| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
203,444 |
173,568 |
$21.09M |
| 00003 |
Internal/system code - not a standard HCPCS code |
21,070 |
18,917 |
$3.37M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
68,501 |
55,057 |
$253K |
| 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 |
2,307 |
1,925 |
$90K |
| 98940 |
|
16,125 |
11,008 |
$50K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,946 |
6,737 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,890 |
6,743 |
$39K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15,165 |
13,795 |
$17K |
| 90791 |
Psychiatric diagnostic evaluation |
3,957 |
3,403 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,411 |
2,209 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,228 |
1,091 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,688 |
1,518 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,087 |
1,013 |
$8K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
133 |
80 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,873 |
1,792 |
$6K |
| 90832 |
Psychotherapy, 30 minutes with patient |
11,067 |
7,479 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
889 |
878 |
$4K |
| 85018 |
|
8,618 |
7,796 |
$4K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
137 |
126 |
$3K |
| 90686 |
|
2,667 |
2,465 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
212 |
190 |
$2K |
| J3490 |
Unclassified drugs |
139 |
131 |
$2K |
| 92551 |
|
4,632 |
4,145 |
$2K |
| 99000 |
|
1,792 |
1,559 |
$2K |
| 0001A |
|
24 |
15 |
$1K |
| V2020 |
Frames, purchases |
3,719 |
3,676 |
$1K |
| 99381 |
|
416 |
398 |
$1K |
| 0012A |
|
24 |
15 |
$1K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
72 |
62 |
$1K |
| 3074F |
|
6,660 |
6,081 |
$968.81 |
| 81005 |
|
2,167 |
1,451 |
$944.10 |
| 0054A |
|
23 |
23 |
$920.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,761 |
2,731 |
$736.82 |
| 83655 |
|
1,243 |
1,151 |
$555.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
46 |
42 |
$553.15 |
| 92015 |
Determination of refractive state |
7,875 |
7,844 |
$526.33 |
| 0011A |
|
18 |
16 |
$491.26 |
| 92341 |
|
550 |
545 |
$457.92 |
| 99173 |
|
4,585 |
4,107 |
$440.20 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$407.10 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
639 |
553 |
$371.50 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
80 |
75 |
$368.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
833 |
831 |
$341.77 |
| 90633 |
|
1,027 |
949 |
$290.85 |
| 90723 |
|
1,534 |
1,468 |
$288.15 |
| 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 |
18 |
$260.11 |
| 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 |
37 |
37 |
$246.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
593 |
591 |
$158.35 |
| 90715 |
|
189 |
169 |
$140.07 |
| 90651 |
|
466 |
418 |
$127.20 |
| 90648 |
|
1,928 |
1,823 |
$122.93 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
13 |
12 |
$118.16 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
58 |
55 |
$91.86 |
| 90700 |
|
190 |
170 |
$73.68 |
| 81003 |
|
2,332 |
1,617 |
$64.81 |
| 90734 |
|
415 |
370 |
$56.74 |
| 90670 |
|
1,792 |
1,699 |
$47.25 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
339 |
329 |
$40.66 |
| 90680 |
|
1,274 |
1,231 |
$40.50 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
29 |
26 |
$27.55 |
| 90710 |
|
201 |
178 |
$13.50 |
| 81025 |
|
99 |
88 |
$11.20 |
| 90696 |
|
175 |
153 |
$9.00 |
| 90716 |
|
272 |
255 |
$9.00 |
| 86580 |
|
13 |
12 |
$4.03 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
7,801 |
7,101 |
$0.00 |
| 3078F |
|
5,920 |
5,416 |
$0.00 |
| 3050F |
|
796 |
711 |
$0.00 |
| 3077F |
|
938 |
876 |
$0.00 |
| 90707 |
|
255 |
236 |
$0.00 |
| 92133 |
|
14 |
14 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
917 |
859 |
$0.00 |
| Z6400 |
|
725 |
724 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
413 |
246 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
71 |
71 |
$0.00 |
| 99201 |
|
49 |
48 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
16 |
16 |
$0.00 |
| 3051F |
|
12 |
12 |
$0.00 |
| 1111F |
|
12,225 |
10,846 |
$0.00 |
| 3048F |
|
2,152 |
1,917 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
8,348 |
7,595 |
$0.00 |
| 3080F |
|
181 |
175 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,810 |
928 |
$0.00 |
| 1036F |
|
12,308 |
10,422 |
$0.00 |
| 3079F |
|
2,184 |
2,038 |
$0.00 |
| 3008F |
|
15,950 |
13,631 |
$0.00 |
| Z6410 |
|
1,022 |
854 |
$0.00 |
| 3049F |
|
1,369 |
1,223 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
307 |
292 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
185 |
138 |
$0.00 |
| 2001F |
|
15,952 |
13,633 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,834 |
1,092 |
$0.00 |
| Z1034 |
|
4,798 |
3,237 |
$0.00 |
| 90474 |
|
107 |
107 |
$0.00 |
| 90698 |
|
118 |
118 |
$0.00 |
| 90744 |
|
88 |
88 |
$0.00 |
| 3044F |
|
115 |
107 |
$0.00 |
| 3075F |
|
785 |
742 |
$0.00 |
| Z1032 |
|
184 |
184 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
194 |
145 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
58 |
45 |
$0.00 |
| 90656 |
|
249 |
246 |
$0.00 |
| 90677 |
|
260 |
253 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
64 |
31 |
$0.00 |
| 90620 |
|
13 |
13 |
$0.00 |
| Z1038 |
|
12 |
12 |
$0.00 |
| 87490 |
|
13 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
13 |
$0.00 |
| 87590 |
|
13 |
12 |
$0.00 |