| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
721,060 |
557,926 |
$97.81M |
| 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 |
74,769 |
53,133 |
$1.50M |
| 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 |
28,980 |
23,068 |
$395K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
4,196 |
3,167 |
$274K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
342,610 |
276,209 |
$119K |
| 82947 |
|
10,792 |
8,523 |
$43K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,524 |
730 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
34,351 |
28,969 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30,160 |
24,829 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
39,643 |
29,768 |
$12K |
| 99223 |
Prolong inpt eval add15 m |
155 |
112 |
$11K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
2,784 |
1,770 |
$6K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
158 |
119 |
$5K |
| 99460 |
|
138 |
94 |
$5K |
| 98940 |
|
8,195 |
3,266 |
$5K |
| 99442 |
|
47,259 |
39,336 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,512 |
4,795 |
$3K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
4,422 |
1,669 |
$2K |
| 97810 |
|
6,179 |
2,389 |
$2K |
| 99490 |
Ccm add 20min |
135 |
68 |
$1K |
| 1159F |
|
22,732 |
18,456 |
$602.75 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,793 |
3,454 |
$475.26 |
| 97803 |
|
802 |
672 |
$354.60 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
987 |
814 |
$347.88 |
| 99441 |
|
1,130 |
938 |
$288.58 |
| 96127 |
|
35,174 |
29,735 |
$240.42 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
475 |
403 |
$230.88 |
| 92551 |
|
35,488 |
33,732 |
$215.60 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
13 |
12 |
$212.41 |
| 1160F |
|
3,872 |
3,171 |
$173.40 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
9,274 |
3,467 |
$173.40 |
| 99443 |
|
267 |
224 |
$171.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
405 |
397 |
$167.81 |
| 99406 |
|
669 |
590 |
$165.33 |
| 97802 |
|
1,263 |
1,040 |
$163.05 |
| G0008 |
Administration of influenza virus vaccine |
1,737 |
1,459 |
$156.72 |
| 93000 |
|
687 |
572 |
$154.31 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
4,326 |
4,026 |
$120.84 |
| 0012A |
|
1,408 |
1,272 |
$113.89 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,716 |
1,533 |
$109.44 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16,833 |
16,203 |
$62.42 |
| 0011A |
|
1,608 |
1,391 |
$53.23 |
| 59430 |
|
817 |
714 |
$42.26 |
| 0064A |
|
404 |
350 |
$40.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,384 |
4,091 |
$36.74 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
58 |
$30.75 |
| 99173 |
|
34,302 |
32,678 |
$5.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
45,353 |
40,847 |
$0.00 |
| 90670 |
|
9,445 |
9,163 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14,990 |
14,368 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16,098 |
14,868 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17,687 |
16,969 |
$0.00 |
| 81002 |
|
13,379 |
9,233 |
$0.00 |
| 90461 |
|
19,174 |
18,249 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,487 |
2,230 |
$0.00 |
| 81003 |
|
19,370 |
14,793 |
$0.00 |
| 81025 |
|
6,885 |
6,413 |
$0.00 |
| 90707 |
|
414 |
405 |
$0.00 |
| 90648 |
|
381 |
372 |
$0.00 |
| 90633 |
|
3,889 |
3,775 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,595 |
2,462 |
$0.00 |
| 90671 |
|
1,773 |
1,750 |
$0.00 |
| 90756 |
|
1,534 |
1,436 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,513 |
1,176 |
$0.00 |
| 90658 |
|
78 |
78 |
$0.00 |
| 90685 |
|
934 |
897 |
$0.00 |
| 90473 |
|
1,072 |
1,062 |
$0.00 |
| 99001 |
|
260 |
240 |
$0.00 |
| 6100F |
|
72 |
49 |
$0.00 |
| 90734 |
|
1,774 |
1,728 |
$0.00 |
| 90715 |
|
854 |
808 |
$0.00 |
| 87210 |
|
541 |
498 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
257 |
207 |
$0.00 |
| 0002A |
|
861 |
811 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
396 |
380 |
$0.00 |
| G0246 |
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education |
286 |
280 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
249 |
236 |
$0.00 |
| 90710 |
|
207 |
201 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,463 |
836 |
$0.00 |
| 3078F |
|
219 |
172 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
182 |
169 |
$0.00 |
| 97811 |
|
2,636 |
1,297 |
$0.00 |
| 90672 |
|
35 |
29 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
486 |
359 |
$0.00 |
