| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
91,311 |
77,006 |
$12.16M |
| 00003 |
Internal/system code - not a standard HCPCS code |
9,045 |
6,875 |
$1.48M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58,159 |
35,247 |
$228K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,387 |
2,936 |
$51K |
| 90791 |
Psychiatric diagnostic evaluation |
2,467 |
1,104 |
$14K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
398 |
213 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18,718 |
11,271 |
$11K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,314 |
995 |
$9K |
| 90837 |
Psychotherapy, 53 minutes with patient |
63 |
41 |
$2K |
| 0013A |
|
78 |
66 |
$1K |
| 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 |
50 |
42 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
48 |
23 |
$1K |
| 81025 |
|
1,681 |
1,211 |
$964.54 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,010 |
614 |
$883.53 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
527 |
487 |
$870.00 |
| J3490 |
Unclassified drugs |
45 |
39 |
$600.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,203 |
842 |
$512.59 |
| D1110 |
Prophylaxis - adult |
184 |
184 |
$430.50 |
| 0001A |
|
53 |
51 |
$418.94 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
138 |
78 |
$337.95 |
| 0012A |
|
84 |
80 |
$268.00 |
| 0011A |
|
128 |
120 |
$217.94 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
110 |
81 |
$202.65 |
| D1206 |
Topical application of fluoride varnish |
370 |
369 |
$159.00 |
| D0120 |
Periodic oral evaluation - established patient |
240 |
240 |
$104.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,915 |
3,564 |
$96.53 |
| 0002A |
|
29 |
29 |
$67.00 |
| 92081 |
|
5,335 |
3,329 |
$60.00 |
| 85018 |
|
6,505 |
4,060 |
$60.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,717 |
1,042 |
$49.07 |
| 92551 |
|
4,971 |
3,089 |
$43.02 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
68 |
68 |
$43.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,719 |
1,036 |
$41.42 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
857 |
565 |
$35.26 |
| D0274 |
Bitewings - four radiographic images |
313 |
313 |
$34.20 |
| D0220 |
Intraoral - periapical first radiographic image |
407 |
404 |
$27.00 |
| 1158F |
|
814 |
589 |
$24.00 |
| 3351F |
|
38,422 |
26,110 |
$24.00 |
| 99442 |
|
9,684 |
5,410 |
$18.67 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
880 |
859 |
$12.72 |
| 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 |
2,261 |
1,421 |
$10.57 |
| D0230 |
Intraoral - periapical each additional radiographic image |
195 |
195 |
$8.55 |
| 81000 |
|
4,231 |
2,255 |
$7.71 |
| 82962 |
|
193 |
126 |
$1.98 |
| 1160F |
|
8,085 |
7,416 |
$0.00 |
| 3015F |
|
481 |
351 |
$0.00 |
| 3077F |
|
2,315 |
1,790 |
$0.00 |
| 2026F |
|
1,270 |
1,190 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,208 |
1,323 |
$0.00 |
| 3078F |
|
12,677 |
10,050 |
$0.00 |
| 1159F |
|
8,086 |
7,413 |
$0.00 |
| 91300 |
|
96 |
89 |
$0.00 |
| 4040F |
|
389 |
312 |
$0.00 |
| 0502F |
|
599 |
322 |
$0.00 |
| 4274F |
|
3,326 |
2,806 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
416 |
269 |
$0.00 |
| 4004F |
|
585 |
577 |
$0.00 |
| 90734 |
|
497 |
303 |
$0.00 |
| 99401 |
|
34 |
24 |
$0.00 |
| 3725F |
|
209 |
207 |
$0.00 |
| 90670 |
|
843 |
561 |
$0.00 |
| 90633 |
|
947 |
590 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
369 |
153 |
$0.00 |
| D0160 |
|
2,124 |
1,803 |
$0.00 |
| 90669 |
|
178 |
178 |
$0.00 |
| 1090F |
|
140 |
