| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
124,443 |
103,626 |
$23.87M |
| 00003 |
Internal/system code - not a standard HCPCS code |
22,713 |
13,828 |
$5.17M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,150 |
38,455 |
$601K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,598 |
11,938 |
$272K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,222 |
2,697 |
$124K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,889 |
2,948 |
$112K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,190 |
5,120 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,948 |
3,922 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,848 |
1,731 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,077 |
1,949 |
$49K |
| 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 |
4,733 |
3,712 |
$48K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,875 |
1,151 |
$43K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,385 |
5,336 |
$38K |
| 90791 |
Psychiatric diagnostic evaluation |
1,012 |
655 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,024 |
1,361 |
$26K |
| 92551 |
|
3,896 |
2,246 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
810 |
806 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
774 |
548 |
$16K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
173 |
110 |
$11K |
| 92552 |
|
2,054 |
1,350 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
184 |
107 |
$10K |
| 0071A |
|
185 |
93 |
$10K |
| 0072A |
|
179 |
92 |
$10K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
4,501 |
2,817 |
$9K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,085 |
1,399 |
$8K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
146 |
109 |
$7K |
| 85018 |
|
6,767 |
4,307 |
$7K |
| 98940 |
|
3,212 |
2,196 |
$6K |
| 90686 |
|
3,298 |
2,372 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
417 |
362 |
$5K |
| 81002 |
|
5,662 |
3,602 |
$5K |
| 99173 |
|
5,528 |
3,963 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
8,030 |
7,615 |
$4K |
| 90656 |
|
574 |
373 |
$3K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
52 |
41 |
$3K |
| G9012 |
Other specified case management service not elsewhere classified |
33 |
18 |
$3K |
| 90671 |
|
476 |
291 |
$3K |
| 90461 |
|
3,949 |
2,652 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
123 |
83 |
$3K |
| 90750 |
|
23 |
14 |
$2K |
| 82962 |
|
2,519 |
1,675 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,774 |
1,409 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
603 |
503 |
$2K |
| 90677 |
|
335 |
205 |
$2K |
| 90715 |
|
199 |
158 |
$2K |
| 90633 |
|
619 |
426 |
$2K |
| 0003A |
|
29 |
16 |
$2K |
| 99215 |
Prolong outpt/office vis |
38 |
27 |
$1K |
| 90697 |
|
367 |
223 |
$1K |
| 90647 |
|
825 |
588 |
$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 |
83 |
83 |
$1K |
| 90680 |
|
666 |
490 |
$1K |
| 90651 |
|
347 |
240 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
100 |
73 |
$1K |
| 90670 |
|
721 |
559 |
$945.00 |
| 90688 |
|
332 |
273 |
$934.89 |
| 90710 |
|
194 |
127 |
$920.83 |
| 90723 |
|
648 |
488 |
$891.00 |
| 90694 |
|
24 |
17 |
$685.26 |
| 99383 |
|
25 |
15 |
$657.96 |
| T1016 |
Case management, each 15 minutes |
28 |
17 |
$455.94 |
| 90620 |
|
12 |
12 |
$297.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
311 |
292 |
$283.82 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
149 |
131 |
$253.71 |
| 90619 |
|
99 |
50 |
$252.00 |
| 96127 |
|
146 |
114 |
$153.92 |
| 81025 |
|
179 |
147 |
$148.40 |
| 86580 |
|
104 |
94 |
$124.32 |
| 90734 |
|
144 |
116 |
$117.40 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
15 |
$97.35 |
| 90621 |
|
17 |
13 |
$45.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
12 |
$44.60 |
| 87420 |
|
16 |
14 |
$41.96 |
| 90707 |
|
25 |
15 |
$36.00 |
| 90716 |
|
23 |
14 |
$27.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
5,242 |
3,028 |
$7.41 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
5,010 |
2,867 |
$7.14 |
| 1159F |
|
27,344 |
22,052 |
$6.14 |
| 1036F |
|
28,199 |
21,156 |
$2.07 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
601 |
379 |
$0.96 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
390 |
220 |
$0.70 |
| 3051F |
|
354 |
232 |
$0.45 |
| 2022F |
|
4,991 |
3,656 |
$0.40 |
| 3052F |
|
103 |
64 |
$0.11 |
| 1034F |
|
1,218 |
945 |
$0.09 |
| 3044F |
|
678 |
555 |
$0.04 |
| 3074F |
|
16,674 |
12,881 |
$0.02 |
| 3008F |
|
28,110 |
21,567 |
$0.02 |
| 2001F |
|
28,132 |
21,585 |
$0.02 |
| 3078F |
|
16,403 |
12,752 |
$0.02 |
| 1126F |
|
6,145 |
4,907 |
$0.01 |
| 1035F |
|
24 |
15 |
$0.01 |
| 3046F |
|
51 |
41 |
$0.01 |
| 1125F |
|
1,808 |
1,479 |
$0.00 |
| 3079F |
|
4,322 |
3,419 |
$0.00 |
| 96146 |
|
14 |
14 |
$0.00 |
| 3080F |
|
690 |
503 |
$0.00 |
| 3075F |
|
3,096 |
2,476 |
$0.00 |
| 92002 |
|
2,011 |
2,003 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
26 |
26 |
$0.00 |
| 0500F |
|
12 |
12 |
$0.00 |
| Z1034 |
|
57 |
44 |
$0.00 |
| 90696 |
|
19 |
19 |
$0.00 |
| 1111F |
|
26 |
21 |
$0.00 |
| 90732 |
|
13 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$0.00 |
| 4004F |
|
797 |
726 |
$0.00 |
| 3077F |
|
1,812 |
1,432 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
65 |
65 |
$0.00 |
| 0502F |
|
248 |
180 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
220 |
169 |
$0.00 |
| 92015 |
Determination of refractive state |
25 |
25 |
$0.00 |
| 87400 |
|
24 |
24 |
$0.00 |