| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
156,013 |
126,017 |
$20.90M |
| 00003 |
Internal/system code - not a standard HCPCS code |
82,500 |
34,755 |
$15.94M |
| 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 |
21,356 |
18,686 |
$976K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,584 |
56,169 |
$131K |
| 90791 |
Psychiatric diagnostic evaluation |
1,616 |
1,368 |
$51K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24,684 |
22,527 |
$50K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,167 |
2,892 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17,303 |
15,355 |
$27K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,066 |
1,476 |
$25K |
| 90677 |
|
707 |
594 |
$14K |
| 0011A |
|
213 |
201 |
$12K |
| 0001A |
|
187 |
187 |
$12K |
| 0002A |
|
171 |
171 |
$11K |
| 90832 |
Psychotherapy, 30 minutes with patient |
715 |
584 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,174 |
10,859 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,869 |
2,644 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,987 |
1,720 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
924 |
740 |
$6K |
| 0012A |
|
92 |
92 |
$6K |
| 90837 |
Psychotherapy, 53 minutes with patient |
416 |
267 |
$6K |
| 0112A |
|
110 |
110 |
$5K |
| 99188 |
|
1,766 |
1,511 |
$5K |
| 0164A |
|
155 |
155 |
$5K |
| 0031A |
|
67 |
67 |
$4K |
| 0111A |
|
270 |
267 |
$4K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
4,087 |
3,519 |
$4K |
| 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 |
89 |
82 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,307 |
1,270 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
342 |
302 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
830 |
805 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,605 |
1,537 |
$3K |
| 0072A |
|
40 |
40 |
$3K |
| 99215 |
Prolong outpt/office vis |
1,547 |
1,409 |
$3K |
| 0054A |
|
39 |
39 |
$3K |
| 0071A |
|
38 |
38 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,226 |
2,150 |
$2K |
| 92551 |
|
4,862 |
4,622 |
$2K |
| 90480 |
|
1,021 |
976 |
$2K |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
27 |
27 |
$2K |
| 90461 |
|
3,560 |
3,449 |
$2K |
| 99381 |
|
467 |
431 |
$2K |
| 99173 |
|
3,958 |
3,600 |
$1K |
| 90686 |
|
6,319 |
5,911 |
$1K |
| 82947 |
|
6,759 |
6,063 |
$1K |
| 92250 |
|
169 |
169 |
$1K |
| 0064A |
|
20 |
20 |
$1K |
| J3490 |
Unclassified drugs |
20 |
12 |
$1K |
| 90651 |
|
1,955 |
1,844 |
$1K |
| 0004A |
|
17 |
17 |
$1K |
| 90715 |
|
943 |
892 |
$997.22 |
| 90670 |
|
1,938 |
1,740 |
$937.14 |
| 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 |
25 |
25 |
$930.25 |
| 71046 |
Radiologic examination, chest; 2 views |
450 |
409 |
$913.67 |
| 0124A |
|
13 |
13 |
$871.00 |
| 90619 |
|
517 |
473 |
$841.36 |
| 0074A |
|
12 |
12 |
$804.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
541 |
502 |
$759.39 |
| 99384 |
|
82 |
73 |
$532.29 |
| 81025 |
|
1,964 |
1,862 |
$461.47 |
| 85018 |
|
6,870 |
6,562 |
$428.79 |
| 88142 |
|
887 |
874 |
$404.56 |
| 81003 |
|
9,826 |
7,013 |
$387.01 |
| 90750 |
|
79 |
76 |
$374.21 |
| 90678 |
|
18 |
16 |
$322.00 |
| 81000 |
|
2,211 |
1,582 |
$313.29 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
25 |
$261.82 |
| 72100 |
|
89 |
77 |
$257.46 |
| 90688 |
|
498 |
492 |
$241.41 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
550 |
524 |
$234.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,436 |
2,352 |
$223.57 |
| 72110 |
|
74 |
59 |
$209.50 |
| 90680 |
|
1,405 |
1,230 |
$179.67 |
| 86403 |
|
173 |
157 |
$175.40 |
| 90672 |
|
988 |
936 |
$175.02 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,046 |
958 |
$151.91 |
| 90633 |
|
1,775 |
1,641 |
$145.35 |
| 83655 |
|
443 |
428 |
$144.63 |
| 82950 |
|
552 |
493 |
$142.58 |
| 90685 |
|
210 |
210 |
$117.00 |
| 99383 |
|
66 |
60 |
$109.66 |
| 90756 |
|
147 |
147 |
$109.00 |
| 90656 |
|
421 |
375 |
$102.08 |
| 93000 |
|
96 |
86 |
$91.27 |
| 90697 |
|
1,302 |
1,163 |
$81.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,200 |
1,188 |
$68.26 |
| 87590 |
|
767 |
755 |
$67.64 |
| 87490 |
|
769 |
757 |
$67.64 |
| 73562 |
|
53 |
43 |
$63.12 |
| 90658 |
|
89 |
87 |
$49.02 |
| 86580 |
|
483 |
481 |
$43.68 |
| 90713 |
|
47 |
42 |
$41.90 |
| 90723 |
|
639 |
564 |
$36.00 |
| 73560 |
|
33 |
26 |
$19.02 |
| 90707 |
|
339 |
304 |
$18.00 |
| 71045 |
Radiologic examination, chest; single view |
13 |
12 |
$17.65 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
477 |
456 |
$13.09 |
| 90648 |
|
1,010 |
910 |
$12.23 |
| 87210 |
|
100 |
98 |
$12.04 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
34 |
31 |
$12.03 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
76 |
74 |
$10.09 |
| 90700 |
|
265 |
244 |
$9.00 |
| 90687 |
|
222 |
222 |
$0.00 |
| 91322 |
|
581 |
512 |
$0.00 |
| 91311 |
|
418 |
417 |
$0.00 |
| 3078F |
|
471 |
468 |
$0.00 |
| 90734 |
|
718 |
697 |
$0.00 |
| 1159F |
|
567 |
562 |
$0.00 |
| 91321 |
|
1,408 |
1,185 |
$0.00 |
| 91313 |
|
132 |
130 |
$0.00 |
| 90710 |
|
273 |
254 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 3077F |
|
50 |
50 |
$0.00 |
| 99382 |
|
13 |
13 |
$0.00 |
| 76942 |
|
32 |
28 |
$0.00 |
| 90380 |
|
39 |
34 |
$0.00 |
| 99397 |
|
27 |
27 |
$0.00 |
| 73565 |
|
15 |
13 |
$0.00 |
| 73030 |
|
12 |
12 |
$0.00 |
| 90649 |
|
32 |
32 |
$0.00 |
| 87625 |
|
231 |
231 |
$0.00 |
| 1126F |
|
416 |
413 |
$0.00 |
| 3074F |
|
451 |
447 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
58 |
57 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
130 |
113 |
$0.00 |
| 90716 |
|
540 |
497 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
144 |
144 |
$0.00 |
| 90660 |
|
205 |
205 |
$0.00 |
| 90696 |
|
125 |
119 |
$0.00 |
| 83986 |
|
30 |
30 |
$0.00 |
| 91316 |
|
47 |
45 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
18 |
18 |
$0.00 |
| 1125F |
|
66 |
66 |
$0.00 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
16 |
16 |
$0.00 |
| 90381 |
|
91 |
82 |
$0.00 |
| 3044F |
|
15 |
15 |
$0.00 |
| 91314 |
|
35 |
35 |
$0.00 |
| 3079F |
|
91 |
91 |
$0.00 |
| 90744 |
|
14 |
12 |
$0.00 |
| 3075F |
|
56 |
55 |
$0.00 |