| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
311,343 |
254,698 |
$59.17M |
| 00003 |
Internal/system code - not a standard HCPCS code |
11,566 |
9,474 |
$4.06M |
| 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 |
23,890 |
20,184 |
$1.07M |
| 0510 |
|
31,870 |
31,697 |
$932K |
| 92552 |
|
21,705 |
21,416 |
$331K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
8,632 |
7,119 |
$169K |
| 90686 |
|
11,753 |
11,424 |
$95K |
| 90698 |
|
8,933 |
8,819 |
$67K |
| 90670 |
|
8,701 |
8,539 |
$64K |
| 90633 |
|
5,404 |
5,329 |
$43K |
| 90744 |
|
5,213 |
5,133 |
$39K |
| 90681 |
|
4,450 |
4,341 |
$33K |
| 83655 |
|
3,933 |
3,858 |
$27K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
443 |
443 |
$27K |
| 85018 |
|
12,617 |
12,423 |
$23K |
| 90716 |
|
2,825 |
2,788 |
$22K |
| 90707 |
|
2,570 |
2,541 |
$21K |
| 90651 |
|
2,291 |
2,252 |
$19K |
| 90710 |
|
1,620 |
1,613 |
$12K |
| 90734 |
|
1,622 |
1,583 |
$11K |
| 90696 |
|
1,319 |
1,312 |
$11K |
| 90715 |
|
1,509 |
1,501 |
$11K |
| 90688 |
|
974 |
973 |
$9K |
| 90619 |
|
573 |
573 |
$6K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
138 |
108 |
$5K |
| 90685 |
|
455 |
445 |
$5K |
| 90677 |
|
505 |
503 |
$5K |
| 90733 |
|
268 |
268 |
$3K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
28 |
27 |
$3K |
| 86480 |
|
652 |
646 |
$2K |
| 0450 |
Emergency room services |
47 |
45 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,633 |
1,627 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,633 |
1,628 |
$2K |
| 96112 |
|
974 |
964 |
$1K |
| 90648 |
|
113 |
113 |
$1K |
| 90700 |
|
106 |
106 |
$1K |
| 90682 |
|
239 |
239 |
$987.14 |
| 90649 |
|
59 |
59 |
$653.13 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,490 |
7,472 |
$408.47 |
| 96127 |
|
977 |
974 |
$307.84 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,327 |
2,285 |
$276.82 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,047 |
1,004 |
$274.14 |
| 90381 |
|
19 |
19 |
$210.33 |
| 80053 |
Comprehensive metabolic panel |
156 |
155 |
$128.01 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
124 |
123 |
$114.23 |
| 99070 |
|
29 |
19 |
$72.96 |
| 81003 |
|
3,039 |
2,552 |
$68.09 |
| 81025 |
|
16 |
16 |
$57.96 |
| 92015 |
Determination of refractive state |
2,515 |
2,493 |
$49.25 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40,732 |
38,046 |
$46.13 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,394 |
6,318 |
$42.67 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
13 |
13 |
$35.50 |
| 88720 |
|
1,542 |
1,226 |
$5.29 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,207 |
7,194 |
$0.00 |
| Z7500 |
|
20,798 |
18,964 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,527 |
5,521 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
1,209 |
1,138 |
$0.00 |
| D4910 |
|
412 |
408 |
$0.00 |
| D1120 |
Prophylaxis - child |
526 |
526 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
5,507 |
5,442 |
$0.00 |
| D0270 |
|
813 |
804 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13,821 |
13,126 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,228 |
1,214 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
7,759 |
7,255 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
462 |
304 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
7,613 |
7,517 |
$0.00 |
| 96158 |
|
1,724 |
1,239 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
263 |
263 |
$0.00 |
| 87653 |
|
128 |
128 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
178 |
150 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,242 |
1,226 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,254 |
4,251 |
$0.00 |
| D9430 |
|
1,583 |
1,510 |
$0.00 |
| 76857 |
|
459 |
447 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
505 |
465 |
$0.00 |
| D4341 |
|
230 |
190 |
$0.00 |
| 86787 |
|
67 |
67 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
719 |
577 |
$0.00 |
| 99173 |
|
5,628 |
5,626 |
$0.00 |
| 0004A |
|
46 |
46 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
431 |
430 |
$0.00 |
| 11721 |
|
1,665 |
1,654 |
$0.00 |
| 91300 |
|
217 |
216 |
$0.00 |
| 11056 |
|
259 |
259 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
118 |
118 |
$0.00 |
| 3077F |
|
2,696 |
2,585 |
$0.00 |
| 80061 |
Lipid panel |
148 |
