| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
255,067 |
221,012 |
$33.19M |
| 00003 |
Internal/system code - not a standard HCPCS code |
51,793 |
36,694 |
$8.53M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
294,284 |
226,082 |
$643K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
95,190 |
74,637 |
$316K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
4,367 |
2,125 |
$307K |
| D8670 |
Periodic orthodontic treatment visit |
840 |
840 |
$272K |
| G9012 |
Other specified case management service not elsewhere classified |
2,990 |
1,589 |
$227K |
| 99460 |
|
5,385 |
4,678 |
$171K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,495 |
1,491 |
$144K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17,051 |
13,776 |
$130K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13,971 |
10,780 |
$123K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56,780 |
43,783 |
$100K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
275 |
275 |
$100K |
| 99401 |
|
9,995 |
8,502 |
$82K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
10,207 |
8,887 |
$81K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
7,405 |
5,500 |
$68K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,044 |
1,702 |
$66K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,439 |
6,376 |
$58K |
| 59425 |
|
2,146 |
1,417 |
$55K |
| 99462 |
|
2,340 |
1,842 |
$49K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
3,160 |
2,462 |
$49K |
| A4267 |
Contraceptive supply, condom, male, each |
6,442 |
6,254 |
$46K |
| 90686 |
|
30,089 |
24,250 |
$34K |
| 0011A |
|
465 |
458 |
$30K |
| 90670 |
|
11,595 |
10,208 |
$29K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,747 |
1,534 |
$28K |
| 0012A |
|
420 |
417 |
$27K |
| 92551 |
|
29,351 |
22,695 |
$26K |
| 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 |
2,262 |
2,003 |
$22K |
| 0072A |
|
364 |
269 |
$20K |
| 0071A |
|
327 |
238 |
$18K |
| 0064A |
|
326 |
239 |
$17K |
| 0001A |
|
255 |
254 |
$16K |
| 90723 |
|
7,641 |
6,731 |
$16K |
| 0004A |
|
252 |
177 |
$14K |
| 0002A |
|
222 |
219 |
$14K |
| J3490 |
Unclassified drugs |
670 |
563 |
$12K |
| 90647 |
|
5,913 |
5,045 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
651 |
436 |
$11K |
| 90633 |
|
4,917 |
4,393 |
$10K |
| 90681 |
|
2,683 |
2,411 |
$9K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,653 |
3,147 |
$8K |
| H2000 |
Comprehensive multidisciplinary evaluation |
3,104 |
2,363 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,467 |
4,148 |
$6K |
| 59025 |
Fetal non-stress test |
669 |
449 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,005 |
3,252 |
$6K |
| A4268 |
Contraceptive supply, condom, female, each |
392 |
383 |
$5K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
23,756 |
19,198 |
$5K |
| 81002 |
|
14,343 |
11,229 |
$5K |
| 90716 |
|
1,417 |
1,347 |
$5K |
| 99221 |
|
185 |
175 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
693 |
483 |
$5K |
| 90651 |
|
3,639 |
3,223 |
$5K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
8,091 |
7,071 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,071 |
1,008 |
$5K |
| 90707 |
|
1,302 |
1,246 |
$4K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
702 |
616 |
$4K |
| 90648 |
|
2,316 |
2,292 |
$4K |
| 97803 |
|
5,139 |
4,819 |
$3K |
| 90700 |
|
1,096 |
1,026 |
$3K |
| 90734 |
|
1,881 |
1,745 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18,084 |
14,588 |
$3K |
| S5199 |
Personal care item, nos, each |
6,692 |
6,478 |
$3K |
| 92552 |
|
271 |
271 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
11,721 |
11,458 |
$3K |
| 82948 |
|
15,025 |
11,905 |
$3K |
| 0053A |
|
71 |
40 |
$3K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
9,299 |
6,969 |
$2K |
| 92081 |
|
2,233 |
2,231 |
$2K |
| 90715 |
|
1,717 |
1,623 |
$2K |
| 99000 |
|
1,404 |
1,345 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
358 |
252 |
$2K |
| 0111A |
|
47 |
38 |
$2K |
| 99201 |
|
1,435 |
992 |
$2K |
| 0054A |
|
44 |
39 |
$2K |
| 90710 |
|
1,121 |
1,058 |
$2K |
| 85018 |
|
5,520 |
5,314 |
$2K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
55 |
52 |
$2K |
| 90696 |
|
1,118 |
1,052 |
$2K |
| 0081A |
|
25 |
24 |
$2K |
| 81025 |
|
5,518 |
5,355 |
$2K |
| D0470 |
|
19 |
19 |
$1K |
| 99173 |
|
24,110 |
18,780 |
$1K |
| 92015 |
Determination of refractive state |
10,976 |
7,346 |
$1K |
| 99381 |
|
503 |
419 |
$1K |
| 0082A |
|
17 |
17 |
$1K |
| 96151 |
|
997 |
991 |
$1K |
| 0074A |
|
18 |
16 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
309 |
287 |
$1K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
1,258 |
1,234 |
$672.70 |
| 99215 |
Prolong outpt/office vis |
1,082 |
1,031 |
