCS code |
17,981 |
15,504 |
$4.38M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
60,100 |
37,707 |
$85K |
| 96156 |
|
16,835 |
11,506 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,111 |
7,538 |
$34K |
| 97802 |
|
28,775 |
18,620 |
$28K |
| 59425 |
|
2,679 |
1,906 |
$27K |
| 94760 |
|
107,856 |
65,592 |
$22K |
| 97803 |
|
11,514 |
7,728 |
$19K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,766 |
1,199 |
$11K |
| 92551 |
|
11,167 |
7,466 |
$11K |
| 99215 |
Prolong outpt/office vis |
1,647 |
1,140 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,373 |
948 |
$8K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
12,693 |
8,124 |
$7K |
| 90674 |
|
3,667 |
2,685 |
$7K |
| 99205 |
Prolong outpt/office vis |
433 |
334 |
$7K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,326 |
1,475 |
$6K |
| 90791 |
Psychiatric diagnostic evaluation |
738 |
610 |
$6K |
| 90837 |
Psychotherapy, 53 minutes with patient |
523 |
322 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,557 |
3,652 |
$5K |
| 99401 |
|
3,651 |
2,728 |
$5K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,483 |
1,172 |
$4K |
| 59430 |
|
361 |
346 |
$3K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
2,390 |
1,618 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
766 |
512 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,103 |
1,365 |
$3K |
| 90686 |
|
4,474 |
3,039 |
$3K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
650 |
593 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,222 |
1,509 |
$3K |
| 90715 |
|
1,026 |
709 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
788 |
505 |
$2K |
| 99385 |
|
503 |
330 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,750 |
1,129 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
92 |
66 |
$2K |
| 96127 |
|
6,242 |
4,325 |
$1K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
3,328 |
2,365 |
$1K |
| 90651 |
|
1,479 |
1,013 |
$1K |
| 90633 |
|
1,281 |
896 |
$846.71 |
| 90648 |
|
385 |
251 |
$792.00 |
| 90671 |
|
400 |
262 |
$780.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
190 |
188 |
$588.70 |
| 90723 |
|
315 |
209 |
$588.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,599 |
1,080 |
$520.00 |
| 98960 |
|
161 |
123 |
$468.18 |
| 85018 |
|
7,963 |
5,438 |
$451.02 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
124 |
102 |
$450.00 |
| 90677 |
|
1,459 |
965 |
$424.80 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,118 |
1,333 |
$410.55 |
| 90680 |
|
237 |
156 |
$402.00 |
| 99386 |
|
311 |
210 |
$396.60 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,599 |
1,020 |
$394.65 |
| 90734 |
|
277 |
168 |
$357.00 |
| 90710 |
|
364 |
235 |
$306.00 |
| 99000 |
|
12,402 |
8,372 |
$297.38 |
| 86580 |
|
70 |
42 |
$290.00 |
| 82962 |
|
3,170 |
2,193 |
$290.00 |
| 90672 |
|
189 |
111 |
$288.00 |
| 99407 |
|
656 |
370 |
$239.16 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
454 |
359 |
$236.64 |
| 90620 |
|
425 |
266 |
$204.00 |
| 36425 |
|
217 |
147 |
$179.22 |
| 90619 |
|
551 |
367 |
$171.00 |
| 90700 |
|
111 |
65 |
$141.00 |
| 87428 |
|
200 |
120 |
$123.76 |
| 81025 |
|
580 |
426 |
$114.77 |
| 99383 |
|
1,120 |
665 |
$109.66 |
| 81002 |
|
1,178 |
817 |
$105.33 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,821 |
1,917 |
$93.90 |
| 99381 |
|
316 |
282 |
$90.66 |
| 90697 |
|
1,038 |
691 |
$88.00 |
| 90688 |
|
238 |
196 |
$74.84 |
| 92015 |
Determination of refractive state |
693 |
519 |
$56.07 |
| 90381 |
|
88 |
56 |
$52.00 |