148 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
693 |
690 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
312 |
312 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
131 |
122 |
$0.00 |
| D1110 |
Prophylaxis - adult |
628 |
620 |
$0.00 |
| 99336 |
|
12 |
12 |
$0.00 |
| 3078F |
|
16,489 |
15,160 |
$0.00 |
| D9990 |
|
846 |
782 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
115 |
114 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
202 |
201 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
44 |
30 |
$0.00 |
| 86900 |
|
54 |
54 |
$0.00 |
| 94375 |
|
32 |
29 |
$0.00 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
31 |
30 |
$0.00 |
| 92133 |
|
28 |
27 |
$0.00 |
| 96152 |
|
45 |
33 |
$0.00 |
| 99442 |
|
26 |
26 |
$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 |
383 |
332 |
$0.00 |
| 99201 |
|
596 |
586 |
$0.00 |
| 1159F |
|
95 |
93 |
$0.00 |
| 90714 |
|
14 |
14 |
$0.00 |
| 99382 |
|
52 |
52 |
$0.00 |
| 1160F |
|
86 |
84 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
24 |
24 |
$0.00 |
| 90713 |
|
27 |
27 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
35 |
35 |
$0.00 |
| 99348 |
|
12 |
12 |
$0.00 |
| 92083 |
|
12 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
656 |
654 |
$0.00 |
| Z1038 |
|
1,945 |
1,815 |
$0.00 |
| Z1032 |
|
1,055 |
1,031 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,604 |
3,584 |
$0.00 |
| Z1034 |
|
14,775 |
11,161 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,535 |
1,519 |
$0.00 |
| 96156 |
|
846 |
755 |
$0.00 |
| D0603 |
|
768 |
756 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
637 |
556 |
$0.00 |
| 99383 |
|
411 |
411 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
67,179 |
61,080 |
$0.00 |
| 99381 |
|
1,820 |
1,806 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
521 |
473 |
$0.00 |
| 3079F |
|
3,566 |
3,420 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,158 |
1,152 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,429 |
2,411 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
316 |
314 |
$0.00 |
| 1125F |
|
14 |
14 |
$0.00 |
| 20610 |
|
630 |
613 |
$0.00 |
| D1330 |
|
1,702 |
1,630 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12,421 |
12,345 |
$0.00 |
| 3074F |
|
15,563 |
14,246 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
184 |
184 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
67 |
67 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
71 |
71 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,213 |
1,199 |
$0.00 |
| 92002 |
|
162 |
162 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
40 |
40 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
671 |
667 |
$0.00 |
| 51798 |
|
275 |
268 |
$0.00 |
| 3080F |
|
945 |
918 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
59 |
56 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
280 |
279 |
$0.00 |
| 3075F |
|
2,573 |
2,524 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
684 |
682 |
$0.00 |
| 90474 |
|
64 |
64 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
504 |
502 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
444 |
444 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,166 |
772 |
$0.00 |
| 0001A |
|
52 |
52 |
$0.00 |
| 86762 |
|
52 |
52 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
188 |
187 |
$0.00 |
| 99349 |
|
89 |
86 |
$0.00 |
| 85027 |
|
193 |
193 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
37 |
37 |
$0.00 |
| 99384 |
|
303 |
303 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
144 |
144 |
$0.00 |
| 86803 |
|
52 |
52 |
$0.00 |
| 3008F |
|
103 |
98 |
$0.00 |
| 87081 |
|
138 |
138 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
24 |
24 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
108 |
108 |
$0.00 |
| 87340 |
|
40 |
40 |
$0.00 |
| 99241 |
|
44 |
44 |
$0.00 |
| 76801 |
|
29 |
26 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
34 |
31 |
$0.00 |
| 52000 |
|
13 |
13 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
12 |
12 |
$0.00 |
| 86780 |
|
91 |
91 |
$0.00 |
| 86850 |
|
52 |
52 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 86901 |
|
66 |
66 |
$0.00 |
| 92250 |
|
18 |
18 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
16 |
16 |
$0.00 |
| 58300 |
|
15 |
15 |
$0.00 |
| 20550 |
|
14 |
14 |
$0.00 |