| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
232,679 |
214,856 |
$32.81M |
| 00003 |
Internal/system code - not a standard HCPCS code |
7,152 |
6,627 |
$1.60M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
124,726 |
108,208 |
$1.37M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50,286 |
43,440 |
$773K |
| 96156 |
|
19,143 |
18,532 |
$560K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,305 |
1,859 |
$197K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,084 |
8,177 |
$197K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
9,046 |
8,002 |
$192K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,634 |
4,707 |
$171K |
| 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 |
6,789 |
5,851 |
$129K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,619 |
4,089 |
$125K |
| 59425 |
|
2,050 |
1,391 |
$121K |
| 96158 |
|
5,050 |
2,923 |
$118K |
| 90686 |
|
14,837 |
13,990 |
$91K |
| 0012A |
|
1,530 |
890 |
$78K |
| 0011A |
|
1,521 |
892 |
$64K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,945 |
1,852 |
$63K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,283 |
2,001 |
$60K |
| 99215 |
Prolong outpt/office vis |
1,242 |
1,081 |
$55K |
| 0001A |
|
1,196 |
654 |
$54K |
| 0002A |
|
1,002 |
551 |
$52K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,031 |
1,000 |
$51K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,581 |
7,820 |
$47K |
| 97802 |
|
1,116 |
942 |
$45K |
| 90670 |
|
7,535 |
6,375 |
$43K |
| 97811 |
|
2,969 |
1,779 |
$42K |
| 97810 |
|
3,017 |
1,809 |
$42K |
| 90715 |
|
1,729 |
1,682 |
$41K |
| 90677 |
|
1,588 |
1,023 |
$38K |
| 90651 |
|
1,023 |
968 |
$35K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13,144 |
11,891 |
$30K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,607 |
1,418 |
$28K |
| 97803 |
|
1,154 |
952 |
$28K |
| G9920 |
Screening performed and negative |
6,106 |
5,215 |
$27K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
6,273 |
5,172 |
$26K |
| 59430 |
|
289 |
282 |
$24K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
466 |
465 |
$24K |
| 96151 |
|
2,336 |
2,305 |
$24K |
| 0064A |
|
436 |
257 |
$22K |
| 90750 |
|
149 |
143 |
$22K |
| 96167 |
|
559 |
483 |
$20K |
| 90698 |
|
4,023 |
3,320 |
$19K |
| 96159 |
|
2,696 |
1,374 |
$18K |
| 0072A |
|
322 |
164 |
$17K |
| H1000 |
Prenatal care, at-risk assessment |
111 |
110 |
$17K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
184 |
176 |
$17K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
431 |
427 |
$16K |
| 90633 |
|
2,624 |
2,472 |
$16K |
| 0071A |
|
354 |
181 |
$16K |
| D1110 |
Prophylaxis - adult |
274 |
273 |
$16K |
| 99051 |
|
3,382 |
3,213 |
$15K |
| 0004A |
|
293 |
165 |
$15K |
| D1120 |
Prophylaxis - child |
644 |
625 |
$15K |
| 81003 |
|
23,159 |
17,660 |
$15K |
| 90681 |
|
2,669 |
2,133 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,033 |
1,884 |
$13K |
| D0120 |
Periodic oral evaluation - established patient |
467 |
464 |
$12K |
| 90656 |
|
1,397 |
1,036 |
$11K |
| 90744 |
|
1,977 |
1,948 |
$11K |
| 99385 |
|
138 |
138 |
$9K |
| T1027 |
Family training and counseling for child development, per 15 minutes |
744 |
513 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
188 |
185 |
$8K |
| 81025 |
|
3,032 |
2,774 |
$7K |
