| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
123,593 |
103,502 |
$15.06M |
| 00003 |
Internal/system code - not a standard HCPCS code |
11,800 |
9,592 |
$2.18M |
| G9012 |
Other specified case management service not elsewhere classified |
4,273 |
2,090 |
$298K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
6,485 |
6,482 |
$268K |
| 0012A |
|
3,237 |
2,318 |
$155K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
154,096 |
109,712 |
$139K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
6,794 |
5,277 |
$137K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
3,848 |
2,420 |
$133K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,500 |
5,276 |
$132K |
| 0011A |
|
2,701 |
2,179 |
$114K |
| 0064A |
|
2,168 |
1,595 |
$105K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,449 |
4,400 |
$100K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,738 |
2,198 |
$71K |
| 92551 |
|
15,773 |
12,808 |
$58K |
| 0001A |
|
1,082 |
690 |
$53K |
| 0002A |
|
1,064 |
667 |
$53K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29,771 |
20,271 |
$53K |
| V2020 |
Frames, purchases |
7,103 |
5,700 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,778 |
2,237 |
$50K |
| 90686 |
|
10,692 |
9,471 |
$48K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21,305 |
18,495 |
$47K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,808 |
3,929 |
$46K |
| 0004A |
|
852 |
633 |
$39K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,285 |
449 |
$36K |
| 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 |
1,694 |
1,449 |
$32K |
| 92015 |
Determination of refractive state |
10,345 |
8,328 |
$28K |
| 92002 |
|
1,368 |
1,217 |
$25K |
| 92341 |
|
1,886 |
1,389 |
$25K |
| 0071A |
|
449 |
261 |
$23K |
| 0072A |
|
421 |
266 |
$21K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
503 |
443 |
$21K |
| 59425 |
|
930 |
702 |
$20K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,121 |
1,121 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,065 |
14,748 |
$14K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
831 |
831 |
$13K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,429 |
5,412 |
$13K |
| 0134A |
|
211 |
208 |
$12K |
| 91322 |
|
99 |
99 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,162 |
941 |
$11K |
| 90480 |
|
293 |
291 |
$11K |
| 0124A |
|
165 |
163 |
$10K |
| 91320 |
|
103 |
97 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
1,248 |
1,242 |
$9K |
| 85018 |
|
14,880 |
12,491 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
691 |
530 |
$9K |
| 90715 |
|
774 |
668 |
$7K |
| 0054A |
|
125 |
124 |
$7K |
| 90670 |
|
1,312 |
1,175 |
$7K |
| 90651 |
|
1,342 |
1,186 |
$6K |
| 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 |
508 |
495 |
$5K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
294 |
247 |
$5K |
| 92552 |
|
483 |
481 |
$5K |
| 90734 |
|
755 |
679 |
$4K |
| 90648 |
|
878 |
805 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
64 |
53 |
$3K |
| 99173 |
|
1,437 |
1,422 |
$3K |
| 59430 |
|
487 |
295 |
$3K |
| 90633 |
|
408 |
385 |
$3K |
| 81002 |
|
18,534 |
10,780 |
$3K |
| 76801 |
|
269 |
189 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
95 |
26 |
$2K |
| 83026 |
|
808 |
808 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
226 |
190 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
332 |
268 |
$2K |
| 90620 |
|
350 |
307 |
$2K |
| 90619 |
|
375 |
330 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
223 |
199 |
$1K |
| 76770 |
|
77 |
77 |
$1K |
| 81025 |
|
948 |
795 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
761 |
713 |
$988.00 |
| D0210 |
Intraoral - complete series of radiographic images |
690 |
644 |
$983.00 |
| 90723 |
|
334 |
307 |
$945.00 |
| 90710 |
|
103 |
102 |
$927.00 |
| 93000 |
|
99 |
77 |
$925.60 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,522 |
1,025 |
$881.28 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
80 |
51 |
$848.88 |
| D4341 |
|
502 |
280 |
$800.00 |
| 92081 |
|
9,428 |
7,437 |
$782.88 |
| 0052A |
|
17 |
17 |
$680.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
600 |
527 |
$557.18 |
| 73030 |
|
42 |
42 |
$484.64 |
| 90697 |
|
232 |
197 |
$459.00 |
| 90671 |
|
199 |
172 |
$441.00 |
| D0120 |
Periodic oral evaluation - established patient |
