| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
157,055 |
125,320 |
$23.37M |
| 00003 |
Internal/system code - not a standard HCPCS code |
39,670 |
35,324 |
$6.59M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52,186 |
37,439 |
$505K |
| 90834 |
Psychotherapy, 45 minutes with patient |
13,878 |
5,202 |
$483K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39,655 |
28,931 |
$404K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,450 |
6,428 |
$190K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,275 |
7,172 |
$175K |
| 59425 |
|
5,039 |
3,219 |
$158K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,525 |
2,520 |
$154K |
| V2020 |
Frames, purchases |
14,601 |
10,041 |
$140K |
| 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 |
11,827 |
10,577 |
$109K |
| 92015 |
Determination of refractive state |
20,124 |
14,056 |
$67K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
4,195 |
1,936 |
$59K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
9,989 |
4,737 |
$58K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
118 |
83 |
$37K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,493 |
768 |
$35K |
| 90686 |
|
2,355 |
1,841 |
$31K |
| G9920 |
Screening performed and negative |
4,949 |
3,640 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
11,862 |
4,664 |
$23K |
| J3490 |
Unclassified drugs |
1,362 |
1,125 |
$21K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
696 |
539 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,049 |
726 |
$18K |
| 99401 |
|
1,326 |
945 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,171 |
1,523 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,474 |
3,242 |
$16K |
| 92551 |
|
15,388 |
11,014 |
$13K |
| 90791 |
Psychiatric diagnostic evaluation |
282 |
151 |
$11K |
| 99205 |
Prolong outpt/office vis |
326 |
209 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,594 |
795 |
$10K |
| 11981 |
|
71 |
56 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
640 |
449 |
$8K |
| 0072A |
|
114 |
114 |
$8K |
| 0071A |
|
94 |
93 |
$6K |
| 81025 |
|
4,016 |
3,365 |
$6K |
| 90715 |
|
322 |
211 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
667 |
425 |
$5K |
| 0054A |
|
69 |
69 |
$5K |
| 0012A |
|
63 |
63 |
$4K |
| 99381 |
|
612 |
539 |
$4K |
| 0011A |
|
61 |
61 |
$4K |
| 99000 |
|
14,350 |
9,843 |
$4K |
| 97803 |
|
328 |
266 |
$4K |
| 59430 |
|
277 |
254 |
$3K |
| 99215 |
Prolong outpt/office vis |
2,842 |
2,158 |
$3K |
| 0001A |
|
44 |
44 |
$3K |
| 96156 |
|
285 |
237 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,825 |
4,250 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,369 |
5,312 |
$2K |
| 0004A |
|
28 |
27 |
$2K |
| 0002A |
|
23 |
23 |
$2K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
24 |
14 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
44 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26,453 |
20,226 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,807 |
2,033 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,510 |
3,452 |
$903.30 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
58 |
51 |
$781.82 |
| 92341 |
|
29 |
16 |
$744.12 |
| 90656 |
|
200 |
189 |
$717.23 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
20 |
13 |
$687.70 |
| 85018 |
|
26,183 |
19,024 |
$563.68 |
| 0124A |
|
12 |
12 |
$480.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16,062 |
8,321 |
$427.67 |
| 99402 |
|
12 |
12 |
$381.48 |
| S9452 |
Nutrition classes, non-physician provider, per session |
28 |
26 |
$314.41 |
| 97802 |
|
22 |
17 |
$207.00 |
| V2744 |
Tint, photochromatic, per lens |
146 |
52 |
$161.64 |
| 99188 |
|
709 |
573 |
$129.81 |
| 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 |
165 |
107 |
$122.20 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
443 |
439 |
$119.68 |
| 96158 |
|
12 |
12 |
$108.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
569 |
412 |
$85.42 |
| 81002 |
|
2,626 |
1,974 |
$74.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
715 |
279 |
$73.08 |
| 81003 |
|
4,233 |
2,837 |
$72.74 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
411 |
251 |
$36.00 |
| 86580 |
|
288 |
240 |
$12.09 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
41 |
29 |
$12.00 |
| 99173 |
|
13,624 |
9,361 |
$4.45 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
5,368 |
1,993 |
$0.00 |
| Z1038 |
|
438 |
418 |
$0.00 |
| 3008F |
|
8,592 |
7,574 |
$0.00 |
| Z6406 |
|
289 |
254 |
$0.00 |
| 3075F |
|
817 |
795 |
$0.00 |
| 36416 |
|
11,093 |
9,197 |
$0.00 |
| Z6410 |
|
3,623 |
1,977 |
$0.00 |
| 3079F |
|
1,583 |
1,498 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,156 |
3,082 |
$0.00 |
| 3074F |
|
6,402 |
5,645 |
$0.00 |
| Z6204 |
|
591 |
545 |
$0.00 |
| Z1032 |
|
559 |
556 |
$0.00 |
| Z1034 |
|
5,633 |
3,806 |
$0.00 |
| Z6404 |
|
72 |
49 |
$0.00 |
| 1111F |
|
1,149 |
1,019 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
25 |
13 |
$0.00 |
| 3080F |
|
162 |
102 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
143 |
143 |
$0.00 |
| 99460 |
|
104 |
104 |
$0.00 |
| 96127 |
|
112 |
105 |
$0.00 |
| Z6402 |
|
69 |
69 |
$0.00 |
| V2781 |
Progressive lens, per lens |
33 |
14 |
$0.00 |
| 1159F |
|
25,508 |
16,569 |
$0.00 |
| 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 |
281 |
253 |
$0.00 |
| Z6400 |
|
597 |
563 |
$0.00 |
| 90473 |
|
1,724 |
1,235 |
$0.00 |
| 1160F |
|
25,506 |
16,568 |
$0.00 |
| 3078F |
|
6,486 |
5,704 |
$0.00 |
| Z6300 |
|
70 |
70 |
$0.00 |
| 96160 |
|
1,908 |
1,729 |
$0.00 |
| 59426 |
|
705 |
395 |
$0.00 |
| 3077F |
|
1,456 |
953 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
23 |
12 |
$0.00 |
| Z6414 |
|
107 |
92 |
$0.00 |
| Z6202 |
|
88 |
71 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
35 |
35 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$0.00 |
| Z6304 |
|
140 |
137 |
$0.00 |
| Z6200 |
|
17 |
17 |
$0.00 |
| 99242 |
|
44 |
38 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
145 |
145 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$0.00 |
| Z6208 |
|
26 |
24 |
$0.00 |
| 94150 |
|
29 |
29 |
$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) |
13 |
13 |
$0.00 |