| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
205,061 |
150,804 |
$32.45M |
| 00003 |
Internal/system code - not a standard HCPCS code |
26,724 |
21,794 |
$5.08M |
| G9012 |
Other specified case management service not elsewhere classified |
22,851 |
10,029 |
$669K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
108,832 |
76,993 |
$539K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
8,167 |
4,379 |
$292K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
55,839 |
41,268 |
$146K |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,025 |
2,736 |
$83K |
| 90791 |
Psychiatric diagnostic evaluation |
3,035 |
1,832 |
$48K |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,008 |
2,741 |
$38K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,240 |
3,822 |
$34K |
| 0011A |
|
727 |
423 |
$29K |
| 0002A |
|
552 |
354 |
$24K |
| 0012A |
|
553 |
330 |
$22K |
| G9920 |
Screening performed and negative |
8,634 |
7,222 |
$22K |
| 0001A |
|
444 |
287 |
$22K |
| 99401 |
|
1,596 |
1,527 |
$19K |
| 90686 |
|
4,091 |
3,106 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,014 |
2,212 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,408 |
8,537 |
$10K |
| 0013A |
|
186 |
126 |
$8K |
| D9999 |
Unspecified adjunctive procedure, by report |
56 |
56 |
$7K |
| 0003A |
|
142 |
142 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,641 |
1,245 |
$7K |
| J3490 |
Unclassified drugs |
88 |
43 |
$6K |
| 92551 |
|
6,812 |
5,550 |
$5K |
| 90746 |
|
192 |
176 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,941 |
1,512 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,063 |
1,789 |
$5K |
| 90688 |
|
775 |
623 |
$4K |
| 0072A |
|
136 |
89 |
$4K |
| 99000 |
|
16,823 |
13,955 |
$3K |
| H0049 |
Alcohol and/or drug screening |
945 |
655 |
$3K |
| 0071A |
|
70 |
65 |
$3K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
546 |
469 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
728 |
571 |
$2K |
| 90670 |
|
2,144 |
1,654 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
246 |
241 |
$2K |
| 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 |
368 |
330 |
$2K |
| 0031A |
|
41 |
22 |
$2K |
| 81025 |
|
2,623 |
2,262 |
$2K |
| 85018 |
|
12,827 |
10,282 |
$2K |
| 90647 |
|
1,721 |
1,296 |
$1K |
| 90723 |
|
1,723 |
1,323 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,492 |
3,337 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,310 |
1,060 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
233 |
175 |
$975.00 |
| D1310 |
|
1,013 |
804 |
$966.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,801 |
1,166 |
$804.23 |
| D1208 |
Topical application of fluoride, excluding varnish |
506 |
402 |
$658.80 |
| 90633 |
|
789 |
531 |
$630.00 |
| 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 |
116 |
98 |
$615.36 |
| 90677 |
|
330 |
242 |
$585.00 |
| D0210 |
Intraoral - complete series of radiographic images |
180 |
139 |
$540.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
85 |
60 |
$459.17 |
| 81000 |
|
16,181 |
11,314 |
$272.72 |
| 90681 |
|
428 |
314 |
$270.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
4,497 |
3,696 |
$211.98 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,291 |
1,024 |
$208.66 |
| 90651 |
|
310 |
236 |
$207.00 |
| 0124A |
|
35 |
26 |
$201.00 |
| 90655 |
|
120 |
93 |
$198.00 |
| 99215 |
Prolong outpt/office vis |
6,906 |
3,609 |
$150.89 |
| D0602 |
|
599 |
461 |
$150.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,242 |
1,739 |
$147.96 |
| 90734 |
|
114 |
70 |
$117.00 |
| 88174 |
|
349 |
276 |
$113.44 |
| 99173 |
|
13,454 |
10,941 |
$113.41 |
| 83655 |
|
728 |
456 |
$95.80 |
| D1206 |
Topical application of fluoride varnish |
31 |
25 |
$82.00 |
| 90715 |
|
235 |
203 |
$81.00 |
| 90716 |
|
186 |
119 |
$63.00 |
| 82948 |
|
5,035 |
3,774 |
$58.85 |
| 86703 |
|
1,654 |
1,265 |
$50.24 |
| 99201 |
|
119 |
95 |
$47.88 |
| 96127 |
|
257 |
175 |
$45.70 |
| 36415 |
Collection of venous blood by venipuncture |
9,764 |
8,102 |
$43.51 |
| D0603 |
|
90 |
60 |
$30.00 |
| 97803 |
|
246 |
203 |
$25.23 |
| 90707 |
|
120 |
77 |
$18.00 |
| 80061 |
Lipid panel |
4,827 |
3,984 |
$10.60 |
| 90700 |
|
126 |
80 |
$9.00 |
| 86592 |
|
1,597 |
1,295 |
$5.77 |
| 36416 |
|
16,550 |
12,899 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,606 |
2,256 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,045 |
3,345 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,492 |
2,164 |
$0.00 |
| 1036F |
|
5,732 |
3,360 |
$0.00 |
| 3079F |
|
693 |
512 |
$0.00 |
| 99383 |
|
196 |
155 |
$0.00 |
| 3008F |
|
42,245 |
30,790 |
$0.00 |
| Z1034 |
|
4,773 |
3,410 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,285 |
