| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
482,656 |
405,024 |
$66.49M |
| 00003 |
Internal/system code - not a standard HCPCS code |
139,743 |
94,428 |
$23.06M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
32,358 |
27,288 |
$756K |
| V2020 |
Frames, purchases |
21,385 |
21,334 |
$392K |
| 90791 |
Psychiatric diagnostic evaluation |
10,109 |
7,583 |
$386K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
224,876 |
146,372 |
$356K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
16,489 |
16,449 |
$298K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
118,100 |
80,535 |
$282K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
794 |
779 |
$278K |
| G9012 |
Other specified case management service not elsewhere classified |
1,130 |
1,050 |
$244K |
| 90832 |
Psychotherapy, 30 minutes with patient |
13,354 |
8,416 |
$221K |
| 92015 |
Determination of refractive state |
34,239 |
29,243 |
$151K |
| 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 |
3,542 |
3,069 |
$99K |
| 92341 |
|
3,080 |
3,080 |
$85K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
517 |
382 |
$47K |
| G9920 |
Screening performed and negative |
14,869 |
10,578 |
$41K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16,997 |
13,278 |
$29K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
362 |
281 |
$25K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
78 |
76 |
$23K |
| J3490 |
Unclassified drugs |
4,498 |
3,447 |
$22K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
12,983 |
10,063 |
$14K |
| 0011A |
|
198 |
198 |
$13K |
| 92250 |
|
3,209 |
2,247 |
$12K |
| 99460 |
|
986 |
732 |
$12K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,378 |
1,022 |
$11K |
| 99381 |
|
1,343 |
1,177 |
$11K |
| 81025 |
|
39,384 |
28,790 |
$11K |
| 11976 |
|
574 |
352 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,293 |
5,208 |
$9K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
684 |
462 |
$8K |
| 0072A |
|
111 |
111 |
$7K |
| 11981 |
|
309 |
241 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,573 |
2,951 |
$6K |
| 0071A |
|
65 |
65 |
$4K |
| 0002A |
|
64 |
64 |
$4K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
288 |
281 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15,297 |
11,019 |
$3K |
| 0004A |
|
52 |
52 |
$3K |
| 0001A |
|
49 |
49 |
$3K |
| 59514 |
|
12 |
12 |
$3K |
| 0012A |
|
44 |
44 |
$3K |
| H1000 |
Prenatal care, at-risk assessment |
671 |
670 |
$3K |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
6,454 |
3,843 |
$2K |
| 92133 |
|
647 |
469 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
119 |
113 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,671 |
6,539 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
146 |
95 |
$2K |
| 90670 |
|
10,024 |
7,915 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,078 |
3,256 |
$1K |
| 90680 |
|
8,082 |
6,280 |
$1K |
| G9919 |
Screening performed and positive and provision of recommendations |
118 |
104 |
$1K |
| 59425 |
|
10,211 |
7,867 |
$1K |
| 90715 |
|
4,686 |
3,039 |
$1K |
| 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 |
96 |
96 |
$1K |
| 88720 |
|
2,151 |
1,546 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,514 |
934 |
$995.15 |
| 90686 |
|
13,470 |
11,090 |
$958.44 |
| 90723 |
|
5,969 |
4,800 |
$924.75 |
| 76813 |
|
103 |
102 |
$911.88 |
| 90647 |
|
5,916 |
4,759 |
$873.59 |
| 81002 |
|
67,921 |
43,143 |
$873.12 |
| 90651 |
|
1,544 |
1,040 |
$817.34 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
41 |
14 |
$646.38 |
| 92551 |
|
19,906 |
13,915 |
$640.84 |
| 99241 |
|
27 |
26 |
$632.64 |
| 90697 |
|
3,149 |
2,257 |
$590.86 |
| 92285 |
|
226 |
142 |
$494.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
205 |
201 |
$477.02 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,983 |
1,962 |
$448.22 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
7,262 |
4,236 |
$429.72 |
| 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 |
