| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
148,750 |
123,076 |
$20.06M |
| 00003 |
Internal/system code - not a standard HCPCS code |
2,009 |
1,865 |
$361K |
| 90834 |
Psychotherapy, 45 minutes with patient |
15,157 |
5,799 |
$248K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
204,694 |
158,032 |
$197K |
| 90832 |
Psychotherapy, 30 minutes with patient |
21,475 |
6,978 |
$193K |
| 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 |
5,206 |
4,356 |
$192K |
| G9012 |
Other specified case management service not elsewhere classified |
2,703 |
1,779 |
$162K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
97,306 |
76,143 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37,917 |
30,919 |
$46K |
| 90791 |
Psychiatric diagnostic evaluation |
1,939 |
1,447 |
$39K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,063 |
5,837 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,655 |
4,510 |
$16K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
2,826 |
2,426 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,298 |
2,165 |
$12K |
| 0072A |
|
226 |
129 |
$12K |
| 0001A |
|
298 |
280 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,983 |
2,869 |
$11K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,348 |
2,062 |
$10K |
| 0064A |
|
180 |
103 |
$9K |
| 0002A |
|
206 |
188 |
$9K |
| 0519 |
|
66 |
58 |
$8K |
| 0012A |
|
717 |
696 |
$8K |
| 90686 |
|
11,530 |
11,279 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
486 |
466 |
$7K |
| 0071A |
|
126 |
72 |
$6K |
| 0011A |
|
633 |
622 |
$6K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$5K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
554 |
452 |
$5K |
| 0054A |
|
95 |
58 |
$5K |
| 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 |
45 |
43 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,372 |
2,324 |
$4K |
| 92551 |
|
9,206 |
9,007 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,105 |
740 |
$3K |
| G9920 |
Screening performed and negative |
9,230 |
9,022 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18,304 |
17,722 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,102 |
5,169 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
348 |
233 |
$2K |
| 0052A |
|
29 |
17 |
$2K |
| 86769 |
|
2,657 |
2,461 |
$1K |
| 85018 |
|
17,036 |
16,364 |
$1K |
| 97803 |
|
3,075 |
2,684 |
$1K |
| 99215 |
Prolong outpt/office vis |
1,358 |
1,147 |
$1K |
| 81025 |
|
2,774 |
2,693 |
$867.67 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,627 |
1,483 |
$834.96 |
| 99173 |
|
12,277 |
11,902 |
$817.65 |
| 82947 |
|
34,771 |
31,486 |
$805.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,833 |
2,589 |
$608.93 |
| 90715 |
|
1,911 |
1,900 |
$544.46 |
| 90670 |
|
2,494 |
2,443 |
$498.15 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
36 |
13 |
$434.40 |
| 97802 |
|
608 |
597 |
$420.64 |
| J3490 |
Unclassified drugs |
98 |
98 |
$390.00 |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
2,316 |
2,205 |
$359.17 |
| 90732 |
|
12 |
12 |
$334.00 |
| 0031A |
|
44 |
44 |
$320.00 |
| 90651 |
|
1,571 |
1,560 |
$290.00 |
| 90734 |
|
600 |
598 |
$277.91 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,339 |
5,213 |
$237.98 |
| 11721 |
|
984 |
871 |
$232.19 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,249 |
11,922 |
$213.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,838 |
6,711 |
$199.30 |
| 90647 |
|
2,122 |
2,094 |
$180.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
375 |
374 |
$180.00 |
| 92015 |
Determination of refractive state |
1,452 |
1,452 |
$175.09 |
| 90723 |
|
1,602 |
1,586 |
$162.00 |
| 81000 |
|
12,651 |
10,549 |
$162.00 |
| 90633 |
|
2,118 |
2,089 |
$162.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
4,325 |
3,345 |
$147.83 |
| 88142 |
|
1,311 |
1,247 |
$124.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
122 |
111 |
$120.00 |
| 99385 |
|
176 |
166 |
$114.10 |
| 1036F |
|
52,547 |
47,372 |
$109.81 |
| 96151 |
|
119 |
119 |
$103.62 |
| 99408 |
|
489 |
417 |
$86.28 |
| 1160F |
|
59,969 |
53,878 |
$84.98 |
| 92250 |
|
186 |
186 |
$83.42 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,311 |
1,273 |
$83.28 |
| 1157F |
|
541 |
500 |
$80.59 |
| 90700 |
|
329 |
326 |
$72.00 |
| 98940 |
|
747 |
655 |
$66.88 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
71 |
71 |
$58.28 |
| 90716 |
|
566 |
557 |
