| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
20,616 |
3,769 |
$4.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
80,174 |
74,004 |
$2.44M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30,575 |
28,856 |
$1.14M |
| 96165 |
|
16,745 |
5,055 |
$814K |
| H0019 |
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem |
2,469 |
247 |
$456K |
| H2036 |
Alcohol and/or other drug treatment program, per diem |
26,515 |
4,478 |
$294K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
3,773 |
2,846 |
$266K |
| 96164 |
|
16,568 |
5,058 |
$232K |
| 99442 |
|
11,727 |
11,167 |
$223K |
| 99443 |
|
3,053 |
2,292 |
$151K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,137 |
2,368 |
$146K |
| 99441 |
|
12,263 |
11,704 |
$122K |
| 80305 |
|
12,870 |
9,819 |
$88K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,635 |
5,392 |
$84K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,204 |
8,057 |
$58K |
| H0001 |
Alcohol and/or drug assessment |
355 |
353 |
$45K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,171 |
3,581 |
$42K |
| 90686 |
|
5,829 |
5,768 |
$38K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
741 |
732 |
$29K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,665 |
3,630 |
$21K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
831 |
827 |
$20K |
| 36415 |
Collection of venous blood by venipuncture |
8,333 |
7,950 |
$16K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
185 |
179 |
$15K |
| 99348 |
|
281 |
185 |
$14K |
| 99215 |
Prolong outpt/office vis |
291 |
281 |
$13K |
| G9149 |
National committee for quality assurance - level 2 medical home |
74 |
74 |
$13K |
| 81025 |
|
1,761 |
1,714 |
$12K |
| 0031A |
|
323 |
322 |
$11K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
435 |
427 |
$11K |
| 90834 |
Psychotherapy, 45 minutes with patient |
203 |
179 |
$11K |
| 90677 |
|
39 |
38 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
109 |
109 |
$10K |
| 90746 |
|
249 |
246 |
$10K |
| 0012A |
|
231 |
231 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
132 |
131 |
$8K |
| 0011A |
|
216 |
216 |
$8K |
| 0064A |
|
193 |
191 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
558 |
549 |
$7K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$5K |
| 90837 |
Psychotherapy, 53 minutes with patient |
65 |
58 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
396 |
364 |
$4K |
| 90715 |
|
425 |
419 |
$4K |
| 99422 |
|
103 |
101 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
58 |
$4K |
| 81002 |
|
1,606 |
1,562 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
60 |
60 |
$3K |
| 90619 |
|
42 |
42 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
169 |
167 |
$2K |
| 90651 |
|
161 |
161 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
322 |
316 |
$2K |
| 36416 |
|
2,109 |
2,082 |
$1K |
| 90732 |
|
13 |
13 |
$1K |
| 99423 |
|
17 |
16 |
$988.04 |
| 99421 |
|
49 |
48 |
$937.34 |
| 3074F |
|
72,996 |
66,545 |
$906.32 |
| 90656 |
|
80 |
80 |
$674.30 |
| 99205 |
Prolong outpt/office vis |
14 |
14 |
$667.71 |
| 90707 |
|
25 |
25 |
$579.72 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
820 |
701 |
$574.57 |
| 0034A |
|
14 |
14 |
$560.00 |
| 90688 |
|
62 |
62 |
$481.74 |
| 0134A |
|
49 |
49 |
$400.38 |
| 99499 |
|
18 |
18 |
$365.00 |
| 99201 |
|
14 |
13 |
$207.84 |
| 90658 |
|
29 |
29 |
$200.00 |
| 86580 |
|
75 |
69 |
$178.31 |
| 83037 |
|
15 |
15 |
$153.44 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
21 |
21 |
$149.11 |
| 90734 |
|
82 |
79 |
$134.41 |
| 3044F |
|
646 |
640 |
$100.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
26 |
25 |
$57.06 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16 |
14 |
$33.64 |
| 85018 |
|
17 |
15 |
$28.32 |
| 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 |
242 |
209 |
$8.60 |
| 3078F |
|
66,069 |
60,282 |
$0.23 |
| 3079F |
|
16,819 |
15,816 |
$0.03 |
| 91313 |
|
183 |
182 |
$0.01 |
| 3077F |
|
2,630 |
2,454 |
$0.00 |
| T1017 |
Targeted case management, each 15 minutes |
103 |
44 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
100 |
100 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90633 |
|
50 |
48 |
$0.00 |
| 90710 |
|
27 |
27 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
89 |
43 |
$0.00 |
| 3075F |
|
6,419 |
5,998 |
$0.00 |
| 3080F |
|
1,992 |
1,893 |
$0.00 |
| 99402 |
|
188 |
139 |
$0.00 |
| 91301 |
|
551 |
547 |
$0.00 |
| 91306 |
|
254 |
250 |
$0.00 |
| 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 |
3,752 |
3,350 |
$0.00 |
| 91303 |
|
373 |
372 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
26 |
26 |
$0.00 |
| 99406 |
|
12 |
12 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |