| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
69,718 |
59,529 |
$10.72M |
| 00003 |
Internal/system code - not a standard HCPCS code |
21,332 |
17,270 |
$3.84M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
67,858 |
49,974 |
$1.01M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,795 |
14,420 |
$743K |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,596 |
5,058 |
$406K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15,081 |
12,011 |
$274K |
| 90791 |
Psychiatric diagnostic evaluation |
2,522 |
2,095 |
$261K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,528 |
5,529 |
$205K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
759 |
723 |
$93K |
| 99215 |
Prolong outpt/office vis |
788 |
652 |
$88K |
| 97802 |
|
3,437 |
2,656 |
$73K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,374 |
732 |
$58K |
| H0049 |
Alcohol and/or drug screening |
2,520 |
2,127 |
$57K |
| 97803 |
|
2,516 |
2,215 |
$52K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
444 |
371 |
$51K |
| 59425 |
|
2,613 |
1,833 |
$51K |
| 94760 |
|
79,003 |
55,167 |
$48K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,346 |
1,173 |
$43K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,533 |
1,325 |
$42K |
| 90837 |
Psychotherapy, 53 minutes with patient |
542 |
302 |
$41K |
| 92015 |
Determination of refractive state |
7,783 |
6,612 |
$41K |
| 96156 |
|
8,375 |
6,722 |
$38K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
234 |
217 |
$37K |
| 99401 |
|
1,161 |
997 |
$37K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,519 |
1,179 |
$22K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
245 |
242 |
$21K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,596 |
1,267 |
$19K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
1,887 |
1,625 |
$14K |
| 99173 |
|
11,784 |
9,436 |
$11K |
| 90686 |
|
5,834 |
4,536 |
$10K |
| 99000 |
|
15,816 |
13,706 |
$9K |
| 92551 |
|
7,105 |
5,551 |
$9K |
| 96160 |
|
955 |
809 |
$8K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
216 |
205 |
$6K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
617 |
545 |
$6K |
| H2000 |
Comprehensive multidisciplinary evaluation |
190 |
190 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
757 |
516 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
932 |
630 |
$5K |
| 82962 |
|
8,820 |
5,368 |
$5K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
525 |
502 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
894 |
881 |
$4K |
| 81025 |
|
3,040 |
2,619 |
$4K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,212 |
1,000 |
$4K |
| 96127 |
|
327 |
227 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
773 |
554 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,920 |
1,354 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
495 |
486 |
$3K |
| 90715 |
|
445 |
321 |
$3K |
| 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 |
149 |
121 |
$2K |
| 88141 |
|
42 |
31 |
$2K |
| 90839 |
|
14 |
14 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,440 |
1,031 |
$2K |
| 96161 |
|
516 |
397 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
507 |
381 |
$1K |
| 85018 |
|
9,401 |
7,196 |
$1K |
| 81002 |
|
7,611 |
4,893 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
768 |
642 |
$758.42 |
| 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 |
12 |
12 |
$555.28 |
| 99383 |
|
317 |
225 |
$492.58 |
| 90688 |
|
293 |
222 |
$451.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
71 |
67 |
$447.75 |
| 90671 |
|
288 |
198 |
$392.22 |
| 90648 |
|
110 |
101 |
$380.22 |
| 3008F |
|
94,041 |
66,483 |
$360.00 |
| 86580 |
|
426 |
371 |
$325.52 |
| 99407 |
|
30 |
21 |
$300.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
54 |
31 |
$285.81 |
| 90633 |
|
275 |
221 |
$145.65 |
| 90651 |
|
699 |
511 |
$130.82 |
| 90723 |
|
22 |
22 |
$124.74 |
| 90696 |
|
42 |
37 |
$115.83 |
| 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 |
772 |
760 |
$110.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,322 |
3,183 |
$98.00 |
| 90680 |
|
16 |
16 |
$89.10 |
| 90461 |
|
2,019 |
1,447 |
$84.00 |
| 99384 |
|
146 |
104 |
$75.98 |
| 82947 |
|
2,607 |
1,535 |
$70.76 |
| 98960 |
|
2,007 |
1,614 |
$65.00 |
| 90677 |
|
55 |
42 |
$46.82 |
| 90619 |
|
139 |
85 |
$29.00 |
| 83655 |
|
80 |
80 |
$21.26 |
| 90670 |
|
488 |
404 |
$21.00 |
| 90674 |
|
104 |
89 |
$20.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
30 |
29 |
$16.82 |
| 90681 |
|
72 |
52 |
$12.00 |
| 98966 |
|
194 |
101 |
$10.30 |
| 90744 |
|
111 |
84 |
$6.00 |
| 90700 |
|
42 |
35 |
$6.00 |
| 90713 |
|
39 |
32 |
$6.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
13,754 |
9,694 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
391 |
373 |
$0.00 |
| 3074F |
|
10,846 |
8,076 |
$0.00 |
| Z1034 |
|
2,110 |
1,476 |
$0.00 |
| 3079F |
|
1,610 |
