| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
61,805 |
53,398 |
$12.71M |
| 00003 |
Internal/system code - not a standard HCPCS code |
43,010 |
36,525 |
$10.61M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29,989 |
19,659 |
$157K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,956 |
1,864 |
$43K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20,814 |
13,290 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,583 |
2,480 |
$30K |
| 98940 |
|
3,578 |
2,071 |
$25K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,162 |
1,991 |
$13K |
| 90750 |
|
263 |
197 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,079 |
695 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,321 |
1,312 |
$7K |
| 90739 |
|
224 |
185 |
$6K |
| 90671 |
|
178 |
128 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,558 |
1,014 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,699 |
2,750 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,067 |
4,281 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,450 |
944 |
$2K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
743 |
397 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,205 |
1,019 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
629 |
616 |
$1K |
| 90686 |
|
3,356 |
2,368 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
42 |
24 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
954 |
641 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
86 |
55 |
$870.72 |
| 90656 |
|
329 |
245 |
$802.73 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
102 |
69 |
$712.65 |
| 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 |
18 |
16 |
$706.14 |
| 85018 |
|
6,072 |
4,100 |
$651.73 |
| 90715 |
|
301 |
211 |
$357.12 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,312 |
981 |
$307.05 |
| 81002 |
|
3,381 |
2,474 |
$283.87 |
| 90662 |
|
107 |
83 |
$150.38 |
| 90670 |
|
97 |
68 |
$108.75 |
| 99201 |
|
533 |
405 |
$77.86 |
| 81025 |
|
125 |
119 |
$64.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31 |
30 |
$51.27 |
| 92551 |
|
2,390 |
1,641 |
$20.37 |
| 92015 |
Determination of refractive state |
4,552 |
4,550 |
$9.85 |
| G0008 |
Administration of influenza virus vaccine |
31 |
26 |
$5.82 |
| 36416 |
|
382 |
288 |
$0.00 |
| 82962 |
|
1,881 |
1,354 |
$0.00 |
| 1036F |
|
312 |
299 |
$0.00 |
| 2010F |
|
253 |
241 |
$0.00 |
| 3008F |
|
506 |
485 |
$0.00 |
| 90651 |
|
411 |
269 |
$0.00 |
| 2001F |
|
227 |
219 |
$0.00 |
| 1125F |
|
15 |
13 |
$0.00 |
| 3074F |
|
106 |
101 |
$0.00 |
| 1126F |
|
59 |
57 |
$0.00 |
| 87428 |
|
20 |
14 |
$0.00 |
| 90480 |
|
52 |
41 |
$0.00 |
| 3079F |
|
28 |
28 |
$0.00 |
| 90688 |
|
163 |
150 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| Z6410 |
|
75 |
68 |
$0.00 |
| 4037F |
|
106 |
106 |
$0.00 |
| 90716 |
|
16 |
13 |
$0.00 |
| 4010F |
|
21 |
20 |
$0.00 |
| 90619 |
|
38 |
25 |
$0.00 |
| 92002 |
|
15 |
15 |
$0.00 |
| 82948 |
|
2,030 |
1,472 |
$0.00 |
| 4274F |
|
255 |
235 |
$0.00 |
| 99173 |
|
1,810 |
1,656 |
$0.00 |
| 90461 |
|
219 |
186 |
$0.00 |
| 1159F |
|
145 |
141 |
$0.00 |
| 90633 |
|
241 |
179 |
$0.00 |
| 59425 |
|
200 |
128 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
111 |
111 |
$0.00 |
| 90734 |
|
268 |
179 |
$0.00 |
| 1160F |
|
145 |
141 |
$0.00 |
| 98942 |
|
285 |
208 |
$0.00 |
| 3078F |
|
82 |
79 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
58 |
38 |
$0.00 |
| 91321 |
|
21 |
14 |
$0.00 |
| 4040F |
|
16 |
15 |
$0.00 |
| 91322 |
|
15 |
12 |
$0.00 |
| 4004F |
|
16 |
15 |
$0.00 |