| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
68,724 |
53,782 |
$12.04M |
| 00003 |
Internal/system code - not a standard HCPCS code |
36,715 |
14,806 |
$8.44M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,412 |
6,060 |
$193K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42,006 |
27,045 |
$140K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,417 |
1,408 |
$127K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,402 |
2,270 |
$105K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
9,038 |
4,207 |
$102K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,077 |
2,030 |
$64K |
| V2020 |
Frames, purchases |
4,431 |
3,140 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,018 |
1,927 |
$37K |
| 99205 |
Prolong outpt/office vis |
565 |
353 |
$21K |
| 90686 |
|
1,472 |
1,031 |
$21K |
| 92015 |
Determination of refractive state |
6,290 |
4,255 |
$21K |
| 97014 |
|
4,534 |
2,153 |
$21K |
| 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 |
2,902 |
2,427 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
573 |
416 |
$11K |
| 98940 |
|
712 |
450 |
$9K |
| 90746 |
|
142 |
101 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,343 |
2,412 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
213 |
151 |
$6K |
| G9920 |
Screening performed and negative |
1,662 |
1,245 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,115 |
889 |
$6K |
| 59425 |
|
181 |
131 |
$4K |
| 92551 |
|
2,063 |
1,551 |
$4K |
| 0011A |
|
46 |
46 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
36 |
22 |
$3K |
| 90750 |
|
22 |
12 |
$2K |
| 99000 |
|
7,873 |
5,484 |
$2K |
| 0012A |
|
35 |
35 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
36 |
36 |
$2K |
| 97035 |
|
940 |
453 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
79 |
65 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
168 |
104 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
84 |
67 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
65 |
30 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
222 |
181 |
$1K |
| 0002A |
|
16 |
16 |
$1K |
| 81025 |
|
883 |
697 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
126 |
78 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
682 |
626 |
$954.64 |
| 0001A |
|
14 |
14 |
$938.00 |
| 90715 |
|
17 |
12 |
$517.56 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
204 |
171 |
$493.49 |
| 90656 |
|
93 |
88 |
$425.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,166 |
4,598 |
$419.66 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
71 |
70 |
$356.16 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
255 |
200 |
$355.23 |
| J3490 |
Unclassified drugs |
51 |
42 |
$336.19 |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
78 |
65 |
$309.90 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
484 |
341 |
$282.58 |
| 85018 |
|
4,851 |
3,538 |
$261.85 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
400 |
376 |
$227.26 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
528 |
413 |
$147.57 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
49 |
49 |
$138.11 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
527 |
405 |
$134.61 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
218 |
124 |
$102.55 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
64 |
59 |
$96.49 |
| 81003 |
|
199 |
167 |
$69.38 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,104 |
1,176 |
$26.75 |
| 87807 |
|
25 |
22 |
$25.72 |
| 99188 |
|
12 |
12 |
$21.60 |
| 81002 |
|
87 |
75 |
$5.16 |
| Z1034 |
|
71 |
59 |
$0.00 |
| 1111F |
|
1,115 |
873 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,129 |
2,097 |
$0.00 |
| 36416 |
|
2,437 |
2,021 |
$0.00 |
| 3008F |
|
6,122 |
5,356 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,206 |
484 |
$0.00 |
| 3074F |
|
4,529 |
4,071 |
$0.00 |
| 3080F |
|
343 |
223 |
$0.00 |
| 3079F |
|
1,592 |
1,527 |
$0.00 |
| 3075F |
|
335 |
323 |
$0.00 |
| 1170F |
|
14 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |
| 1160F |
|
19,281 |
12,305 |
$0.00 |
| 3078F |
|
3,407 |
3,063 |
$0.00 |
| 1159F |
|
19,283 |
12,307 |
$0.00 |
| 99173 |
|
1,790 |
1,297 |
$0.00 |
| 96160 |
|
388 |
366 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
265 |
265 |
$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 |
36 |
28 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
507 |
500 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
231 |
90 |
$0.00 |
| 3077F |
|
548 |
390 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
180 |
180 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
14 |
14 |
$0.00 |