| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
325,132 |
260,252 |
$84.73M |
| 00003 |
Internal/system code - not a standard HCPCS code |
238,192 |
172,844 |
$74.11M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
262,971 |
179,441 |
$1.63M |
| 90832 |
Psychotherapy, 30 minutes with patient |
28,057 |
11,743 |
$597K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
59,400 |
46,353 |
$539K |
| 98940 |
|
4,839 |
2,720 |
$375K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56,843 |
39,780 |
$370K |
| G9012 |
Other specified case management service not elsewhere classified |
2,617 |
2,147 |
$317K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
8,547 |
6,407 |
$261K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
22,703 |
12,062 |
$230K |
| 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 |
1,303 |
1,039 |
$108K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,957 |
2,780 |
$85K |
| 90651 |
|
2,595 |
2,055 |
$82K |
| 90791 |
Psychiatric diagnostic evaluation |
1,633 |
1,277 |
$59K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,580 |
1,303 |
$54K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,233 |
696 |
$53K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,345 |
998 |
$52K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,127 |
1,575 |
$50K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
426 |
314 |
$49K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,546 |
1,960 |
$48K |
| J3490 |
Unclassified drugs |
1,320 |
1,088 |
$45K |
| 90715 |
|
3,729 |
2,849 |
$43K |
| 90750 |
|
816 |
645 |
$41K |
| 99215 |
Prolong outpt/office vis |
3,866 |
2,562 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,508 |
1,478 |
$38K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,849 |
1,344 |
$33K |
| 90739 |
|
755 |
656 |
$32K |
| 90677 |
|
579 |
460 |
$32K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,651 |
1,206 |
$25K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,712 |
4,741 |
$24K |
| 90686 |
|
5,870 |
4,685 |
$21K |
| 92552 |
|
2,717 |
2,307 |
$20K |
| 59425 |
|
442 |
327 |
$20K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,775 |
1,634 |
$19K |
| 99401 |
|
1,043 |
895 |
$17K |
| S4993 |
Contraceptive pills for birth control |
660 |
653 |
$17K |
| 90619 |
|
464 |
397 |
$17K |
| A4267 |
Contraceptive supply, condom, male, each |
3,530 |
3,312 |
$14K |
| 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 |
550 |
540 |
$14K |
| 0004A |
|
204 |
204 |
$13K |
| 83026 |
|
9,073 |
7,101 |
$12K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
43 |
39 |
$11K |
| G9920 |
Screening performed and negative |
8,652 |
6,597 |
$11K |
| 96156 |
|
495 |
472 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
926 |
683 |
$11K |
| 97803 |
|
625 |
531 |
$9K |
| 90746 |
|
267 |
212 |
$7K |
| 82947 |
|
3,425 |
2,658 |
$6K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
470 |
418 |
$6K |
| 97813 |
|
1,536 |
909 |
$5K |
| 90656 |
|
1,114 |
877 |
$5K |
| 0002A |
|
78 |
77 |
$5K |
| 97802 |
|
209 |
208 |
$5K |
| 0064A |
|
85 |
85 |
$5K |
| 99383 |
|
344 |
284 |
$5K |
| 90633 |
|
1,733 |
1,482 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,237 |
1,733 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,089 |
8,226 |
$4K |
| 90734 |
|
790 |
611 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,142 |
870 |
$4K |
| 90660 |
|
814 |
687 |
$4K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
318 |
318 |
$4K |
| 97810 |
|
1,622 |
942 |
$4K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
545 |
470 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
462 |
405 |
$4K |
| 0012A |
|
57 |
56 |
$4K |
| 99384 |
|
156 |
114 |
$3K |
| 84703 |
|
4,016 |
3,332 |
$3K |
| 98942 |
|
3,801 |
1,302 |
$3K |
| 85018 |
|
3,914 |
3,380 |
$3K |
| 0001A |
|
46 |
46 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,084 |
968 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
122 |
76 |
$3K |
| 90670 |
|
702 |
573 |
$2K |
| 90661 |
|
570 |
437 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
16 |
15 |
$2K |
| 90707 |
|
191 |
160 |
$2K |
| 81025 |
|
1,747 |
1,608 |
$2K |
| 99188 |
|
328 |
233 |
$2K |
