| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
277,422 |
209,209 |
$30.48M |
| 00003 |
Internal/system code - not a standard HCPCS code |
74,513 |
46,719 |
$10.80M |
| 0001A |
|
4,039 |
2,312 |
$180K |
| 0002A |
|
3,745 |
2,158 |
$168K |
| 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 |
1,727 |
1,288 |
$69K |
| 0012A |
|
1,448 |
896 |
$63K |
| 0011A |
|
1,497 |
931 |
$51K |
| 0071A |
|
865 |
473 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,444 |
2,896 |
$39K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,243 |
3,565 |
$31K |
| 0064A |
|
687 |
433 |
$31K |
| 0031A |
|
657 |
406 |
$30K |
| V2020 |
Frames, purchases |
1,468 |
1,466 |
$28K |
| 0004A |
|
558 |
362 |
$27K |
| 0072A |
|
511 |
290 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,185 |
1,181 |
$23K |
| 92015 |
Determination of refractive state |
8,562 |
7,279 |
$14K |
| 0013A |
|
183 |
110 |
$8K |
| 0034A |
|
144 |
91 |
$6K |
| G9920 |
Screening performed and negative |
2,070 |
1,930 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
771 |
690 |
$3K |
| 0134A |
|
33 |
33 |
$2K |
| 0003A |
|
20 |
20 |
$1K |
| 92341 |
|
44 |
44 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
80,344 |
68,664 |
$1K |
| 0124A |
|
14 |
14 |
$938.00 |
| 92250 |
|
1,053 |
1,042 |
$758.40 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,313 |
563 |
$0.00 |
| 85018 |
|
12,095 |
12,016 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,170 |
20,117 |
$0.00 |
| Z1034 |
|
11,703 |
7,331 |
$0.00 |
| 1126F |
|
5,410 |
4,952 |
$0.00 |
| 3075F |
|
1,510 |
1,449 |
$0.00 |
| Z6406 |
|
3,045 |
2,713 |
$0.00 |
| 1036F |
|
13,142 |
10,714 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
33 |
33 |
$0.00 |
| 90686 |
|
4,568 |
4,549 |
$0.00 |
| 92551 |
|
6,288 |
6,272 |
$0.00 |
| Z6402 |
|
1,007 |
1,004 |
$0.00 |
| 3008F |
|
17,665 |
15,504 |
$0.00 |
| 90647 |
|
1,384 |
1,382 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
4,567 |
4,496 |
$0.00 |
| 3074F |
|
15,048 |
13,108 |
$0.00 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
3,621 |
2,584 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,139 |
863 |
$0.00 |
| 90619 |
|
156 |
156 |
$0.00 |
| 90723 |
|
1,230 |
1,229 |
$0.00 |
| 90696 |
|
188 |
188 |
$0.00 |
| 90716 |
|
171 |
171 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
271 |
271 |
$0.00 |
| 90732 |
|
63 |
63 |
$0.00 |
| D0603 |
|
562 |
561 |
$0.00 |
| 86580 |
|
588 |
533 |
$0.00 |
| 90697 |
|
615 |
615 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
83 |
83 |
$0.00 |
| 3079F |
|
1,859 |
1,786 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
151 |
141 |
$0.00 |
| Z6204 |
|
2,163 |
1,949 |
$0.00 |
| 3080F |
|
66 |
66 |
$0.00 |
| 90688 |
|
1,586 |
1,584 |
$0.00 |
| 99381 |
|
239 |
239 |
$0.00 |
| J3490 |
Unclassified drugs |
108 |
108 |
$0.00 |
| Z1038 |
|
73 |
73 |
$0.00 |
| 90650 |
|
15 |
15 |
$0.00 |
| 90677 |
|
326 |
326 |
$0.00 |
| 1125F |
|
124 |
122 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
671 |
663 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
89 |
89 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
25 |
25 |
$0.00 |
| Z6410 |
|
451 |
439 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
45 |
44 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
68 |
59 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
12 |
12 |
$0.00 |
| 82962 |
|
176 |
171 |
$0.00 |
| D1351 |
Sealant - per tooth |
177 |
90 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
289 |
288 |
$0.00 |
| Z1032 |
|
77 |
77 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
62 |
62 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
209 |
209 |
$0.00 |
| 93000 |
|
37 |
37 |
$0.00 |
| 87428 |
|
204 |
199 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
56 |
56 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
568 |
567 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |
| 1034F |
|
16 |
14 |
$0.00 |
| 90733 |
|
14 |
14 |
$0.00 |
| D1310 |
|
149 |
149 |
$0.00 |
| Z6414 |
|
617 |
541 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,026 |
3,025 |
$0.00 |
| 99173 |
|
6,159 |
6,152 |
$0.00 |
| 3078F |
|
14,797 |
12,911 |
$0.00 |
| S3000 |
Diabetic indicator; retinal eye exam, dilated, bilateral |
860 |
860 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,504 |
4,504 |
$0.00 |
| 81025 |
|
2,809 |
2,771 |
$0.00 |
| 81003 |
|
14,660 |
10,722 |
$0.00 |
| 3077F |
|
333 |
325 |
$0.00 |
| 90681 |
|
704 |
704 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,292 |
3,248 |
$0.00 |
| 90670 |
|
2,372 |
2,371 |
$0.00 |
| Z6300 |
|
1,030 |
1,021 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,013 |
1,013 |
$0.00 |
| 90649 |
|
269 |
268 |
$0.00 |
| Z6400 |
|
2,541 |
1,981 |
$0.00 |
| 59025 |
Fetal non-stress test |
364 |
200 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,220 |
9,438 |
$0.00 |
| Z6308 |
|
399 |
395 |
$0.00 |
| 98940 |
|
1,194 |
804 |
$0.00 |
| 90633 |
|
1,112 |
1,110 |
$0.00 |
| 3725F |
|
11,001 |
9,510 |
$0.00 |
| 90715 |
|
709 |
707 |
$0.00 |
| Z6200 |
|
970 |
964 |
$0.00 |
| 90700 |
|
90 |
90 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
485 |
475 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
735 |
602 |
$0.00 |
| 1159F |
|
7,296 |
6,353 |
$0.00 |
| 1160F |
|
7,295 |
6,352 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
123 |
123 |
$0.00 |
| 90710 |
|
207 |
207 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
352 |
352 |
$0.00 |
| D0270 |
|
129 |
127 |
$0.00 |
| Z6208 |
|
254 |
252 |
$0.00 |
| Z6304 |
|
2,688 |
2,395 |
$0.00 |
| D9430 |
|
235 |
232 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
474 |
474 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
413 |
369 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
115 |
91 |
$0.00 |
| 90707 |
|
109 |
109 |
$0.00 |
| D1120 |
Prophylaxis - child |
506 |
505 |
$0.00 |
| 90734 |
|
24 |
24 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
967 |
958 |
$0.00 |
| 90630 |
|
81 |
81 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
31 |
31 |
$0.00 |
| 90644 |
|
25 |
25 |
$0.00 |
| 90685 |
|
43 |
43 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
13 |
13 |
$0.00 |
| 92134 |
|
15 |
15 |
$0.00 |
| 11721 |
|
12 |
12 |
$0.00 |