$642.72 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,186 |
1,351 |
$623.66 |
| D0140 |
Limited oral evaluation - problem focused |
17 |
17 |
$595.00 |
| 90620 |
|
1,074 |
952 |
$594.00 |
| S4993 |
Contraceptive pills for birth control |
86 |
82 |
$588.20 |
| 99222 |
Initial hospital care, per day, moderate complexity |
12 |
12 |
$584.87 |
| 90685 |
|
250 |
249 |
$438.00 |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$390.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
82 |
28 |
$357.70 |
| 90619 |
|
764 |
636 |
$324.00 |
| 90461 |
|
6,975 |
5,909 |
$250.48 |
| 90688 |
|
206 |
201 |
$234.99 |
| 90662 |
|
29 |
29 |
$220.00 |
| 90744 |
|
25 |
24 |
$198.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,018 |
694 |
$193.98 |
| 90621 |
|
134 |
132 |
$180.00 |
| 88720 |
|
1,591 |
1,268 |
$171.74 |
| D0120 |
Periodic oral evaluation - established patient |
337 |
322 |
$140.00 |
| 92227 |
|
562 |
498 |
$132.10 |
| H1000 |
Prenatal care, at-risk assessment |
211 |
205 |
$125.05 |
| 99490 |
Ccm add 20min |
22 |
21 |
$109.86 |
| 17110 |
|
13 |
13 |
$99.78 |
| 96127 |
|
6,420 |
5,459 |
$90.84 |
| 86580 |
|
390 |
388 |
$89.99 |
| 93000 |
|
98 |
98 |
$85.23 |
| 0503F |
|
381 |
372 |
$66.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
412 |
66 |
$63.90 |
| D0274 |
Bitewings - four radiographic images |
19 |
12 |
$61.20 |
| 0501F |
|
812 |
790 |
$60.00 |
| 86403 |
|
445 |
289 |
$55.32 |
| 99383 |
|
52 |
52 |
$54.28 |
| D0220 |
Intraoral - periapical first radiographic image |
67 |
38 |
$45.00 |
| 0500F |
|
469 |
462 |
$40.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
14 |
$33.96 |
| 85013 |
|
631 |
408 |
$30.15 |
| S9452 |
Nutrition classes, non-physician provider, per session |
266 |
266 |
$24.99 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
297 |
219 |
$22.59 |
| 90750 |
|
721 |
575 |
$20.00 |
| 96152 |
|
126 |
126 |
$16.34 |
| 90689 |
|
109 |
84 |
$15.00 |
| 90677 |
|
514 |
436 |
$9.00 |
| 82962 |
|
1,537 |
1,439 |
$7.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
800 |
538 |
$6.99 |
| 94760 |
|
26 |
25 |
$5.53 |
| 0502F |
|
17,192 |
13,946 |
$0.00 |
| 3078F |
|
6,571 |
6,221 |
$0.00 |
| D9430 |
|
22 |
12 |
$0.00 |
| 3725F |
|
4,985 |
4,376 |
$0.00 |
| 1160F |
|
5,867 |
5,227 |
$0.00 |
| 1159F |
|
8,504 |
7,216 |
$0.00 |
| 2022F |
|
94 |
68 |
$0.00 |
| 94060 |
|
54 |
28 |
$0.00 |
| Z0316 |
|
24 |
24 |
$0.00 |
| 90661 |
|
815 |
813 |
$0.00 |
| 87400 |
|
451 |
276 |
$0.00 |
| 96158 |
|
231 |
228 |
$0.00 |
| T1017 |
Targeted case management, each 15 minutes |
56 |
56 |
$0.00 |
| 3077F |
|
57 |
57 |
$0.00 |
| 90687 |
|
156 |
156 |
$0.00 |
| 90746 |
|
221 |
207 |
$0.00 |
| H0046 |
Mental health services, not otherwise specified |
336 |
118 |
$0.00 |
| 82274 |
|
37 |
37 |
$0.00 |
| 83655 |
|
39 |
39 |
$0.00 |
| 87210 |
|
28 |
28 |
$0.00 |
| 2026F |
|
25 |
21 |
$0.00 |
| G9920 |
Screening performed and negative |
65 |
65 |
$0.00 |
| 96159 |
|
27 |
27 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
522 |
520 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$0.00 |
| 96156 |
|
3,033 |
2,772 |
$0.00 |
| S9446 |
Patient education, not otherwise classified, non-physician provider, group, per session |
2,907 |
2,049 |
$0.00 |
| 3008F |
|
12,286 |
11,593 |
$0.00 |
| 3074F |
|
6,914 |
6,576 |
$0.00 |
| 1036F |
|
4,843 |
4,323 |
$0.00 |
| 90674 |
|
420 |
420 |
$0.00 |
| Z1034 |
|
149 |
118 |
$0.00 |
| 3075F |
|
66 |
61 |
$0.00 |
| 2023F |
|
1,191 |
881 |
$0.00 |
| 3079F |
|
386 |
383 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
127 |
116 |
$0.00 |
| 90656 |
|
606 |
606 |
$0.00 |
| 92250 |
|
597 |
482 |
$0.00 |
| D1330 |
|
12 |
12 |
$0.00 |
| 90739 |
|
210 |
192 |
$0.00 |
| 90694 |
|
45 |
39 |
$0.00 |
| 99384 |
|
57 |
37 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
30 |
25 |
$0.00 |
| 59430 |
|
551 |
522 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
58 |
39 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
143 |
138 |
$0.00 |
| 97802 |
|
576 |
553 |
$0.00 |
| Z6410 |
|
665 |
488 |
$0.00 |
| 90480 |
|
21 |
14 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
28 |
28 |
$0.00 |
| 99172 |
|
136 |
136 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$0.00 |
| 99403 |
|
29 |
29 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
75 |
74 |
$0.00 |
| 92567 |
|
36 |
26 |
$0.00 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
46 |
45 |
$0.00 |
| 96161 |
|
81 |
76 |
$0.00 |
| 99441 |
|
68 |
28 |
$0.00 |
| 85032 |
|
223 |
223 |
$0.00 |
| 90657 |
|
103 |
103 |
$0.00 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
70 |
56 |
$0.00 |
| 92002 |
|
18 |
12 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
13 |
$0.00 |