| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
256,426 |
227,262 |
$53.29M |
| 00003 |
Internal/system code - not a standard HCPCS code |
60,605 |
58,925 |
$15.96M |
| G9012 |
Other specified case management service not elsewhere classified |
3,049 |
2,726 |
$1.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
86,443 |
70,503 |
$471K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
168,288 |
138,325 |
$435K |
| 90791 |
Psychiatric diagnostic evaluation |
9,170 |
6,646 |
$281K |
| 90832 |
Psychotherapy, 30 minutes with patient |
21,128 |
13,233 |
$269K |
| 98940 |
|
9,994 |
6,600 |
$206K |
| 90750 |
|
1,242 |
1,160 |
$187K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,586 |
1,783 |
$157K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,597 |
4,717 |
$152K |
| 90688 |
|
9,091 |
8,632 |
$149K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,457 |
2,289 |
$142K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
76,140 |
64,660 |
$128K |
| 97810 |
|
7,933 |
5,619 |
$126K |
| 90715 |
|
3,448 |
3,122 |
$91K |
| 99215 |
Prolong outpt/office vis |
2,591 |
1,813 |
$89K |
| 97811 |
|
4,879 |
3,741 |
$83K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
4,086 |
3,743 |
$78K |
| G9920 |
Screening performed and negative |
4,387 |
4,233 |
$77K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,554 |
1,135 |
$67K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
2,000 |
978 |
$65K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,216 |
2,968 |
$62K |
| 90686 |
|
6,989 |
6,282 |
$61K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,246 |
4,629 |
$51K |
| 90651 |
|
2,562 |
2,364 |
$50K |
| 0012A |
|
1,027 |
620 |
$49K |
| 0011A |
|
1,059 |
661 |
$47K |
| 59425 |
|
711 |
560 |
$43K |
| 90670 |
|
3,992 |
3,705 |
$40K |
| J3490 |
Unclassified drugs |
798 |
728 |
$40K |
| 0001A |
|
813 |
460 |
$40K |
| 0002A |
|
772 |
447 |
$38K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,881 |
1,748 |
$31K |
| H1011 |
Family assessment by licensed behavioral health professional for state defined purposes |
302 |
292 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,944 |
1,766 |
$27K |
| 90698 |
|
3,360 |
3,001 |
$26K |
| 71046 |
Radiologic examination, chest; 2 views |
1,744 |
837 |
$25K |
| 90744 |
|
2,804 |
2,409 |
$22K |
| 90633 |
|
2,894 |
2,495 |
$21K |
| 90716 |
|
1,446 |
1,251 |
$20K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
769 |
659 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,132 |
3,773 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,355 |
6,583 |
$16K |
| 90681 |
|
1,698 |
1,522 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,206 |
4,780 |
$15K |
| 90662 |
|
247 |
229 |
$15K |
| 90746 |
|
268 |
239 |
$15K |
| 90837 |
Psychotherapy, 53 minutes with patient |
426 |
349 |
$15K |
| 90707 |
|
1,130 |
1,011 |
$14K |
| 90658 |
|
1,193 |
944 |
$14K |
| 90743 |
|
282 |
239 |
$13K |
| 90734 |
|
1,308 |
1,295 |
$13K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
32 |
28 |
$12K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,353 |
1,261 |
$12K |
| 0072A |
|
220 |
117 |
$11K |
| 59430 |
|
169 |
129 |
$10K |
| 20610 |
|
192 |
158 |
$10K |
| 0013A |
|
200 |
146 |
$10K |
| T1027 |
Family training and counseling for child development, per 15 minutes |
252 |
216 |
$10K |
| 0071A |
|
192 |
104 |
$9K |
| 90677 |
|
1,021 |
747 |
$9K |
| 72100 |
|
551 |
262 |
$9K |
| 81025 |
|
3,294 |
2,839 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
429 |
345 |
$8K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
225 |
129 |
$8K |
| 0031A |
|
154 |
97 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,090 |
5,278 |
$7K |
| 87428 |
|
111 |
103 |
$7K |
| H2016 |
Comprehensive community support services, per diem |
17 |
12 |
$7K |
| 90619 |
|
400 |
332 |
$6K |
| G9919 |
Screening performed and positive and provision of recommendations |
233 |
223 |
$6K |
| 99460 |
|
130 |
115 |
$6K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,302 |
640 |
