| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
88,751 |
75,276 |
$17.23M |
| 00003 |
Internal/system code - not a standard HCPCS code |
4,455 |
3,739 |
$1.85M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58,441 |
37,447 |
$119K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
52,885 |
31,855 |
$66K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,652 |
2,798 |
$57K |
| J3490 |
Unclassified drugs |
1,237 |
900 |
$26K |
| 0011A |
|
386 |
386 |
$26K |
| 0012A |
|
302 |
302 |
$20K |
| 90732 |
|
186 |
174 |
$16K |
| 90715 |
|
496 |
472 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,885 |
9,519 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,859 |
1,303 |
$10K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,030 |
2,661 |
$10K |
| A4267 |
Contraceptive supply, condom, male, each |
473 |
466 |
$5K |
| 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 |
170 |
165 |
$4K |
| 0013A |
|
55 |
55 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
1,003 |
793 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
367 |
288 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
730 |
499 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
540 |
453 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
44,343 |
39,177 |
$1K |
| 97802 |
|
13 |
12 |
$1K |
| 97804 |
|
33 |
33 |
$1K |
| 99000 |
|
6,085 |
5,909 |
$1K |
| 90688 |
|
123 |
123 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,055 |
619 |
$1K |
| 81025 |
|
594 |
584 |
$865.02 |
| G9919 |
Screening performed and positive and provision of recommendations |
2,084 |
2,076 |
$835.20 |
| 90651 |
|
54 |
54 |
$585.68 |
| 90686 |
|
198 |
197 |
$430.00 |
| 90656 |
|
85 |
84 |
$304.99 |
| 99215 |
Prolong outpt/office vis |
398 |
286 |
$286.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,604 |
3,555 |
$262.87 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
296 |
277 |
$204.54 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,642 |
3,609 |
$194.71 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
65 |
$175.40 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
770 |
738 |
$133.26 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
64 |
64 |
$119.20 |
| 90837 |
Psychotherapy, 53 minutes with patient |
675 |
303 |
$98.02 |
| G9920 |
Screening performed and negative |
102 |
102 |
$86.42 |
| 99234 |
|
3,254 |
2,745 |
$68.20 |
| 81003 |
|
987 |
947 |
$67.59 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
38 |
38 |
$62.07 |
| 85018 |
|
533 |
529 |
$58.95 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
378 |
366 |
$48.24 |
| 87428 |
|
27 |
25 |
$46.41 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
149 |
148 |
$40.97 |
| 90716 |
|
27 |
27 |
$30.00 |
| 90707 |
|
20 |
19 |
$29.00 |
| 82962 |
|
1,620 |
1,578 |
$23.86 |
| H0049 |
Alcohol and/or drug screening |
22,225 |
20,016 |
$17.14 |
| 99173 |
|
486 |
486 |
$11.97 |
| 84443 |
Thyroid stimulating hormone (TSH) |
530 |
519 |
$11.81 |
| 90696 |
|
12 |
12 |
$10.00 |
| 90734 |
|
31 |
31 |
$9.00 |
| 80053 |
Comprehensive metabolic panel |
1,327 |
1,261 |
$7.42 |
| 85027 |
|
494 |
481 |
$4.57 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
373 |
362 |
$4.46 |
| 96160 |
|
2,096 |
2,088 |
$2.56 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
305 |
197 |
$0.00 |
| 3077F |
|
2,920 |
2,760 |
$0.00 |
| 90750 |
|
109 |
109 |
$0.00 |
| 3051F |
|
68 |
68 |
$0.00 |
| 3078F |
|
11,405 |
10,751 |
$0.00 |
| 90713 |
|
42 |
41 |
$0.00 |
| 99442 |
|
132 |
128 |
$0.00 |
| 80061 |
Lipid panel |
884 |
879 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
152 |
146 |
$0.00 |
| A4306 |
Disposable drug delivery system, flow rate of less than 50 ml per hour |
37 |
37 |
$0.00 |
| 93975 |
|
13 |
13 |
$0.00 |
| 82948 |
|
13 |
13 |
$0.00 |
| 3046F |
|
172 |
172 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
42 |
25 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
38 |
$0.00 |
| 3045F |
|
93 |
93 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
176 |
164 |
$0.00 |
| 0510 |
|
496 |
413 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
51 |
51 |
$0.00 |
| 82947 |
|
76 |
37 |
$0.00 |
| 90633 |
|
25 |
25 |
$0.00 |
| 90710 |
|
32 |
32 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
15 |
13 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
62 |
36 |
$0.00 |
| 85610 |
|
12 |
12 |
$0.00 |
| 3079F |
|
7,796 |
7,481 |
$0.00 |
| 3044F |
|
322 |
322 |
$0.00 |
| 3075F |
|
4,124 |
4,021 |
$0.00 |
| 3080F |
|
1,467 |
1,397 |
$0.00 |
| G9012 |
Other specified case management service not elsewhere classified |
1,019 |
861 |
$0.00 |
| 3074F |
|
13,513 |
12,703 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
828 |
758 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
49 |
49 |
$0.00 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
2,619 |
2,114 |
$0.00 |
| 86803 |
|
628 |
627 |
$0.00 |
| 90677 |
|
248 |
247 |
$0.00 |
| 83690 |
|
50 |
47 |
$0.00 |
| 99443 |
|
192 |
147 |
$0.00 |
| 99441 |
|
132 |
121 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
32 |
32 |
$0.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
516 |
474 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
338 |
325 |
$0.00 |
| 97139 |
|
35 |
12 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
94 |
88 |
$0.00 |
| 99241 |
|
55 |
50 |
$0.00 |
| 3008F |
|
18 |
17 |
$0.00 |
| 3052F |
|
24 |
24 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
22 |
20 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
86 |
86 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
90 |
86 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
249 |
234 |
$0.00 |
| 1036F |
|
14 |
14 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
34 |
31 |
$0.00 |
| A4616 |
Tubing (oxygen), per foot |
28 |
28 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
31 |
31 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
62 |
62 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
51 |
49 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
53 |
48 |
$0.00 |
| 90723 |
|
26 |
26 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
13 |
12 |
$0.00 |
| 82044 |
|
12 |
12 |
$0.00 |
| 86592 |
|
26 |
26 |
$0.00 |
| 85651 |
|
15 |
12 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
15 |
13 |
$0.00 |