| 99173 |
|
16,283 |
11,157 |
$47.15 |
| 99382 |
|
516 |
318 |
$47.13 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
1,727 |
1,251 |
$45.89 |
| H0049 |
Alcohol and/or drug screening |
26,872 |
17,379 |
$45.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
209 |
137 |
$39.44 |
| 90681 |
|
366 |
251 |
$39.00 |
| 90696 |
|
67 |
45 |
$36.00 |
| 91321 |
|
20 |
14 |
$26.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
26 |
$20.97 |
| 96161 |
|
10,857 |
7,516 |
$2.56 |
| 3077F |
|
6,373 |
4,048 |
$0.00 |
| 3078F |
|
58,855 |
36,475 |
$0.00 |
| 1159F |
|
17,357 |
10,867 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
3,496 |
2,090 |
$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 |
551 |
393 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
461 |
290 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
1,310 |
728 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
201 |
201 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,000 |
1,000 |
$0.00 |
| D9430 |
|
1,123 |
1,105 |
$0.00 |
| 83655 |
|
291 |
188 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
72 |
45 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
14,144 |
9,051 |
$0.00 |
| Z6400 |
|
1,045 |
1,021 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
7,545 |
4,940 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
898 |
528 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
236 |
187 |
$0.00 |
| 1160F |
|
16,643 |
10,154 |
$0.00 |
| D1120 |
Prophylaxis - child |
2,250 |
2,250 |
$0.00 |
| D2140 |
|
139 |
103 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
169 |
130 |
$0.00 |
| D4341 |
|
937 |
745 |
$0.00 |
| Z6300 |
|
374 |
373 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,868 |
1,706 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
3,359 |
2,120 |
$0.00 |
| 3015F |
|
1,719 |
1,268 |
$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) |
2,269 |
1,352 |
$0.00 |
| Z6304 |
|
503 |
500 |
$0.00 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
114 |
78 |
$0.00 |
| 96160 |
|
5,199 |
3,680 |
$0.00 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
283 |
221 |
$0.00 |
| G9920 |
Screening performed and negative |
2,273 |
1,579 |
$0.00 |
| 4004F |
|
644 |
343 |
$0.00 |
| 0521F |
|
3,118 |
1,748 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
411 |
257 |
$0.00 |
| Z6200 |
|
374 |
373 |
$0.00 |
| 90461 |
|
1,303 |
885 |
$0.00 |
| 80061 |
Lipid panel |
393 |
275 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
310 |
237 |
$0.00 |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
246 |
161 |
$0.00 |
| 80074 |
|
131 |
95 |
$0.00 |
| 81479 |
Unlisted molecular pathology procedure |
184 |
124 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
1,515 |
1,070 |
$0.00 |
| 81329 |
|
114 |
78 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
287 |
186 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
250 |
161 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
55 |
55 |
$0.00 |
| Z6414 |
|
151 |
143 |
$0.00 |
| 0502F |
|
291 |
156 |
$0.00 |
| D0270 |
|
44 |
44 |
$0.00 |
| D1110 |
Prophylaxis - adult |
26 |
26 |
$0.00 |
| D4910 |
|
30 |
30 |
$0.00 |
| 88164 |
|
126 |
93 |
$0.00 |
| 82274 |
|
188 |
142 |
$0.00 |
| Z6308 |
|
118 |
116 |
$0.00 |
| 3046F |
|
15 |
13 |
$0.00 |
| 90670 |
|
63 |
45 |
$0.00 |
| 81422 |
|
184 |
124 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
107 |
69 |
$0.00 |
| 99483 |
Prolong outpt/office vis |
66 |
53 |
$0.00 |
| Z6208 |
|
85 |
82 |
$0.00 |
