| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
5,189 |
4,215 |
$971K |
| T1015 |
Clinic visit/encounter, all-inclusive |
15,493 |
12,763 |
$970K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,167 |
3,841 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,292 |
7,753 |
$7K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
256 |
211 |
$6K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,387 |
734 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
437 |
296 |
$912.21 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
519 |
292 |
$502.95 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
487 |
296 |
$423.42 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
34 |
33 |
$413.80 |
| 0134A |
|
23 |
17 |
$201.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
459 |
254 |
$115.85 |
| 83655 |
|
357 |
200 |
$65.77 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,007 |
852 |
$52.62 |
| 90715 |
|
318 |
218 |
$41.22 |
| 99188 |
|
388 |
217 |
$39.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,748 |
2,157 |
$36.60 |
| 90474 |
|
105 |
78 |
$32.37 |
| 90688 |
|
268 |
179 |
$24.94 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
520 |
290 |
$18.10 |
| 85018 |
|
1,447 |
813 |
$12.81 |
| 90677 |
|
507 |
352 |
$10.80 |
| 90648 |
|
462 |
314 |
$10.80 |
| 3074F |
|
4,032 |
3,718 |
$0.00 |
| 3079F |
|
1,986 |
1,879 |
$0.00 |
| 90716 |
|
49 |
26 |
$0.00 |
| 90656 |
|
257 |
175 |
$0.00 |
| 3044F |
|
71 |
49 |
$0.00 |
| 3075F |
|
816 |
775 |
$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 |
159 |
146 |
$0.00 |
| 90680 |
|
96 |
68 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
244 |
241 |
$0.00 |
| 90651 |
|
259 |
160 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
67 |
38 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
392 |
257 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
233 |
151 |
$0.00 |
| 90723 |
|
306 |
199 |
$0.00 |
| 3080F |
|
214 |
201 |
$0.00 |
| 90381 |
|
17 |
12 |
$0.00 |
| 90739 |
|
292 |
198 |
$0.00 |
| 92551 |
|
110 |
63 |
$0.00 |
| 90620 |
|
48 |
30 |
$0.00 |
| 96380 |
|
12 |
12 |
$0.00 |
| 99381 |
|
28 |
22 |
$0.00 |
| 92250 |
|
13 |
13 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| 90686 |
|
320 |
185 |
$0.00 |
| 90750 |
|
80 |
49 |
$0.00 |
| 3078F |
|
3,369 |
3,108 |
$0.00 |
| 3077F |
|
869 |
796 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
715 |
440 |
$0.00 |
| 90681 |
|
129 |
82 |
$0.00 |
| 90658 |
|
144 |
102 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
242 |
134 |
$0.00 |
| 90633 |
|
219 |
141 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
199 |
117 |
$0.00 |
| 90734 |
|
131 |
91 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
77 |
57 |
$0.00 |
| 90700 |
|
40 |
24 |
$0.00 |
| 99173 |
|
116 |
65 |
$0.00 |
| 90380 |
|
22 |
17 |
$0.00 |
| 90670 |
|
63 |
47 |
$0.00 |
| 90707 |
|
30 |
14 |
$0.00 |
| 81002 |
|
19 |
12 |
$0.00 |
| 91313 |
|
12 |
12 |
$0.00 |
| 81025 |
|
22 |
12 |
$0.00 |