| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
122,689 |
110,149 |
$13.04M |
| 00003 |
Internal/system code - not a standard HCPCS code |
11,261 |
9,414 |
$1.94M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
71,110 |
59,451 |
$199K |
| 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 |
1,910 |
1,723 |
$45K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
11,896 |
10,344 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,238 |
2,032 |
$13K |
| 90832 |
Psychotherapy, 30 minutes with patient |
9,869 |
8,623 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,237 |
1,122 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,480 |
1,367 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,526 |
2,246 |
$6K |
| 98940 |
|
2,441 |
1,718 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
749 |
697 |
$4K |
| 0012A |
|
89 |
56 |
$4K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
52 |
37 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
503 |
468 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
1,407 |
1,360 |
$3K |
| 99000 |
|
4,309 |
3,865 |
$3K |
| 81005 |
|
1,512 |
1,090 |
$2K |
| 0011A |
|
65 |
42 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,085 |
4,050 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
119 |
114 |
$2K |
| 0031A |
|
34 |
22 |
$2K |
| 85018 |
|
5,802 |
5,366 |
$2K |
| 90686 |
|
2,038 |
1,854 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
429 |
417 |
$1K |
| V2020 |
Frames, purchases |
2,576 |
2,535 |
$1K |
| 99381 |
|
286 |
267 |
$1K |
| 92551 |
|
3,704 |
3,402 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,018 |
1,988 |
$775.60 |
| 3074F |
|
4,970 |
4,689 |
$650.27 |
| 90723 |
|
1,412 |
1,309 |
$543.40 |
| 90834 |
Psychotherapy, 45 minutes with patient |
475 |
432 |
$492.88 |
| 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 |
36 |
36 |
$492.84 |
| 90633 |
|
1,049 |
942 |
$483.35 |
| 83655 |
|
662 |
604 |
$451.35 |
| 92015 |
Determination of refractive state |
4,835 |
4,797 |
$418.18 |
| 81003 |
|
1,056 |
835 |
$385.05 |
| 99382 |
|
18 |
13 |
$343.40 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
550 |
545 |
$319.50 |
| 92341 |
|
360 |
354 |
$314.82 |
| 90677 |
|
267 |
261 |
$284.00 |
| 90680 |
|
1,036 |
965 |
$262.14 |
| 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 |
51 |
49 |
$238.50 |
| J3490 |
Unclassified drugs |
12 |
12 |
$210.72 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
163 |
153 |
$164.64 |
| 90696 |
|
126 |
112 |
$139.24 |
| 99173 |
|
2,921 |
2,688 |
$82.42 |
| 90700 |
|
200 |
181 |
$73.68 |
| 1111F |
|
10,036 |
9,114 |
$72.58 |
| 81025 |
|
252 |
221 |
$69.16 |
| 90648 |
|
1,837 |
1,693 |
$56.25 |
| 90670 |
|
1,641 |
1,496 |
$47.25 |
| 90651 |
|
574 |
510 |
$27.00 |
| 90734 |
|
398 |
358 |
$9.00 |
| 90620 |
|
26 |
25 |
$9.00 |
| 99177 |
|
121 |
111 |
$7.50 |
| 97813 |
|
171 |
132 |
$5.21 |
| 97814 |
|
170 |
131 |
$5.21 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
5,914 |
5,575 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
256 |
244 |
$0.00 |
| 3050F |
|
462 |
398 |
$0.00 |
| 3078F |
|
4,126 |
3,907 |
$0.00 |
| 3077F |
|
256 |
244 |
$0.00 |
| 90707 |
|
231 |
210 |
$0.00 |
| 90715 |
|
130 |
124 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
403 |
240 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
69 |
69 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
31 |
29 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
170 |
169 |
$0.00 |
| 97811 |
|
14 |
13 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
207 |
206 |
$0.00 |
| Z6400 |
|
72 |
71 |
$0.00 |
| 90710 |
|
98 |
87 |
$0.00 |
| 97810 |
|
14 |
13 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
187 |
168 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
20 |
20 |
$0.00 |
| 4004F |
|
31 |
28 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,534 |
775 |
$0.00 |
| 3008F |
|
13,033 |
11,626 |
$0.00 |
| 2001F |
|
13,033 |
11,626 |
$0.00 |
| 1036F |
|
9,671 |
8,590 |
$0.00 |
| 3049F |
|
764 |
654 |
$0.00 |
| 3079F |
|
1,497 |
1,439 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
386 |
257 |
$0.00 |
| Z1034 |
|
2,727 |
2,063 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
6,146 |
5,786 |
$0.00 |
| 3048F |
|
1,775 |
1,569 |
$0.00 |
| 3075F |
|
399 |
384 |
$0.00 |
| 90716 |
|
268 |
241 |
$0.00 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
434 |
356 |
$0.00 |
| 90656 |
|
184 |
184 |
$0.00 |
| Z6410 |
|
664 |
653 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
296 |
294 |
$0.00 |
| 90474 |
|
53 |
52 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,782 |
1,040 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
119 |
116 |
$0.00 |
| 97026 |
|
191 |
145 |
$0.00 |
| 90381 |
|
25 |
25 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
88 |
66 |
$0.00 |
| 3044F |
|
31 |
27 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
27 |
26 |
$0.00 |
| 3080F |
|
58 |
57 |
$0.00 |
| 86580 |
|
31 |
28 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
30 |
14 |
$0.00 |
| 99383 |
|
12 |
12 |
$0.00 |