| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
264,364 |
233,043 |
$67.14M |
| 00003 |
Internal/system code - not a standard HCPCS code |
46,767 |
38,459 |
$14.97M |
| 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 |
10,282 |
9,390 |
$1.16M |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
2,863 |
2,173 |
$369K |
| G9012 |
Other specified case management service not elsewhere classified |
3,145 |
2,645 |
$179K |
| 98940 |
|
1,336 |
896 |
$96K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
92,788 |
82,975 |
$42K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18,190 |
15,686 |
$35K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,579 |
2,146 |
$25K |
| 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 |
1,260 |
1,254 |
$10K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
32 |
31 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,073 |
1,644 |
$8K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
9,176 |
8,410 |
$6K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
136 |
131 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,509 |
8,450 |
$6K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
23 |
18 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,725 |
2,515 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,241 |
20,922 |
$4K |
| 0013A |
|
66 |
66 |
$4K |
| 92015 |
Determination of refractive state |
5,341 |
4,225 |
$2K |
| 86701 |
|
7,016 |
6,501 |
$2K |
| 99401 |
|
1,203 |
1,117 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,753 |
1,724 |
$689.11 |
| 81025 |
|
8,732 |
7,680 |
$493.50 |
| 99402 |
|
221 |
211 |
$405.32 |
| 90791 |
Psychiatric diagnostic evaluation |
356 |
329 |
$384.24 |
| J3490 |
Unclassified drugs |
850 |
815 |
$339.47 |
| 87808 |
|
7,199 |
6,993 |
$278.66 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,523 |
3,441 |
$272.29 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
3,138 |
3,069 |
$246.40 |
| 97802 |
|
2,331 |
2,089 |
$209.42 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,686 |
2,628 |
$167.97 |
| 92002 |
|
390 |
341 |
$147.60 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,873 |
2,764 |
$126.91 |
| 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 |
3,966 |
3,741 |
$118.39 |
| 99490 |
Ccm add 20min |
14 |
14 |
$93.48 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,047 |
982 |
$90.42 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
309 |
259 |
$81.32 |
| 92250 |
|
1,304 |
1,098 |
$75.84 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,911 |
2,826 |
$54.28 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
698 |
660 |
$51.67 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,919 |
3,825 |
$43.85 |
| 11721 |
|
1,211 |
1,194 |
$33.17 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
435 |
416 |
$28.76 |
| 97803 |
|
2,054 |
1,894 |
$23.50 |
| 80053 |
Comprehensive metabolic panel |
521 |
502 |
$21.52 |
| 92551 |
|
4,006 |
3,922 |
$21.12 |
| 81000 |
|
12,450 |
10,194 |
$21.10 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,968 |
1,655 |
$18.75 |
| 87390 |
|
6,803 |
6,314 |
$16.50 |
| 82728 |
|
14 |
14 |
$11.95 |
| 87905 |
|
6,975 |
6,784 |
$11.94 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,381 |
5,144 |
$10.71 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,316 |
4,223 |
$8.54 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13,046 |
11,004 |
$8.08 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,071 |
1,055 |
$6.64 |
| 82962 |
|
8,290 |
7,684 |
$6.00 |
| 83540 |
|
58 |
58 |
$5.66 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
537 |
500 |
$5.35 |
| 81001 |
|
342 |
338 |
$5.34 |
| 82570 |
|
70 |
70 |
$5.13 |
| 99173 |
|
3,242 |
3,176 |
$4.58 |
| G8734 |
Elder maltreatment screen documented as negative, follow-up is not required |
73 |
72 |
$0.00 |
| 86580 |
|
1,539 |
1,438 |
$0.00 |
| 90686 |
|
3,013 |
2,980 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
293 |
292 |
$0.00 |
| 86762 |
|
668 |
650 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,011 |
483 |
$0.00 |
| 3079F |
|
5,698 |
5,535 |
$0.00 |
| 90651 |
|
924 |
910 |
$0.00 |
| 3075F |
|
2,632 |
2,573 |
$0.00 |
| 1170F |
|
73 |
72 |
$0.00 |
| 3074F |
|
20,896 |
19,319 |
$0.00 |
| Z6204 |
|
467 |
464 |
$0.00 |
| 11730 |
|
550 |
442 |