| 11721 |
|
220 |
162 |
$0.00 |
| 87400 |
|
84 |
70 |
$0.00 |
| 82465 |
|
12 |
12 |
$0.00 |
| 97813 |
|
335 |
167 |
$0.00 |
| 94664 |
|
190 |
179 |
$0.00 |
| G0247 |
Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails |
288 |
282 |
$0.00 |
| 20552 |
|
19 |
13 |
$0.00 |
| 3725F |
|
750 |
558 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
200 |
194 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
206 |
169 |
$0.00 |
| 91300 |
|
431 |
389 |
$0.00 |
| 0521F |
|
91 |
79 |
$0.00 |
| 0004A |
|
170 |
157 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
342 |
328 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
158 |
156 |
$0.00 |
| 4062F |
|
210 |
200 |
$0.00 |
| 90750 |
|
14 |
12 |
$0.00 |
| 90681 |
|
59 |
55 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
99 |
79 |
$0.00 |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
79 |
69 |
$0.00 |
| 99461 |
|
15 |
13 |
$0.00 |
| 0071A |
|
480 |
438 |
$0.00 |
| 90470 |
|
18 |
18 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
14 |
13 |
$0.00 |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
14 |
14 |
$0.00 |
| 90661 |
|
23 |
19 |
$0.00 |
| 83037 |
|
16 |
15 |
$0.00 |
| 91313 |
|
16 |
14 |
$0.00 |
| 90686 |
|
28,742 |
27,777 |
$0.00 |
| 90674 |
|
4,716 |
4,440 |
$0.00 |
| 94760 |
|
1,215 |
1,103 |
$0.00 |
| 90744 |
|
3,473 |
3,392 |
$0.00 |
| 4056F |
|
3,795 |
3,212 |
$0.00 |
| 85018 |
|
11,533 |
11,120 |
$0.00 |
| 90698 |
|
9,709 |
9,487 |
$0.00 |
| 6090F |
|
20,494 |
16,608 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,328 |
2,257 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13,709 |
12,801 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15,366 |
14,398 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
285 |
285 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,294 |
1,218 |
$0.00 |
| 90651 |
|
2,425 |
2,344 |
$0.00 |
| 99381 |
|
410 |
399 |
$0.00 |
| 90680 |
|
5,899 |
5,749 |
$0.00 |
| 90619 |
|
948 |
931 |
$0.00 |
| 97814 |
|
372 |
196 |
$0.00 |
| 97026 |
|
1,542 |
646 |
$0.00 |
| 82271 |
|
705 |
622 |
$0.00 |
| 3008F |
|
3,706 |
3,198 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
450 |
424 |
$0.00 |
| 90716 |
|
613 |
603 |
$0.00 |
| 90723 |
|
578 |
562 |
$0.00 |
| 3351F |
|
1,257 |
1,125 |
$0.00 |
| 91301 |
|
3,752 |
3,260 |
$0.00 |
| 99000 |
|
1,899 |
1,717 |
$0.00 |
| 36416 |
|
334 |
332 |
$0.00 |
| 1220F |
|
854 |
658 |
$0.00 |
| 0001A |
|
966 |
866 |
$0.00 |
| 1126F |
|
553 |
450 |
$0.00 |
| 90647 |
|
384 |
355 |
$0.00 |
| 83986 |
|
732 |
650 |
$0.00 |
| 99384 |
|
33 |
28 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
217 |
166 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
732 |
552 |
$0.00 |
| 90688 |
|
938 |
899 |
$0.00 |
| 4293F |
|
675 |
619 |
$0.00 |
| 4000F |
|
44 |
39 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
696 |
293 |
$0.00 |
| 99386 |
|
62 |
58 |
$0.00 |
| 90620 |
|
440 |
431 |
$0.00 |
| 90696 |
|
178 |
173 |
$0.00 |
| 91307 |
|
723 |
677 |
$0.00 |
| 84703 |
|
113 |
98 |
$0.00 |
| 99457 |
|
37 |
37 |
$0.00 |
| 86580 |
|
138 |
109 |
$0.00 |
| 95249 |
|
215 |
147 |
$0.00 |
| 90656 |
|
409 |
403 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
198 |
189 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
984 |
857 |
$0.00 |
| 91305 |
|
23 |
15 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
58 |
42 |
$0.00 |
| 0134A |
|
16 |
14 |
$0.00 |
| 90694 |
|
192 |
181 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
118 |
105 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
296 |
241 |
$0.00 |
| 0072A |
|
361 |
335 |
$0.00 |
| 4063F |
|
81 |
74 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
163 |
128 |
$0.00 |
| 99385 |
|
13 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
25 |
24 |
$0.00 |
| 3074F |
|
117 |
102 |
$0.00 |
| 90677 |
|
77 |
77 |
$0.00 |
| 99407 |
|
55 |
47 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
124 |
113 |
$0.00 |
| 99454 |
|
47 |
43 |
$0.00 |
| 98943 |
|
133 |
85 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
26 |
$0.00 |
| 90646 |
|
55 |
54 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
20 |
12 |
$0.00 |
| 81005 |
|
30 |
25 |
$0.00 |
| 97016 |
|
22 |
12 |
$0.00 |
| 99422 |
|
17 |
16 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
28 |
13 |
$0.00 |
| 81000 |
|
18 |
15 |
$0.00 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
14 |
14 |
$0.00 |
| 97139 |
|
36 |
12 |
$0.00 |
| 2010F |
|
16 |
14 |
$0.00 |