| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
104,285 |
93,256 |
$26.93M |
| 00003 |
Internal/system code - not a standard HCPCS code |
5,126 |
3,999 |
$2.01M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
37,764 |
32,689 |
$510K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,159 |
8,043 |
$171K |
| 59425 |
|
2,240 |
1,288 |
$134K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26,960 |
24,053 |
$120K |
| H0033 |
Oral medication administration, direct observation |
4,382 |
303 |
$76K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,125 |
1,136 |
$67K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,119 |
1,067 |
$43K |
| 0012A |
|
1,006 |
923 |
$39K |
| 90750 |
|
494 |
351 |
$38K |
| 0002A |
|
807 |
443 |
$34K |
| 0001A |
|
685 |
393 |
$29K |
| 97802 |
|
556 |
551 |
$28K |
| 0011A |
|
920 |
840 |
$26K |
| 87536 |
|
278 |
251 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
682 |
601 |
$19K |
| 90715 |
|
1,849 |
1,693 |
$17K |
| 0064A |
|
425 |
296 |
$16K |
| 90734 |
|
975 |
895 |
$15K |
| 90837 |
Psychotherapy, 53 minutes with patient |
162 |
95 |
$15K |
| 90670 |
|
830 |
779 |
$15K |
| 86360 |
|
271 |
249 |
$11K |
| 90710 |
|
1,496 |
1,489 |
$10K |
| 90633 |
|
1,236 |
1,230 |
$9K |
| 90832 |
Psychotherapy, 30 minutes with patient |
346 |
190 |
$9K |
| 90677 |
|
63 |
42 |
$9K |
| 90686 |
|
2,046 |
1,824 |
$8K |
| 81002 |
|
9,272 |
4,266 |
$8K |
| 90651 |
|
732 |
728 |
$7K |
| 99215 |
Prolong outpt/office vis |
839 |
826 |
$6K |
| 0071A |
|
146 |
92 |
$6K |
| 0072A |
|
133 |
90 |
$6K |
| 90707 |
|
377 |
340 |
$5K |
| 99403 |
|
104 |
75 |
$5K |
| 90744 |
|
704 |
698 |
$5K |
| 0004A |
|
117 |
71 |
$5K |
| 99000 |
|
1,821 |
1,589 |
$4K |
| 97803 |
|
137 |
137 |
$4K |
| 0031A |
|
83 |
47 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
384 |
329 |
$3K |
| 90696 |
|
398 |
396 |
$3K |
| 90713 |
|
397 |
394 |
$3K |
| 0054A |
|
48 |
48 |
$3K |
| 90739 |
|
73 |
39 |
$3K |
| 90698 |
|
380 |
379 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
31 |
19 |
$2K |
| 86480 |
|
32 |
28 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
1,734 |
1,638 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
53 |
47 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
13 |
13 |
$1K |
| 90700 |
|
202 |
202 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
334 |
206 |
$1K |
| 90688 |
|
579 |
534 |
$1K |
| 81025 |
|
1,252 |
1,007 |
$1K |
| 90716 |
|
15 |
12 |
$870.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
316 |
306 |
$829.60 |
| 86803 |
|
50 |
40 |
$622.00 |
| 0052A |
|
15 |
14 |
$560.00 |
| 86780 |
|
47 |
44 |
$530.63 |
| 0051A |
|
13 |
13 |
$520.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
16 |
15 |
$493.76 |
| 86704 |
|
46 |
42 |
$493.12 |
| 87340 |
|
46 |
40 |
$415.38 |
| 86706 |
|
43 |
39 |
$404.63 |
| 85018 |
|
198 |
165 |
$355.07 |
| 90656 |
|
46 |
46 |
$349.60 |
| 86708 |
|
27 |
26 |
$301.05 |
| 86703 |
|
270 |
222 |
$280.05 |
| 90680 |
|
41 |
41 |
$276.40 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
20 |
12 |
$273.20 |
| 90647 |
|
25 |
25 |
$223.49 |
| 87210 |
|
75 |
73 |
$220.56 |
| 86593 |
|
55 |
51 |
$217.80 |
| 86592 |
|
55 |
52 |
$209.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
13 |
13 |
$158.34 |
| 83655 |
|
15 |
15 |
$140.92 |
| 90723 |
|
30 |
30 |
$138.47 |
| 90620 |
|
13 |
13 |
$120.42 |
| 90672 |
|
26 |
26 |
$112.50 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
355 |
325 |
$111.65 |
| 99201 |
|
23 |
23 |
$92.74 |
| 99205 |
Prolong outpt/office vis |
66 |
66 |
$81.87 |
| 90674 |
|
20 |
12 |
$80.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,065 |
1,813 |
$67.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
251 |
251 |
$57.07 |
| 82465 |
|
16 |
15 |
$53.90 |
| 80305 |
|
137 |
121 |
$49.90 |
| 86580 |
|
13 |
13 |
$39.12 |
| 92551 |
|
947 |
945 |
$22.04 |
| 99173 |
|
973 |
971 |
$6.82 |
| S5000 |
Prescription drug, generic |
27 |
27 |
$6.44 |
| 3078F |
|
20,385 |
19,514 |
$0.00 |
| G9920 |
Screening performed and negative |
11,283 |
11,000 |
$0.00 |
| 3077F |
|
5,960 |
5,802 |
$0.00 |
| 91322 |
|
41 |
41 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
864 |
839 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
627 |
623 |
$0.00 |
| D0350 |
|
2,433 |
659 |
$0.00 |
| 91313 |
|
12 |
12 |
$0.00 |
| D1120 |
Prophylaxis - child |
552 |
551 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
104 |
104 |
$0.00 |
| 99188 |
|
202 |
138 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
80 |
80 |
$0.00 |
| SBIRT |
|
24 |
24 |
$0.00 |
| D1354 |
|
213 |
37 |
$0.00 |
| 3046F |
|
37 |
37 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
31 |
14 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
115 |
114 |
$0.00 |
| 99401 |
|
14 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
25 |
25 |
$0.00 |
| D4921 |
|
54 |
27 |
$0.00 |
| 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 |
48 |
47 |
$0.00 |
| 90479 |
|
15 |
15 |
$0.00 |
| 3075F |
|
4,679 |
4,615 |
$0.00 |
| Z1032 |
|
543 |
543 |
$0.00 |
| 3044F |
|
16,019 |
15,340 |
$0.00 |
| Z1034 |
|
4,309 |
2,785 |
$0.00 |
| 3074F |
|
20,548 |
19,628 |
$0.00 |
| 3079F |
|
9,729 |
9,548 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
572 |
571 |
$0.00 |
| 4000F |
|
339 |
332 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
454 |
454 |
$0.00 |
| 3080F |
|
1,213 |
1,187 |
$0.00 |
| D1330 |
|
480 |
480 |
$0.00 |
| 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 |
490 |
463 |
$0.00 |
| 91301 |
|
127 |
126 |
$0.00 |
| Z1038 |
|
63 |
58 |
$0.00 |
| D1310 |
|
124 |
124 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
353 |
353 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
783 |
761 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,282 |
511 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
230 |
170 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
16 |
16 |
$0.00 |
| 91306 |
|
43 |
43 |
$0.00 |
| D0603 |
|
14 |
14 |
$0.00 |
| 90480 |
|
39 |
39 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
17 |
12 |
$0.00 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
16 |
12 |
$0.00 |
| MPID1 |
|
14 |
14 |
$0.00 |