| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
71,003 |
32,113 |
$10.02M |
| T1015 |
Clinic visit/encounter, all-inclusive |
41,725 |
27,536 |
$6.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,427 |
13,239 |
$164K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
896 |
381 |
$125K |
| 98940 |
|
478 |
193 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
288 |
217 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
373 |
351 |
$16K |
| 92552 |
|
1,077 |
901 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,512 |
2,057 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,403 |
1,050 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
475 |
393 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
90 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
458 |
368 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
63 |
$2K |
| 90660 |
|
520 |
351 |
$2K |
| 85018 |
|
1,555 |
1,299 |
$2K |
| J3490 |
Unclassified drugs |
12 |
12 |
$960.00 |
| 90686 |
|
214 |
168 |
$920.88 |
| 90715 |
|
48 |
42 |
$548.88 |
| 81025 |
|
433 |
414 |
$544.86 |
| 82962 |
|
343 |
261 |
$396.68 |
| 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 |
494 |
408 |
$392.59 |
| 90656 |
|
18 |
18 |
$349.74 |
| 90658 |
|
41 |
41 |
$327.36 |
| 86580 |
|
179 |
161 |
$268.02 |
| 90651 |
|
31 |
28 |
$128.96 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
27 |
25 |
$122.69 |
| 90734 |
|
29 |
28 |
$119.04 |
| 84443 |
Thyroid stimulating hormone (TSH) |
44 |
38 |
$86.21 |
| 81002 |
|
206 |
184 |
$82.38 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
12 |
$37.42 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
368 |
214 |
$37.23 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
71 |
43 |
$30.03 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
157 |
141 |
$4.46 |
| 99173 |
|
472 |
391 |
$0.00 |
| 92015 |
Determination of refractive state |
131 |
128 |
$0.00 |
| 11721 |
|
12 |
12 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
36 |
29 |
$0.00 |