| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
82,894 |
65,740 |
$16.93M |
| 00003 |
Internal/system code - not a standard HCPCS code |
31,548 |
25,028 |
$8.13M |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,108 |
2,676 |
$260K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43,527 |
29,698 |
$196K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
19,085 |
7,789 |
$167K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,304 |
3,746 |
$144K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,933 |
2,604 |
$91K |
| V2020 |
Frames, purchases |
5,303 |
3,857 |
$64K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,283 |
7,648 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,620 |
1,915 |
$36K |
| 97014 |
|
11,742 |
5,479 |
$36K |
| 92015 |
Determination of refractive state |
8,720 |
6,015 |
$34K |
| 59425 |
|
1,008 |
736 |
$30K |
| 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 |
4,827 |
4,102 |
$26K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
250 |
183 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
929 |
677 |
$16K |
| 90832 |
Psychotherapy, 30 minutes with patient |
510 |
207 |
$11K |
| 90686 |
|
692 |
583 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,491 |
1,136 |
$9K |
| 0011A |
|
136 |
136 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
852 |
480 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
192 |
127 |
$8K |
| 0012A |
|
109 |
109 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,626 |
1,126 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
291 |
182 |
$6K |
| 99205 |
Prolong outpt/office vis |
67 |
67 |
$6K |
| G9920 |
Screening performed and negative |
1,144 |
1,049 |
$4K |
| 99000 |
|
8,076 |
5,806 |
$4K |
| 0054A |
|
55 |
54 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
49 |
27 |
$3K |
| 0072A |
|
42 |
42 |
$3K |
| 90750 |
|
17 |
12 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,600 |
1,060 |
$2K |
| 0071A |
|
32 |
31 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
191 |
127 |
$2K |
| 0004A |
|
29 |
27 |
$2K |
| 92551 |
|
4,043 |
3,080 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,929 |
1,489 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,385 |
1,041 |
$1K |
| 81025 |
|
860 |
727 |
$1K |
| 98940 |
|
94 |
67 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
851 |
661 |
$1K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
57 |
40 |
$1K |
| 99215 |
Prolong outpt/office vis |
99 |
94 |
$978.20 |
| 90746 |
|
14 |
13 |
$975.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
285 |
139 |
$905.22 |
| 92083 |
|
73 |
38 |
$677.62 |
| L0625 |
Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf |
82 |
72 |
$643.94 |
| V2750 |
Anti-reflective coating, per lens |
730 |
300 |
$552.00 |
| 0124A |
|
12 |
12 |
$480.00 |
| 85018 |
|
7,770 |
5,855 |
$432.75 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,153 |
5,534 |
$369.57 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
15 |
$330.72 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
578 |
468 |
$186.55 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,363 |
2,281 |
$159.45 |
| 99401 |
|
13 |
12 |
$151.43 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
145 |
90 |
$107.35 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
32 |
14 |
$100.56 |
| 90656 |
|
18 |
18 |
$100.00 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
71 |
44 |
$81.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
66 |
65 |
$58.73 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
294 |
88 |
$43.62 |
| 99188 |
|
59 |
59 |
$21.60 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
17 |
16 |
$20.22 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$12.00 |
| 81002 |
|
177 |
156 |
$4.24 |
| 99173 |
|
3,684 |
2,697 |
$4.18 |
| 81003 |
|
69 |
62 |
$1.77 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,073 |
438 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,537 |
1,514 |
$0.00 |
| 36416 |
|
3,531 |
3,000 |
$0.00 |
| 3079F |
|
1,134 |
1,039 |
$0.00 |
| 1111F |
|
663 |
551 |
$0.00 |
| 3008F |
|
6,542 |
5,547 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
443 |
271 |
$0.00 |
| 3074F |
|
4,664 |
4,045 |
$0.00 |
| 3075F |
|
321 |
305 |
$0.00 |
| Z1034 |
|
736 |
563 |
$0.00 |
| 3080F |
|
76 |
69 |
$0.00 |
| Z1032 |
|
40 |
40 |
$0.00 |
| 96127 |
|
15 |
15 |
$0.00 |
| Z6410 |
|
96 |
51 |
$0.00 |
| 1159F |
|
25,483 |
15,985 |
$0.00 |
| 96160 |
|
1,380 |
1,237 |
$0.00 |
| 3078F |
|
4,031 |
3,536 |
$0.00 |
| 1160F |
|
25,481 |
15,984 |
$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) |
54 |
53 |
$0.00 |
| 3077F |
|
538 |
465 |
$0.00 |
| 90473 |
|
222 |
173 |
$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 |
80 |
60 |
$0.00 |
| 59426 |
|
50 |
31 |
$0.00 |