| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
22,188 |
12,827 |
$2.36M |
| 99199 |
Unlisted special service, procedure or report |
114,777 |
58,679 |
$661K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
875 |
699 |
$63K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
725 |
422 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
381 |
311 |
$29K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,823 |
1,998 |
$27K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,309 |
978 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
290 |
185 |
$14K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
570 |
317 |
$11K |
| 99383 |
|
143 |
92 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
995 |
816 |
$9K |
| 0012A |
|
141 |
138 |
$8K |
| G9919 |
Screening performed and positive and provision of recommendations |
417 |
236 |
$8K |
| 0011A |
|
140 |
137 |
$6K |
| 99401 |
|
287 |
179 |
$5K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
47 |
36 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
83 |
46 |
$4K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
92 |
80 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
32 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
74 |
66 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,304 |
1,029 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
106 |
83 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
309 |
208 |
$2K |
| 90474 |
|
122 |
97 |
$2K |
| 90674 |
|
219 |
179 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
13 |
$1K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
15 |
12 |
$1K |
| 96161 |
|
450 |
365 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$1K |
| 81025 |
|
227 |
163 |
$1K |
| 0001A |
|
17 |
17 |
$1K |
| 99382 |
|
17 |
12 |
$1K |
| 99381 |
|
18 |
12 |
$1K |
| 92551 |
|
416 |
314 |
$973.49 |
| 0002A |
|
14 |
14 |
$910.00 |
| 0071A |
|
16 |
12 |
$845.00 |
| 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 |
47 |
31 |
$840.40 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
185 |
114 |
$694.56 |
| 90686 |
|
341 |
233 |
$660.15 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
75 |
33 |
$472.73 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
79 |
33 |
$472.73 |
| 96127 |
|
985 |
698 |
$440.64 |
| 99173 |
|
513 |
379 |
$323.78 |
| 81002 |
|
122 |
85 |
$284.47 |
| 87210 |
|
24 |
12 |
$72.60 |
| 90744 |
|
286 |
197 |
$26.61 |
| 91301 |
|
303 |
295 |
$2.00 |
| J3490 |
Unclassified drugs |
251 |
146 |
$0.17 |
| 3074F |
|
2,721 |
1,704 |
$0.00 |
| 90698 |
|
419 |
368 |
$0.00 |
| 3079F |
|
295 |
192 |
$0.00 |
| 3008F |
|
164 |
102 |
$0.00 |
| 99441 |
|
45 |
12 |
$0.00 |
| 91307 |
|
16 |
12 |
$0.00 |
| 90716 |
|
33 |
12 |
$0.00 |
| 3078F |
|
2,362 |
1,501 |
$0.00 |
| 90670 |
|
654 |
548 |
$0.00 |
| 90633 |
|
224 |
155 |
$0.00 |
| 90681 |
|
120 |
95 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
70 |
47 |
$0.00 |
| 91300 |
|
84 |
66 |
$0.00 |
| 90473 |
|
32 |
12 |
$0.00 |
| 90672 |
|
32 |
12 |
$0.00 |