| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
111,426 |
96,563 |
$20.78M |
| 00003 |
Internal/system code - not a standard HCPCS code |
72,518 |
68,402 |
$17.01M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
77,883 |
47,879 |
$1.31M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19,853 |
12,823 |
$395K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26,937 |
14,784 |
$276K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,077 |
2,369 |
$196K |
| 90791 |
Psychiatric diagnostic evaluation |
1,778 |
1,045 |
$140K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
8,619 |
8,526 |
$102K |
| 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 |
769 |
661 |
$98K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,229 |
1,927 |
$79K |
| 90739 |
|
674 |
561 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,891 |
1,453 |
$69K |
| 90677 |
|
639 |
454 |
$65K |
| 90750 |
|
755 |
578 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,919 |
1,165 |
$51K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,291 |
772 |
$49K |
| G9920 |
Screening performed and negative |
1,608 |
1,501 |
$40K |
| 99078 |
|
2,171 |
1,435 |
$37K |
| 99215 |
Prolong outpt/office vis |
1,607 |
932 |
$35K |
| 0011A |
|
1,041 |
855 |
$31K |
| V2020 |
Frames, purchases |
1,653 |
1,619 |
$29K |
| 92552 |
|
3,765 |
2,194 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14,584 |
10,172 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
716 |
453 |
$20K |
| 0012A |
|
556 |
431 |
$19K |
| 92015 |
Determination of refractive state |
2,916 |
2,308 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
808 |
775 |
$13K |
| 92250 |
|
384 |
316 |
$13K |
| 90686 |
|
4,803 |
3,302 |
$10K |
| 90715 |
|
557 |
373 |
$9K |
| 92341 |
|
523 |
523 |
$9K |
| 90656 |
|
890 |
590 |
$6K |
| 0124A |
|
375 |
314 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
263 |
214 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
64 |
47 |
$6K |
| 97802 |
|
85 |
80 |
$6K |
| 82947 |
|
2,517 |
1,905 |
$5K |
| 0004A |
|
188 |
144 |
$5K |
| 99173 |
|
4,814 |
2,991 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,765 |
1,435 |
$5K |
| 0031A |
|
117 |
117 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
360 |
218 |
$4K |
| 96156 |
|
140 |
103 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
151 |
82 |
$4K |
| 90688 |
|
211 |
198 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
108 |
69 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,358 |
3,507 |
$3K |
| 90662 |
|
63 |
57 |
$3K |
| 0054A |
|
138 |
123 |
$3K |
| 0072A |
|
47 |
47 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
22 |
13 |
$2K |
| 90670 |
|
1,051 |
728 |
$1K |
| 0002A |
|
24 |
24 |
$1K |
| 90651 |
|
725 |
465 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
22 |
13 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
114 |
62 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
293 |
221 |
$1K |
| 0111A |
|
15 |
15 |
$1K |
| 90658 |
|
55 |
48 |
$893.00 |
| 0112A |
|
12 |
12 |
$804.00 |
| 81025 |
|
397 |
300 |
$749.28 |
| 0064A |
|
18 |
18 |
$720.00 |
| 0071A |
|
15 |
15 |
$600.00 |
| 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 |
26 |
26 |
$577.34 |
| 90698 |
|
568 |
390 |
$535.93 |
| 97803 |
|
12 |
12 |
$526.03 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
77 |
42 |
$425.94 |
| 90619 |
|
129 |
77 |
$315.40 |
| 81002 |
|
252 |
164 |
$225.24 |
| 90734 |
|
250 |
158 |
$152.18 |
| 92551 |
|
558 |
485 |
$143.28 |
| 90744 |
|
386 |
266 |
$137.20 |
| 90681 |
|
244 |
182 |
$134.68 |
| 99188 |
|
18 |
12 |
$126.00 |
| 90633 |
|
845 |
544 |
$120.33 |
| 90707 |
|
41 |
26 |
$84.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
30 |
28 |
$40.66 |
| 90480 |
|
63 |
37 |
$40.00 |
| 90700 |
|
50 |
29 |
$33.32 |
| 85018 |
|
18 |
12 |
$12.08 |
| 96380 |
|
21 |
12 |
$11.25 |
| 91300 |
|
80 |
45 |
$0.02 |
| 91312 |
|
270 |
215 |
$0.01 |
| 90671 |
|
182 |
117 |
$0.00 |
| Z6300 |
|
64 |
64 |
$0.00 |
| Z6302 |
|
55 |
55 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
48 |
37 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
13 |
12 |
$0.00 |
| Z6304 |
|
238 |
220 |
$0.00 |
| 90648 |
|
153 |
124 |
$0.00 |
| 99382 |
|
59 |
51 |
$0.00 |
| Z6200 |
|
45 |
45 |
$0.00 |
| 90710 |
|
41 |
26 |
$0.00 |
| 91322 |
|
20 |
13 |
$0.00 |
| 2022F |
|
54 |
43 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
736 |
606 |
$0.00 |
| 90696 |
|
45 |
26 |
$0.00 |
| 3072F |
|
399 |
342 |
$0.00 |
| 2023F |
|
234 |
198 |
$0.00 |
| 91305 |
|
89 |
76 |
$0.00 |
| Z6402 |
|
37 |
37 |
$0.00 |
| 90716 |
|
94 |
65 |
$0.00 |
| Z6204 |
|
72 |
72 |
$0.00 |
| Z1034 |
|
483 |
344 |
$0.00 |
| 90697 |
|
159 |
96 |
$0.00 |
| Z6406 |
|
28 |
28 |
$0.00 |
| 82962 |
|
287 |
247 |
$0.00 |
| 99383 |
|
17 |
15 |
$0.00 |
| 90723 |
|
61 |
51 |
$0.00 |
| 90474 |
|
22 |
13 |
$0.00 |
| 90620 |
|
19 |
12 |
$0.00 |