| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
100,427 |
89,029 |
$25.29M |
| 00003 |
Internal/system code - not a standard HCPCS code |
3,927 |
3,343 |
$1.07M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
76,017 |
45,861 |
$444K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24,342 |
15,023 |
$198K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,839 |
2,103 |
$167K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,039 |
513 |
$25K |
| 90791 |
Psychiatric diagnostic evaluation |
445 |
320 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,259 |
5,587 |
$18K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
189 |
159 |
$14K |
| J3490 |
Unclassified drugs |
403 |
309 |
$8K |
| 90837 |
Psychotherapy, 53 minutes with patient |
164 |
68 |
$8K |
| G9920 |
Screening performed and negative |
4,080 |
3,076 |
$5K |
| 99201 |
|
92 |
82 |
$3K |
| 90686 |
|
11,171 |
7,697 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
206 |
165 |
$3K |
| 81025 |
|
3,143 |
2,434 |
$3K |
| 99402 |
|
90 |
82 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18,604 |
12,587 |
$2K |
| 0071A |
|
51 |
51 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
545 |
348 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
612 |
432 |
$2K |
| 99401 |
|
354 |
248 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,818 |
1,040 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
37 |
37 |
$1K |
| 59425 |
|
39 |
30 |
$1K |
| 0054A |
|
41 |
39 |
$1K |
| 0001A |
|
34 |
32 |
$1K |
| 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 |
41 |
41 |
$1K |
| 90651 |
|
904 |
621 |
$985.12 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,714 |
1,659 |
$946.20 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,227 |
1,409 |
$893.97 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
794 |
675 |
$853.73 |
| 0004A |
|
25 |
24 |
$840.00 |
| A4267 |
Contraceptive supply, condom, male, each |
141 |
129 |
$795.34 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
227 |
177 |
$640.10 |
| 0072A |
|
16 |
16 |
$600.00 |
| 0002A |
|
17 |
16 |
$600.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
630 |
621 |
$583.27 |
| 92551 |
|
3,028 |
2,302 |
$564.92 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
366 |
325 |
$510.53 |
| 90715 |
|
406 |
299 |
$446.02 |
| 90739 |
|
14 |
14 |
$420.09 |
| 86703 |
|
120 |
111 |
$403.75 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,830 |
4,160 |
$402.39 |
| 81002 |
|
629 |
505 |
$364.94 |
| 90677 |
|
101 |
79 |
$293.12 |
| 90633 |
|
457 |
319 |
$292.00 |
| 99385 |
|
17 |
12 |
$290.97 |
| 90656 |
|
1,501 |
974 |
$238.76 |
| 85018 |
|
4,389 |
2,900 |
$226.57 |
| 90480 |
|
110 |
105 |
$215.00 |
| 97802 |
|
15 |
12 |
$204.86 |
| 0154A |
|
12 |
12 |
$201.00 |
| 99188 |
|
803 |
489 |
$178.20 |
| 90698 |
|
186 |
137 |
$148.46 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
148 |
104 |
$146.27 |
| 90619 |
|
190 |
113 |
$145.09 |
| 90716 |
|
111 |
89 |
$113.06 |
| 99000 |
|
241 |
235 |
$94.05 |
| 90734 |
|
222 |
148 |
$93.00 |
| 0124A |
|
14 |
12 |
$67.00 |
| 90744 |
|
199 |
157 |
$54.00 |
| 92015 |
Determination of refractive state |
913 |
779 |
$48.06 |
| V2020 |
Frames, purchases |
310 |
264 |
$42.62 |
| 99173 |
|
2,736 |
2,162 |
$37.69 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
299 |
253 |
$33.39 |
| 90670 |
|
400 |
292 |
$27.00 |
| 90620 |
|
127 |
82 |
$18.00 |
| 90713 |
|
33 |
31 |
$18.00 |
| S5199 |
Personal care item, nos, each |
13 |
13 |
$14.99 |
| 97803 |
|
41 |
26 |
$14.30 |
| H0049 |
Alcohol and/or drug screening |
367 |
332 |
$0.00 |
| 90688 |
|
138 |
138 |
$0.00 |
| Z6410 |
|
63 |
55 |
$0.00 |
| 91307 |
|
13 |
12 |
$0.00 |
| Z6404 |
|
77 |
77 |
$0.00 |
| Z6402 |
|
114 |
114 |
$0.00 |
| Z1034 |
|
217 |
174 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
93 |
87 |
$0.00 |
| 90697 |
|
14 |
12 |
$0.00 |
| Z6406 |
|
22 |
16 |
$0.00 |
| 90696 |
|
24 |
13 |
$0.00 |
| 99460 |
|
17 |
17 |
$0.00 |
| Z6400 |
|
116 |
116 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
518 |
509 |
$0.00 |
| 92552 |
|
90 |
53 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
42 |
31 |
$0.00 |
| 83655 |
|
22 |
12 |
$0.00 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
17 |
17 |
$0.00 |
| 90710 |
|
24 |
13 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
145 |
75 |
$0.00 |
| 91321 |
|
20 |
17 |
$0.00 |
| 90671 |
|
108 |
71 |
$0.00 |
| 90672 |
|
14 |
13 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
50 |
26 |
$0.00 |
| 90658 |
|
12 |
12 |
$0.00 |