140 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
165 |
119 |
$0.00 |
| G9920 |
Screening performed and negative |
219 |
213 |
$0.00 |
| 2028F |
|
1,309 |
1,087 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
230 |
158 |
$0.00 |
| 90715 |
|
253 |
166 |
$0.00 |
| D4921 |
|
18 |
15 |
$0.00 |
| 90681 |
|
103 |
72 |
$0.00 |
| 91320 |
|
49 |
33 |
$0.00 |
| Z6400 |
|
210 |
205 |
$0.00 |
| 90648 |
|
466 |
307 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
68 |
68 |
$0.00 |
| 90707 |
|
42 |
25 |
$0.00 |
| D4341 |
|
82 |
54 |
$0.00 |
| D1120 |
Prophylaxis - child |
59 |
58 |
$0.00 |
| 90658 |
|
127 |
100 |
$0.00 |
| 99382 |
|
34 |
28 |
$0.00 |
| 1003F |
|
140 |
140 |
$0.00 |
| 90710 |
|
207 |
126 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
48 |
27 |
$0.00 |
| 80301 |
|
13 |
12 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
101 |
61 |
$0.00 |
| 90750 |
|
14 |
12 |
$0.00 |
| 90713 |
|
13 |
13 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
38 |
$0.00 |
| 90672 |
|
57 |
33 |
$0.00 |
| 82274 |
|
13 |
12 |
$0.00 |
| 90758 |
|
123 |
76 |
$0.00 |
| 90749 |
|
27 |
17 |
$0.00 |
| D2140 |
|
17 |
12 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
43 |
27 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
12 |
12 |
$0.00 |
| D4910 |
|
12 |
12 |
$0.00 |
| 3074F |
|
12,368 |
9,783 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,532 |
2,497 |
$0.00 |
| 3008F |
|
8,513 |
8,169 |
$0.00 |
| 3017F |
|
1,183 |
987 |
$0.00 |
| 2010F |
|
8,607 |
8,280 |
$0.00 |
| 90686 |
|
2,423 |
1,538 |
$0.00 |
| 90651 |
|
1,371 |
832 |
$0.00 |
| 99441 |
|
5,516 |
3,195 |
$0.00 |
| T1002 |
Rn services, up to 15 minutes |
505 |
492 |
$0.00 |
| 3075F |
|
2,696 |
2,253 |
$0.00 |
| 3072F |
|
443 |
442 |
$0.00 |
| 1111F |
|
948 |
627 |
$0.00 |
| 2001F |
|
8,451 |
8,142 |
$0.00 |
| 90688 |
|
1,182 |
827 |
$0.00 |
| 3079F |
|
4,960 |
3,994 |
$0.00 |
| 99383 |
|
259 |
186 |
$0.00 |
| 2000F |
|
8,212 |
7,929 |
$0.00 |
| 3014F |
|
232 |
224 |
$0.00 |
| 90674 |
|
378 |
291 |
$0.00 |
| 90620 |
|
186 |
115 |
$0.00 |
| D0229 |
|
165 |
164 |
$0.00 |
| 1101F |
|
88 |
88 |
$0.00 |
| 90656 |
|
509 |
355 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
37 |
37 |
$0.00 |
| 90744 |
|
43 |
31 |
$0.00 |
| 1126F |
|
957 |
745 |
$0.00 |
| 1036F |
|
9,315 |
8,818 |
$0.00 |
| 4010F |
|
3,027 |
2,551 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
534 |
265 |
$0.00 |
| 90723 |
|
515 |
342 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
91 |
89 |
$0.00 |
| 91301 |
|
263 |
259 |
$0.00 |
| 99406 |
|
35 |
24 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
166 |
158 |
$0.00 |
| 4037F |
|
200 |
200 |
$0.00 |
| 90647 |
|
356 |
223 |
$0.00 |
| 1170F |
|
144 |
143 |
$0.00 |
| 2033F |
|
171 |
168 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
114 |
113 |
$0.00 |
| 3080F |
|
273 |
193 |
$0.00 |
| 99606 |
|
36 |
28 |
$0.00 |
| 90696 |
|
49 |
28 |
$0.00 |
| 90716 |
|
78 |
54 |
$0.00 |
| 93000 |
|
28 |
16 |
$0.00 |
| 99381 |
|
78 |
61 |
$0.00 |
| 1000F |
|
174 |
159 |
$0.00 |
| 1034F |
|
13 |
12 |
$0.00 |
| 90677 |
|
171 |
113 |
$0.00 |
| 99384 |
|
149 |
117 |
$0.00 |
| Z6402 |
|
54 |
54 |
$0.00 |
| 90619 |
|
191 |
116 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
30 |
27 |
$0.00 |
| 1125F |
|
51 |
26 |
$0.00 |
| 3352F |
|
24 |
13 |
$0.00 |
| 99443 |
|
139 |
71 |
$0.00 |
| 90698 |
|
39 |
24 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
14 |
14 |
$0.00 |
| 90697 |
|
19 |
12 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
14 |
14 |
$0.00 |