| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
62,598 |
40,871 |
$9.16M |
| 00003 |
Internal/system code - not a standard HCPCS code |
2,080 |
1,538 |
$409K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,975 |
1,962 |
$331K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14,048 |
11,805 |
$106K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26,270 |
21,047 |
$61K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,570 |
1,570 |
$20K |
| 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 |
760 |
519 |
$14K |
| A4267 |
Contraceptive supply, condom, male, each |
1,573 |
1,571 |
$6K |
| 99000 |
|
1,822 |
1,792 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
186 |
185 |
$680.68 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
569 |
533 |
$415.01 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
530 |
527 |
$242.64 |
| 99401 |
|
10,155 |
8,418 |
$187.71 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
157 |
152 |
$171.60 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
352 |
350 |
$101.87 |
| 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 |
1,620 |
1,469 |
$99.04 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,656 |
1,148 |
$97.10 |
| 81025 |
|
72 |
71 |
$89.60 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,668 |
1,498 |
$59.40 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
2,076 |
1,732 |
$39.81 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
2,013 |
1,923 |
$32.00 |
| 1159F |
|
12,955 |
10,387 |
$31.95 |
| 82948 |
|
530 |
447 |
$26.80 |
| 1126F |
|
9,161 |
7,615 |
$24.22 |
| 92551 |
|
190 |
190 |
$22.04 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
8,051 |
6,609 |
$21.67 |
| 1125F |
|
3,194 |
2,822 |
$19.80 |
| 0521F |
|
1,737 |
1,503 |
$17.30 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
653 |
624 |
$9.90 |
| 4004F |
|
1,143 |
977 |
$7.50 |
| 1000F |
|
12,127 |
9,659 |
$7.50 |
| 1160F |
|
13,353 |
10,634 |
$6.03 |
| 1034F |
|
1,231 |
1,038 |
$3.00 |
| 3725F |
|
3,425 |
2,894 |
$0.00 |
| 3077F |
|
2,600 |
2,286 |
$0.00 |
| 3078F |
|
4,177 |
3,764 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
425 |
424 |
$0.00 |
| 1158F |
|
3,837 |
3,021 |
$0.00 |
| 99173 |
|
1,396 |
1,377 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
30 |
27 |
$0.00 |
| 99201 |
|
354 |
334 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$0.00 |
| 99499 |
|
280 |
234 |
$0.00 |
| 99342 |
|
17 |
17 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
52 |
$0.00 |
| 97803 |
|
174 |
157 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
38 |
38 |
$0.00 |
| 99408 |
|
37 |
35 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
17 |
$0.00 |
| 99448 |
|
21 |
17 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |
| 99348 |
|
162 |
147 |
$0.00 |
| 99347 |
|
13 |
13 |
$0.00 |
| 1036F |
|
9,540 |
7,499 |
$0.00 |
| 3074F |
|
5,959 |
5,182 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
535 |
507 |
$0.00 |
| 3079F |
|
3,274 |
2,989 |
$0.00 |
| 97802 |
|
1,270 |
1,238 |
$0.00 |
| 3080F |
|
2,443 |
2,162 |
$0.00 |
| 3008F |
|
13,633 |
10,906 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
820 |
795 |
$0.00 |
| 81000 |
|
32 |
29 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
57 |
57 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
278 |
252 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
127 |
113 |
$0.00 |
| 99385 |
|
220 |
220 |
$0.00 |
| 3075F |
|
1,280 |
1,201 |
$0.00 |
| 36416 |
|
452 |
402 |
$0.00 |
| 99386 |
|
56 |
56 |
$0.00 |
| 96156 |
|
141 |
141 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
404 |
367 |
$0.00 |
| 99447 |
|
373 |
351 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
42 |
40 |
$0.00 |
| 96151 |
|
14 |
14 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
29 |
28 |
$0.00 |
| 99343 |
|
78 |
78 |
$0.00 |
| 85018 |
|
73 |
73 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$0.00 |
| 99384 |
|
12 |
12 |
$0.00 |
| 96150 |
|
12 |
12 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
26 |
25 |
$0.00 |