| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
59,877 |
49,939 |
$9.41M |
| 00003 |
Internal/system code - not a standard HCPCS code |
13,601 |
9,892 |
$2.50M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,246 |
2,171 |
$593K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
50,265 |
37,764 |
$482K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,668 |
6,700 |
$277K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
221 |
221 |
$38K |
| J3490 |
Unclassified drugs |
312 |
288 |
$29K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
2,655 |
2,487 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,300 |
6,131 |
$21K |
| 99000 |
|
17,065 |
14,462 |
$15K |
| 3008F |
|
60,941 |
43,278 |
$11K |
| 90686 |
|
6,361 |
5,280 |
$9K |
| 96156 |
|
8,265 |
7,218 |
$8K |
| 98960 |
|
12,302 |
8,936 |
$8K |
| 90674 |
|
244 |
244 |
$5K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
7,097 |
4,817 |
$4K |
| 94760 |
|
37,430 |
27,187 |
$4K |
| 92551 |
|
6,938 |
5,819 |
$4K |
| 90688 |
|
317 |
279 |
$3K |
| 81025 |
|
1,837 |
1,712 |
$3K |
| 97803 |
|
4,941 |
3,443 |
$2K |
| 59425 |
|
73 |
40 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
117 |
92 |
$2K |
| 85018 |
|
8,580 |
6,856 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
810 |
591 |
$1K |
| 97802 |
|
4,428 |
3,306 |
$1K |
| 90715 |
|
241 |
196 |
$1K |
| 99173 |
|
11,147 |
9,422 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,307 |
988 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
189 |
99 |
$951.13 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,038 |
2,522 |
$899.32 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
468 |
385 |
$861.61 |
| 99383 |
|
265 |
198 |
$786.23 |
| 81002 |
|
5,395 |
3,783 |
$677.94 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,394 |
1,231 |
$658.96 |
| 36425 |
|
185 |
109 |
$656.08 |
| 90633 |
|
1,035 |
822 |
$637.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,765 |
4,044 |
$599.26 |
| 87428 |
|
199 |
124 |
$556.92 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
1,944 |
1,344 |
$441.80 |
| 86580 |
|
542 |
431 |
$439.77 |
| 59430 |
|
142 |
128 |
$434.99 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
682 |
569 |
$413.83 |
| 90670 |
|
784 |
663 |
$405.00 |
| 99384 |
|
170 |
137 |
$403.60 |
| 90677 |
|
187 |
123 |
$378.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
1,816 |
1,290 |
$312.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
359 |
327 |
$302.76 |
| 90461 |
|
2,001 |
1,698 |
$289.02 |
| 1000F |
|
5,673 |
4,857 |
$286.49 |
| 90651 |
|
620 |
434 |
$230.59 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,721 |
1,076 |
$225.22 |
| 90734 |
|
182 |
132 |
$216.81 |
| 82962 |
|
3,108 |
2,043 |
$208.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,558 |
1,227 |
$179.70 |
| 90658 |
|
168 |
166 |
$147.17 |
| 99385 |
|
23 |
14 |
$144.10 |
| S9470 |
Nutritional counseling, dietitian visit |
792 |
589 |
$133.92 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
9,337 |
6,917 |
$118.00 |
| 99215 |
Prolong outpt/office vis |
172 |
134 |
$114.40 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
138 |
105 |
$109.90 |
| 3079F |
|
2,254 |
1,697 |
$95.32 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
2,467 |
1,697 |
$94.41 |
| 99382 |
|
116 |
91 |
$93.32 |
| 90744 |
|
363 |
268 |
$81.00 |
| G8482 |
Influenza immunization administered or previously received |
7,411 |
5,155 |
$77.09 |
| 99401 |
|
996 |
755 |
$76.36 |
| 36415 |
Collection of venous blood by venipuncture |
3,703 |
3,125 |
$68.79 |
| S9451 |
Exercise classes, non-physician provider, per session |
2,430 |
2,088 |
$65.21 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
3,649 |
2,670 |
$65.21 |
| 2014F |
|
1,893 |
1,785 |
$65.21 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
153 |
94 |
$55.92 |
| 90698 |
|
258 |
193 |
$54.00 |
| 90619 |
|
39 |
27 |
$54.00 |
| G0406 |
Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth |
983 |
636 |
$50.34 |
| 99381 |
|
20 |
14 |
$45.33 |
| 96127 |
|
794 |
686 |
$43.29 |
| 90697 |
|
393 |
319 |
$42.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
5,455 |
3,596 |
$37.50 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
350 |
250 |
$37.25 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
133 |
93 |
$37.08 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
873 |
694 |
$28.00 |
| 90671 |
|
108 |
80 |
$27.00 |
| 96161 |
|
884 |
701 |
$22.50 |
| 90713 |
|
38 |
31 |
$18.00 |
| 90620 |
|
36 |
27 |
$15.00 |
| 90710 |
|
90 |
70 |
$9.00 |
| H0049 |
Alcohol and/or drug screening |
2,015 |
1,571 |
$7.50 |
| 1036F |
|
6,505 |
4,922 |
$5.09 |