1,113 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
4,798 |
3,254 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12,737 |
9,845 |
$0.00 |
| 1036F |
|
3,360 |
2,831 |
$0.00 |
| G9906 |
Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
110 |
69 |
$0.00 |
| 3075F |
|
863 |
568 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
197 |
131 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,270 |
2,972 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
3,576 |
2,448 |
$0.00 |
| 3080F |
|
93 |
58 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
438 |
437 |
$0.00 |
| 1000F |
|
2,601 |
2,220 |
$0.00 |
| 3044F |
|
281 |
178 |
$0.00 |
| G9717 |
Documentation stating the patient has had a diagnosis of bipolar disorder |
288 |
179 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
362 |
306 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
711 |
707 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
1,440 |
986 |
$0.00 |
| Z6410 |
|
852 |
701 |
$0.00 |
| 90697 |
|
280 |
190 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,090 |
1,852 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
680 |
207 |
$0.00 |
| Z6406 |
|
219 |
219 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
543 |
542 |
$0.00 |
| 1031F |
|
1,023 |
720 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
1,927 |
1,282 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
189 |
136 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
14 |
14 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
999 |
854 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
349 |
215 |
$0.00 |
| 2023F |
|
129 |
97 |
$0.00 |
| 99385 |
|
187 |
130 |
$0.00 |
| 87428 |
|
30 |
17 |
$0.00 |
| 86803 |
|
126 |
95 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
678 |
677 |
$0.00 |
| 90716 |
|
43 |
36 |
$0.00 |
| 90698 |
|
90 |
76 |
$0.00 |
| G0406 |
Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth |
550 |
336 |
$0.00 |
| D0603 |
|
1,309 |
1,309 |
$0.00 |
| 99402 |
|
27 |
27 |
$0.00 |
| 3017F |
|
32 |
25 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
22 |
13 |
$0.00 |
| Z6204 |
|
232 |
232 |
$0.00 |
| D0602 |
|
27 |
27 |
$0.00 |
| 1126F |
|
96 |
90 |
$0.00 |
| D1351 |
Sealant - per tooth |
48 |
16 |
$0.00 |
| Z6402 |
|
29 |
29 |
$0.00 |
| 99441 |
|
72 |
61 |
$0.00 |
| 1034F |
|
31 |
22 |
$0.00 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
46 |
32 |
$0.00 |
| 99386 |
|
60 |
39 |
$0.00 |
| Z1032 |
|
19 |
15 |
$0.00 |
| 1111F |
|
22 |
13 |
$0.00 |
| 90620 |
|
45 |
37 |
$0.00 |
| COVID |
Covid-19 convalescent plasma |
15 |
15 |
$0.00 |
| Z1038 |
|
25 |
25 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |
| D1352 |
|
16 |
12 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
3,241 |
2,064 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
14,817 |
10,315 |
$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) |
4,459 |
3,193 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
6,041 |
4,586 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
12,024 |
8,631 |
$0.00 |
| 3078F |
|
10,380 |
7,900 |
$0.00 |
| D1120 |
Prophylaxis - child |
518 |
514 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
2,846 |
1,937 |
$0.00 |
| 90734 |
|
240 |
160 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
189 |
177 |
$0.00 |
| 90756 |
|
330 |
238 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
2,016 |
1,225 |
$0.00 |
| 1160F |
|
2,725 |
2,225 |
$0.00 |
| Z6400 |
|
804 |
799 |
$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 |
329 |
253 |
$0.00 |
| 3077F |
|
725 |
392 |
$0.00 |
| D9430 |
|
195 |
191 |
$0.00 |
| G9920 |
Screening performed and negative |
405 |
347 |
$0.00 |
| Z6304 |
|
220 |
220 |
$0.00 |
| D4341 |
|
254 |
212 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
153 |
153 |
$0.00 |
| 4004F |
|
144 |
84 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
200 |
167 |
$0.00 |
| 1159F |
|
2,178 |
1,750 |
$0.00 |
| 96159 |
|
12 |
12 |
$0.00 |
| Z6500 |
|
212 |
212 |
$0.00 |
| 80061 |
Lipid panel |
477 |
342 |
$0.00 |
| 3046F |
|
19 |
13 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
411 |
358 |
$0.00 |
| Z6300 |
|
30 |
30 |
$0.00 |
| 90658 |
|
59 |
57 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
136 |
130 |
$0.00 |
| Z6200 |
|
30 |
30 |
$0.00 |
| D4910 |
|
39 |
39 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
63 |
50 |
$0.00 |
| G0407 |
Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth |
16 |
16 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
197 |
149 |
$0.00 |
| 2014F |
|
18 |
17 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
44 |
44 |
$0.00 |
| 80074 |
|
19 |
12 |
$0.00 |
| 90710 |
|
45 |
38 |
$0.00 |
| 81003 |
|
15 |
15 |
$0.00 |
| Z6414 |
|
28 |
25 |
$0.00 |
| 91312 |
|
35 |
19 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
12 |
12 |
$0.00 |