$0.00 |
| 87625 |
|
3,093 |
3,028 |
$0.00 |
| 90677 |
|
155 |
153 |
$0.00 |
| 97014 |
|
225 |
90 |
$0.00 |
| 11001 |
|
124 |
99 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
497 |
466 |
$0.00 |
| Z1034 |
|
1,283 |
941 |
$0.00 |
| 80055 |
|
667 |
650 |
$0.00 |
| 3080F |
|
416 |
401 |
$0.00 |
| Z6410 |
|
173 |
147 |
$0.00 |
| 90680 |
|
222 |
221 |
$0.00 |
| 97010 |
|
443 |
195 |
$0.00 |
| 90696 |
|
89 |
89 |
$0.00 |
| 99383 |
|
227 |
224 |
$0.00 |
| 90698 |
|
1,023 |
1,009 |
$0.00 |
| 86592 |
|
390 |
387 |
$0.00 |
| 99386 |
|
300 |
291 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
311 |
310 |
$0.00 |
| 29540 |
|
363 |
299 |
$0.00 |
| 83550 |
|
55 |
55 |
$0.00 |
| 90620 |
|
148 |
148 |
$0.00 |
| 90744 |
|
373 |
372 |
$0.00 |
| 11732 |
|
280 |
271 |
$0.00 |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
24 |
20 |
$0.00 |
| 82043 |
|
69 |
69 |
$0.00 |
| 96156 |
|
797 |
720 |
$0.00 |
| 1111F |
|
198 |
191 |
$0.00 |
| 94760 |
|
45 |
43 |
$0.00 |
| Z6404 |
|
28 |
27 |
$0.00 |
| Z6406 |
|
113 |
112 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
443 |
432 |
$0.00 |
| 99384 |
|
236 |
230 |
$0.00 |
| 99381 |
|
43 |
39 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
43 |
42 |
$0.00 |
| 97162 |
|
26 |
26 |
$0.00 |
| 1125F |
|
73 |
72 |
$0.00 |
| 99385 |
|
283 |
270 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
13 |
13 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15 |
14 |
$0.00 |
| 86803 |
|
15 |
15 |
$0.00 |
| Z6402 |
|
149 |
147 |
$0.00 |
| 90674 |
|
105 |
99 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
28 |
28 |
$0.00 |
| 3072F |
|
48 |
25 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
17 |
17 |
$0.00 |
| 87088 |
|
12 |
12 |
$0.00 |
| Z1032 |
|
23 |
23 |
$0.00 |
| Z1038 |
|
12 |
12 |
$0.00 |
| 2022F |
|
667 |
612 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,427 |
2,357 |
$0.00 |
| Z6300 |
|
153 |
151 |
$0.00 |
| 1160F |
|
130 |
128 |
$0.00 |
| 11422 |
|
491 |
439 |
$0.00 |
| 90734 |
|
932 |
917 |
$0.00 |
| Z6200 |
|
111 |
111 |
$0.00 |
| 3078F |
|
20,828 |
19,397 |
$0.00 |
| 90700 |
|
37 |
37 |
$0.00 |
| 99201 |
|
712 |
681 |
$0.00 |
| 90633 |
|
862 |
846 |
$0.00 |
| 1158F |
|
126 |
124 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,060 |
1,036 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
787 |
772 |
$0.00 |
| Z6400 |
|
665 |
658 |
$0.00 |
| 3077F |
|
3,269 |
3,202 |
$0.00 |
| 90756 |
|
117 |
116 |
$0.00 |
| 90670 |
|
1,411 |
1,383 |
$0.00 |
| 2028F |
|
453 |
425 |
$0.00 |
| 90715 |
|
631 |
624 |
$0.00 |
| Z6500 |
|
25 |
25 |
$0.00 |
| 90710 |
|
504 |
502 |
$0.00 |
| Z6308 |
|
34 |
32 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
547 |
540 |
$0.00 |
| 86900 |
|
397 |
392 |
$0.00 |
| Z6304 |
|
105 |
105 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
807 |
799 |
$0.00 |
| 1494F |
|
73 |
72 |
$0.00 |
| 1159F |
|
129 |
127 |
$0.00 |
| 11423 |
|
252 |
234 |
$0.00 |
| Z6208 |
|
34 |
32 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
74 |
73 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
759 |
513 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
532 |
531 |
$0.00 |
| 11421 |
|
292 |
237 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
925 |
837 |
$0.00 |
| 99080 |
|
436 |
418 |
$0.00 |
| P3001 |
Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician |
118 |
117 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
153 |
150 |
$0.00 |
| 80061 |
Lipid panel |
440 |
436 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
285 |
278 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
459 |
204 |
$0.00 |
| 99382 |
|
41 |
40 |
$0.00 |
| 96167 |
|
247 |
225 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
175 |
172 |
$0.00 |
| 11056 |
|
39 |
39 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
163 |
162 |
$0.00 |
| 99387 |
|
95 |
92 |
$0.00 |
| 11420 |
|
48 |
43 |
$0.00 |
| G0127 |
Trimming of dystrophic nails, any number |
89 |
89 |
$0.00 |
| 98960 |
|
31 |
15 |
$0.00 |
| 90750 |
|
29 |
28 |
$0.00 |
| Z6414 |
|
82 |
80 |
$0.00 |
| 11000 |
|
29 |
26 |
$0.00 |
| 90649 |
|
26 |
26 |
$0.00 |
| G0402 |
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment |
28 |
28 |
$0.00 |
| 84155 |
|
17 |
14 |
$0.00 |
| 11057 |
|
14 |
14 |
$0.00 |
| 80076 |
|
13 |
12 |
$0.00 |