| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
326,500 |
272,898 |
$64.12M |
| 00003 |
Internal/system code - not a standard HCPCS code |
89,540 |
65,339 |
$22.49M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
252,998 |
164,967 |
$1.57M |
| 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 |
6,288 |
4,982 |
$864K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
34,910 |
26,182 |
$471K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82,311 |
49,183 |
$350K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,836 |
3,367 |
$285K |
| 90791 |
Psychiatric diagnostic evaluation |
2,029 |
1,434 |
$165K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,441 |
3,331 |
$163K |
| 97802 |
|
2,977 |
2,049 |
$68K |
| J3490 |
Unclassified drugs |
2,082 |
1,765 |
$49K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
696 |
685 |
$36K |
| 92551 |
|
15,610 |
12,337 |
$33K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16,569 |
11,107 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,314 |
6,265 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17,449 |
11,163 |
$27K |
| 0002A |
|
411 |
409 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
51,857 |
35,883 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,023 |
2,015 |
$20K |
| 97803 |
|
4,086 |
3,094 |
$20K |
| 59425 |
|
316 |
192 |
$20K |
| G9920 |
Screening performed and negative |
15,623 |
11,307 |
$18K |
| 0001A |
|
292 |
287 |
$17K |
| 0054A |
|
379 |
376 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
425 |
425 |
$17K |
| 0072A |
|
389 |
388 |
$15K |
| 90686 |
|
35,466 |
25,558 |
$14K |
| 0071A |
|
318 |
318 |
$13K |
| 92015 |
Determination of refractive state |
1,443 |
1,432 |
$12K |
| V2020 |
Frames, purchases |
548 |
543 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
503 |
498 |
$11K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
7,553 |
7,489 |
$10K |
| 0112A |
|
147 |
147 |
$10K |
| 0004A |
|
183 |
179 |
$10K |
| 0011A |
|
336 |
206 |
$9K |
| 90688 |
|
1,845 |
1,631 |
$9K |
| 0124A |
|
197 |
193 |
$9K |
| 99173 |
|
20,201 |
15,835 |
$8K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
597 |
243 |
$8K |
| 99215 |
Prolong outpt/office vis |
239 |
187 |
$8K |
| 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 |
420 |
400 |
$8K |
| 0012A |
|
168 |
110 |
$7K |
| 81025 |
|
7,013 |
5,589 |
$6K |
| 90677 |
|
1,967 |
1,335 |
$6K |
| 90739 |
|
658 |
509 |
$6K |
| 81002 |
|
5,054 |
3,991 |
$5K |
| 99078 |
|
301 |
183 |
$5K |
| 99401 |
|
354 |
335 |
$4K |
| 90670 |
|
4,212 |
2,877 |
$4K |
| 90480 |
|
281 |
271 |
$4K |
| 0074A |
|
108 |
103 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14,153 |
10,314 |
$4K |
| 85018 |
|
1,298 |
1,280 |
$4K |
| 99382 |
|
68 |
68 |
$4K |
| 82962 |
|
4,003 |
3,422 |
$3K |
| 0064A |
|
48 |
48 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,736 |
1,185 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
2,052 |
1,527 |
$3K |
| 97810 |
|
1,434 |
789 |
$3K |
| 97811 |
|
1,419 |
785 |
$2K |
| 0081A |
