| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
430,506 |
373,189 |
$59.56M |
| 00003 |
Internal/system code - not a standard HCPCS code |
82,730 |
66,647 |
$14.26M |
| 98940 |
|
5,357 |
2,758 |
$603K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
5,752 |
2,722 |
$428K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
290,615 |
177,290 |
$271K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
16,400 |
13,380 |
$222K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
128,541 |
79,888 |
$201K |
| G9012 |
Other specified case management service not elsewhere classified |
1,499 |
1,347 |
$196K |
| 90791 |
Psychiatric diagnostic evaluation |
4,263 |
2,843 |
$115K |
| V2020 |
Frames, purchases |
9,058 |
9,046 |
$114K |
| 90832 |
Psychotherapy, 30 minutes with patient |
8,716 |
4,795 |
$97K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,083 |
7,071 |
$69K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,170 |
961 |
$58K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
223 |
223 |
$48K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
290 |
199 |
$28K |
| 92015 |
Determination of refractive state |
17,564 |
14,761 |
$26K |
| 92341 |
|
1,270 |
1,268 |
$23K |
| J3490 |
Unclassified drugs |
2,813 |
1,965 |
$13K |
| 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 |
5,402 |
4,242 |
$12K |
| 0002A |
|
184 |
143 |
$11K |
| 0001A |
|
181 |
149 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,530 |
1,142 |
$9K |
| 11981 |
|
262 |
175 |
$8K |
| 81025 |
|
29,905 |
20,253 |
$7K |
| 11976 |
|
337 |
187 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
316 |
182 |
$6K |
| 99460 |
|
601 |
512 |
$3K |
| 0011A |
|
48 |
48 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
582 |
448 |
$3K |
| 0012A |
|
40 |
40 |
$3K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
322 |
266 |
$2K |
| 92250 |
|
2,562 |
1,847 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,105 |
11,593 |
$2K |
| 59425 |
|
4,537 |
3,754 |
$2K |
| 0031A |
|
21 |
21 |
$1K |
| G9920 |
Screening performed and negative |
4,026 |
2,541 |
$1K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
10,564 |
8,478 |
$948.51 |
| 0071A |
|
14 |
14 |
$871.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
414 |
330 |
$859.03 |
| 0004A |
|
12 |
12 |
$804.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,580 |
3,529 |
$730.14 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15,344 |
11,724 |
$610.81 |
| 58300 |
|
79 |
51 |
$540.07 |
| 99243 |
|
1,522 |
1,221 |
$532.41 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
1,463 |
1,461 |
$522.48 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
8,992 |
5,514 |
$447.12 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
312 |
285 |
$407.70 |
| 81002 |
|
38,975 |
23,967 |
$365.90 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
3,087 |
2,026 |
$318.71 |
| H1000 |
Prenatal care, at-risk assessment |
327 |
327 |
$248.38 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15,260 |
10,277 |
$216.15 |
| 92551 |
|
20,033 |
12,946 |
$210.20 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,501 |
1,497 |
$188.51 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,979 |
2,447 |
$109.11 |
| 90686 |
|
8,545 |
6,382 |
$89.59 |
| 90715 |
|
1,975 |
1,418 |
$86.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
8,427 |
5,365 |
$71.07 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16,211 |
