| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
123,157 |
107,339 |
$8.24M |
| 00003 |
Internal/system code - not a standard HCPCS code |
4,438 |
3,399 |
$1.22M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
135,668 |
75,883 |
$188K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,307 |
3,980 |
$69K |
| 0011A |
|
291 |
291 |
$19K |
| J3490 |
Unclassified drugs |
234 |
182 |
$19K |
| 0001A |
|
268 |
265 |
$18K |
| 0012A |
|
241 |
241 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20,728 |
11,241 |
$16K |
| 0002A |
|
190 |
190 |
$13K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,976 |
1,318 |
$12K |
| 90715 |
|
360 |
326 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,500 |
14,572 |
$9K |
| 90677 |
|
622 |
617 |
$6K |
| 90651 |
|
322 |
308 |
$5K |
| 92552 |
|
302 |
272 |
$5K |
| 0054A |
|
57 |
57 |
$4K |
| 0004A |
|
54 |
53 |
$4K |
| 0064A |
|
43 |
43 |
$3K |
| 97802 |
|
30 |
27 |
$3K |
| 90732 |
|
31 |
26 |
$3K |
| 0124A |
|
36 |
36 |
$2K |
| 90686 |
|
456 |
451 |
$2K |
| G9919 |
Screening performed and positive and provision of recommendations |
4,049 |
4,036 |
$2K |
| 0003A |
|
35 |
33 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,056 |
2,818 |
$2K |
| 99000 |
|
23,284 |
22,512 |
$2K |
| 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 |
67 |
54 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
1,555 |
1,157 |
$1K |
| H1011 |
Family assessment by licensed behavioral health professional for state defined purposes |
12 |
12 |
$1K |
| 90688 |
|
135 |
134 |
$1K |
| 0013A |
|
21 |
21 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,106 |
700 |
$1K |
| 81025 |
|
1,107 |
1,096 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
223 |
129 |
$847.65 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
61,343 |
54,702 |
$831.69 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,550 |
1,059 |
$826.61 |
| 0031A |
|
12 |
12 |
$804.00 |
| G9920 |
Screening performed and negative |
1,225 |
1,225 |
$746.18 |
| 90734 |
|
188 |
180 |
$738.37 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,846 |
7,704 |
$615.83 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,593 |
1,513 |
$520.50 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,867 |
4,833 |
$498.38 |
| A4267 |
Contraceptive supply, condom, male, each |
61 |
61 |
$486.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,389 |
1,371 |
$435.89 |
| 83013 |
|
772 |
767 |
$409.56 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
324 |
324 |
$357.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,069 |
1,231 |
$345.19 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
868 |
503 |
$306.64 |
| 99215 |
Prolong outpt/office vis |
314 |
168 |
$283.15 |
| H2015 |
Comprehensive community support services, per 15 minutes |
12 |
12 |
$241.32 |
| T1027 |
Family training and counseling for child development, per 15 minutes |
12 |
12 |
$241.32 |
| 90656 |
|
211 |
211 |
$239.90 |
| H2027 |
Psychoeducational service, per 15 minutes |
12 |
12 |
$231.72 |
| 90837 |
Psychotherapy, 53 minutes with patient |
930 |
510 |
$229.01 |
| 90658 |
|
47 |
47 |
$190.53 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
908 |
855 |
$185.62 |
| 99401 |
|
15 |
14 |
$159.65 |
| 85018 |
|
4,329 |
4,258 |
$151.40 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
2,229 |
2,127 |
$133.26 |
| 99386 |
|
17 |
12 |
$132.20 |
| 99384 |
|
112 |
73 |
$130.90 |
| 90670 |
|
25 |
25 |
$117.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
819 |
503 |
$108.80 |
| 81005 |
|
2,688 |
2,665 |
$78.83 |
| 99173 |
|
2,663 |
2,660 |
$62.10 |
| 99383 |
|
194 |
129 |
$54.83 |
| 99381 |
|
55 |
38 |
$44.88 |
| 99188 |
|
37 |
37 |
$35.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
946 |
935 |
$33.66 |
| 92551 |
|
32 |
32 |
$22.15 |
| 90633 |
|
69 |
69 |
$20.00 |
| 90723 |
|
14 |
14 |
$19.80 |
| 88142 |
|
112 |
110 |
$18.13 |
| 83655 |
|
12 |
12 |
$10.63 |
| 90620 |
|
12 |
12 |
$9.00 |
| 90671 |
|
26 |
26 |
$8.91 |
| 81002 |
|
100 |
98 |
$6.83 |
| 81003 |
|
177 |
173 |
$3.90 |
| 82962 |
|
385 |
377 |
$1.98 |
| 3077F |
|
3,955 |
3,785 |
$0.00 |
| 3078F |
|
18,328 |
17,620 |
$0.00 |
| 96160 |
|
4,815 |
4,797 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,086 |
1,078 |
$0.00 |
| 99442 |
|
51 |
47 |
$0.00 |
| 11720 |
|
14 |
14 |
$0.00 |
| 91312 |
|
37 |
37 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
192 |
186 |
$0.00 |
| 3046F |
|
274 |
270 |
$0.00 |
| 90750 |
|
28 |
28 |
$0.00 |
| 3045F |
|
55 |
54 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90662 |
|
15 |
15 |
$0.00 |
| 90649 |
|
17 |
12 |
$0.00 |
| 3051F |
|
135 |
132 |
$0.00 |
| 90710 |
|
15 |
15 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
72 |
39 |
$0.00 |
| 99382 |
|
50 |
28 |
$0.00 |
| 99441 |
|
78 |
70 |
$0.00 |
| 3079F |
|
9,314 |
9,110 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
42,227 |
38,501 |
$0.00 |
| 3080F |
|
1,844 |
1,791 |
$0.00 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
4,000 |
3,253 |
$0.00 |
| 3044F |
|
1,198 |
1,188 |
$0.00 |
| 3052F |
|
244 |
240 |
$0.00 |
| 99385 |
|
267 |
163 |
$0.00 |
| 3074F |
|
20,816 |
20,042 |
$0.00 |
| 86580 |
|
65 |
64 |
$0.00 |
| G9012 |
Other specified case management service not elsewhere classified |
1,043 |
805 |
$0.00 |
| 3075F |
|
4,660 |
4,603 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
713 |
708 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
261 |
261 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
31 |
31 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
140 |
135 |
$0.00 |
| 90696 |
|
18 |
18 |
$0.00 |
| G8433 |
Screening for depression not completed, documented patient or medical reason |
38 |
38 |
$0.00 |