| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
13,217 |
10,786 |
$295K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,011 |
1,006 |
$33K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,538 |
907 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
1,755 |
1,561 |
$5K |
| 90686 |
|
733 |
717 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
33 |
30 |
$739.60 |
| 90656 |
|
128 |
128 |
$378.93 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
463 |
442 |
$300.24 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
108 |
106 |
$262.14 |
| 90480 |
|
91 |
89 |
$80.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,209 |
2,183 |
$77.04 |
| 90832 |
Psychotherapy, 30 minutes with patient |
174 |
103 |
$65.62 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
156 |
149 |
$51.31 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
52 |
52 |
$38.09 |
| 90678 |
|
28 |
28 |
$23.22 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
300 |
296 |
$12.91 |
| ATP03 |
|
764 |
657 |
$6.95 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
24 |
24 |
$6.85 |
| 81003 |
|
39 |
38 |
$1.98 |
| G0008 |
Administration of influenza virus vaccine |
961 |
948 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,063 |
1,028 |
$0.00 |
| 82043 |
|
152 |
150 |
$0.00 |
| 0134A |
|
33 |
32 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
181 |
179 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
691 |
683 |
$0.00 |
| 0011A |
|
541 |
541 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,409 |
3,187 |
$0.00 |
| 96380 |
|
28 |
28 |
$0.00 |
| 91303 |
|
99 |
99 |
$0.00 |
| 91301 |
|
1,334 |
1,311 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
37 |
37 |
$0.00 |
| 0064A |
|
279 |
279 |
$0.00 |
| 0001A |
|
97 |
97 |
$0.00 |
| 85027 |
|
78 |
77 |
$0.00 |
| 91305 |
|
15 |
15 |
$0.00 |
| 91306 |
|
179 |
179 |
$0.00 |
| 0031A |
|
109 |
109 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
16 |
16 |
$0.00 |
| 0012A |
|
716 |
715 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
26 |
26 |
$0.00 |
| 82570 |
|
152 |
150 |
$0.00 |
| 80061 |
Lipid panel |
1,603 |
1,584 |
$0.00 |
| 0002A |
|
126 |
126 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
155 |
133 |
$0.00 |
| 91300 |
|
385 |
360 |
$0.00 |
| 91313 |
|
33 |
32 |
$0.00 |
| 0124A |
|
13 |
13 |
$0.00 |
| 91312 |
|
25 |
25 |
$0.00 |
| 91322 |
|
90 |
88 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
31 |
31 |
$0.00 |
| 0013A |
|
27 |
27 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
28 |
28 |
$0.00 |
| 0003A |
|
15 |
15 |
$0.00 |
| 0004A |
|
89 |
88 |
$0.00 |
| 0054A |
|
14 |
14 |
$0.00 |