| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
166,721 |
141,099 |
$23.18M |
| 00003 |
Internal/system code - not a standard HCPCS code |
39,784 |
33,030 |
$6.76M |
| G9012 |
Other specified case management service not elsewhere classified |
693 |
665 |
$195K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
527 |
523 |
$175K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12,318 |
11,133 |
$127K |
| V2020 |
Frames, purchases |
4,903 |
4,866 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
126,671 |
71,322 |
$81K |
| 98940 |
|
779 |
398 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,328 |
3,297 |
$64K |
| 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 |
2,959 |
2,475 |
$58K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40,877 |
25,564 |
$41K |
| 92341 |
|
1,149 |
1,149 |
$33K |
| G9920 |
Screening performed and negative |
12,839 |
8,579 |
$20K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
181 |
105 |
$18K |
| 92015 |
Determination of refractive state |
12,842 |
11,915 |
$14K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,648 |
1,044 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,529 |
3,977 |
$7K |
| 90791 |
Psychiatric diagnostic evaluation |
913 |
769 |
$7K |
| 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 |
459 |
459 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,868 |
4,934 |
$3K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
34 |
26 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,325 |
1,386 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,685 |
3,901 |
$2K |
| J3490 |
Unclassified drugs |
1,132 |
726 |
$2K |
| 92250 |
|
1,470 |
997 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,664 |
3,620 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
265 |
166 |
$2K |
| 81025 |
|
9,273 |
5,775 |
$2K |
| 92133 |
|
1,607 |
1,121 |
$2K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
111 |
52 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,376 |
2,174 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,200 |
731 |
$1K |
| 92551 |
|
12,336 |
7,964 |
$830.09 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
60 |
55 |
$759.78 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,283 |
980 |
$743.75 |
| 11981 |
|
34 |
26 |
$731.01 |
| 90686 |
|
5,276 |
3,676 |
$514.58 |
| 90680 |
|
2,617 |
1,869 |
$456.75 |
| 90670 |
|
3,282 |
2,307 |
$447.75 |
| H1000 |
Prenatal care, at-risk assessment |
84 |
84 |
$381.09 |
| 85018 |
|
25,427 |
16,184 |
$351.15 |
| 90697 |
|
1,704 |
1,214 |
$336.75 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,481 |
2,532 |
$289.56 |
| 90633 |
|
2,616 |
1,676 |
$243.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
302 |
191 |
$232.00 |
| 99173 |
|
11,639 |
7,476 |
$225.34 |
| 90723 |
|
1,552 |
1,108 |
$222.75 |
| 81002 |
|
11,938 |
6,797 |
$208.25 |
| 83655 |
|
2,224 |
1,417 |
$189.69 |
| 90677 |
|
1,522 |
1,063 |
$177.65 |
| 92134 |
|
360 |
241 |
$170.70 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
16 |
13 |
$136.15 |
| 90647 |
|
1,750 |
1,263 |
$132.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,305 |
1,298 |
$118.26 |
| 11976 |
|
24 |
12 |
$111.67 |
| 90651 |
|
1,691 |
1,096 |
$99.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,668 |
945 |
$93.75 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,481 |
1,452 |
$87.99 |
| 90700 |
|
2,011 |
1,257 |
$81.00 |
| 90716 |
|
309 |
199 |
$72.00 |
| 90734 |
|
1,193 |
725 |
$66.75 |
| 99381 |
|
58 |
53 |
$44.88 |
| 90707 |
|
212 |
139 |
$36.00 |
| 88720 |
|
110 |
61 |
$34.08 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,130 |
1,417 |
$33.88 |
| 82962 |
|
2,227 |
1,392 |
$19.97 |
| 90688 |
|
1,618 |
895 |
$18.00 |
| 90710 |
|
264 |
174 |
$18.00 |
| 90715 |
|
412 |
282 |
$18.00 |
| 90713 |
|
272 |
183 |
$18.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
50,301 |
26,801 |
$13.55 |
| 86580 |
|
533 |
357 |
$6.69 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,628 |
1,000 |
$0.68 |
| 99406 |
|
216 |
113 |
$0.02 |
| 3079F |
|
5,741 |
3,340 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
1,812 |
1,068 |
$0.00 |
| 3074F |
|
7,655 |
4,523 |
$0.00 |
| Z1034 |
|
2,808 |
2,227 |
$0.00 |
| 3044F |
|
527 |
302 |
$0.00 |
| 3080F |
|
1,922 |
1,052 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
87 |
56 |
$0.00 |
| 2023F |
|
1,413 |
957 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
2,243 |
2,046 |
$0.00 |
| Z1038 |
|
43 |
43 |
$0.00 |
| Z1032 |
|
369 |
366 |
$0.00 |
| 59430 |
|
43 |
43 |
$0.00 |
| 3075F |
|
3,080 |
1,780 |
$0.00 |
| 90732 |
|
70 |
42 |
$0.00 |
| 3052F |
|
23 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
23 |
15 |
$0.00 |
| 3078F |
|
7,314 |
4,328 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
4,555 |
2,636 |
$0.00 |
| 59425 |
|
593 |
463 |
$0.00 |
| 3077F |
|
4,180 |
2,400 |
$0.00 |
| 86703 |
|
150 |
86 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
35 |
24 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$0.00 |
| 3051F |
|
53 |
28 |
$0.00 |
| 3046F |
|
97 |
52 |
$0.00 |