| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
16,594 |
10,931 |
$4.35M |
| T1015 |
Clinic visit/encounter, all-inclusive |
16,388 |
13,530 |
$3.70M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,358 |
9,104 |
$213K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,297 |
5,542 |
$198K |
| 99215 |
Prolong outpt/office vis |
728 |
504 |
$21K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
236 |
195 |
$16K |
| 90750 |
|
132 |
111 |
$15K |
| 92551 |
|
1,608 |
1,116 |
$15K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
362 |
270 |
$15K |
| 90686 |
|
918 |
730 |
$13K |
| 0012A |
|
240 |
235 |
$10K |
| 90715 |
|
421 |
346 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
193 |
158 |
$9K |
| 0011A |
|
244 |
238 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
122 |
94 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
143 |
112 |
$5K |
| 99173 |
|
1,685 |
1,189 |
$4K |
| 0064A |
|
93 |
92 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
839 |
574 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
45 |
$3K |
| 99205 |
Prolong outpt/office vis |
71 |
47 |
$3K |
| 85018 |
|
2,430 |
1,651 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
281 |
151 |
$3K |
| 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 |
26 |
25 |
$2K |
| 90656 |
|
126 |
109 |
$1K |
| 0001A |
|
32 |
32 |
$1K |
| 92552 |
|
26 |
26 |
$851.19 |
| 90651 |
|
49 |
40 |
$795.25 |
| 0002A |
|
17 |
17 |
$680.00 |
| 90716 |
|
71 |
61 |
$639.00 |
| 0072A |
|
15 |
15 |
$600.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
16 |
$560.85 |
| 0004A |
|
14 |
14 |
$560.00 |
| 0071A |
|
14 |
14 |
$560.00 |
| 81002 |
|
347 |
249 |
$321.95 |
| 90633 |
|
34 |
25 |
$288.00 |
| 90619 |
|
14 |
14 |
$278.69 |
| 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 |
30 |
24 |
$166.22 |
| 83655 |
|
24 |
13 |
$103.63 |
| 99188 |
|
19 |
15 |
$102.62 |
| 81025 |
|
20 |
13 |
$34.85 |