| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
88,038 |
73,107 |
$14.24M |
| 00003 |
Internal/system code - not a standard HCPCS code |
8,109 |
6,099 |
$1.71M |
| 90832 |
Psychotherapy, 30 minutes with patient |
15,464 |
5,519 |
$163K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,973 |
21,440 |
$76K |
| 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 |
414 |
358 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,143 |
2,001 |
$20K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
259 |
259 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,993 |
10,637 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14,168 |
13,441 |
$12K |
| 90791 |
Psychiatric diagnostic evaluation |
512 |
404 |
$12K |
| J3490 |
Unclassified drugs |
363 |
270 |
$10K |
| 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 |
65 |
42 |
$7K |
| 0012A |
|
118 |
69 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
673 |
653 |
$4K |
| 0519 |
|
36 |
28 |
$3K |
| 0124A |
|
61 |
61 |
$3K |
| 0011A |
|
61 |
38 |
$2K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
135 |
135 |
$2K |
| 81025 |
|
575 |
570 |
$2K |
| 99000 |
|
1,726 |
1,718 |
$1K |
| S4993 |
Contraceptive pills for birth control |
83 |
83 |
$1K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
56 |
40 |
$847.98 |
| D4341 |
|
98 |
56 |
$760.00 |
| 0054A |
|
15 |
15 |
$750.00 |
| D1120 |
Prophylaxis - child |
312 |
290 |
$616.50 |
| 90480 |
|
82 |
82 |
$600.00 |
| D1206 |
Topical application of fluoride varnish |
585 |
535 |
$599.50 |
| D1310 |
|
1,700 |
1,537 |
$598.00 |
| D0210 |
Intraoral - complete series of radiographic images |
372 |
333 |
$456.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
301 |
272 |
$347.00 |
| D1110 |
Prophylaxis - adult |
99 |
86 |
$319.50 |
| D0120 |
Periodic oral evaluation - established patient |
234 |
213 |
$267.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
54 |
38 |
$264.70 |
| 91320 |
|
15 |
15 |
$262.20 |
| D1208 |
Topical application of fluoride, excluding varnish |
238 |
206 |
$259.20 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
45 |
36 |
$233.60 |
| D0220 |
Intraoral - periapical first radiographic image |
282 |
241 |
$143.00 |
| D0274 |
Bitewings - four radiographic images |
96 |
83 |
$104.40 |
| A4267 |
Contraceptive supply, condom, male, each |
54 |
54 |
$84.24 |
| D0603 |
|
98 |
88 |
$30.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,571 |
2,533 |
$9.90 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
292 |
290 |
$0.00 |
| 94729 |
|
16 |
16 |
$0.00 |
| 1159F |
|
1,392 |
1,364 |
$0.00 |
| 99173 |
|
5,393 |
5,386 |
$0.00 |
| D9993 |
|
1,695 |
1,545 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
518 |
513 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
254 |
254 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,211 |
2,126 |
$0.00 |
| 90670 |
|
121 |
121 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
110 |
110 |
$0.00 |
| 92015 |
Determination of refractive state |
3,891 |
3,761 |
$0.00 |
| 90734 |
|
235 |
235 |
$0.00 |
| 90715 |
|
297 |
297 |
$0.00 |
| 92341 |
|
247 |
240 |
$0.00 |
| V2020 |
Frames, purchases |
2,838 |
2,731 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
440 |
440 |
$0.00 |
| 3078F |
|
442 |
441 |
$0.00 |
| 99442 |
|
258 |
235 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
186 |
186 |
$0.00 |
| D4381 |
|
63 |
41 |
$0.00 |
| 90461 |
|
784 |
783 |
$0.00 |
| 99201 |
|
138 |
138 |
$0.00 |
| 2022F |
|
27 |
27 |
$0.00 |
| 1160F |
|
271 |
269 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
250 |
248 |
$0.00 |
| 96152 |
|
276 |
169 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
589 |
589 |
$0.00 |
| 82948 |
|
90 |
88 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
129 |
129 |
$0.00 |
| 81002 |
|
15 |
14 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
39 |
35 |
$0.00 |
| 90746 |
|
123 |
123 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
111 |
108 |
$0.00 |
| 99382 |
|
13 |
12 |
$0.00 |
| 90681 |
|
32 |
32 |
$0.00 |
| 92133 |
|
83 |
83 |
$0.00 |
| 90633 |
|
35 |
35 |
$0.00 |
| 92083 |
|
15 |
15 |
$0.00 |
| 90750 |
|
27 |
27 |
$0.00 |
| 76514 |
|
31 |
31 |
$0.00 |
| 3077F |
|
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,754 |
2,734 |
$0.00 |
| 85018 |
|
658 |
651 |
$0.00 |
| 92002 |
|
218 |
212 |
$0.00 |
| 90686 |
|
2,410 |
2,404 |
$0.00 |
| D1330 |
|
1,791 |
1,616 |
$0.00 |
| 90677 |
|
142 |
142 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
983 |
800 |
$0.00 |
| 3074F |
|
395 |
395 |
$0.00 |
| D0002 |
|
4,601 |
3,487 |
$0.00 |
| D0001 |
|
248 |
248 |
$0.00 |
| 90656 |
|
325 |
325 |
$0.00 |
| 92250 |
|
52 |
52 |
$0.00 |
| 99441 |
|
146 |
134 |
$0.00 |
| 99384 |
|
31 |
31 |
$0.00 |
| 90651 |
|
360 |
360 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
249 |
248 |
$0.00 |
| 92551 |
|
1,308 |
1,307 |
$0.00 |
| 2023F |
|
16 |
16 |
$0.00 |
| 99385 |
|
31 |
31 |
$0.00 |
| 90697 |
|
41 |
41 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| D3120 |
|
39 |
28 |
$0.00 |
| 99383 |
|
42 |
42 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
31 |
27 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
91 |
91 |
$0.00 |
| 99381 |
|
14 |
14 |
$0.00 |
| 3079F |
|
12 |
12 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
69 |
31 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 92082 |
|
12 |
12 |
$0.00 |
| 90620 |
|
18 |
18 |
$0.00 |