| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
121,829 |
102,393 |
$25.12M |
| 00003 |
Internal/system code - not a standard HCPCS code |
34,000 |
25,404 |
$7.31M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,499 |
4,806 |
$62K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,333 |
3,274 |
$58K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,343 |
2,633 |
$26K |
| 92015 |
Determination of refractive state |
6,243 |
5,459 |
$15K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
442 |
421 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
871 |
730 |
$13K |
| 90791 |
Psychiatric diagnostic evaluation |
888 |
813 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,234 |
5,567 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35,928 |
33,446 |
$9K |
| 98940 |
|
2,251 |
1,625 |
$8K |
| 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 |
144 |
132 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
803 |
501 |
$2K |
| 0031A |
|
26 |
26 |
$1K |
| D1120 |
Prophylaxis - child |
185 |
126 |
$904.50 |
| 0011A |
|
18 |
18 |
$720.00 |
| D1206 |
Topical application of fluoride varnish |
163 |
129 |
$689.00 |
| G9920 |
Screening performed and negative |
178 |
177 |
$558.25 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
22 |
15 |
$557.48 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20 |
12 |
$530.90 |
| 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 |
12 |
12 |
$296.87 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
47 |
24 |
$168.00 |
| D9430 |
|
171 |
86 |
$154.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19,741 |
18,628 |
$130.26 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
110 |
110 |
$109.90 |
| D4341 |
|
46 |
12 |
$90.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,034 |
3,024 |
$74.78 |
| D1110 |
Prophylaxis - adult |
30 |
16 |
$65.50 |
| D0210 |
Intraoral - complete series of radiographic images |
17 |
13 |
$44.00 |
| D0274 |
Bitewings - four radiographic images |
31 |
24 |
$41.40 |
| D0220 |
Intraoral - periapical first radiographic image |
25 |
24 |
$35.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,256 |
2,238 |
$34.69 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
13 |
$21.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
640 |
639 |
$18.76 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
72 |
62 |
$16.72 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,951 |
1,946 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
380 |
378 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
919 |
910 |
$0.00 |
| 99173 |
|
302 |
302 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,096 |
1,093 |
$0.00 |
| 90670 |
|
460 |
460 |
$0.00 |
| U0003 |
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, making use of high throughput technologies as described by cms-2020-01-r |
158 |
157 |
$0.00 |
| 90633 |
|
185 |
185 |
$0.00 |
| 3078F |
|
28 |
26 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
62 |
62 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
211 |
205 |
$0.00 |
| 1160F |
|
36 |
34 |
$0.00 |
| 90681 |
|
156 |
156 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
364 |
364 |
$0.00 |
| 90707 |
|
41 |
41 |
$0.00 |
| 1159F |
|
36 |
34 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90700 |
|
18 |
18 |
$0.00 |
| 59425 |
|
51 |
39 |
$0.00 |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
106 |
106 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
30 |
$0.00 |
| 99381 |
|
112 |
112 |
$0.00 |
| 90716 |
|
43 |
43 |
$0.00 |
| D1330 |
|
287 |
226 |
$0.00 |
| 90686 |
|
563 |
563 |
$0.00 |
| 3008F |
|
31 |
29 |
$0.00 |
| D0603 |
|
192 |
172 |
$0.00 |
| 99383 |
|
52 |
42 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
70 |
38 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
254 |
249 |
$0.00 |
| 90647 |
|
336 |
336 |
$0.00 |
| 92551 |
|
201 |
200 |
$0.00 |
| 1036F |
|
12 |
12 |
$0.00 |
| 85018 |
|
532 |
531 |
$0.00 |
| 86769 |
|
124 |
124 |
$0.00 |
| 90723 |
|
308 |
308 |
$0.00 |
| 99385 |
|
38 |
38 |
$0.00 |
| 99441 |
|
13 |
13 |
$0.00 |
| 1126F |
|
32 |
31 |
$0.00 |
| 3074F |
|
29 |
27 |
$0.00 |
| 99384 |
|
33 |
33 |
$0.00 |
| D9995 |
|
20 |
18 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
19 |
19 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$0.00 |
| D9310 |
|
24 |
12 |
$0.00 |
| 90474 |
|
25 |
25 |
$0.00 |