| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
238,124 |
209,421 |
$48.83M |
| 00003 |
Internal/system code - not a standard HCPCS code |
28,780 |
26,012 |
$7.00M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
152,530 |
120,798 |
$437K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12,781 |
8,723 |
$324K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,536 |
15,888 |
$231K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,063 |
7,100 |
$186K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
8,622 |
6,570 |
$133K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15,618 |
14,237 |
$127K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,414 |
2,399 |
$124K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
6,190 |
4,548 |
$116K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,062 |
6,315 |
$111K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
4,327 |
2,869 |
$83K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,629 |
2,652 |
$73K |
| 92551 |
|
18,823 |
14,542 |
$55K |
| 92015 |
Determination of refractive state |
17,606 |
12,013 |
$48K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,990 |
3,268 |
$47K |
| 90791 |
Psychiatric diagnostic evaluation |
1,188 |
828 |
$42K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
22,803 |
15,348 |
$40K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,686 |
5,141 |
$24K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
383 |
354 |
$22K |
| G9012 |
Other specified case management service not elsewhere classified |
424 |
293 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,052 |
2,472 |
$20K |
| 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 |
3,936 |
3,589 |
$19K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
5,439 |
4,888 |
$16K |
| D1206 |
Topical application of fluoride varnish |
1,785 |
1,189 |
$14K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
914 |
519 |
$14K |
| 90686 |
|
7,015 |
6,190 |
$13K |
| 90837 |
Psychotherapy, 53 minutes with patient |
412 |
206 |
$12K |
| 83655 |
|
2,461 |
1,861 |
$10K |
| 90670 |
|
2,977 |
2,478 |
$8K |
| 0012A |
|
340 |
256 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
691 |
578 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
786 |
599 |
$8K |
| 59425 |
|
797 |
589 |
$7K |
| 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 |
285 |
282 |
$7K |
| 99173 |
|
30,631 |
25,405 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
819 |
567 |
$7K |
| 0001A |
|
183 |
100 |
$7K |
| 81002 |
|
10,703 |
6,889 |
$6K |
| 85018 |
|
8,352 |
6,661 |
$5K |
| 0002A |
|
116 |
69 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
2,419 |
1,524 |
$4K |
| D1120 |
Prophylaxis - child |
207 |
142 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
638 |
595 |
$4K |
| H1000 |
Prenatal care, at-risk assessment |
92 |
91 |
$3K |
| 90633 |
|
1,350 |
1,072 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
318 |
293 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
437 |
297 |
$3K |
| 90677 |
|
640 |
538 |
$3K |
| 96156 |
|
593 |
592 |
$3K |
| D1310 |
|
1,058 |
726 |
$3K |
| 90656 |
|
971 |
938 |
$3K |
| 0011A |
|
186 |
145 |
$2K |
| 90680 |
|
1,323 |
1,108 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
657 |
407 |
$2K |
| D1110 |
Prophylaxis - adult |
382 |
252 |
$2K |
| 90697 |
|
1,160 |
934 |
$2K |
| 81025 |
|
3,477 |
3,254 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,846 |
4,071 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,731 |
5,398 |
$2K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
108 |
106 |
$2K |
| 90651 |
|
950 |
735 |
$2K |
| 90647 |
|
719 |
621 |
$1K |
| 90723 |
|
907 |
753 |
$1K |
| 90648 |
|
379 |
307 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
951 |
870 |
$1K |
| 90734 |
|
772 |
597 |
$1K |
