| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
24,632 |
15,407 |
$4.12M |
| T1015 |
Clinic visit/encounter, all-inclusive |
18,791 |
15,580 |
$2.41M |
| 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 |
855 |
600 |
$20K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,224 |
1,443 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,615 |
9,179 |
$7K |
| 87428 |
|
1,534 |
902 |
$6K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
136 |
95 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,256 |
1,383 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,872 |
1,929 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
57 |
44 |
$310.98 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,592 |
1,317 |
$254.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,273 |
1,780 |
$213.36 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
362 |
334 |
$51.59 |
| 90686 |
|
173 |
148 |
$44.00 |
| 92551 |
|
51 |
47 |
$22.71 |
| 90656 |
|
91 |
89 |
$22.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
17 |
12 |
$15.77 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
55 |
30 |
$13.76 |
| 85018 |
|
406 |
362 |
$10.51 |
| 99173 |
|
51 |
47 |
$8.22 |
| 86580 |
|
14 |
12 |
$3.33 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
22 |
13 |
$0.26 |
| 3074F |
|
397 |
378 |
$0.00 |
| 3079F |
|
54 |
53 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
12 |
12 |
$0.00 |
| 3078F |
|
364 |
346 |
$0.00 |
| 81002 |
|
14 |
13 |
$0.00 |
| Z6400 |
|
74 |
74 |
$0.00 |
| 3077F |
|
13 |
13 |
$0.00 |