| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
64,540 |
61,225 |
$13.67M |
| 99199 |
Unlisted special service, procedure or report |
3,379 |
3,229 |
$204K |
| 0521 |
|
2,543 |
2,308 |
$150K |
| 0760 |
|
23,702 |
22,188 |
$115K |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
8,012 |
7,590 |
$26K |
| 0761 |
|
9,136 |
8,105 |
$23K |
| 99215 |
Prolong outpt/office vis |
3,322 |
3,261 |
$18K |
| Q3014 |
Telehealth originating site facility fee |
6,457 |
6,117 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,508 |
8,250 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,522 |
8,196 |
$5K |
| 0360 |
|
817 |
809 |
$5K |
| 99417 |
Prolong home eval add 15m |
320 |
318 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,660 |
1,639 |
$2K |
| 90686 |
|
5,622 |
5,581 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,120 |
2,072 |
$2K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
41 |
41 |
$2K |
| 0124A |
|
37 |
37 |
$2K |
| 97803 |
|
1,280 |
1,271 |
$2K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
493 |
480 |
$2K |
| 99205 |
Prolong outpt/office vis |
172 |
172 |
$2K |
| 90651 |
|
1,279 |
1,272 |
$1K |
| J3490 |
Unclassified drugs |
538 |
480 |
$1K |
| 0001A |
|
29 |
15 |
$1K |
| 90734 |
|
648 |
647 |
$1K |
| 92551 |
|
3,421 |
3,392 |
$1K |
| 90620 |
|
792 |
790 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
271 |
268 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,402 |
1,387 |
$712.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
984 |
960 |
$617.98 |
| 80053 |
Comprehensive metabolic panel |
689 |
680 |
$590.98 |
| 96127 |
|
629 |
624 |
$503.15 |
| 90670 |
|
1,299 |
1,279 |
$409.31 |
| 99188 |
|
1,138 |
1,137 |
$399.53 |
| 90647 |
|
1,314 |
1,296 |
$383.46 |
| 84443 |
Thyroid stimulating hormone (TSH) |
341 |
336 |
$381.12 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
307 |
307 |
$360.80 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
592 |
585 |
$346.76 |
| 90715 |
|
488 |
483 |
$269.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
60 |
59 |
$267.54 |
| 94760 |
|
69 |
65 |
$258.71 |
| 69210 |
|
415 |
317 |
$258.59 |
| 90723 |
|
738 |
727 |
$256.66 |
| 90633 |
|
926 |
919 |
$251.46 |
| 83655 |
|
629 |
620 |
$246.99 |
| 85018 |
|
1,880 |
1,840 |
$191.96 |
| 90680 |
|
434 |
430 |
$152.10 |
| 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 |
32 |
25 |
$85.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
85 |
84 |
$77.17 |
| 84439 |
|
104 |
103 |
$71.96 |
| 87430 |
|
66 |
65 |
$61.08 |
| 90710 |
|
217 |
215 |
$53.25 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
185 |
183 |
$52.50 |
| 81003 |
|
186 |
181 |
$51.29 |
| 99177 |
|
532 |
532 |
$46.95 |
| 90707 |
|
155 |
155 |
$40.00 |
| 90656 |
|
415 |
415 |
$29.84 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
44 |
42 |
$29.48 |
| 90716 |
|
67 |
67 |
$28.30 |
| 90696 |
|
230 |
229 |
$24.59 |
| 87081 |
|
65 |
64 |
$19.62 |
| 80061 |
Lipid panel |
51 |
51 |
$19.13 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
58 |
54 |
$13.94 |
| 0270 |
|
96 |
85 |
$12.53 |
| 81001 |
|
33 |
32 |
$6.83 |
| G9920 |
Screening performed and negative |
112 |
111 |
$0.00 |
| 90700 |
|
24 |
24 |
$0.00 |
| 90685 |
|
20 |
20 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
30 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
12 |
12 |
$0.00 |
| 90677 |
|
133 |
132 |
$0.00 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
48 |
47 |
$0.00 |
| 86580 |
|
67 |
67 |
$0.00 |
| 87088 |
|
13 |
12 |
$0.00 |
| 90688 |
|
32 |
32 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
28 |
28 |
$0.00 |