19 |
19 |
$426.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,276 |
7,974 |
$416.55 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
263 |
263 |
$403.86 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,260 |
3,608 |
$374.80 |
| 90677 |
|
2,809 |
1,974 |
$363.20 |
| 59430 |
|
839 |
835 |
$356.83 |
| 85018 |
|
36,763 |
25,611 |
$351.15 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,791 |
3,090 |
$328.36 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
26 |
26 |
$321.40 |
| 99233 |
Prolong inpt eval add15 m |
24 |
14 |
$288.54 |
| 90633 |
|
4,657 |
3,331 |
$236.25 |
| 83655 |
|
4,172 |
3,089 |
$225.93 |
| 99173 |
|
17,818 |
12,308 |
$207.23 |
| 90734 |
|
1,138 |
740 |
$206.00 |
| 58300 |
|
19 |
12 |
$176.69 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,055 |
1,963 |
$170.16 |
| H2000 |
Comprehensive multidisciplinary evaluation |
319 |
319 |
$135.83 |
| 99215 |
Prolong outpt/office vis |
339 |
338 |
$124.19 |
| 82962 |
|
9,306 |
6,179 |
$121.93 |
| 90732 |
|
25 |
25 |
$110.00 |
| 90716 |
|
1,002 |
725 |
$94.50 |
| 90707 |
|
791 |
558 |
$81.00 |
| 99222 |
Initial hospital care, per day, moderate complexity |
19 |
13 |
$79.86 |
| 90700 |
|
2,578 |
1,854 |
$76.50 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
185 |
114 |
$59.30 |
| 99401 |
|
569 |
568 |
$52.99 |
| 90746 |
|
64 |
56 |
$52.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
20 |
16 |
$48.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
499 |
319 |
$30.42 |
| 96156 |
|
793 |
792 |
$30.28 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
318 |
297 |
$22.71 |
| 97803 |
|
473 |
472 |
$22.71 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
113,709 |
62,026 |
$18.70 |
| 90710 |
|
189 |
115 |
$18.00 |
| 90688 |
|
3,554 |
1,992 |
$9.00 |
| 90713 |
|
242 |
148 |
$9.00 |
| 90380 |
|
26 |
23 |
$9.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
411 |
279 |
$8.88 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
114 |
64 |
$8.00 |
| 90381 |
|
14 |
13 |
$2.55 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,044 |
721 |
$0.32 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12,224 |
11,672 |
$0.10 |
| 2023F |
|
1,548 |
1,054 |
$0.06 |
| 99406 |
|
100 |
61 |
$0.02 |
| 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) |
1,740 |
1,211 |
$0.00 |
| Z1034 |
|
30,651 |
24,085 |
$0.00 |
| Z1032 |
|
2,518 |
2,509 |
$0.00 |
| 3074F |
|
8,815 |
5,243 |
$0.00 |
| 3079F |
|
5,032 |
3,050 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
26 |
25 |
$0.00 |
| Z6410 |
|
395 |
374 |
$0.00 |
| Z1038 |
|
992 |
978 |
$0.00 |
| 3044F |
|
882 |
529 |
$0.00 |
| Z6406 |
|
544 |
542 |
$0.00 |
| 99383 |
|
50 |
50 |
$0.00 |
| Z6204 |
|
465 |
464 |
$0.00 |
| 3075F |
|
2,356 |
1,426 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
149 |
143 |
$0.00 |
| 86580 |
|
185 |
125 |
$0.00 |
| 96151 |
|
27 |
27 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
80 |
80 |
$0.00 |
| 3080F |
|
342 |
204 |
$0.00 |
| 90632 |
|
18 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
22 |
22 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
50 |
26 |
$0.00 |
| 3078F |
|
9,011 |
5,367 |
$0.00 |
| Z6304 |
|
450 |
450 |
$0.00 |
| 3077F |
|
2,752 |
1,674 |
$0.00 |
| Z6500 |
|
1,244 |
1,240 |
$0.00 |
| Z6400 |
|
1,992 |
1,989 |
$0.00 |
| G9357 |
Post-partum screenings, evaluations and education performed |
898 |
620 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
188 |
188 |
$0.00 |
| 99382 |
|
18 |
18 |
$0.00 |
| 90678 |
|
150 |
96 |
$0.00 |
| 98940 |
|
19 |
19 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
22 |
22 |
$0.00 |
| Z6208 |
|
92 |
88 |
$0.00 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
31 |
12 |
$0.00 |
| 11721 |
|
482 |
259 |
$0.00 |
| Z6308 |
|
28 |
28 |
$0.00 |
| 90621 |
|
60 |
49 |
$0.00 |
| 2022F |
|
19 |
13 |
$0.00 |
| Z6414 |
|
33 |
33 |
$0.00 |
| 3046F |
|
25 |
25 |
$0.00 |
| 59025 |
Fetal non-stress test |
36 |
14 |
$0.00 |