| 90697 |
|
2,194 |
1,793 |
$7K |
| 90716 |
|
867 |
721 |
$7K |
| H2015 |
Comprehensive community support services, per 15 minutes |
706 |
463 |
$7K |
| 90707 |
|
775 |
699 |
$7K |
| D1206 |
Topical application of fluoride varnish |
631 |
613 |
$6K |
| D0145 |
Oral evaluation for a patient under three years of age |
180 |
177 |
$6K |
| 90658 |
|
467 |
466 |
$6K |
| 90619 |
|
254 |
202 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
887 |
876 |
$5K |
| 90710 |
|
825 |
501 |
$5K |
| 90700 |
|
512 |
509 |
$5K |
| 92551 |
|
956 |
773 |
$5K |
| 90648 |
|
489 |
487 |
$4K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
2,988 |
2,953 |
$4K |
| 90734 |
|
793 |
455 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
253 |
238 |
$4K |
| 85018 |
|
3,521 |
3,291 |
$4K |
| 0054A |
|
66 |
39 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
79 |
64 |
$3K |
| 93000 |
|
201 |
191 |
$3K |
| 96127 |
|
2,503 |
1,458 |
$3K |
| 99401 |
|
272 |
254 |
$3K |
| 90696 |
|
406 |
341 |
$3K |
| 96170 |
|
138 |
83 |
$3K |
| 99386 |
|
25 |
25 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,033 |
1,659 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
43 |
30 |
$3K |
| 0124A |
|
40 |
40 |
$3K |
| 90649 |
|
604 |
121 |
$2K |
| 96150 |
|
138 |
134 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
144 |
144 |
$2K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
123 |
120 |
$2K |
| 90662 |
|
314 |
313 |
$1K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
145 |
117 |
$1K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
72 |
66 |
$1K |
| 99234 |
|
12,157 |
9,790 |
$1K |
| 90685 |
|
141 |
138 |
$1K |
| 90480 |
|
70 |
41 |
$1K |
| H2027 |
Psychoeducational service, per 15 minutes |
95 |
68 |
$1K |
| 85999 |
|
316 |
316 |
$951.16 |
| 90620 |
|
144 |
124 |
$893.46 |
| D0272 |
Bitewings - two radiographic images |
80 |
79 |
$814.00 |
| 99443 |
|
69 |
68 |
$777.27 |
| 85610 |
|
1,034 |
852 |
$740.61 |
| G0008 |
Administration of influenza virus vaccine |
393 |
388 |
$617.34 |
| D0274 |
Bitewings - four radiographic images |
28 |
28 |
$561.60 |
| 90672 |
|
184 |
162 |
$549.00 |
| 82947 |
|
564 |
525 |
$456.42 |
| 99173 |
|
591 |
579 |
$449.80 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
27 |
$413.54 |
| 99442 |
|
43 |
41 |
$367.84 |
| D0220 |
Intraoral - periapical first radiographic image |
26 |
26 |
$284.00 |
| 91322 |
|
24 |
14 |
$218.88 |
| Q3014 |
Telehealth originating site facility fee |
1,071 |
993 |
$195.25 |
| 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 |
14 |
12 |
$163.94 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
333 |
316 |
$103.95 |
| 99070 |
|
45 |
43 |
$101.81 |
| 96152 |
|
55 |
39 |
$78.74 |
| 96154 |
|
36 |
30 |
$64.65 |
| 81001 |
|
1,052 |
978 |
$62.00 |
| 99381 |
|
40 |
40 |
$60.29 |
| G0009 |
Administration of pneumococcal vaccine |
17 |
12 |
$57.06 |
| 90461 |
|
236 |
220 |
$45.00 |
| 80053 |
Comprehensive metabolic panel |
2,136 |
1,660 |
$40.00 |
| J3490 |
Unclassified drugs |
235 |
194 |
$39.86 |
| 96160 |
|
4,478 |
4,349 |
$20.10 |
| 90660 |
|
23 |
14 |
$18.00 |
| 90746 |
|
24 |
24 |
$4.69 |
| 81002 |
|
25 |
19 |
$3.44 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
438 |
409 |
$2.23 |
| Z1034 |
|
10,807 |
9,074 |
$0.00 |
| 83690 |
|
438 |
