| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
108,420 |
87,316 |
$21.75M |
| 00003 |
Internal/system code - not a standard HCPCS code |
7,178 |
5,918 |
$2.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
146,214 |
111,278 |
$716K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45,324 |
34,667 |
$363K |
| 96156 |
|
15,400 |
13,009 |
$267K |
| 90832 |
Psychotherapy, 30 minutes with patient |
12,632 |
4,382 |
$163K |
| 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 |
11,807 |
7,928 |
$147K |
| 92552 |
|
13,999 |
12,156 |
$51K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
340 |
340 |
$45K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
4,262 |
3,254 |
$45K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
5,212 |
3,048 |
$44K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,814 |
5,727 |
$28K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,343 |
2,646 |
$28K |
| 90686 |
|
6,871 |
6,189 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,092 |
891 |
$27K |
| 90791 |
Psychiatric diagnostic evaluation |
1,089 |
799 |
$25K |
| 97802 |
|
1,405 |
1,120 |
$22K |
| 99385 |
|
1,117 |
966 |
$22K |
| 97124 |
|
7,308 |
3,993 |
$20K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,195 |
1,754 |
$20K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,115 |
1,944 |
$17K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,271 |
1,636 |
$17K |
| 57410 |
|
712 |
701 |
$16K |
| 97810 |
|
9,391 |
5,085 |
$13K |
| 90662 |
|
1,466 |
1,217 |
$12K |
| 92551 |
|
3,797 |
3,739 |
$11K |
| G9920 |
Screening performed and negative |
539 |
499 |
$10K |
| 97026 |
|
3,100 |
1,445 |
$9K |
| 97811 |
|
9,034 |
4,868 |
$8K |
| 97803 |
|
894 |
615 |
$7K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
116 |
115 |
$7K |
| 90677 |
|
481 |
410 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,995 |
14,119 |
$6K |
| 90715 |
|
746 |
638 |
$6K |
| 99386 |
|
473 |
410 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,242 |
1,156 |
$6K |
| 99215 |
Prolong outpt/office vis |
685 |
583 |
$4K |
| 0013A |
|
98 |
97 |
$4K |
| 90651 |
|
487 |
471 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
600 |
574 |
$4K |
| 88142 |
|
712 |
708 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,025 |
3,296 |
$3K |
| 99397 |
|
915 |
678 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
315 |
213 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
987 |
939 |
$3K |
| 86480 |
|
376 |
353 |
$3K |
| 90746 |
|
102 |
96 |
$2K |
| 97813 |
|
2,141 |
1,418 |
$2K |
| 97814 |
|
1,806 |
1,164 |
$2K |
| 90656 |
|
1,011 |
853 |
$2K |
| 11721 |
|
171 |
131 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
240 |
236 |
$2K |
| 0012A |
|
691 |
589 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
88 |
78 |
$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 |
400 |
361 |
$1K |
| 90682 |
|
238 |
238 |
$1K |
| 96160 |
|
12,048 |
11,020 |
$1K |
| 0003A |
|
31 |
31 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
99 |
98 |
$1K |
| 81025 |
|
1,111 |
1,067 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
68 |
67 |
$1K |
| 90670 |
|
60 |
48 |
$1K |
| 80061 |
Lipid panel |
696 |
533 |
$972.30 |
| 11056 |
|
116 |
86 |
$971.15 |
| 90734 |
|
274 |
273 |
$971.00 |
| 95251 |
|
382 |
366 |
$899.00 |
| 85018 |
|
4,126 |
3,889 |
$889.97 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
27 |
24 |
$885.83 |
| 81001 |
|
2,844 |
2,348 |
$844.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
295 |
220 |
$812.59 |
| 90750 |
|
18 |
17 |
$810.05 |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$747.34 |
| 99173 |
|
10,446 |
9,244 |
$734.71 |
| 99000 |
|
543 |
511 |
$629.28 |
| 90633 |
|
164 |
156 |
$615.39 |
| 90620 |
|
67 |
63 |
$605.91 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
812 |
771 |
$568.27 |
| G0127 |
Trimming of dystrophic nails, any number |
285 |
284 |
$567.82 |
| 99406 |
|
430 |
378 |
$523.38 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
283 |
223 |
$491.64 |
| 93000 |
|
35 |
30 |
$489.66 |
| 98942 |
|
199 |
128 |
$451.27 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
14,093 |
11,805 |
$434.95 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
384 |
302 |
$418.48 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
29 |
$353.20 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,847 |
2,113 |
$343.30 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
460 |
393 |
$323.40 |
| 99490 |
Ccm add 20min |
422 |
393 |
$314.31 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12,107 |
9,633 |
$286.68 |
| 80053 |
Comprehensive metabolic panel |
738 |
602 |
$273.89 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
863 |
718 |
$238.77 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
209 |
153 |
$218.60 |
| 86317 |
|
113 |
107 |
