| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
153,253 |
115,484 |
$27.28M |
| 00003 |
Internal/system code - not a standard HCPCS code |
23,649 |
21,307 |
$5.13M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
87,559 |
57,021 |
$310K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,158 |
40,038 |
$251K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
24,543 |
20,591 |
$239K |
| G9920 |
Screening performed and negative |
7,881 |
6,135 |
$90K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,880 |
14,512 |
$80K |
| 59425 |
|
1,881 |
1,386 |
$78K |
| 98940 |
|
3,310 |
2,138 |
$67K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,262 |
5,756 |
$57K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
724 |
404 |
$42K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,378 |
1,236 |
$39K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,464 |
3,258 |
$38K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,301 |
2,285 |
$32K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,714 |
1,257 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,828 |
4,057 |
$26K |
| 99000 |
|
41,914 |
31,424 |
$26K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
5,491 |
3,931 |
$25K |
| 0011A |
|
449 |
409 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,826 |
2,243 |
$23K |
| 92551 |
|
16,253 |
11,834 |
$23K |
| 0012A |
|
356 |
347 |
$21K |
| 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 |
716 |
560 |
$19K |
| 0001A |
|
182 |
178 |
$11K |
| 0002A |
|
171 |
169 |
$11K |
| 0003A |
|
174 |
174 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,050 |
1,373 |
$11K |
| 0072A |
|
188 |
181 |
$10K |
| 0071A |
|
190 |
177 |
$10K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,799 |
1,652 |
$10K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
13 |
12 |
$9K |
| 0013A |
|
129 |
129 |
$9K |
| 99201 |
|
471 |
322 |
$8K |
| 90670 |
|
4,171 |
3,433 |
$7K |
| J3490 |
Unclassified drugs |
129 |
129 |
$7K |
| 59430 |
|
638 |
568 |
$7K |
| 90633 |
|
3,438 |
2,674 |
$7K |
| 99215 |
Prolong outpt/office vis |
363 |
246 |
$6K |
| H2000 |
Comprehensive multidisciplinary evaluation |
371 |
329 |
$6K |
| 81002 |
|
22,595 |
13,368 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,389 |
929 |
$6K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,772 |
1,532 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,417 |
1,020 |
$6K |
| 99402 |
|
175 |
174 |
$6K |
| 90686 |
|
2,200 |
1,647 |
$5K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,271 |
1,173 |
$5K |
| 81025 |
|
5,753 |
4,884 |
$5K |
| A4267 |
Contraceptive supply, condom, male, each |
452 |
449 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,298 |
1,055 |
$5K |
| 92552 |
|
773 |
753 |
$4K |
| 98942 |
|
469 |
291 |
$4K |
| 90700 |
|
1,642 |
1,312 |
$3K |
| 90716 |
|
2,345 |
1,785 |
$3K |
| 99173 |
|
15,248 |
10,994 |
$3K |
| 76801 |
|
110 |
97 |
$3K |
| 90680 |
|
2,377 |
1,933 |
$3K |
| 90648 |
|
1,229 |
898 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,897 |
1,358 |
$2K |
| 90707 |
|
1,911 |
1,429 |
$2K |
| 3008F |
|
7,331 |
6,551 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
391 |
268 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
313 |
306 |
$2K |
| 90698 |
|
1,944 |
1,524 |
$2K |
| 99385 |
|
370 |
245 |
$2K |
| 93000 |
|
329 |
231 |
$2K |
| 90651 |
|
1,700 |
1,200 |
$2K |
| 99384 |
|
345 |
246 |
$2K |
| 90744 |
|
1,722 |
1,389 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
487 |
261 |
$2K |
| Z1034 |
|
8,838 |
6,105 |
$2K |
| 90713 |
|
835 |
702 |
$2K |
| 90734 |
|
1,619 |
1,134 |
$2K |
| 99383 |
|
382 |
285 |
$1K |
| 99386 |
|
137 |
102 |
$1K |
| 85018 |
|
4,156 |
3,292 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
746 |
654 |
$1K |
| 90647 |
|
957 |
864 |
$1K |
| 90710 |
|
382 |
282 |
$1K |
| 90715 |
|
763 |
532 |
$1K |
| 90723 |
|
770 |
629 |
$922.32 |
| 99381 |
|
550 |
506 |
$918.09 |
| 3078F |
|
8,691 |
7,826 |
$912.29 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
589 |
358 |
$801.76 |
| 96156 |
|
750 |
732 |
$741.68 |
| 90696 |
|
574 |
412 |
$600.75 |
| 81000 |
|
1,603 |
1,196 |
$523.07 |
| 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 |
19 |
19 |
$470.44 |
| 90656 |
|
177 |
129 |
$450.00 |
| 97803 |
|
477 |
458 |
$437.13 |
| 99401 |
|
418 |