411 |
$0.00 |
| 3074F |
|
2,257 |
2,204 |
$0.00 |
| D0603 |
|
44 |
44 |
$0.00 |
| 0250 |
|
585 |
548 |
$0.00 |
| 96161 |
|
611 |
552 |
$0.00 |
| 0301 |
|
59 |
56 |
$0.00 |
| 83605 |
|
95 |
82 |
$0.00 |
| 3075F |
|
470 |
459 |
$0.00 |
| 84484 |
|
315 |
282 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,407 |
1,844 |
$0.00 |
| Z1032 |
|
655 |
651 |
$0.00 |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
27 |
26 |
$0.00 |
| 3079F |
|
477 |
461 |
$0.00 |
| 0258 |
|
79 |
75 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
375 |
355 |
$0.00 |
| 0306 |
|
364 |
350 |
$0.00 |
| 83735 |
|
786 |
549 |
$0.00 |
| Z6402 |
|
12 |
12 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
308 |
265 |
$0.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,556 |
2,328 |
$0.00 |
| 0324 |
|
128 |
122 |
$0.00 |
| Z1038 |
|
295 |
288 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
48 |
47 |
$0.00 |
| Z6410 |
|
240 |
202 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
677 |
617 |
$0.00 |
| 0370 |
|
12 |
12 |
$0.00 |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
126 |
118 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
458 |
416 |
$0.00 |
| 85730 |
|
426 |
405 |
$0.00 |
| 0270 |
|
524 |
433 |
$0.00 |
| 0352 |
|
45 |
42 |
$0.00 |
| 0420 |
|
99 |
96 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
379 |
345 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
12 |
$0.00 |
| 3080F |
|
70 |
68 |
$0.00 |
| D0601 |
|
118 |
116 |
$0.00 |
| 0206 |
|
82 |
79 |
$0.00 |
| 86901 |
|
44 |
41 |
$0.00 |
| 86850 |
|
44 |
41 |
$0.00 |
| 0949 |
|
27 |
26 |
$0.00 |
| 0710 |
|
42 |
40 |
$0.00 |
| 0255 |
|
13 |
12 |
$0.00 |
| 99441 |
|
14 |
14 |
$0.00 |
| 3078F |
|
4,699 |
4,495 |
$0.00 |
| 84100 |
|
425 |
277 |
$0.00 |
| 84702 |
|
237 |
221 |
$0.00 |
| 3077F |
|
1,441 |
1,335 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
846 |
786 |
$0.00 |
| 0300 |
|
540 |
505 |
$0.00 |
| 0320 |
|
40 |
39 |
$0.00 |
| G9656 |
Patient transferred directly from anesthetizing location to pacu or other non-icu location |
165 |
160 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
13 |
$0.00 |
| Z6304 |
|
279 |
270 |
$0.00 |
| 0450 |
Emergency room services |
293 |
280 |
$0.00 |
| 0430 |
|
63 |
63 |
$0.00 |
| 0521 |
|
110 |
78 |
$0.00 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
180 |
176 |
$0.00 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,001 |
922 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
84 |
79 |
$0.00 |
| Z6414 |
|
102 |
100 |
$0.00 |
| 0390 |
|
44 |
42 |
$0.00 |
| 99354 |
|
113 |
112 |
$0.00 |
| 99201 |
|
36 |
36 |
$0.00 |
| 0360 |
|
238 |
161 |
$0.00 |
| 0402 |
|
39 |
38 |
$0.00 |
| 0730 |
|
106 |
102 |
$0.00 |
| Z6300 |
|
14 |
14 |
$0.00 |
| 99336 |
|
15 |
14 |
$0.00 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
288 |
276 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
87 |
43 |
$0.00 |
| Z6200 |
|
41 |
37 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
89 |
86 |
$0.00 |
| 0160 |
|
13 |
12 |
$0.00 |
| 92504 |
|
26 |
25 |
$0.00 |
| Z6202 |
|
70 |
70 |
$0.00 |
| 86900 |
|
44 |
41 |
$0.00 |
| 0121 |
|
13 |
12 |
$0.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
24 |
24 |
$0.00 |
| 91321 |
|
20 |
12 |
$0.00 |
| 0760 |
|
229 |
178 |
$0.00 |