| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
110,398 |
91,875 |
$24.32M |
| 00003 |
Internal/system code - not a standard HCPCS code |
49,194 |
30,079 |
$13.50M |
| G9012 |
Other specified case management service not elsewhere classified |
11,477 |
7,589 |
$3.12M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61,375 |
39,166 |
$299K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
18,575 |
12,791 |
$159K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,773 |
1,081 |
$135K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29,996 |
20,827 |
$111K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,861 |
2,035 |
$102K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,877 |
3,885 |
$93K |
| 98940 |
|
6,200 |
2,395 |
$80K |
| 90686 |
|
8,113 |
5,099 |
$68K |
| 90750 |
|
645 |
390 |
$59K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15,630 |
9,704 |
$43K |
| 59425 |
|
527 |
366 |
$32K |
| 90677 |
|
272 |
148 |
$30K |
| G9920 |
Screening performed and negative |
1,909 |
1,374 |
$28K |
| 97802 |
|
476 |
459 |
$26K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
11,263 |
10,006 |
$25K |
| 90651 |
|
768 |
567 |
$22K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
577 |
287 |
$21K |
| 90715 |
|
890 |
632 |
$16K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,645 |
993 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,253 |
1,410 |
$15K |
| 90688 |
|
1,031 |
915 |
$12K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,782 |
1,223 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
858 |
821 |
$10K |
| 90670 |
|
1,342 |
804 |
$8K |
| 90698 |
|
978 |
576 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,262 |
1,412 |
$5K |
| 92551 |
|
11,601 |
8,141 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,229 |
780 |
$4K |
| H0049 |
Alcohol and/or drug screening |
387 |
384 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,081 |
1,828 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,157 |
1,905 |
$4K |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
207 |
206 |
$3K |
| 90662 |
|
246 |
214 |
$3K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
243 |
181 |
$3K |
| 90734 |
|
363 |
250 |
$3K |
| 81025 |
|
1,662 |
1,189 |
$3K |
| G9919 |
Screening performed and positive and provision of recommendations |
204 |
137 |
$3K |
| 99401 |
|
140 |
119 |
$3K |
| 90680 |
|
516 |
312 |
$3K |
| 83655 |
|
447 |
244 |
$3K |
| 90656 |
|
411 |
268 |
$3K |
| 96160 |
|
612 |
583 |
$3K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,438 |
2,909 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,512 |
1,044 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
279 |
195 |
$2K |
| 99215 |
Prolong outpt/office vis |
464 |
395 |
$2K |
| 90756 |
|
96 |
62 |
$2K |
| 90633 |
|
316 |
173 |
$2K |
| 90744 |
|
236 |
168 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
877 |
825 |
$1K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
60 |
52 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
347 |
343 |
$1K |
| J3490 |
Unclassified drugs |
16 |
12 |
$1K |
| 90661 |
|
69 |
50 |
$1K |
| 81002 |
|
3,352 |
2,349 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,055 |
2,783 |
$911.29 |
| 97803 |
|
14 |
14 |
$902.29 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
46 |
41 |
$862.50 |
| 96156 |
|
44 |
39 |
$765.39 |
| 92015 |
Determination of refractive state |
895 |
846 |
$723.30 |
| 96127 |
|
214 |
147 |
$260.69 |
| 90653 |
|
20 |
18 |
$255.96 |
| 94150 |
|
33 |
31 |
$183.81 |
| 90648 |
|
30 |
12 |
$171.00 |
| 90700 |
|
30 |
13 |
$162.00 |
| 90685 |
|
17 |
17 |
$153.00 |
| 93000 |
|
69 |
49 |
$152.21 |
| 85018 |
|
2,435 |
2,353 |
$143.18 |
| 90619 |
|
22 |
14 |
$126.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,731 |
1,691 |
$124.88 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
20 |
12 |
$68.60 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19 |
12 |
$62.88 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
659 |
322 |
$54.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
211 |
205 |
$49.06 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
361 |
256 |
$48.93 |
| 11721 |
|
12 |
12 |
$43.07 |
| 90461 |
|
259 |
258 |
$26.84 |
| 86580 |
|
12 |
12 |
$3.36 |
| 82947 |
|
47 |
37 |
$3.30 |
| 94760 |
|
17 |
13 |
$1.00 |
| 99173 |
|
4,537 |
4,529 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
234 |
214 |
$0.00 |
| 90785 |
|
149 |
112 |
$0.00 |
| Z6400 |
|
112 |
109 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
119 |
116 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
22 |
12 |
$0.00 |
| 90473 |
|
24 |
24 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
19 |
19 |
$0.00 |
| 2028F |
|
12 |
12 |
$0.00 |
| 92133 |
|
14 |
14 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
22 |
13 |
$0.00 |
| 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 |
4,090 |
3,597 |
$0.00 |
| Z1034 |
|
2,127 |
1,447 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
357 |
218 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
154 |
154 |
$0.00 |
| Z6406 |
|
27 |
24 |
$0.00 |
| 90480 |
|
14 |
14 |
$0.00 |
| Z1038 |
|
12 |
12 |
$0.00 |
| 96380 |
|
12 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
20 |
20 |
$0.00 |
| 92250 |
|
15 |
15 |
$0.00 |