| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
65,726 |
56,883 |
$9.33M |
| 00003 |
Internal/system code - not a standard HCPCS code |
6,224 |
5,769 |
$1.23M |
| 0011A |
|
1,071 |
939 |
$48K |
| 0012A |
|
877 |
875 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,104 |
19,249 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,357 |
1,349 |
$15K |
| 0001A |
|
62 |
62 |
$3K |
| 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 |
90 |
78 |
$2K |
| 0002A |
|
48 |
48 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,063 |
1,008 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,202 |
2,946 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
381 |
378 |
$1K |
| 80053 |
Comprehensive metabolic panel |
517 |
514 |
$501.94 |
| 71046 |
Radiologic examination, chest; 2 views |
27 |
27 |
$438.36 |
| D0120 |
Periodic oral evaluation - established patient |
170 |
162 |
$345.00 |
| 92551 |
|
2,128 |
2,113 |
$344.28 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
122 |
122 |
$200.00 |
| 86592 |
|
297 |
297 |
$153.63 |
| 80061 |
Lipid panel |
813 |
810 |
$140.50 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
907 |
902 |
$91.38 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
485 |
476 |
$76.14 |
| 81001 |
|
646 |
631 |
$66.14 |
| 80050 |
General health panel |
311 |
311 |
$53.28 |
| D0220 |
Intraoral - periapical first radiographic image |
323 |
315 |
$36.00 |
| 81025 |
|
12 |
12 |
$25.20 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
380 |
378 |
$19.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
249 |
241 |
$12.15 |
| D0230 |
Intraoral - periapical each additional radiographic image |
210 |
205 |
$7.20 |
| 92081 |
|
2,001 |
1,987 |
$0.00 |
| 3078F |
|
1,436 |
1,355 |
$0.00 |
| 1159F |
|
1,234 |
1,136 |
$0.00 |
| 82948 |
|
2,644 |
2,429 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
723 |
718 |
$0.00 |
| 99442 |
|
2,252 |
2,125 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
855 |
847 |
$0.00 |
| 92341 |
|
25 |
25 |
$0.00 |
| 87806 |
|
378 |
377 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
571 |
560 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
178 |
169 |
$0.00 |
| V2020 |
Frames, purchases |
1,374 |
1,361 |
$0.00 |
| 3062F |
|
27 |
24 |
$0.00 |
| 3725F |
|
326 |
326 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
66 |
64 |
$0.00 |
| 4025F |
|
870 |
784 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
555 |
550 |
$0.00 |
| 3077F |
|
89 |
85 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,170 |
1,159 |
$0.00 |
| 92015 |
Determination of refractive state |
1,963 |
1,944 |
$0.00 |
| 90734 |
|
30 |
30 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
217 |
188 |
$0.00 |
| 1160F |
|
1,234 |
1,136 |
$0.00 |
| D1110 |
Prophylaxis - adult |
167 |
167 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
125 |
124 |
$0.00 |
| 81002 |
|
126 |
121 |
$0.00 |
| 84439 |
|
83 |
83 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
114 |
113 |
$0.00 |
| D4341 |
|
350 |
170 |
$0.00 |
| 86038 |
|
12 |
12 |
$0.00 |
| 1124F |
|
728 |
684 |
$0.00 |
| 87186 |
|
73 |
71 |
$0.00 |
| 99201 |
|
26 |
25 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
38 |
38 |
$0.00 |
| 84550 |
|
67 |
67 |
$0.00 |
| 3015F |
|
12 |
12 |
$0.00 |
| D9110 |
|
12 |
12 |
$0.00 |
| 80076 |
|
12 |
12 |
$0.00 |
| 3080F |
|
124 |
114 |
$0.00 |
| 4037F |
|
268 |
263 |
$0.00 |
| 1170F |
|
1,257 |
1,175 |
$0.00 |
| 1036F |
|
2,783 |
2,445 |
$0.00 |
| 82043 |
|
118 |
118 |
$0.00 |
| 85018 |
|
2,120 |
2,100 |
$0.00 |
| 1126F |
|
1,986 |
1,802 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,439 |
1,424 |
$0.00 |
| 85652 |
|
25 |
25 |
$0.00 |
| 3008F |
|
3,674 |
3,473 |
$0.00 |
| 3044F |
|
1,022 |
895 |
$0.00 |
| 3074F |
|
1,467 |
1,387 |
$0.00 |
| 82270 |
|
96 |
96 |
$0.00 |
| 4010F |
|
938 |
852 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
253 |
253 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
138 |
138 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
104 |
104 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
230 |
230 |
$0.00 |
| 90651 |
|
53 |
53 |
$0.00 |
| 90686 |
|
760 |
751 |
$0.00 |
| 1123F |
|
581 |
544 |
$0.00 |
| 1125F |
|
151 |
137 |
$0.00 |
| 3075F |
|
346 |
333 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
498 |
492 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
105 |
105 |
$0.00 |
| 1000F |
|
41 |
41 |
$0.00 |
| 3079F |
|
696 |
672 |
$0.00 |
| 1220F |
|
208 |
208 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
237 |
231 |
$0.00 |
| 3014F |
|
55 |
48 |
$0.00 |
| 85027 |
|
14 |
14 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$0.00 |
| 3352F |
|
57 |
56 |
$0.00 |
| 3351F |
|
29 |
29 |
$0.00 |
| 82607 |
|
15 |
15 |
$0.00 |
| 90620 |
|
13 |
13 |
$0.00 |
| 87070 |
|
26 |
25 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
25 |
$0.00 |
| 2023F |
|
29 |
29 |
$0.00 |
| 92002 |
|
16 |
16 |
$0.00 |
| 82950 |
|
13 |
13 |
$0.00 |
| 90619 |
|
37 |
37 |
$0.00 |
| 84153 |
|
25 |
25 |
$0.00 |
| 82746 |
|
12 |
12 |
$0.00 |