| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
95,393 |
81,355 |
$14.74M |
| 00003 |
Internal/system code - not a standard HCPCS code |
42,421 |
35,201 |
$10.08M |
| 90834 |
Psychotherapy, 45 minutes with patient |
10,240 |
3,819 |
$347K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,995 |
6,509 |
$268K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43,204 |
31,622 |
$245K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19,792 |
15,031 |
$211K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,472 |
5,575 |
$204K |
| V2020 |
Frames, purchases |
12,989 |
8,562 |
$175K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
8,319 |
4,077 |
$96K |
| 92015 |
Determination of refractive state |
19,033 |
12,680 |
$87K |
| 59425 |
|
1,897 |
1,332 |
$86K |
| 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 |
13,086 |
11,338 |
$59K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,011 |
3,087 |
$27K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
863 |
457 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,164 |
1,115 |
$23K |
| 90686 |
|
1,518 |
1,347 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,686 |
4,994 |
$17K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
564 |
443 |
$17K |
| 90832 |
Psychotherapy, 30 minutes with patient |
642 |
309 |
$16K |
| 99205 |
Prolong outpt/office vis |
230 |
155 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
211 |
200 |
$13K |
| G9920 |
Screening performed and negative |
2,163 |
1,853 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
608 |
365 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,558 |
1,135 |
$8K |
| 0012A |
|
81 |
81 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
360 |
185 |
$5K |
| 11721 |
|
257 |
181 |
$4K |
| 0011A |
|
62 |
62 |
$4K |
| 99000 |
|
7,778 |
5,705 |
$4K |
| 92341 |
|
108 |
66 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
55 |
28 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
37 |
26 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,880 |
1,372 |
$2K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
128 |
76 |
$2K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
329 |
277 |
$2K |
| 92551 |
|
3,348 |
2,545 |
$2K |
| 81025 |
|
851 |
606 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,263 |
947 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
39 |
$1K |
| 59430 |
|
17 |
12 |
$991.92 |
| V2750 |
Anti-reflective coating, per lens |
1,183 |
577 |
$929.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
162 |
135 |
$802.66 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
427 |
341 |
$789.60 |
| 92133 |
|
36 |
29 |
$755.01 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
76 |
75 |
$605.33 |
| 99188 |
|
1,018 |
723 |
$595.60 |
| 17110 |
|
72 |
71 |
$498.90 |
| 85018 |
|
6,676 |
5,157 |
$404.61 |
| 90715 |
|
14 |
12 |
$365.31 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$324.20 |
| V2744 |
Tint, photochromatic, per lens |
295 |
142 |
$251.44 |
| 92083 |
|
15 |
12 |
$199.30 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,880 |
5,592 |
$174.52 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
12 |
$152.14 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
579 |
457 |
$130.34 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,484 |
1,905 |
$126.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
13 |
$123.48 |
| 99243 |
|
15 |
12 |
$119.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
22 |
12 |
$117.00 |
| 93000 |
|
55 |
52 |
$71.90 |
| V2755 |
U-v lens, per lens |
27 |
18 |
$50.58 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
49 |
46 |
$45.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
92 |
56 |
$43.20 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
62 |
32 |
$21.24 |
| 81002 |
|
245 |
212 |
$10.69 |
| 81003 |
|
40 |
37 |
$8.62 |
| 82962 |
|
14 |
14 |
$2.40 |
| 99173 |
|
3,022 |
2,243 |
$2.30 |
| 3074F |
|
4,250 |
3,881 |
$0.00 |
| Z1034 |
|
1,425 |
1,079 |
$0.00 |
| 90656 |
|
76 |
76 |
$0.00 |
| 36416 |
|
3,642 |
3,271 |
$0.00 |
| 3008F |
|
5,467 |
4,974 |
$0.00 |
| 1111F |
|
1,084 |
967 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
2,150 |
816 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,690 |
2,656 |
$0.00 |
| 3079F |
|
1,506 |
1,464 |
$0.00 |
| Z1038 |
|
48 |
46 |
$0.00 |
| 3075F |
|
488 |
479 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
108 |
108 |
$0.00 |
| 86580 |
|
12 |
12 |
$0.00 |
| 3080F |
|
109 |
76 |
$0.00 |
| Z6410 |
|
18 |
14 |
$0.00 |
| Z1032 |
|
26 |
26 |
$0.00 |
| 96127 |
|
25 |
25 |
$0.00 |
| 99999 |
|
32 |
18 |
$0.00 |
| 59426 |
|
55 |
42 |
$0.00 |
| 1160F |
|
18,526 |
13,996 |
$0.00 |
| 1159F |
|
18,528 |
13,998 |
$0.00 |
| 3077F |
|
409 |
364 |
$0.00 |
| 3078F |
|
3,477 |
3,192 |
$0.00 |
| 90473 |
|
448 |
342 |
$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) |
104 |
104 |
$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 |
263 |
225 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
25 |
25 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
28 |
28 |
$0.00 |
| 96160 |
|
209 |
188 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
12 |
12 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
64 |
64 |
$0.00 |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
49 |
38 |
$0.00 |
| A4550 |
Surgical trays |
13 |
12 |
$0.00 |