3,515 |
$0.00 |
| Z6410 |
|
3,280 |
2,537 |
$0.00 |
| 81001 |
|
1,032 |
889 |
$0.00 |
| 1000F |
|
3,617 |
2,290 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
5,616 |
4,637 |
$0.00 |
| 96156 |
|
510 |
482 |
$0.00 |
| 3074F |
|
1,762 |
1,294 |
$0.00 |
| Z6204 |
|
1,765 |
1,551 |
$0.00 |
| 86780 |
|
269 |
184 |
$0.00 |
| Z6406 |
|
628 |
596 |
$0.00 |
| 85027 |
|
15 |
15 |
$0.00 |
| 88142 |
|
702 |
644 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
71 |
67 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
272 |
241 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
909 |
780 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
336 |
319 |
$0.00 |
| 87625 |
|
36 |
36 |
$0.00 |
| 80055 |
|
44 |
43 |
$0.00 |
| D1330 |
|
1,069 |
833 |
$0.00 |
| 99385 |
|
133 |
119 |
$0.00 |
| Z6402 |
|
647 |
639 |
$0.00 |
| 84479 |
|
113 |
111 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
28 |
27 |
$0.00 |
| 84436 |
|
237 |
229 |
$0.00 |
| 86803 |
|
760 |
563 |
$0.00 |
| 87081 |
|
200 |
193 |
$0.00 |
| Z1032 |
|
243 |
235 |
$0.00 |
| 86580 |
|
82 |
80 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
95 |
83 |
$0.00 |
| 3080F |
|
126 |
97 |
$0.00 |
| 1034F |
|
887 |
469 |
$0.00 |
| 99381 |
|
83 |
80 |
$0.00 |
| 82043 |
|
69 |
65 |
$0.00 |
| 91307 |
|
49 |
46 |
$0.00 |
| 3075F |
|
302 |
238 |
$0.00 |
| 87807 |
|
51 |
46 |
$0.00 |
| 3072F |
|
15 |
13 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
16 |
16 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
26 |
25 |
$0.00 |
| G9007 |
Coordinated care fee, scheduled team conference |
317 |
314 |
$0.00 |
| 82962 |
|
24 |
24 |
$0.00 |
| 96151 |
|
14 |
12 |
$0.00 |
| 3014F |
|
33 |
29 |
$0.00 |
| 1126F |
|
133 |
126 |
$0.00 |
| 90680 |
|
16 |
14 |
$0.00 |
| 99384 |
|
56 |
51 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
26 |
24 |
$0.00 |
| 84153 |
|
12 |
12 |
$0.00 |
| 82950 |
|
41 |
41 |
$0.00 |
| 80069 |
|
12 |
12 |
$0.00 |
| 97802 |
|
15 |
15 |
$0.00 |
| 3351F |
|
109 |
102 |
$0.00 |
| 99386 |
|
45 |
40 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
54 |
43 |
$0.00 |
| 88720 |
|
13 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
87 |
68 |
$0.00 |
| 59430 |
|
21 |
20 |
$0.00 |
| 90480 |
|
20 |
18 |
$0.00 |
| 92060 |
|
17 |
17 |
$0.00 |
| 80051 |
|
15 |
13 |
$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) |
26 |
16 |
$0.00 |
| Z6400 |
|
1,876 |
1,731 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,453 |
2,120 |
$0.00 |
| 3078F |
|
2,164 |
1,516 |
$0.00 |
| 3725F |
|
13,920 |
9,084 |
$0.00 |
| Z6414 |
|
435 |
403 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
717 |
502 |
$0.00 |
| 2028F |
|
1,612 |
1,399 |
$0.00 |
| Z6300 |
|
662 |
654 |
$0.00 |
| D0190 |
|
463 |
383 |
$0.00 |
| 11721 |
|
51 |
42 |
$0.00 |
| 4004F |
|
885 |
468 |
$0.00 |
| 80305 |
|
270 |
161 |
$0.00 |
| 90661 |
|
13 |
13 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
22 |
14 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
503 |
471 |
$0.00 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
24 |
24 |
$0.00 |
| 0502F |
|
216 |
131 |
$0.00 |
| Z6308 |
|
196 |
171 |
$0.00 |
| D9993 |
|
1,034 |
810 |
$0.00 |
| 96160 |
|
617 |
473 |
$0.00 |
| 3077F |
|
650 |
468 |
$0.00 |
| Z6200 |
|
725 |
715 |
$0.00 |
| 84442 |
|
319 |
210 |
$0.00 |
| 90836 |
|
38 |
24 |
$0.00 |
| Z6208 |
|
273 |
251 |
$0.00 |
| 91300 |
|
83 |
48 |
$0.00 |
| 03 |
Instill, bupivac and meloxic |
2,523 |
1,657 |
$0.00 |
| 91312 |
|
41 |
26 |
$0.00 |
| 90461 |
|
35 |
20 |
$0.00 |
| 3046F |
|
64 |
53 |
$0.00 |
| 1160F |
|
48 |
46 |
$0.00 |
| 80074 |
|
95 |
92 |
$0.00 |
| Z6304 |
|
838 |
772 |
$0.00 |
| 83540 |
|
29 |
16 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
26 |
$0.00 |
| Z6202 |
|
73 |
62 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
122 |
112 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
179 |
175 |
$0.00 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
17 |
16 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
64 |
63 |
$0.00 |
| 87481 |
|
13 |
12 |
$0.00 |
| 86480 |
|
69 |
68 |
$0.00 |
| 1158F |
|
84 |
79 |
$0.00 |
| 81003 |
|
44 |
44 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
54 |
30 |
$0.00 |
| 83013 |
|
14 |
14 |
$0.00 |
| 91320 |
|
20 |
18 |
$0.00 |
| 82570 |
|
20 |
20 |
$0.00 |
| 80076 |
|
14 |
13 |
$0.00 |
| Z6500 |
|
12 |
12 |
$0.00 |
| H0019 |
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem |
21 |
13 |
$0.00 |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
21 |
14 |
$0.00 |
| 87535 |
|
12 |
12 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
25 |
25 |
$0.00 |
| 99382 |
|
12 |
12 |
$0.00 |