|
30 |
30 |
$2K |
| 90633 |
|
2,956 |
2,047 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
40 |
40 |
$2K |
| 90656 |
|
4,557 |
3,081 |
$1K |
| 0052A |
|
34 |
34 |
$1K |
| 96156 |
|
277 |
242 |
$1K |
| 90698 |
|
4,344 |
2,917 |
$1K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
898 |
552 |
$1K |
| 90651 |
|
2,703 |
2,128 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17,088 |
11,729 |
$763.88 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
553 |
435 |
$756.85 |
| 92552 |
|
7,354 |
4,235 |
$638.88 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
738 |
534 |
$550.29 |
| 90715 |
|
507 |
390 |
$542.64 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$471.48 |
| 82947 |
|
2,606 |
1,765 |
$429.96 |
| 90750 |
|
136 |
87 |
$415.80 |
| 59430 |
|
85 |
81 |
$389.96 |
| 90685 |
|
264 |
252 |
$358.70 |
| 99188 |
|
1,246 |
775 |
$305.10 |
| 90648 |
|
221 |
179 |
$274.13 |
| 76801 |
|
47 |
26 |
$235.26 |
| 90716 |
|
363 |
264 |
$220.00 |
| 72100 |
|
149 |
122 |
$178.54 |
| 90723 |
|
12 |
12 |
$163.08 |
| 92341 |
|
15 |
15 |
$150.30 |
| 90744 |
|
663 |
464 |
$144.00 |
| 90734 |
|
335 |
299 |
$134.49 |
| 73562 |
|
196 |
168 |
$131.53 |
| 90681 |
|
1,025 |
717 |
$118.00 |
| 99381 |
|
96 |
88 |
$99.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$88.08 |
| 73030 |
|
116 |
81 |
$66.86 |
| 73130 |
|
38 |
26 |
$47.76 |
| 90697 |
|
1,510 |
979 |
$30.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
98 |
61 |
$29.00 |
| 90654 |
|
15 |
12 |
$23.41 |
| 96151 |
|
17 |
12 |
$19.18 |
| 81001 |
|
38 |
38 |
$16.08 |
| 87210 |
|
25 |
25 |
$10.68 |
| 74018 |
|
60 |
50 |
$7.35 |
| H0049 |
Alcohol and/or drug screening |
3,027 |
2,955 |
$2.31 |
| 91321 |
|
72 |
68 |
$0.07 |
| Z6308 |
|
81 |
81 |
$0.00 |
| 73610 |
|
12 |
12 |
$0.00 |
| 90671 |
|
1,138 |
760 |
$0.00 |
| Z6300 |
|
544 |
537 |
$0.00 |
| Z6400 |
|
1,552 |
1,536 |
$0.00 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
244 |
229 |
$0.00 |
| Z6200 |
|
735 |
735 |
$0.00 |
| Z6302 |
|
442 |
435 |
$0.00 |
| 90710 |
|
222 |
177 |
$0.00 |
| Z6304 |
|
899 |
851 |
$0.00 |
| Z6202 |
|
253 |
253 |
$0.00 |
| 90662 |
|
98 |
83 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
293 |
285 |
$0.00 |
| 91312 |
|
75 |
70 |
$0.00 |
| 91300 |
|
59 |
49 |
$0.00 |
| 90707 |
|
82 |
54 |
$0.00 |
| 73630 |
|
25 |
12 |
$0.00 |
| 90700 |
|
22 |
13 |
$0.00 |
| Z6410 |
|
1,014 |
995 |
$0.00 |
| 90696 |
|
231 |
189 |
$0.00 |
| Z6204 |
|
666 |
659 |
$0.00 |
| 99460 |
|
530 |
500 |
$0.00 |
| 96380 |
|
115 |
112 |
$0.00 |
| Z6404 |
|
306 |
305 |
$0.00 |
| Z1034 |
|
610 |
475 |
$0.00 |
| Z6402 |
|
179 |
179 |
$0.00 |
| 91307 |
|
102 |
99 |
$0.00 |
| 90619 |
|
77 |
65 |
$0.00 |
| Z1038 |
|
91 |
86 |
$0.00 |
| 90474 |
|
44 |
44 |
$0.00 |
| 90620 |
|
83 |
82 |
$0.00 |
| 88720 |
|
62 |
50 |
$0.00 |
| 90673 |
|
21 |
17 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12 |
12 |
$0.00 |
| 71020 |
|
98 |
98 |
$0.00 |
| 90381 |
|
51 |
39 |
$0.00 |
| Z1032 |
|
13 |
13 |
$0.00 |
| 99462 |
|
23 |
18 |
$0.00 |