120 |
110 |
$288.00 |
| 90696 |
|
30 |
30 |
$270.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
840 |
840 |
$270.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
87 |
70 |
$237.80 |
| 90649 |
|
61 |
61 |
$198.00 |
| 73560 |
|
32 |
32 |
$195.73 |
| 73630 |
|
14 |
14 |
$135.12 |
| 90716 |
|
30 |
30 |
$135.00 |
| 90700 |
|
15 |
15 |
$135.00 |
| 82948 |
|
10,878 |
9,407 |
$132.56 |
| D0220 |
Intraoral - periapical first radiographic image |
223 |
186 |
$119.00 |
| 90707 |
|
26 |
26 |
$117.00 |
| D1206 |
Topical application of fluoride varnish |
110 |
104 |
$115.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
21 |
17 |
$102.90 |
| 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 |
14 |
13 |
$90.78 |
| 86580 |
|
158 |
132 |
$89.14 |
| D1110 |
Prophylaxis - adult |
60 |
59 |
$51.50 |
| D7140 |
Extraction, erupted tooth or exposed root |
20 |
12 |
$45.10 |
| 1126F |
|
17,253 |
12,838 |
$40.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
158 |
140 |
$17.70 |
| 80061 |
Lipid panel |
699 |
696 |
$15.12 |
| 99070 |
|
39 |
28 |
$7.50 |
| 81001 |
|
534 |
531 |
$1.12 |
| 80053 |
Comprehensive metabolic panel |
705 |
704 |
$0.00 |
| 1123F |
|
2,042 |
1,725 |
$0.00 |
| 3351F |
|
2,423 |
1,964 |
$0.00 |
| 1036F |
|
25,007 |
19,551 |
$0.00 |
| 3074F |
|
10,563 |
8,353 |
$0.00 |
| 3044F |
|
12,599 |
10,352 |
$0.00 |
| 3008F |
|
24,400 |
18,494 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
608 |
605 |
$0.00 |
| 3079F |
|
5,440 |
4,397 |
$0.00 |
| 1170F |
|
11,566 |
8,692 |
$0.00 |
| 4010F |
|
9,891 |
7,630 |
$0.00 |
| 1220F |
|
3,621 |
2,999 |
$0.00 |
| 2023F |
|
145 |
123 |
$0.00 |
| 82962 |
|
84 |
76 |
$0.00 |
| 3014F |
|
1,763 |
1,386 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
933 |
932 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
46 |
44 |
$0.00 |
| 3075F |
|
3,354 |
2,774 |
$0.00 |
| 3352F |
|
2,180 |
1,775 |
$0.00 |
| 1000F |
|
6,614 |
5,595 |
$0.00 |
| 3353F |
|
37 |
29 |
$0.00 |
| 3080F |
|
945 |
785 |
$0.00 |
| D0601 |
|
60 |
59 |
$0.00 |
| 3052F |
|
131 |
113 |
$0.00 |
| 1125F |
|
2,630 |
1,924 |
$0.00 |
| 4037F |
|
3,492 |
2,533 |
$0.00 |
| 1101F |
|
1,059 |
1,055 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,688 |
1,688 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
195 |
194 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
64 |
64 |
$0.00 |
| Z1034 |
|
262 |
227 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
25 |
25 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
504 |
504 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
408 |
408 |
$0.00 |
| 90474 |
|
27 |
25 |
$0.00 |
| 88142 |
|
28 |
28 |
$0.00 |
| 3061F |
|
37 |
25 |
$0.00 |
| 1034F |
|
160 |
149 |
$0.00 |
| 3354F |
|
251 |
207 |
$0.00 |
| 99172 |
|
25 |
25 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
15 |
15 |
$0.00 |
| 86592 |
|
115 |
115 |
$0.00 |
| 76536 |
|
13 |
13 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
137 |
116 |
$0.00 |
| 82607 |
|
12 |
12 |
$0.00 |
| 90677 |
|
23 |
15 |
$0.00 |
| 0509F |
|
19 |
14 |
$0.00 |
| 99381 |
|
14 |
13 |
$0.00 |
| 1160F |
|
16,825 |
12,364 |
$0.00 |
| 99442 |
|
25,901 |
19,076 |
$0.00 |
| 4025F |
|
6,036 |
4,433 |
$0.00 |
| 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 |
1,465 |
1,465 |
$0.00 |
| 1124F |
|
3,150 |
2,613 |
$0.00 |
| 3077F |
|
2,401 |
1,946 |
$0.00 |
| 3051F |
|
769 |
603 |
$0.00 |
| 1090F |
|
306 |
291 |
$0.00 |
| 3725F |
|
3,551 |
2,889 |
$0.00 |
| 1158F |
|
5,379 |
4,939 |
$0.00 |
| 1159F |
|
16,860 |
12,389 |
$0.00 |
| 3078F |
|
10,654 |
8,477 |
$0.00 |
| 3015F |
|
1,354 |
1,070 |
$0.00 |
| 3062F |
|
299 |
251 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
459 |
416 |
$0.00 |
| 3046F |
|
1,022 |
761 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
225 |
224 |
$0.00 |
| 72100 |
|
65 |
65 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 2028F |
|
381 |
341 |
$0.00 |
| 4040F |
|
615 |
474 |
$0.00 |
| 3288F |
|
12 |
12 |
$0.00 |
| 99201 |
|
141 |
95 |
$0.00 |
| 84439 |
|
73 |
73 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
25 |
25 |
$0.00 |
| 91313 |
|
14 |
14 |
$0.00 |
| 90681 |
|
57 |
53 |
$0.00 |
| 87806 |
|
106 |
106 |
$0.00 |
| 84550 |
|
14 |
14 |
$0.00 |
| 4274F |
|
111 |
74 |
$0.00 |
| 91300 |
|
57 |
57 |
$0.00 |