| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
26,476 |
21,287 |
$2.20M |
| 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 |
5,416 |
4,720 |
$360K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
132,279 |
114,315 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28,547 |
26,869 |
$11K |
| 90651 |
|
915 |
910 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,013 |
3,009 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22,266 |
19,268 |
$6K |
| 90670 |
|
1,161 |
1,159 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,273 |
3,204 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,800 |
4,731 |
$4K |
| 90710 |
|
545 |
544 |
$4K |
| 97802 |
|
3,466 |
3,151 |
$3K |
| 90734 |
|
855 |
850 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
8,844 |
8,792 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,107 |
8,854 |
$3K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,291 |
602 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
302 |
300 |
$2K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
852 |
805 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,897 |
2,872 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,755 |
1,747 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
2,297 |
2,283 |
$2K |
| 90756 |
|
247 |
246 |
$2K |
| 82962 |
|
15,583 |
14,160 |
$1K |
| 98960 |
|
138 |
77 |
$1K |
| 92002 |
|
385 |
385 |
$1K |
| 90686 |
|
4,827 |
4,736 |
$1K |
| 87390 |
|
7,346 |
7,316 |
$1K |
| 87905 |
|
9,061 |
8,963 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,284 |
14,439 |
$969.25 |
| 73630 |
|
893 |
889 |
$959.20 |
| 87808 |
|
9,288 |
9,178 |
$880.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
3,686 |
3,674 |
$824.18 |
| 90698 |
|
525 |
524 |
$813.33 |
| 87625 |
|
3,501 |
3,491 |
$755.17 |
| 90633 |
|
760 |
758 |
$753.90 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,002 |
2,994 |
$749.32 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,534 |
1,466 |
$716.50 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
582 |
581 |
$711.47 |
| 90715 |
|
521 |
514 |
$704.13 |
| 11721 |
|
1,499 |
1,475 |
$696.57 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,812 |
1,770 |
$679.60 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,355 |
861 |
$671.99 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,072 |
1,072 |
$602.73 |
| 92015 |
Determination of refractive state |
2,346 |
2,346 |
$572.00 |
| 11421 |
|
218 |
210 |
$530.72 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,034 |
5,907 |
$457.88 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,510 |
2,500 |
$441.48 |
| 86701 |
|
7,388 |
7,349 |
$422.82 |
| 11730 |
|
357 |
300 |
$412.10 |
| 81025 |
|
8,728 |
8,486 |
$397.46 |
| 76642 |
|
538 |
537 |
$396.35 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,088 |
1,087 |
$392.41 |
| 73560 |
|
597 |
595 |
$357.77 |
| 72110 |
|
699 |
699 |
$347.28 |
| 29540 |
|
349 |
328 |
$346.56 |
| 97803 |
|
2,931 |
2,816 |
$336.05 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
4,055 |
4,039 |
$336.04 |
| 81000 |
|
15,739 |
13,322 |
$323.84 |
| 97010 |
|
910 |
384 |
$301.94 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,524 |
1,501 |
$297.93 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,106 |
449 |
$292.95 |
| 99215 |
Prolong outpt/office vis |
1,656 |
1,297 |
$283.15 |
| 90696 |
|
52 |
52 |
$266.80 |
| 11420 |
|
30 |
30 |
$263.55 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,866 |
1,835 |
$258.54 |
| 90680 |
|
38 |
38 |
$250.29 |
| 73030 |
|
366 |
365 |
$230.64 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
825 |
760 |
$228.12 |
| 98940 |
|
1,199 |
908 |
$200.64 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
515 |
495 |
$137.36 |
| 97014 |
|
415 |
167 |
$132.36 |
| 73130 |
|
237 |
237 |
$124.45 |
| 90744 |
|
327 |
327 |
$119.40 |
| 11732 |
|
166 |
166 |
$117.92 |
| 80055 |
|
473 |
471 |
$106.41 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
145 |
144 |
$102.64 |
| 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 |
2,272 |
2,062 |
$100.43 |
| 90674 |
|
232 |
223 |
$84.69 |
| 90661 |
|
108 |
108 |
$84.11 |
| 92250 |
|
1,239 |
1,230 |
$83.43 |
| 73610 |
|
26 |
26 |
$74.67 |
| 99201 |
|
192 |
187 |
$68.01 |
| 86762 |
|
484 |
482 |
$64.00 |
| 71045 |
Radiologic examination, chest; single view |
62 |
62 |
$52.47 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,081 |
1,077 |
$44.73 |
| 97760 |
|
27 |
27 |
$39.03 |
| 99401 |
|
2,026 |
1,815 |
$27.95 |
| 86580 |
|
1,052 |
965 |
$19.98 |
| 87081 |
|
49 |
49 |
$16.86 |
| 86900 |
|
483 |
481 |
$11.80 |
| 86901 |
|
24 |
24 |
$7.32 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,198 |
5,103 |
$1.17 |
| J3490 |
