| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
222,426 |
193,502 |
$39.43M |
| 00003 |
Internal/system code - not a standard HCPCS code |
5,159 |
4,163 |
$1.15M |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
51,078 |
34,110 |
$732K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
36,124 |
25,539 |
$691K |
| 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 |
27,111 |
15,441 |
$582K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
130,233 |
76,924 |
$498K |
| 90832 |
Psychotherapy, 30 minutes with patient |
20,197 |
8,204 |
$375K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12,127 |
7,907 |
$274K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38,887 |
25,276 |
$253K |
| 90791 |
Psychiatric diagnostic evaluation |
4,660 |
2,502 |
$189K |
| 92002 |
|
6,492 |
4,338 |
$138K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32,926 |
19,613 |
$122K |
| 0011A |
|
2,114 |
1,264 |
$84K |
| 0012A |
|
1,749 |
1,095 |
$80K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,539 |
1,074 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,280 |
2,829 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,742 |
1,872 |
$24K |
| 0001A |
|
359 |
235 |
$18K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
131 |
75 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,478 |
973 |
$14K |
| 0013A |
|
262 |
143 |
$14K |
| 0002A |
|
266 |
168 |
$14K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,393 |
976 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,675 |
2,368 |
$12K |
| 90686 |
|
5,424 |
4,349 |
$12K |
| 92015 |
Determination of refractive state |
3,626 |
2,498 |
$12K |
| 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 |
371 |
203 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,997 |
1,409 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
596 |
582 |
$10K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
249 |
174 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,192 |
5,233 |
$8K |
| 92552 |
|
1,877 |
1,296 |
$8K |
| 0003A |
|
113 |
60 |
$6K |
| 92133 |
|
411 |
249 |
$6K |
| 90715 |
|
835 |
572 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,034 |
676 |
$4K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
144 |
61 |
$4K |
| 92551 |
|
2,766 |
1,836 |
$4K |
| 0071A |
|
64 |
32 |
$3K |
| 81002 |
|
9,424 |
5,741 |
$3K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
1,312 |
1,311 |
$3K |
| 90694 |
|
162 |
134 |
$3K |
| 0072A |
|
58 |
29 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,290 |
891 |
$3K |
| 90674 |
|
1,471 |
991 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14,274 |
9,645 |
$3K |
| 90688 |
|
435 |
365 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,847 |
2,606 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
321 |
205 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
28 |
12 |
$2K |
| 85018 |
|
7,419 |
4,834 |
$2K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
119 |
86 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
55 |
53 |
$2K |
| 80305 |
|
911 |
419 |
$2K |
| 99173 |
|
5,115 |
3,241 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,222 |
1,772 |
$2K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,658 |
1,079 |
$2K |
| 90670 |
|
1,823 |
1,267 |
$1K |
| 92083 |
|
124 |
72 |
$1K |
| G9012 |
Other specified case management service not elsewhere classified |
13 |
13 |
$1K |
| 99215 |
Prolong outpt/office vis |
194 |
127 |
$1K |
| 98940 |
|
839 |
553 |
$1K |
| 90647 |
|
1,680 |
1,096 |
$1K |
| 90746 |
|
73 |
50 |
$1K |
| 0134A |
|
31 |
28 |
$1K |
| 90633 |
|
1,309 |
861 |
$1K |
| 81025 |
|
1,699 |
1,101 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
290 |
213 |
$1K |
| 90723 |
|
1,190 |
829 |
$990.00 |
| 82962 |
|
1,963 |
1,337 |
$982.64 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
246 |
159 |
$977.50 |
| 90461 |
|
2,799 |
2,007 |
$768.28 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
24 |
24 |
$679.15 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
288 |
258 |
$670.89 |
| 93000 |
|
365 |
225 |
$609.74 |
| 90680 |
|
631 |
453 |
$549.27 |
| 90834 |
Psychotherapy, 45 minutes with patient |
27 |
17 |
$537.28 |
| J3490 |
Unclassified drugs |
37 |
25 |
$510.04 |
| 90651 |
|
701 |
460 |
$504.00 |
| 1036F |
|
34,143 |
20,642 |
$437.78 |
| G9919 |
Screening performed and positive and provision of recommendations |
17 |
17 |
$406.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,071 |
3,302 |
$338.49 |
| 90734 |
|
424 |
284 |
$225.00 |
| 90671 |
|
503 |
344 |
$213.81 |
| 99382 |
|
105 |
77 |
$157.20 |
| 97813 |
|
373 |
182 |
$156.33 |
| 96127 |
|
655 |
434 |
$153.87 |
| 90656 |
|
207 |
154 |
$125.70 |
| 90710 |
|
743 |
480 |
$108.81 |
| 86580 |
|
70 |
60 |
$97.44 |
| 99381 |
|
93 |
69 |
$90.66 |
| 90621 |
|
55 |
39 |
$65.36 |
| 90696 |
|
173 |
105 |
$54.54 |
| 90661 |
|
128 |
89 |
$50.00 |
| 90697 |
|
383 |
265 |
$45.27 |
| 97814 |
|
291 |
133 |
$40.53 |
| 90700 |
|
92 |
57 |
$36.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
361 |
248 |
$26.59 |
| 87400 |
|
65 |
61 |
$23.16 |
| 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 |
23 |
20 |
$19.92 |
| S0197 |
Prenatal vitamins, 30-day supply |
16 |
13 |
$4.05 |
| 1159F |
|
31,096 |
19,842 |
$0.22 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
3,463 |
2,132 |
$0.20 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
3,261 |
1,973 |
$0.20 |
| 1034F |
|
705 |
420 |
$0.04 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
575 |
350 |
$0.04 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
775 |
496 |
$0.03 |
| 3051F |
|
606 |
407 |
$0.03 |
| 2022F |
|
4,482 |
2,555 |
$0.02 |
| 3075F |
|
5,587 |
3,602 |
$0.00 |
| 2001F |
|
31,392 |
19,583 |
$0.00 |
| 3008F |
|
31,387 |
19,581 |
$0.00 |
| 1126F |
|
2,421 |
1,565 |
$0.00 |
| 3044F |
|
875 |
579 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
97 |
97 |
$0.00 |
| 3079F |
|
8,167 |
5,188 |
$0.00 |
| 3074F |
|
19,870 |
12,521 |
$0.00 |
| 99383 |
|
283 |
183 |
$0.00 |
| 91301 |
|
410 |
335 |
$0.00 |
| 3080F |
|
3,068 |
1,895 |
$0.00 |
| 90619 |
|
43 |
27 |
$0.00 |
| 90716 |
|
63 |
38 |
$0.00 |
| 90474 |
|
30 |
30 |
$0.00 |
| 3052F |
|
321 |
199 |
$0.00 |
| 1125F |
|
888 |
572 |
$0.00 |
| 99384 |
|
136 |
97 |
$0.00 |
| 90732 |
|
14 |
13 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
13 |
13 |
$0.00 |
| 0501F |
|
19 |
14 |
$0.00 |
| 3078F |
|
18,995 |
12,054 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
351 |
246 |
$0.00 |
| 0502F |
|
259 |
137 |
$0.00 |
| 90658 |
|
61 |
41 |
$0.00 |
| 3046F |
|
538 |
339 |
$0.00 |
| 90473 |
|
79 |
46 |
$0.00 |
| Z6500 |
|
13 |
13 |
$0.00 |
| 3077F |
|
4,818 |
3,046 |
$0.00 |
| 4004F |
|
55 |
35 |
$0.00 |
| 90707 |
|
41 |
25 |
$0.00 |