| 90380 |
|
15 |
14 |
$0.00 |
| 91312 |
|
18 |
17 |
$0.00 |
| 90707 |
|
16 |
13 |
$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 |
19 |
14 |
$0.00 |
| 1036F |
|
20,799 |
14,238 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13,676 |
8,786 |
$0.00 |
| 3074F |
|
61,401 |
37,592 |
$0.00 |
| 1000F |
|
22,464 |
14,264 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,694 |
990 |
$0.00 |
| 1125F |
|
3,475 |
2,196 |
$0.00 |
| 3008F |
|
100,228 |
61,519 |
$0.00 |
| D0603 |
|
5,044 |
5,043 |
$0.00 |
| 3075F |
|
6,861 |
4,566 |
$0.00 |
| 1126F |
|
9,858 |
6,164 |
$0.00 |
| 3079F |
|
12,948 |
8,277 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
2,577 |
2,571 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,462 |
1,727 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,036 |
3,029 |
$0.00 |
| 1034F |
|
1,193 |
829 |
$0.00 |
| 1031F |
|
9,839 |
6,829 |
$0.00 |
| Z6402 |
|
372 |
371 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
3,254 |
3,244 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
733 |
525 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
643 |
469 |
$0.00 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
116 |
79 |
$0.00 |
| 2023F |
|
66 |
50 |
$0.00 |
| Z1034 |
|
3,807 |
2,759 |
$0.00 |
| 3080F |
|
2,280 |
1,413 |
$0.00 |
| D1352 |
|
61 |
38 |
$0.00 |
| Z1032 |
|
249 |
236 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,922 |
1,920 |
$0.00 |
| 99402 |
|
721 |
704 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
469 |
289 |
$0.00 |
| Z6410 |
|
2,104 |
1,697 |
$0.00 |
| Z6406 |
|
677 |
640 |
$0.00 |
| 1111F |
|
177 |
117 |
$0.00 |
| Z6204 |
|
571 |
560 |
$0.00 |
| 99384 |
|
728 |
420 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
1,185 |
688 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
2,133 |
1,418 |
$0.00 |
| 86592 |
|
329 |
228 |
$0.00 |
| D0602 |
|
108 |
108 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
221 |
209 |
$0.00 |
| 82950 |
|
22 |
19 |
$0.00 |
| 3044F |
|
1,047 |
753 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
284 |
186 |
$0.00 |
| 86803 |
|
250 |
173 |
$0.00 |
| Z1038 |
|
161 |
151 |
$0.00 |
| D1351 |
Sealant - per tooth |
564 |
174 |
$0.00 |
| 0501F |
|
334 |
180 |
$0.00 |
| 93000 |
|
71 |
46 |
$0.00 |
| 90716 |
|
95 |
76 |
$0.00 |
| M1207 |
Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
174 |
132 |
$0.00 |
| COVID |
Covid-19 convalescent plasma |
15 |
15 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
227 |
179 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
19 |
14 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
329 |
228 |
$0.00 |
| 99441 |
|
209 |
145 |
$0.00 |
| 99447 |
|
17 |
12 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
56 |
36 |
$0.00 |
| D4342 |
|
122 |
72 |
$0.00 |
| D0601 |
|
30 |
30 |
$0.00 |
| G9745 |
Documented reason for not screening or recommending a follow-up for high blood pressure |
131 |
96 |
$0.00 |
| D9995 |
|
91 |
91 |
$0.00 |
| 90839 |
|
24 |
20 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
36 |
27 |
$0.00 |
| 4010F |
|
44 |
29 |
$0.00 |
| 98967 |
|
14 |
13 |
$0.00 |
| 3017F |
|
38 |
24 |
$0.00 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
110 |
86 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
22 |
13 |
$0.00 |
| 36410 |
|
21 |
13 |
$0.00 |
| 3351F |
|
17 |
14 |
$0.00 |
| 87081 |
|
27 |
14 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
91 |
91 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
15 |
15 |
$0.00 |