Unclassified drugs |
649 |
646 |
$0.17 |
| 11422 |
|
398 |
383 |
$0.08 |
| 90750 |
|
30 |
30 |
$0.00 |
| 3078F |
|
24,903 |
22,679 |
$0.00 |
| 3077F |
|
3,276 |
3,133 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
370 |
362 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
743 |
739 |
$0.00 |
| G0402 |
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment |
458 |
458 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
919 |
918 |
$0.00 |
| 99173 |
|
3,908 |
3,891 |
$0.00 |
| 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 |
482 |
482 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
191 |
186 |
$0.00 |
| 11056 |
|
53 |
52 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
563 |
562 |
$0.00 |
| 99442 |
|
218 |
205 |
$0.00 |
| G0127 |
Trimming of dystrophic nails, any number |
92 |
92 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
321 |
321 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
514 |
511 |
$0.00 |
| 0013A |
|
14 |
14 |
$0.00 |
| 99080 |
|
366 |
360 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
303 |
299 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
692 |
690 |
$0.00 |
| 2022F |
|
642 |
641 |
$0.00 |
| 1160F |
|
105 |
105 |
$0.00 |
| 1158F |
|
77 |
77 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
189 |
189 |
$0.00 |
| P3001 |
Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician |
170 |
169 |
$0.00 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
27 |
27 |
$0.00 |
| 2028F |
|
767 |
697 |
$0.00 |
| 11000 |
|
15 |
13 |
$0.00 |
| 11423 |
|
163 |
161 |
$0.00 |
| 90649 |
|
14 |
14 |
$0.00 |
| 11720 |
|
12 |
12 |
$0.00 |
| 73565 |
|
37 |
37 |
$0.00 |
| 99490 |
Ccm add 20min |
122 |
122 |
$0.00 |
| 96167 |
|
456 |
453 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$0.00 |
| 1159F |
|
105 |
105 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
149 |
148 |
$0.00 |
| 98942 |
|
15 |
14 |
$0.00 |
| 90700 |
|
24 |
24 |
$0.00 |
| 84439 |
|
31 |
29 |
$0.00 |
| 3046F |
|
76 |
74 |
$0.00 |
| 99387 |
|
41 |
41 |
$0.00 |
| 71047 |
|
45 |
45 |
$0.00 |
| 96158 |
|
49 |
40 |
$0.00 |
| 97763 |
|
27 |
27 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
25 |
25 |
$0.00 |
| S3000 |
Diabetic indicator; retinal eye exam, dilated, bilateral |
12 |
12 |
$0.00 |
| 82274 |
|
15 |
15 |
$0.00 |
| 76882 |
|
13 |
13 |
$0.00 |
| 76801 |
|
399 |
398 |
$0.00 |
| 3074F |
|
25,525 |
23,021 |
$0.00 |
| 92551 |
|
3,941 |
3,924 |
$0.00 |
| 3075F |
|
3,179 |
2,956 |
$0.00 |
| 3079F |
|
6,918 |
6,349 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
545 |
534 |
$0.00 |
| 72080 |
|
27 |
27 |
$0.00 |
| 99402 |
|
423 |
419 |
$0.00 |
| 99386 |
|
538 |
535 |
$0.00 |
| 3080F |
|
693 |
620 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
14 |
12 |
$0.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
458 |
337 |
$0.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,378 |
1,704 |
$0.00 |
| 96156 |
|
2,292 |
2,238 |
$0.00 |
| 99385 |
|
196 |
196 |
$0.00 |
| 1111F |
|
252 |
220 |
$0.00 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
402 |
348 |
$0.00 |
| 99384 |
|
166 |
163 |
$0.00 |
| 99172 |
|
26 |
26 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
13 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
354 |
348 |
$0.00 |
| 11001 |
|
56 |
54 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
160 |
159 |
$0.00 |
| G9012 |
Other specified case management service not elsewhere classified |
370 |
355 |
$0.00 |
| 99383 |
|
118 |
118 |
$0.00 |
| 90620 |
|
128 |
128 |
$0.00 |
| 72040 |
|
40 |
40 |
$0.00 |
| 59430 |
|
116 |
114 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
180 |
180 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
705 |
656 |
$0.00 |
| 76641 |
|
51 |
51 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$0.00 |
| 81001 |
|
12 |
12 |
$0.00 |
| 99403 |
|
27 |
26 |
$0.00 |
| 97162 |
|
28 |
28 |
$0.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
13 |
$0.00 |
| 94760 |
|
40 |
39 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
79 |
79 |
$0.00 |
| 72072 |
|
13 |
13 |
$0.00 |
| 3072F |
|
60 |
60 |
$0.00 |
| 90677 |
|
106 |
106 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
196 |
195 |
$0.00 |
| 3044F |
|
59 |
57 |
$0.00 |
| 99443 |
|
33 |
33 |
$0.00 |
| 11055 |
|
27 |
27 |
$0.00 |
| 20550 |
|
17 |
15 |
$0.00 |
| 99381 |
|
26 |
24 |
$0.00 |
| 72120 |
|
60 |
60 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
28 |
15 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
27 |
27 |
$0.00 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
44 |
38 |
$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) |
17 |
12 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |
| 73600 |
|
12 |
12 |
$0.00 |