| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
55,180 |
42,582 |
$12.75M |
| T1015 |
Clinic visit/encounter, all-inclusive |
51,826 |
37,346 |
$6.41M |
| 90837 |
Psychotherapy, 53 minutes with patient |
17,860 |
6,783 |
$469K |
| H2016 |
Comprehensive community support services, per diem |
526 |
526 |
$203K |
| 97810 |
|
12,794 |
4,848 |
$168K |
| 97811 |
|
12,730 |
4,851 |
$155K |
| G9012 |
Other specified case management service not elsewhere classified |
499 |
325 |
$132K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,071 |
1,074 |
$75K |
| T2040 |
Financial management, self-directed, waiver; per 15 minutes |
335 |
240 |
$74K |
| H0043 |
Supported housing, per diem |
95 |
95 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,236 |
23,561 |
$33K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
2,660 |
2,143 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,585 |
5,430 |
$11K |
| 80305 |
|
2,621 |
1,797 |
$11K |
| 90674 |
|
432 |
362 |
$9K |
| 0002A |
|
109 |
109 |
$7K |
| A0390 |
Als mileage (per mile) |
30 |
29 |
$5K |
| 90832 |
Psychotherapy, 30 minutes with patient |
360 |
179 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
394 |
275 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,835 |
4,291 |
$5K |
| 0001A |
|
71 |
71 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
731 |
578 |
$4K |
| 0003A |
|
62 |
62 |
$4K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
345 |
174 |
$4K |
| 98940 |
|
322 |
160 |
$3K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
102 |
91 |
$3K |
| 0012A |
|
40 |
40 |
$3K |
| 90686 |
|
106 |
106 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
18 |
18 |
$2K |
| 90715 |
|
95 |
73 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
114 |
91 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
97 |
81 |
$2K |
| 0011A |
|
23 |
23 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,191 |
1,986 |
$1K |
| 91322 |
|
25 |
25 |
$1K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
16 |
12 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
59 |
38 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
921 |
795 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
117 |
92 |
$902.59 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
16 |
14 |
$667.03 |
| Q3014 |
Telehealth originating site facility fee |
14 |
14 |
$420.00 |
| G9920 |
Screening performed and negative |
28 |
26 |
$406.00 |
| 82274 |
|
26 |
25 |
$367.64 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
51 |
$328.98 |
| 81002 |
|
467 |
375 |
$309.45 |
| 90658 |
|
14 |
14 |
$249.76 |
| 81025 |
|
124 |
80 |
$210.00 |
| 92551 |
|
151 |
127 |
$193.80 |
| 87430 |
|
14 |
14 |
$114.52 |
| 82962 |
|
41 |
40 |
$82.00 |
| 90480 |
|
12 |
12 |
$80.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
80 |
75 |
$22.30 |
| 85018 |
|
16 |
13 |
$2.07 |
| 99406 |
|
18 |
13 |
$0.05 |
| 99408 |
|
116 |
116 |
$0.00 |
| 4004F |
|
255 |
250 |
$0.00 |
| 99173 |
|
55 |
55 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18 |
14 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$0.00 |
| 99201 |
|
13 |
13 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
400 |
396 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
282 |
279 |
$0.00 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
16 |
16 |
$0.00 |
| Z1034 |
|
50 |
39 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
45 |
39 |
$0.00 |
| 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 |
121 |
117 |
$0.00 |