| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
133,002 |
115,143 |
$32.51M |
| 00003 |
Internal/system code - not a standard HCPCS code |
17,115 |
13,035 |
$5.06M |
| 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 |
4,187 |
3,532 |
$731K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
91,782 |
65,026 |
$117K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66,604 |
47,298 |
$99K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
513 |
502 |
$90K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16,180 |
12,982 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
10,899 |
8,342 |
$40K |
| 99215 |
Prolong outpt/office vis |
4,335 |
3,060 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,598 |
6,222 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,078 |
4,581 |
$4K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
1,006 |
568 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,274 |
3,643 |
$2K |
| 93000 |
|
839 |
744 |
$2K |
| 99205 |
Prolong outpt/office vis |
375 |
280 |
$1K |
| 94060 |
|
620 |
357 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,511 |
1,796 |
$817.70 |
| 1159F |
|
53,383 |
46,926 |
$792.02 |
| 95117 |
|
1,109 |
561 |
$590.46 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
133 |
103 |
$582.03 |
| 90686 |
|
5,146 |
3,927 |
$559.45 |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
441 |
331 |
$531.12 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,599 |
5,219 |
$496.46 |
| 90670 |
|
3,655 |
2,854 |
$424.98 |
| 90630 |
|
48 |
48 |
$421.60 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
486 |
331 |
$377.91 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
199 |
181 |
$356.22 |
| 90647 |
|
3,184 |
2,354 |
$299.10 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
497 |
400 |
$279.63 |
| 90715 |
|
1,140 |
981 |
$236.22 |
| 11721 |
|
289 |
223 |
$232.15 |
| 99381 |
|
173 |
147 |
$224.85 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,579 |
2,059 |
$220.91 |
| 92552 |
|
2,021 |
1,710 |
$200.65 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
251 |
238 |
$153.93 |
| 90723 |
|
3,433 |
2,584 |
$150.75 |
| 0011A |
|
57 |
47 |
$147.00 |
| 99443 |
|
585 |
560 |
$134.56 |
| 99442 |
|
581 |
542 |
$128.21 |
| 90680 |
|
2,408 |
1,912 |
$122.85 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
51 |
46 |
$111.00 |
| 0012A |
|
76 |
64 |
$107.00 |
| 81025 |
|
2,029 |
1,589 |
$103.73 |
| 81002 |
|
534 |
506 |
$98.54 |
| 20610 |
|
47 |
42 |
$91.58 |
| 90688 |
|
800 |
654 |
$90.73 |
| 85018 |
|
7,966 |
5,734 |
$74.86 |
| 90707 |
|
1,208 |
881 |
$64.80 |
| 90716 |
|
1,194 |
867 |
$56.25 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,111 |
2,861 |
$44.48 |
| 92551 |
|
722 |
429 |
$33.39 |
| 81003 |
|
2,583 |
2,070 |
$32.29 |
| 82948 |
|
2,949 |
2,537 |
$28.71 |
| 90633 |
|
1,196 |
806 |
$28.35 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
56 |
54 |
$25.94 |
| 90656 |
|
751 |
560 |
$23.99 |
| J3490 |
Unclassified drugs |
68 |
50 |
$22.50 |
| 90677 |
|
778 |
599 |
$18.90 |
| 90700 |
|
128 |
79 |
$9.45 |
| 86580 |
|
216 |
179 |
$3.53 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
47 |
47 |
$0.88 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
388 |
351 |
$0.22 |
| 1160F |
|
42,203 |
37,058 |
$0.00 |
| 90687 |
|
149 |
107 |
$0.00 |
| 3078F |
|
3,967 |
3,752 |
$0.00 |
| 90649 |
|
34 |
28 |
$0.00 |
| 3077F |
|
1,291 |
1,194 |
$0.00 |
| 3046F |
|
93 |
91 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
50 |
41 |
$0.00 |
| 90734 |
|
45 |
40 |
$0.00 |
| 90746 |
|
152 |
92 |
$0.00 |
| 90685 |
|
41 |
27 |
$0.00 |
| 3051F |
|
426 |
420 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
183 |
121 |
$0.00 |
| 90658 |
|
19 |
19 |
$0.00 |
| Z7500 |
|
14 |
14 |
$0.00 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
55 |
55 |
$0.00 |
| 90681 |
|
40 |
26 |
$0.00 |
| 3008F |
|
42,723 |
39,380 |
$0.00 |
| 3074F |
|
3,623 |
3,425 |
$0.00 |
| 3075F |
|
1,589 |
1,544 |
$0.00 |
| 3079F |
|
2,150 |
2,049 |
$0.00 |
| 3080F |
|
635 |
602 |
$0.00 |
| 88720 |
|
32 |
14 |
$0.00 |
| 3044F |
|
861 |
857 |
$0.00 |
| 82962 |
|
1,063 |
649 |
$0.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
38 |
24 |
$0.00 |
| 90732 |
|
62 |
35 |
$0.00 |
| G9964 |
Patient received at least one well-child visit with a pcp during the performance period |
72 |
71 |
$0.00 |
| Z1034 |
|
111 |
73 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
43 |
41 |
$0.00 |
| 91301 |
|
107 |
102 |
$0.00 |
| 97802 |
|
74 |
42 |
$0.00 |
| 11730 |
|
18 |
16 |
$0.00 |
| 95024 |
|
18 |
12 |
$0.00 |
| 90657 |
|
33 |
30 |
$0.00 |
| 94010 |
|
18 |
12 |
$0.00 |
| 90696 |
|
19 |
12 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
41 |
30 |
$0.00 |