| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
300,802 |
228,184 |
$32.58M |
| 00003 |
Internal/system code - not a standard HCPCS code |
97,115 |
58,377 |
$14.07M |
| 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 |
6,526 |
4,887 |
$249K |
| 0001A |
|
2,397 |
1,316 |
$107K |
| 0002A |
|
2,183 |
1,209 |
$98K |
| 0012A |
|
973 |
581 |
$43K |
| 0011A |
|
973 |
582 |
$36K |
| 0064A |
|
696 |
424 |
$31K |
| 0071A |
|
644 |
342 |
$29K |
| 0004A |
|
490 |
314 |
$23K |
| 0072A |
|
392 |
220 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
121,664 |
93,726 |
$13K |
| 0031A |
|
228 |
132 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29,648 |
24,125 |
$10K |
| G9920 |
Screening performed and negative |
1,837 |
1,696 |
$2K |
| 0034A |
|
54 |
36 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,328 |
9,981 |
$2K |
| J3490 |
Unclassified drugs |
290 |
287 |
$2K |
| 0013A |
|
43 |
27 |
$2K |
| 0134A |
|
12 |
12 |
$804.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
350 |
347 |
$607.95 |
| G9919 |
Screening performed and positive and provision of recommendations |
79 |
79 |
$58.00 |
| 81025 |
|
1,418 |
1,398 |
$46.90 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,350 |
1,350 |
$0.00 |
| 3725F |
|
25,530 |
21,772 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,961 |
1,961 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,574 |
1,553 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,290 |
4,286 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
605 |
576 |
$0.00 |
| 99173 |
|
5,490 |
5,468 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,314 |
2,313 |
$0.00 |
| 1159F |
|
10,647 |
9,275 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
800 |
796 |
$0.00 |
| 3078F |
|
18,019 |
16,555 |
$0.00 |
| 90715 |
|
658 |
650 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
501 |
501 |
$0.00 |
| 90633 |
|
685 |
682 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,476 |
1,474 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
550 |
538 |
$0.00 |
| Z6400 |
|
743 |
726 |
$0.00 |
| 1160F |
|
10,648 |
9,276 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,364 |
1,355 |
$0.00 |
| 81003 |
|
3,806 |
3,487 |
$0.00 |
| 90710 |
|
386 |
386 |
$0.00 |
| D9430 |
|
1,135 |
1,095 |
$0.00 |
| 90644 |
|
37 |
36 |
$0.00 |
| 90649 |
|
439 |
438 |
$0.00 |
| 90658 |
|
261 |
260 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
469 |
468 |
$0.00 |
| 98940 |
|
1,699 |
1,144 |
$0.00 |
| 3077F |
|
1,591 |
1,507 |
$0.00 |
| 90670 |
|
868 |
867 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
650 |
648 |
$0.00 |
| Z6300 |
|
338 |
336 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
240 |
194 |
$0.00 |
| S3000 |
Diabetic indicator; retinal eye exam, dilated, bilateral |
640 |
638 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
208 |
205 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,587 |
1,555 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
167 |
162 |
$0.00 |
| Z6304 |
|
1,289 |
998 |
$0.00 |
| 92015 |
Determination of refractive state |
7,026 |
7,015 |
$0.00 |
| Z6308 |
|
107 |
105 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
45 |
36 |
$0.00 |
| D1110 |
Prophylaxis - adult |
203 |
201 |
$0.00 |
| 82274 |
|
114 |
108 |
$0.00 |
| Z6200 |
|
294 |
292 |
$0.00 |
| 90630 |
|
264 |
264 |
$0.00 |
| D4341 |
|
18 |
14 |
$0.00 |
| Z6208 |
|
28 |
28 |
$0.00 |
| D0270 |
|
122 |
121 |
$0.00 |
| 90681 |
|
128 |
128 |
$0.00 |
| 90707 |
|
17 |
17 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$0.00 |
| 90700 |
|
73 |
72 |
$0.00 |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
26 |
26 |
$0.00 |
| 90734 |
|
37 |
37 |
$0.00 |
| 90713 |
|
15 |
15 |
$0.00 |
| 11750 |
|
13 |
12 |
$0.00 |
| Z6414 |
|
38 |
38 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
70 |
69 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
13 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
2,034 |
1,995 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
146 |
144 |
$0.00 |
| 3074F |
|
20,417 |
18,651 |
$0.00 |
| 1036F |
|
27,372 |
22,764 |
$0.00 |
| 85018 |
|
4,636 |
4,605 |
$0.00 |
| 90723 |
|
363 |
362 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,803 |
2,801 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
645 |
643 |
$0.00 |
| Z6204 |
|
491 |
448 |
$0.00 |
| 1126F |
|
20,528 |
18,689 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,288 |
6,065 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,698 |
1,531 |
$0.00 |
| 3008F |
|
26,999 |
24,431 |
$0.00 |
| Z1034 |
|
2,560 |
1,996 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
86 |
86 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
307 |
299 |
$0.00 |
| 3079F |
|
7,136 |
6,745 |
$0.00 |
| 92551 |
|
5,191 |
5,164 |
$0.00 |
| 90677 |
|
349 |
349 |
$0.00 |
| D0603 |
|
631 |
628 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
4,143 |
3,892 |
$0.00 |
| 87428 |
|
159 |
158 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
6,586 |
1,808 |
$0.00 |
| 1125F |
|
1,019 |
989 |
$0.00 |
| Z6402 |
|
495 |
491 |
$0.00 |
| 90651 |
|
38 |
38 |
$0.00 |
| 90688 |
|
1,036 |
1,036 |
$0.00 |
| 3075F |
|
3,952 |
3,797 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
328 |
278 |
$0.00 |
| 90686 |
|
1,247 |
1,244 |
$0.00 |
| D1351 |
Sealant - per tooth |
135 |
39 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,063 |
1,020 |
$0.00 |
| 90697 |
|
410 |
410 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
686 |
677 |
$0.00 |
| D1310 |
|
300 |
297 |
$0.00 |
| Z6406 |
|
1,306 |
1,105 |
$0.00 |
| 90647 |
|
369 |
369 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,908 |
2,424 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
32 |
31 |
$0.00 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
8,561 |
5,831 |
$0.00 |
| 3080F |
|
503 |
487 |
$0.00 |
| 90696 |
|
63 |
63 |
$0.00 |
| 1034F |
|
320 |
253 |
$0.00 |
| 90619 |
|
171 |
171 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
176 |
171 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
69 |
69 |
$0.00 |
| 90656 |
|
322 |
322 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
15 |
15 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
243 |
242 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
57 |
57 |
$0.00 |
| 99381 |
|
79 |
77 |
$0.00 |
| 82962 |
|
106 |
103 |
$0.00 |
| 92227 |
|
54 |
50 |
$0.00 |
| 99243 |
|
19 |
19 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
34 |
34 |
$0.00 |
| 90716 |
|
18 |
18 |
$0.00 |
| D0601 |
|
28 |
28 |
$0.00 |
| D0602 |
|
60 |
60 |
$0.00 |
| 90381 |
|
14 |
14 |
$0.00 |
| 90620 |
|
24 |
24 |
$0.00 |
| 90657 |
|
53 |
53 |
$0.00 |