$6K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
217 |
158 |
$6K |
| 92551 |
|
9,082 |
8,953 |
$6K |
| 90696 |
|
655 |
617 |
$5K |
| 90710 |
|
661 |
624 |
$5K |
| 90700 |
|
687 |
636 |
$5K |
| 97803 |
|
254 |
236 |
$5K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
430 |
372 |
$5K |
| 99462 |
|
224 |
156 |
$5K |
| 99401 |
|
495 |
404 |
$5K |
| 58300 |
|
38 |
24 |
$5K |
| 80305 |
|
556 |
446 |
$5K |
| 11976 |
|
76 |
42 |
$5K |
| 0053A |
|
77 |
68 |
$4K |
| 90647 |
|
535 |
496 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
280 |
222 |
$4K |
| S5000 |
Prescription drug, generic |
477 |
359 |
$4K |
| 0003A |
|
78 |
54 |
$4K |
| 97802 |
|
82 |
82 |
$4K |
| 96156 |
|
370 |
310 |
$4K |
| 90685 |
|
298 |
298 |
$3K |
| 96127 |
|
670 |
600 |
$3K |
| 11981 |
|
16 |
16 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
409 |
350 |
$3K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
19 |
15 |
$3K |
| 0064A |
|
44 |
44 |
$3K |
| 11102 |
|
41 |
38 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
344 |
274 |
$3K |
| 73562 |
|
166 |
83 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
194 |
176 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,898 |
1,710 |
$2K |
| 99242 |
|
76 |
58 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
59 |
55 |
$2K |
| H0049 |
Alcohol and/or drug screening |
80 |
79 |
$2K |
| 11982 |
|
17 |
13 |
$2K |
| 72040 |
|
127 |
66 |
$2K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
154 |
129 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
5,101 |
4,333 |
$2K |
| S4993 |
Contraceptive pills for birth control |
25 |
25 |
$2K |
| 73560 |
|
118 |
60 |
$1K |
| H2015 |
Comprehensive community support services, per 15 minutes |
76 |
62 |
$1K |
| 90656 |
|
623 |
401 |
$1K |
| 0081A |
|
21 |
21 |
$1K |
| 90480 |
|
192 |
192 |
$1K |
| A4267 |
Contraceptive supply, condom, male, each |
94 |
94 |
$927.87 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
18 |
14 |
$923.58 |
| 81002 |
|
716 |
659 |
$904.30 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
190 |
188 |
$896.04 |
| 81003 |
|
517 |
439 |
$884.15 |
| 0082A |
|
14 |
14 |
$840.00 |
| 90713 |
|
87 |
80 |
$783.00 |
| 0073A |
|
13 |
13 |
$780.00 |
| 73030 |
|
52 |
25 |
$728.94 |
| 73630 |
|
48 |
24 |
$710.25 |
| H2000 |
Comprehensive multidisciplinary evaluation |
84 |
73 |
$706.44 |
| 93000 |
|
162 |
153 |
$597.40 |
| 99381 |
|
75 |
46 |
$589.29 |
| 97804 |
|
42 |
36 |
$584.22 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
806 |
782 |
$532.58 |
| 83986 |
|
217 |
183 |
$495.99 |
| 87210 |
|
173 |
158 |
$386.62 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,143 |
2,138 |
$372.06 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
54 |
39 |
$324.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
647 |
640 |
$293.51 |
| 82962 |
|
1,844 |
1,754 |
$291.83 |
| 90691 |
|
13 |
13 |
$247.34 |
| 85018 |
|
1,661 |
1,628 |
$215.82 |
| 69210 |
|
50 |
49 |
$213.71 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
12 |
12 |
$198.00 |
| 85610 |
|
45 |
39 |
$156.51 |
| 90682 |
|
12 |
12 |
$154.00 |
| S0197 |
Prenatal vitamins, 30-day supply |
109 |
91 |
$133.44 |
| 90672 |
|
150 |
103 |
$90.96 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
71 |
61 |
$67.20 |
| 86580 |
|
155 |
151 |
$50.40 |
| 90660 |
|
44 |
27 |
$0.17 |
| Z1034 |
|
2,608 |
2,166 |
$0.00 |
| Z6410 |
|
163 |
150 |
$0.00 |
| 36416 |
|
164 |
164 |
$0.00 |
| Z6406 |
|
525 |
465 |
$0.00 |
| Z6204 |
|
99 |
87 |
$0.00 |
| Z1032 |
|
24 |
24 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
44 |
44 |
$0.00 |
| 0134A |
|
30 |
30 |
$0.00 |
| Z1038 |
|
12 |
12 |
$0.00 |
| 92015 |
Determination of refractive state |
130 |
130 |
$0.00 |
| 91313 |
|
62 |
62 |
$0.00 |
| 99173 |
|
1,886 |
1,885 |
$0.00 |
| Z6400 |
|
741 |
697 |
$0.00 |
| Z6414 |
|
207 |
186 |
$0.00 |
| Z6304 |
|
128 |
115 |
$0.00 |
| 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 |
57 |
57 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
71 |
71 |
$0.00 |