$54.00 |
| 90681 |
|
171 |
169 |
$54.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
286 |
286 |
$50.00 |
| G0246 |
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education |
289 |
251 |
$45.70 |
| 90710 |
|
220 |
220 |
$45.00 |
| 3045F |
|
107 |
107 |
$40.00 |
| 90696 |
|
126 |
126 |
$27.00 |
| 90620 |
|
337 |
336 |
$27.00 |
| 90707 |
|
406 |
400 |
$27.00 |
| 82274 |
|
963 |
959 |
$20.90 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
87 |
86 |
$20.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
193 |
189 |
$20.00 |
| 90685 |
|
94 |
94 |
$18.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
325 |
312 |
$9.00 |
| A4550 |
Surgical trays |
71 |
66 |
$4.50 |
| 3044F |
|
4,479 |
4,237 |
$0.60 |
| 3046F |
|
681 |
663 |
$0.30 |
| 3014F |
|
474 |
443 |
$0.00 |
| 3075F |
|
6,874 |
6,707 |
$0.00 |
| 3074F |
|
39,998 |
37,750 |
$0.00 |
| 3008F |
|
58,727 |
53,647 |
$0.00 |
| 1170F |
|
18,353 |
17,412 |
$0.00 |
| 1125F |
|
27,977 |
25,511 |
$0.00 |
| 1034F |
|
1,170 |
1,049 |
$0.00 |
| 4037F |
|
3,426 |
3,131 |
$0.00 |
| 4010F |
|
18,229 |
16,023 |
$0.00 |
| 3079F |
|
9,298 |
8,998 |
$0.00 |
| 3351F |
|
3,985 |
3,928 |
$0.00 |
| 86580 |
|
270 |
269 |
$0.00 |
| 1126F |
|
37,019 |
34,934 |
$0.00 |
| 96156 |
|
298 |
298 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
242 |
242 |
$0.00 |
| 90656 |
|
1,507 |
1,506 |
$0.00 |
| 91303 |
|
31 |
31 |
$0.00 |
| 1000F |
|
2,256 |
2,079 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
614 |
306 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,853 |
1,798 |
$0.00 |
| 99441 |
|
966 |
808 |
$0.00 |
| 90677 |
|
854 |
852 |
$0.00 |
| 3352F |
|
1,685 |
1,676 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
977 |
928 |
$0.00 |
| 3353F |
|
332 |
330 |
$0.00 |
| 2023F |
|
107 |
104 |
$0.00 |
| 3061F |
|
189 |
166 |
$0.00 |
| 3052F |
|
202 |
196 |
$0.00 |
| 90680 |
|
271 |
265 |
$0.00 |
| 90688 |
|
193 |
176 |
$0.00 |
| 99386 |
|
168 |
166 |
$0.00 |
| 99403 |
|
131 |
131 |
$0.00 |
| 3080F |
|
415 |
402 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
60 |
60 |
$0.00 |
| 59430 |
|
437 |
420 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
75 |
74 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
27 |
27 |
$0.00 |
| 90619 |
|
134 |
134 |
$0.00 |
| S0257 |
Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service) |
114 |
114 |
$0.00 |
| 3060F |
|
213 |
195 |
$0.00 |
| 1101F |
|
62 |
62 |
$0.00 |
| 96150 |
|
28 |
28 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
208 |
119 |
$0.00 |
| 93000 |
|
53 |
52 |
$0.00 |
| 90480 |
|
32 |
32 |
$0.00 |
| Z6410 |
|
19 |
18 |
$0.00 |
| 91301 |
|
939 |
909 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
26 |
26 |
$0.00 |
| 90474 |
|
39 |
39 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
32 |
32 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
41 |
40 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
13 |
13 |
$0.00 |
| 87081 |
|
27 |
27 |
$0.00 |
| 1159F |
|
60,575 |
54,392 |
$0.00 |
| 4040F |
|
1,873 |
1,789 |
$0.00 |
| 1158F |
|
6,646 |
6,504 |
$0.00 |
| 3725F |
|
8,213 |
8,093 |
$0.00 |
| 3077F |
|
5,552 |
5,315 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
154 |
147 |
$0.00 |
| 3078F |
|
43,210 |
40,752 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,256 |
1,256 |
$0.00 |
| 90461 |
|
2,644 |
2,603 |
$0.00 |
| 4025F |
|
11,562 |
10,096 |
$0.00 |
| 2028F |
|
4,465 |
4,227 |
$0.00 |
| 59426 |
|
3,301 |
2,098 |
$0.00 |
| 91322 |
|
65 |
65 |
$0.00 |
| 59425 |
|
2,571 |
2,011 |
$0.00 |
| 90746 |
|
152 |
152 |
$0.00 |
| 3015F |
|
1,396 |
1,363 |
$0.00 |
| 2022F |
|
1,128 |
1,106 |
$0.00 |
| 4274F |
|
146 |
142 |
$0.00 |
| 99188 |
|
451 |
444 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
101 |
101 |
$0.00 |
| 3051F |
|
536 |
519 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
226 |
226 |
$0.00 |
| 3062F |
|
506 |
497 |
$0.00 |
| V2020 |
Frames, purchases |
367 |
367 |
$0.00 |
| 99442 |
|
501 |
408 |
$0.00 |
| 83655 |
|
210 |
208 |
$0.00 |
| 90714 |
|
43 |
43 |
$0.00 |
| 90661 |
|
70 |
70 |
$0.00 |
| 80061 |
Lipid panel |
48 |
48 |
$0.00 |
| 99401 |
|
43 |
43 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
14 |
14 |
$0.00 |
| 91321 |
|
12 |
12 |
$0.00 |
| V2219 |
Bifocal seg width over 28 mm |
24 |
12 |
$0.00 |
| 90750 |
|
14 |
13 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$0.00 |