| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
31,769 |
28,526 |
$4.28M |
| 00003 |
Internal/system code - not a standard HCPCS code |
794 |
706 |
$156K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,362 |
2,059 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,846 |
9,037 |
$15K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
207 |
150 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,883 |
4,573 |
$7K |
| 90832 |
Psychotherapy, 30 minutes with patient |
351 |
215 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
95 |
64 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
350 |
348 |
$3K |
| G9920 |
Screening performed and negative |
1,216 |
1,151 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
491 |
456 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
330 |
294 |
$1K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
79 |
79 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
18 |
13 |
$1K |
| 92552 |
|
940 |
862 |
$956.48 |
| 92551 |
|
203 |
199 |
$734.14 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
266 |
247 |
$610.71 |
| 90686 |
|
683 |
638 |
$603.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
153 |
140 |
$591.88 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
103 |
76 |
$565.60 |
| 85018 |
|
785 |
776 |
$131.09 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
89 |
84 |
$129.36 |
| 97803 |
|
360 |
357 |
$47.00 |
| 90651 |
|
48 |
42 |
$18.00 |
| 99173 |
|
35 |
28 |
$15.96 |
| 92015 |
Determination of refractive state |
943 |
936 |
$15.94 |
| 90648 |
|
82 |
77 |
$9.00 |
| 3078F |
|
417 |
388 |
$0.00 |
| 1159F |
|
413 |
391 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 1160F |
|
412 |
390 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
100 |
94 |
$0.00 |
| 92081 |
|
63 |
63 |
$0.00 |
| 90633 |
|
57 |
57 |
$0.00 |
| 3077F |
|
14 |
14 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
83 |
77 |
$0.00 |
| 90670 |
|
69 |
68 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 97802 |
|
152 |
152 |
$0.00 |
| 3074F |
|
186 |
175 |
$0.00 |
| 1125F |
|
13 |
13 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
198 |
194 |
$0.00 |
| 90656 |
|
97 |
96 |
$0.00 |
| 1170F |
|
111 |
110 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 92060 |
|
21 |
21 |
$0.00 |
| 1126F |
|
170 |
165 |
$0.00 |
| 1111F |
|
39 |
39 |
$0.00 |
| 90723 |
|
30 |
30 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |
| 3075F |
|
12 |
12 |
$0.00 |