| 82947 |
|
131 |
95 |
$3.30 |
| 3044F |
|
1,034 |
653 |
$0.00 |
| Z1034 |
|
1,385 |
936 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
63 |
46 |
$0.00 |
| 3074F |
|
10,914 |
8,009 |
$0.00 |
| 1031F |
|
2,216 |
1,817 |
$0.00 |
| 1126F |
|
86 |
82 |
$0.00 |
| 3075F |
|
1,128 |
820 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,257 |
1,496 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
527 |
516 |
$0.00 |
| 90716 |
|
82 |
67 |
$0.00 |
| Z6410 |
|
437 |
348 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,575 |
354 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
841 |
783 |
$0.00 |
| D0603 |
|
1,302 |
1,299 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
776 |
710 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
1,240 |
791 |
$0.00 |
| Z6406 |
|
16 |
16 |
$0.00 |
| Z1032 |
|
63 |
51 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
584 |
581 |
$0.00 |
| 86803 |
|
474 |
299 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,354 |
922 |
$0.00 |
| G2062 |
Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes |
98 |
67 |
$0.00 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
514 |
320 |
$0.00 |
| 86592 |
|
111 |
74 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
15 |
13 |
$0.00 |
| 3080F |
|
192 |
123 |
$0.00 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
22 |
13 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
193 |
138 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
150 |
107 |
$0.00 |
| 99406 |
|
125 |
81 |
$0.00 |
| 4000F |
|
23 |
12 |
$0.00 |
| Z6402 |
|
24 |
24 |
$0.00 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
43 |
27 |
$0.00 |
| 3017F |
|
37 |
24 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
60 |
60 |
$0.00 |
| 99441 |
|
119 |
87 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37 |
29 |
$0.00 |
| Z6204 |
|
30 |
28 |
$0.00 |
| 98967 |
|
21 |
17 |
$0.00 |
| D0601 |
|
12 |
12 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
16 |
12 |
$0.00 |
| G9906 |
Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
17 |
12 |
$0.00 |
| 1125F |
|
29 |
27 |
$0.00 |
| 90696 |
|
14 |
12 |
$0.00 |
| G9717 |
Documentation stating the patient has had a diagnosis of bipolar disorder |
23 |
13 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
21 |
14 |
$0.00 |
| 3078F |
|
10,457 |
7,699 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
5,564 |
3,783 |
$0.00 |
| Z6400 |
|
485 |
474 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
392 |
360 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
49 |
29 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
6,043 |
4,077 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
605 |
395 |
$0.00 |
| G9920 |
Screening performed and negative |
909 |
646 |
$0.00 |
| D1120 |
Prophylaxis - child |
696 |
635 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
2,428 |
1,885 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
418 |
284 |
$0.00 |
| 80061 |
Lipid panel |
1,400 |
926 |
$0.00 |
| 82274 |
|
137 |
91 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
262 |
183 |
$0.00 |
| 3725F |
|
92 |
85 |
$0.00 |
| 90756 |
|
641 |
451 |
$0.00 |
| Z6500 |
|
89 |
89 |
$0.00 |
| 96160 |
|
911 |
689 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
949 |
525 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
1,615 |
1,100 |
$0.00 |
| 1159F |
|
2,675 |
1,589 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
675 |
454 |
$0.00 |
| 3051F |
|
73 |
42 |
$0.00 |
| D9430 |
|
187 |
177 |
$0.00 |
| 90685 |
|
59 |
37 |
$0.00 |
| 0521F |
|
30 |
28 |
$0.00 |
| D4341 |
|
106 |
64 |
$0.00 |
| 3077F |
|
644 |
445 |
$0.00 |
| Z6200 |
|
24 |
24 |
$0.00 |
| 1160F |
|
2,700 |
1,610 |
$0.00 |
| G0407 |
Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth |
317 |
192 |
$0.00 |
| G2089 |
Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0% |
20 |
12 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
234 |
167 |
$0.00 |
| 92552 |
|
32 |
24 |
$0.00 |
| 3015F |
|
373 |
290 |
$0.00 |
| D2140 |
|
48 |
31 |
$0.00 |
| 3046F |
|
90 |
52 |
$0.00 |
| Z6304 |
|
29 |
29 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
65 |
65 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
55 |
41 |
$0.00 |
| 2028F |
|
15 |
12 |
$0.00 |
| 90681 |
|
65 |
52 |
$0.00 |
| 99442 |
|
60 |
43 |
$0.00 |
| 90707 |
|
32 |
24 |
$0.00 |
| 90682 |
|
17 |
13 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
16 |
12 |
$0.00 |
| G0445 |
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes |
16 |
16 |
$0.00 |
| D4910 |
|
28 |
26 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
157 |
94 |
$0.00 |
| Z6300 |
|
24 |
24 |
$0.00 |