| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,751 |
17,602 |
$2.77M |
| 00003 |
Internal/system code - not a standard HCPCS code |
2,565 |
1,608 |
$533K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,434 |
10,741 |
$234K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,363 |
4,124 |
$105K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,360 |
1,840 |
$32K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
441 |
437 |
$24K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
398 |
236 |
$19K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
232 |
206 |
$10K |
| 99215 |
Prolong outpt/office vis |
80 |
80 |
$10K |
| 96156 |
|
387 |
328 |
$9K |
| 99385 |
|
191 |
140 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
133 |
74 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
145 |
116 |
$4K |
| 99386 |
|
98 |
64 |
$4K |
| 96127 |
|
1,326 |
922 |
$3K |
| 99245 |
|
563 |
473 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
274 |
242 |
$2K |
| 90686 |
|
319 |
255 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
24 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
71 |
69 |
$831.60 |
| 99000 |
|
713 |
676 |
$716.93 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,011 |
668 |
$624.86 |
| 88142 |
|
126 |
76 |
$585.00 |
| 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 |
42 |
41 |
$516.75 |
| 90688 |
|
142 |
73 |
$259.40 |
| H0049 |
Alcohol and/or drug screening |
123 |
97 |
$239.96 |
| 90656 |
|
54 |
38 |
$198.00 |
| 99406 |
|
44 |
31 |
$194.30 |
| 88141 |
|
32 |
30 |
$136.89 |
| 92551 |
|
72 |
42 |
$81.73 |
| G9920 |
Screening performed and negative |
93 |
65 |
$29.00 |
| 3079F |
|
70 |
59 |
$0.00 |
| 3074F |
|
164 |
136 |
$0.00 |
| 3075F |
|
17 |
15 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 99201 |
|
15 |
15 |
$0.00 |
| 3077F |
|
40 |
32 |
$0.00 |
| 3078F |
|
197 |
161 |
$0.00 |
| 3342F |
|
33 |
32 |
$0.00 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
29 |
29 |
$0.00 |
| 99401 |
|
14 |
12 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
18 |
16 |
$0.00 |
| 99173 |
|
42 |
27 |
$0.00 |