$178.75 |
| 1036F |
|
24,101 |
20,062 |
$175.56 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$136.80 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,367 |
1,302 |
$126.72 |
| 90619 |
|
80 |
71 |
$126.00 |
| G0008 |
Administration of influenza virus vaccine |
320 |
280 |
$108.16 |
| G8482 |
Influenza immunization administered or previously received |
987 |
866 |
$85.18 |
| 86704 |
|
131 |
130 |
$83.60 |
| 98940 |
|
15 |
15 |
$83.60 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,240 |
1,166 |
$72.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
84 |
76 |
$69.76 |
| 82274 |
|
92 |
64 |
$69.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$68.40 |
| 81000 |
|
677 |
524 |
$67.71 |
| 96127 |
|
394 |
385 |
$60.80 |
| 59425 |
|
20 |
12 |
$60.48 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
448 |
385 |
$57.20 |
| 87340 |
|
149 |
145 |
$57.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
23 |
23 |
$52.73 |
| 86706 |
|
131 |
130 |
$52.25 |
| 90461 |
|
989 |
710 |
$50.86 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
624 |
532 |
$49.60 |
| 90732 |
|
68 |
55 |
$45.00 |
| 99442 |
|
63 |
57 |
$37.72 |
| 90744 |
|
12 |
12 |
$32.68 |
| 90674 |
|
231 |
188 |
$28.51 |
| 3078F |
|
21,422 |
19,211 |
$27.83 |
| 90710 |
|
15 |
12 |
$27.00 |
| 3074F |
|
21,643 |
19,492 |
$26.69 |
| 87623 |
|
342 |
338 |
$24.63 |
| 3017F |
|
2,281 |
1,752 |
$24.02 |
| 4040F |
|
48 |
30 |
$24.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
102 |
78 |
$24.00 |
| 81003 |
|
182 |
118 |
$19.09 |
| 82962 |
|
54 |
41 |
$15.80 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
16 |
16 |
$9.50 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,337 |
1,159 |
$3.13 |
| 84436 |
|
13 |
13 |
$2.45 |
| 84479 |
|
13 |
13 |
$2.37 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
932 |
886 |
$1.24 |
| 3725F |
|
17,990 |
15,631 |
$0.48 |
| 3008F |
|
41,538 |
35,729 |
$0.36 |
| 1159F |
|
12,943 |
10,964 |
$0.33 |
| 81528 |
Oncology (colorectal) screening, quantitative real-time target and signal amplification |
271 |
262 |
$0.27 |
| 1126F |
|
2,956 |
2,559 |
$0.27 |
| 3075F |
|
4,578 |
4,258 |
$0.27 |
| 3079F |
|
9,120 |
8,421 |
$0.25 |
| 3077F |
|
4,493 |
4,004 |
$0.24 |
| 1160F |
|
15,506 |
13,097 |
$0.23 |
| S0316 |
Disease management program, follow-up/reassessment |
730 |
641 |
$0.10 |
| 3080F |
|
1,008 |
940 |
$0.06 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
1,453 |
1,124 |
$0.04 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
2,509 |
2,116 |
$0.03 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,388 |
2,079 |
$0.02 |
| 3044F |
|
511 |
456 |
$0.01 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
1,022 |
892 |
$0.00 |
| 1000F |
|
24,739 |
20,655 |
$0.00 |
| 3352F |
|
13,380 |
11,299 |
$0.00 |
| 2000F |
|
19,760 |
16,423 |
$0.00 |
| 91301 |
|
1,475 |
1,255 |
$0.00 |
| 3014F |
|
1,228 |
987 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
177 |
149 |
$0.00 |
| E0205 |
Heat lamp, with stand, includes bulb, or infrared element |
397 |
212 |
$0.00 |
| 0011A |
|
788 |
708 |
$0.00 |
| 3011F |
|
52 |
42 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
596 |
478 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
83 |
80 |
$0.00 |
| 2001F |
|
1,298 |
1,177 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
29 |
26 |
$0.00 |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
75 |
64 |
$0.00 |
| 86803 |
|
50 |
44 |
$0.00 |
| 1125F |
|
89 |
69 |
$0.00 |
| 4037F |
|
14 |
13 |
$0.00 |
| 1170F |
|
28 |
26 |
$0.00 |
| 2023F |
|
30 |
29 |
$0.00 |
| 3052F |
|
61 |
54 |
$0.00 |
| 0031A |
|
18 |
16 |
$0.00 |
| 91303 |
|
20 |
17 |
$0.00 |
| G9906 |
Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
13 |
12 |
$0.00 |
| 99457 |
|
35 |
31 |
$0.00 |
| G9745 |
Documented reason for not screening or recommending a follow-up for high blood pressure |
12 |
12 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
185 |
165 |
$0.00 |
| 4551F |
|
714 |
684 |
$0.00 |
| G9899 |
Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed |
203 |
135 |
$0.00 |
| 3016F |
|
2,717 |
2,264 |
$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 |
84 |
66 |
$0.00 |
| 3015F |
|
1,412 |
1,139 |
$0.00 |
| 3046F |
|
56 |
53 |
$0.00 |
| 4004F |
|
307 |
259 |
$0.00 |
| 3051F |
|
116 |
100 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
540 |
467 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
78 |
73 |
$0.00 |
| 90713 |
|
13 |
13 |
$0.00 |
| 2028F |
|
330 |
268 |
$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) |
57 |
56 |
$0.00 |
| G9991 |
Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period |
68 |
50 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
14 |
14 |
$0.00 |
| 77062 |
|
13 |
13 |
$0.00 |
| 91300 |
|
12 |
12 |
$0.00 |
| 82570 |
|
18 |
12 |
$0.00 |