| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
111,518 |
94,435 |
$12.93M |
| 00003 |
Internal/system code - not a standard HCPCS code |
20,628 |
16,231 |
$3.62M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44,672 |
35,939 |
$221K |
| 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 |
2,119 |
1,669 |
$71K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,969 |
5,819 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,009 |
4,326 |
$20K |
| 98940 |
|
3,260 |
2,236 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,051 |
934 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,646 |
3,285 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,371 |
1,275 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
700 |
632 |
$6K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
3,131 |
2,128 |
$5K |
| 0012A |
|
96 |
52 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,191 |
1,123 |
$4K |
| 0031A |
|
65 |
38 |
$3K |
| 99000 |
|
1,942 |
1,742 |
$2K |
| 0053A |
|
32 |
31 |
$1K |
| 92551 |
|
3,021 |
2,748 |
$1K |
| 90686 |
|
1,779 |
1,630 |
$1K |
| 0011A |
|
34 |
34 |
$1K |
| 85018 |
|
3,687 |
3,353 |
$1K |
| V2020 |
Frames, purchases |
3,156 |
3,135 |
$1K |
| 0071A |
|
15 |
13 |
$951.00 |
| 81025 |
|
1,153 |
1,073 |
$914.61 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,392 |
2,373 |
$736.82 |
| 90677 |
|
342 |
338 |
$568.00 |
| 92015 |
Determination of refractive state |
6,160 |
6,132 |
$453.76 |
| 99173 |
|
2,903 |
2,638 |
$402.46 |
| 81005 |
|
1,565 |
1,201 |
$388.31 |
| J3490 |
Unclassified drugs |
13 |
12 |
$385.88 |
| 90723 |
|
911 |
863 |
$373.93 |
| 90648 |
|
1,248 |
1,172 |
$273.30 |
| 90670 |
|
891 |
827 |
$216.86 |
| 92341 |
|
212 |
211 |
$171.72 |
| 81003 |
|
1,696 |
1,367 |
$154.95 |
| 99215 |
Prolong outpt/office vis |
119 |
111 |
$143.53 |
| 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 |
27 |
27 |
$142.65 |
| 90633 |
|
665 |
615 |
$117.00 |
| 83655 |
|
87 |
78 |
$112.52 |
| 90680 |
|
832 |
789 |
$92.25 |
| 90734 |
|
292 |
262 |
$80.03 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
27 |
$71.00 |
| 3074F |
|
3,776 |
3,494 |
$62.44 |
| 90700 |
|
59 |
57 |
$49.42 |
| 90651 |
|
376 |
347 |
$45.00 |
| G9920 |
Screening performed and negative |
20 |
19 |
$29.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
229 |
226 |
$28.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
338 |
334 |
$26.75 |
| 90710 |
|
123 |
113 |
$18.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
44 |
42 |
$16.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
51 |
51 |
$10.10 |
| 90715 |
|
113 |
101 |
$9.00 |
| 99381 |
|
44 |
43 |
$9.00 |
| 2001F |
|
8,303 |
7,035 |
$4.03 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
4,262 |
3,918 |
$0.00 |
| 3078F |
|
3,371 |
3,118 |
$0.00 |
| Z6400 |
|
775 |
772 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
291 |
271 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
256 |
160 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
67 |
64 |
$0.00 |
| 3050F |
|
154 |
123 |
$0.00 |
| 3077F |
|
305 |
283 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
28 |
25 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
40 |
39 |
$0.00 |
| 90713 |
|
29 |
27 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
139 |
121 |
$0.00 |
| 4004F |
|
766 |
726 |
$0.00 |
| 90707 |
|
73 |
70 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
133 |
132 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$0.00 |
| 3046F |
|
30 |
26 |
$0.00 |
| Z6300 |
|
15 |
15 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
12 |
$0.00 |
| Z6500 |
|
12 |
12 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,717 |
1,078 |
$0.00 |
| 3008F |
|
8,302 |
7,036 |
$0.00 |
| 3048F |
|
1,511 |
1,265 |
$0.00 |
| Z1034 |
|
3,349 |
2,619 |
$0.00 |
| 1036F |
|
8,038 |
6,824 |
$0.00 |
| 1111F |
|
7,181 |
6,325 |
$0.00 |
| Z6410 |
|
685 |
640 |
$0.00 |
| 3079F |
|
1,191 |
1,126 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
4,589 |
4,192 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,822 |
923 |
$0.00 |
| 3049F |
|
738 |
619 |
$0.00 |
| 3075F |
|
300 |
285 |
$0.00 |
| 90716 |
|
68 |
64 |
$0.00 |
| 90656 |
|
173 |
170 |
$0.00 |
| 90744 |
|
15 |
15 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
41 |
39 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 86580 |
|
21 |
14 |
$0.00 |
| 90688 |
|
93 |
87 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
54 |
54 |
$0.00 |
| Z6406 |
|
211 |
211 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
105 |
79 |
$0.00 |
| 3080F |
|
14 |
12 |
$0.00 |
| Z6402 |
|
27 |
27 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
23 |
16 |
$0.00 |
| Z1032 |
|
16 |
16 |
$0.00 |