415 |
$435.24 |
| 86580 |
|
307 |
209 |
$390.69 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
460 |
324 |
$361.94 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
138 |
114 |
$280.87 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
60 |
60 |
$268.94 |
| 90837 |
Psychotherapy, 53 minutes with patient |
25 |
15 |
$245.05 |
| 92015 |
Determination of refractive state |
376 |
365 |
$240.22 |
| 90658 |
|
65 |
39 |
$236.57 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
569 |
382 |
$193.99 |
| 90688 |
|
695 |
556 |
$176.63 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
399 |
254 |
$172.65 |
| 90649 |
|
113 |
89 |
$170.91 |
| S9452 |
Nutrition classes, non-physician provider, per session |
138 |
131 |
$134.56 |
| 97802 |
|
50 |
50 |
$120.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
127 |
68 |
$111.84 |
| 82962 |
|
623 |
416 |
$101.51 |
| 36415 |
Collection of venous blood by venipuncture |
1,898 |
1,322 |
$96.00 |
| 3075F |
|
1,842 |
1,744 |
$80.00 |
| 3074F |
|
8,815 |
7,934 |
$76.30 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
13 |
13 |
$60.00 |
| 90697 |
|
25 |
25 |
$54.00 |
| 3079F |
|
2,854 |
2,679 |
$52.06 |
| 94760 |
|
81 |
47 |
$50.31 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
539 |
394 |
$48.10 |
| 99382 |
|
97 |
79 |
$47.13 |
| G9919 |
Screening performed and positive and provision of recommendations |
51 |
37 |
$40.47 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16 |
14 |
$35.19 |
| 92002 |
|
72 |
54 |
$32.47 |
| 36416 |
|
1,434 |
1,018 |
$30.78 |
| 97124 |
|
499 |
350 |
$30.77 |
| 90685 |
|
35 |
26 |
$27.00 |
| 4004F |
|
729 |
696 |
$23.76 |
| 3077F |
|
1,192 |
1,121 |
$20.17 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
468 |
318 |
$17.84 |
| 1160F |
|
2,456 |
2,215 |
$10.20 |
| 85014 |
|
36 |
35 |
$8.58 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
13 |
12 |
$0.48 |
| 97010 |
|
202 |
155 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
426 |
425 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
182 |
182 |
$0.00 |
| 3017F |
|
58 |
43 |
$0.00 |
| 3080F |
|
204 |
198 |
$0.00 |
| D0001 |
|
932 |
931 |
$0.00 |
| D0601 |
|
2,179 |
2,176 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
435 |
294 |
$0.00 |
| Z1038 |
|
236 |
216 |
$0.00 |
| Z1032 |
|
1,035 |
1,032 |
$0.00 |
| D0602 |
|
1,614 |
1,613 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,051 |
1,046 |
$0.00 |
| D0603 |
|
2,542 |
2,527 |
$0.00 |
| Z6406 |
|
242 |
220 |
$0.00 |
| 98943 |
|
161 |
117 |
$0.00 |
| Z6410 |
|
853 |
667 |
$0.00 |
| 3014F |
|
174 |
156 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
419 |
414 |
$0.00 |
| OBL13 |
|
13 |
12 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
802 |
570 |
$0.00 |
| Z6204 |
|
294 |
270 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
208 |
195 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
127 |
81 |
$0.00 |
| 3044F |
|
44 |
43 |
$0.00 |
| 88142 |
|
69 |
64 |
$0.00 |
| Z6402 |
|
71 |
71 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
93 |
81 |
$0.00 |
| OBL28 |
|
24 |
16 |
$0.00 |
| 0503F |
|
12 |
12 |
$0.00 |
| 1159F |
|
835 |
748 |
$0.00 |
| D9430 |
|
6,200 |
6,179 |
$0.00 |
| Z6400 |
|
1,722 |
1,564 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
337 |
336 |
$0.00 |
| D1120 |
Prophylaxis - child |
406 |
406 |
$0.00 |
| Z6500 |
|
428 |
424 |
$0.00 |
| Z6304 |
|
255 |
234 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
135 |
88 |
$0.00 |
| 3725F |
|
329 |
312 |
$0.00 |
| D1110 |
Prophylaxis - adult |
167 |
167 |
$0.00 |
| 92081 |
|
13 |
13 |
$0.00 |
| Z6300 |
|
71 |
71 |
$0.00 |
| 3015F |
|
158 |
125 |
$0.00 |
| S0197 |
Prenatal vitamins, 30-day supply |
49 |
49 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
55 |
41 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
36 |
36 |
$0.00 |
| Z6414 |
|
67 |
53 |
$0.00 |
| 90461 |
|
254 |
191 |
$0.00 |
| Z6200 |
|
71 |
71 |
$0.00 |
| 0502F |
|
451 |
356 |
$0.00 |
| 4124F |
|
28 |
26 |
$0.00 |
| D9110 |
|
20 |
19 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
12 |
12 |
$0.00 |
| Z6208 |
|
12 |
12 |
$0.00 |
| 99397 |
|
17 |
13 |
$0.00 |
| Z6308 |
|
12 |
12 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
17 |
13 |
$0.00 |
| 83655 |
|
14 |
14 |
$0.00 |
| 90621 |
|
12 |
12 |
$0.00 |