| 90648 |
|
586 |
490 |
$2K |
| 96151 |
|
264 |
231 |
$2K |
| 99205 |
Prolong outpt/office vis |
181 |
115 |
$1K |
| 90716 |
|
606 |
551 |
$1K |
| 90837 |
Psychotherapy, 53 minutes with patient |
55 |
27 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
25 |
25 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
932 |
861 |
$993.84 |
| 87428 |
|
16 |
16 |
$953.85 |
| 90688 |
|
509 |
408 |
$946.86 |
| 90674 |
|
135 |
106 |
$917.53 |
| 90620 |
|
105 |
84 |
$890.12 |
| 90710 |
|
285 |
241 |
$828.40 |
| 0054A |
|
12 |
12 |
$804.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
192 |
138 |
$694.69 |
| 82962 |
|
1,263 |
1,094 |
$669.45 |
| 87210 |
|
271 |
266 |
$645.78 |
| 90655 |
|
137 |
126 |
$628.44 |
| 97814 |
|
1,467 |
871 |
$598.88 |
| 90713 |
|
286 |
266 |
$578.76 |
| 81002 |
|
1,418 |
1,190 |
$569.01 |
| 90756 |
|
166 |
121 |
$567.00 |
| 90694 |
|
15 |
13 |
$496.23 |
| S5000 |
Prescription drug, generic |
323 |
273 |
$483.28 |
| 83655 |
|
119 |
102 |
$462.00 |
| 86580 |
|
756 |
626 |
$456.04 |
| 83986 |
|
207 |
203 |
$451.18 |
| 97811 |
|
1,620 |
934 |
$446.53 |
| 90744 |
|
239 |
215 |
$441.92 |
| 99381 |
|
38 |
31 |
$440.16 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
204 |
143 |
$408.20 |
| 92250 |
|
578 |
570 |
$379.17 |
| 90723 |
|
215 |
180 |
$326.04 |
| 90680 |
|
143 |
111 |
$297.20 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
34 |
17 |
$292.20 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
286 |
273 |
$249.93 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
429 |
411 |
$243.33 |
| 92551 |
|
221 |
174 |
$217.54 |
| 90700 |
|
57 |
52 |
$191.04 |
| 20610 |
|
125 |
85 |
$189.00 |
| 99078 |
|
40 |
34 |
$119.16 |
| 97804 |
|
38 |
31 |
$113.25 |
| 90714 |
|
45 |
44 |
$113.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,767 |
1,748 |
$111.45 |
| 87806 |
|
32 |
30 |
$96.12 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
26 |
$88.50 |
| 96127 |
|
115 |
75 |
$82.15 |
| 90698 |
|
56 |
44 |
$81.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
62 |
61 |
$64.87 |
| 90461 |
|
357 |
327 |
$59.40 |
| 96153 |
|
19 |
16 |
$58.90 |
| 92015 |
Determination of refractive state |
6,940 |
6,814 |
$56.07 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,808 |
1,576 |
$47.04 |
| 92133 |
|
51 |
50 |
$32.25 |
| 93000 |
|
126 |
112 |
$31.57 |
| 97032 |
|
1,468 |
779 |
$16.76 |
| 81003 |
|
134 |
121 |
$11.02 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
21 |
19 |
$10.70 |
| 88720 |
|
27 |
19 |
$4.30 |
| 3077F |
|
3,395 |
3,195 |
$0.00 |
| 3078F |
|
13,375 |
11,396 |
$0.00 |
| 99442 |
|
271 |
252 |
$0.00 |
| Z6304 |
|
1,391 |
1,274 |
$0.00 |
| Z6500 |
|
305 |
299 |
$0.00 |
| Z6200 |
|
364 |
360 |
$0.00 |
| Z6400 |
|
1,053 |
860 |
$0.00 |
| Z6300 |
|
147 |
147 |
$0.00 |
| V2020 |
Frames, purchases |
450 |
448 |
$0.00 |
| 3046F |
|
371 |
276 |
$0.00 |
| Z6302 |
|
261 |
254 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
305 |
303 |
$0.00 |
| 99173 |
|
2,119 |
2,085 |
$0.00 |
| S0197 |
Prenatal vitamins, 30-day supply |
45 |
28 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
69 |
51 |
$0.00 |
| 3051F |
|
17 |
14 |
$0.00 |
| Z6308 |
|
24 |
24 |
$0.00 |
| 92341 |
|
15 |
15 |
$0.00 |
| Z6208 |
|
24 |
24 |
$0.00 |
| Z6414 |
|
37 |
36 |
$0.00 |
| Z6206 |
|
65 |
56 |
$0.00 |
| Z6408 |
|
73 |
64 |
$0.00 |
| 09920 |
|
12 |
12 |
$0.00 |
| Z6202 |
|
22 |
17 |
$0.00 |
| 3074F |
|
14,240 |
12,044 |
$0.00 |
| 3075F |
|
1,123 |
1,046 |
$0.00 |
| 3079F |
|
3,067 |
2,740 |
$0.00 |
| Z6204 |
|
1,190 |
1,072 |
$0.00 |
| Z6406 |
|
1,775 |
1,597 |
$0.00 |
| 3080F |
|
623 |
581 |
$0.00 |
| Z1034 |
|
901 |
709 |
$0.00 |
| 3044F |
|
989 |
766 |
$0.00 |
| 36416 |
|
40 |
33 |
$0.00 |
| Z6404 |
|
331 |
317 |
$0.00 |
| Z1032 |
|
210 |
183 |
$0.00 |
| 92002 |
|
104 |
104 |
$0.00 |
| 97010 |
|
727 |
477 |
$0.00 |
| 97014 |
|
1,515 |
990 |
$0.00 |
| Z6410 |
|
455 |
427 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
682 |
541 |
$0.00 |
| Z6402 |
|
143 |
143 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
42 |
30 |
$0.00 |
| Z6306 |
|
68 |
58 |
$0.00 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
14 |
14 |
$0.00 |