| 82962 |
|
13,865 |
11,425 |
$1K |
| D9430 |
|
451 |
290 |
$1K |
| 90710 |
|
575 |
444 |
$984.83 |
| 90685 |
|
535 |
422 |
$972.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
302 |
282 |
$937.50 |
| 3074F |
|
48,300 |
40,671 |
$925.12 |
| 3008F |
|
94,203 |
75,997 |
$863.76 |
| 90750 |
|
56 |
44 |
$832.35 |
| 99215 |
Prolong outpt/office vis |
46 |
28 |
$787.52 |
| 88150 |
|
1,337 |
1,330 |
$776.59 |
| 90715 |
|
909 |
754 |
$766.43 |
| 90672 |
|
543 |
415 |
$742.52 |
| D0603 |
|
398 |
377 |
$686.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
120 |
120 |
$672.99 |
| 92552 |
|
56 |
56 |
$530.91 |
| 90649 |
|
133 |
89 |
$513.00 |
| 0003A |
|
38 |
30 |
$508.00 |
| 99406 |
|
3,663 |
3,048 |
$466.87 |
| 99383 |
|
85 |
72 |
$441.09 |
| 91300 |
|
44 |
39 |
$360.00 |
| 99381 |
|
105 |
95 |
$350.91 |
| 11750 |
|
50 |
27 |
$336.56 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
28 |
27 |
$325.98 |
| 97803 |
|
89 |
89 |
$317.99 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
21 |
12 |
$317.00 |
| D4910 |
|
17 |
12 |
$260.00 |
| 99401 |
|
374 |
374 |
$250.69 |
| 90655 |
|
38 |
38 |
$215.55 |
| 94760 |
|
2,772 |
2,332 |
$209.69 |
| D0274 |
Bitewings - four radiographic images |
73 |
41 |
$187.20 |
| 3075F |
|
8,292 |
7,005 |
$160.39 |
| 3078F |
|
48,324 |
40,499 |
$157.72 |
| D0272 |
Bitewings - two radiographic images |
19 |
14 |
$150.00 |
| 90700 |
|
69 |
58 |
$144.00 |
| 3079F |
|
13,309 |
11,575 |
$140.10 |
| D0270 |
|
140 |
92 |
$117.50 |
| 90716 |
|
51 |
44 |
$117.00 |
| 93000 |
|
133 |
132 |
$108.41 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
278 |
222 |
$90.73 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
289 |
288 |
$77.40 |
| 92081 |
|
97 |
97 |
$65.29 |
| 99384 |
|
14 |
13 |
$65.12 |
| 86580 |
|
55 |
50 |
$60.77 |
| 3077F |
|
7,075 |
5,799 |
$51.31 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
8,311 |
5,745 |
$45.03 |
| 90863 |
|
289 |
288 |
$22.89 |
| 90707 |
|
16 |
13 |
$9.00 |
| 99000 |
|
439 |
435 |
$7.26 |
| 99001 |
|
1,350 |
1,328 |
$7.00 |
| 3046F |
|
309 |
276 |
$0.13 |
| 3080F |
|
1,801 |
1,515 |
$0.04 |
| 3044F |
|
303 |
248 |
$0.03 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
8,025 |
5,541 |
$0.03 |
| D0191 |
|
548 |
363 |
$0.00 |
| Z6304 |
|
1,022 |
971 |
$0.00 |
| 0502F |
|
3,381 |
1,663 |
$0.00 |
| Z6208 |
|
116 |
110 |
$0.00 |
| Z6400 |
|
749 |
730 |
$0.00 |
| 90662 |
|
90 |
72 |
$0.00 |
| Z6308 |
|
116 |
110 |
$0.00 |
| D9993 |
|
648 |
440 |
$0.00 |
| 3051F |
|
96 |
83 |
$0.00 |
| Z6500 |
|
538 |
530 |
$0.00 |
| Z6414 |
|
128 |
122 |
$0.00 |
| 90621 |
|
17 |
12 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
44 |
42 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
14 |
14 |
$0.00 |
| Z1034 |
|
7,970 |
5,724 |
$0.00 |
| D1330 |
|
3,151 |
2,224 |
$0.00 |
| Z6410 |
|
973 |
937 |
$0.00 |
| Z1032 |
|
534 |
527 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
112 |
111 |
$0.00 |
| Z6204 |
|
1,035 |
984 |
$0.00 |
| 97802 |
|
245 |
245 |
$0.00 |
| 0500F |
|
137 |
83 |
$0.00 |
| Z6406 |
|
1,025 |
972 |
$0.00 |
| 91301 |
|
359 |
338 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
127 |
119 |
$0.00 |
| D9995 |
|
195 |
191 |
$0.00 |
| 90480 |
|
34 |
30 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
941 |
833 |
$0.00 |
| 99172 |
|
101 |
101 |
$0.00 |
| 0503F |
|
13 |
13 |
$0.00 |
| 85032 |
|
26 |
26 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
112 |
108 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
18 |
17 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
15 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
15 |
$0.00 |
| D0602 |
|
26 |
20 |
$0.00 |
| 96380 |
|
18 |
16 |
$0.00 |
| Z1038 |
|
32 |
32 |
$0.00 |
| D1320 |
|
40 |
29 |
$0.00 |
| D9992 |
|
46 |
30 |
$0.00 |
| 3052F |
|
14 |
12 |
$0.00 |