9,750 |
$66.28 |
| 90670 |
|
10,070 |
7,547 |
$63.00 |
| 85018 |
|
9,407 |
6,722 |
$38.89 |
| 90647 |
|
6,778 |
5,062 |
$36.00 |
| 90734 |
|
1,041 |
645 |
$36.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
20 |
12 |
$32.88 |
| 92133 |
|
571 |
400 |
$31.93 |
| 90723 |
|
6,461 |
4,998 |
$27.00 |
| 90651 |
|
1,622 |
999 |
$27.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,946 |
5,284 |
$24.22 |
| 99173 |
|
20,721 |
13,290 |
$19.47 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,978 |
3,273 |
$18.43 |
| 90680 |
|
8,011 |
6,066 |
$18.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,657 |
4,140 |
$17.21 |
| 82962 |
|
6,439 |
4,337 |
$9.20 |
| 90633 |
|
5,190 |
3,503 |
$9.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
337 |
245 |
$2.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
163,727 |
90,064 |
$1.09 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,946 |
4,052 |
$1.03 |
| 90716 |
|
1,566 |
1,053 |
$0.00 |
| Z1034 |
|
17,685 |
14,244 |
$0.00 |
| 3044F |
|
1,183 |
739 |
$0.00 |
| Z1032 |
|
1,644 |
1,636 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13,228 |
9,940 |
$0.00 |
| 90732 |
|
56 |
40 |
$0.00 |
| 3080F |
|
2,325 |
1,349 |
$0.00 |
| 99381 |
|
1,218 |
1,034 |
$0.00 |
| 88720 |
|
1,570 |
1,182 |
$0.00 |
| 3075F |
|
5,318 |
3,225 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,538 |
1,038 |
$0.00 |
| 3079F |
|
9,747 |
5,810 |
$0.00 |
| 90688 |
|
1,478 |
844 |
$0.00 |
| 3052F |
|
21 |
12 |
$0.00 |
| 99406 |
|
633 |
445 |
$0.00 |
| 90697 |
|
2,740 |
1,989 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
4,183 |
2,720 |
$0.00 |
| 3074F |
|
11,471 |
6,899 |
$0.00 |
| Z6406 |
|
137 |
135 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
70 |
38 |
$0.00 |
| Z1038 |
|
476 |
459 |
$0.00 |
| 90677 |
|
2,215 |
1,591 |
$0.00 |
| 90381 |
|
97 |
79 |
$0.00 |
| 96156 |
|
155 |
155 |
$0.00 |
| 59430 |
|
400 |
396 |
$0.00 |
| 2023F |
|
501 |
333 |
$0.00 |
| 99462 |
|
45 |
25 |
$0.00 |
| Z6204 |
|
105 |
104 |
$0.00 |
| 93000 |
|
199 |
131 |
$0.00 |
| 86580 |
|
53 |
34 |
$0.00 |
| 99384 |
|
33 |
28 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
20 |
13 |
$0.00 |
| 3072F |
|
32 |
24 |
$0.00 |
| 99383 |
|
14 |
12 |
$0.00 |
| 3078F |
|
11,694 |
7,066 |
$0.00 |
| 3077F |
|
6,942 |
4,095 |
$0.00 |
| Z6400 |
|
1,780 |
1,771 |
$0.00 |
| 83655 |
|
1,587 |
1,132 |
$0.00 |
| 90700 |
|
3,851 |
2,522 |
$0.00 |
| Z6500 |
|
185 |
185 |
$0.00 |
| 90713 |
|
582 |
375 |
$0.00 |
| 90710 |
|
405 |
259 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
2,668 |
1,657 |
$0.00 |
| 90707 |
|
1,567 |
1,056 |
$0.00 |
| 3046F |
|
450 |
292 |
$0.00 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
12 |
12 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
32 |
32 |
$0.00 |
| Z6304 |
|
92 |
91 |
$0.00 |
| G9357 |
Post-partum screenings, evaluations and education performed |
346 |
237 |
$0.00 |
| 11721 |
|
78 |
69 |
$0.00 |
| 3051F |
|
210 |
136 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
96 |
91 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
57 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
73 |
73 |
$0.00 |
| 90681 |
|
28 |
17 |
$0.00 |
| 99401 |
|
107 |
106 |
$0.00 |
| 97803 |
|
102 |
102 |
$0.00 |
| 90648 |
|
14 |
13 |
$0.00 |
| 92083 |
|
13 |
12 |
$0.00 |
| 90380 |
|
56 |
48 |
$0.00 |
| 90621 |
|
19 |
12 |
$0.00 |
| 59025 |
Fetal non-stress test |
18 |
13 |
$0.00 |