| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
71,534 |
52,575 |
$10.95M |
| 00003 |
Internal/system code - not a standard HCPCS code |
24,219 |
15,392 |
$4.88M |
| G9012 |
Other specified case management service not elsewhere classified |
2,353 |
1,848 |
$424K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
1,100 |
936 |
$316K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,672 |
17,579 |
$145K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,502 |
11,756 |
$67K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
11,708 |
9,421 |
$58K |
| 90832 |
Psychotherapy, 30 minutes with patient |
11,117 |
5,820 |
$43K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
259 |
259 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,316 |
2,678 |
$15K |
| 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 |
3,155 |
2,723 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
54 |
41 |
$10K |
| 0012A |
|
250 |
233 |
$9K |
| V2020 |
Frames, purchases |
1,408 |
1,225 |
$8K |
| 0011A |
|
233 |
212 |
$8K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,336 |
747 |
$8K |
| 0002A |
|
172 |
172 |
$7K |
| J3490 |
Unclassified drugs |
51 |
51 |
$6K |
| 0001A |
|
147 |
147 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,111 |
982 |
$5K |
| 0013A |
|
71 |
71 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
556 |
446 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
208 |
189 |
$2K |
| 0072A |
|
53 |
53 |
$2K |
| 0031A |
|
52 |
52 |
$2K |
| 59425 |
|
111 |
80 |
$2K |
| 0071A |
|
44 |
44 |
$2K |
| 81025 |
|
1,093 |
1,007 |
$877.71 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
95 |
95 |
$754.06 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
93 |
93 |
$751.64 |
| 0004A |
|
18 |
18 |
$680.00 |
| 90791 |
Psychiatric diagnostic evaluation |
105 |
76 |
$672.42 |
| 81002 |
|
2,464 |
1,836 |
$493.43 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
82 |
63 |
$309.75 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
126 |
126 |
$301.35 |
| 92002 |
|
102 |
102 |
$239.11 |
| 90834 |
Psychotherapy, 45 minutes with patient |
18 |
12 |
$201.48 |
| 96156 |
|
1,492 |
1,456 |
$193.46 |
| 90620 |
|
34 |
26 |
$175.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
398 |
327 |
$141.18 |
| 90686 |
|
2,372 |
2,102 |
$138.06 |
| 99000 |
|
677 |
602 |
$136.99 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
304 |
258 |
$108.56 |
| 93000 |
|
13 |
13 |
$86.10 |
| 92551 |
|
787 |
728 |
$84.18 |
| 90670 |
|
272 |
249 |
$56.00 |
| 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 |
882 |
547 |
$52.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
320 |
276 |
$37.02 |
| 90715 |
|
50 |
39 |
$36.93 |
| 90647 |
|
50 |
49 |
$29.65 |
| 86703 |
|
12 |
12 |
$28.71 |
| 36415 |
Collection of venous blood by venipuncture |
1,104 |
980 |
$20.00 |
| 80053 |
Comprehensive metabolic panel |
75 |
75 |
$18.47 |
| 85018 |
|
920 |
851 |
$16.06 |
| 84443 |
Thyroid stimulating hormone (TSH) |
41 |
40 |
$14.61 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
33 |
33 |
$13.43 |
| 99173 |
|
847 |
799 |
$12.90 |
| 80061 |
Lipid panel |
31 |
31 |
$11.54 |
| 90633 |
|
159 |
147 |
$9.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
44 |
35 |
$8.76 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
35 |
35 |
$8.54 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
240 |
222 |
$8.21 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
26 |
$3.96 |
| 82962 |
|
23 |
17 |
$1.98 |
| 3074F |
|
13,836 |
11,135 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,517 |
2,927 |
$0.00 |
| 3044F |
|
726 |
714 |
$0.00 |
| 36416 |
|
27 |
27 |
$0.00 |
| 3075F |
|
3,186 |
2,726 |
$0.00 |
| 3079F |
|
4,133 |
3,480 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
2,613 |
1,816 |
$0.00 |
| Z1034 |
|
1,077 |
741 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,081 |
1,044 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
1,419 |
1,380 |
$0.00 |
| 3080F |
|
945 |
783 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
681 |
639 |
$0.00 |
| 90651 |
|
174 |
158 |
$0.00 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
317 |
309 |
$0.00 |
| 90723 |
|
158 |
142 |
$0.00 |
| Z6406 |
|
184 |
184 |
$0.00 |
| Z6204 |
|
417 |
409 |
$0.00 |
| 90656 |
|
114 |
114 |
$0.00 |
| 3008F |
|
30 |
30 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
34 |
34 |
$0.00 |
| 85027 |
|
12 |
12 |
$0.00 |
| 82105 |
|
26 |
25 |
$0.00 |
| 96161 |
|
197 |
179 |
$0.00 |
| 88142 |
|
15 |
15 |
$0.00 |
| 1220F |
|
333 |
296 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
14 |
14 |
$0.00 |
| Z1032 |
|
12 |
12 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
338 |
302 |
$0.00 |
| 3078F |
|
14,372 |
11,549 |
$0.00 |
| 3077F |
|
2,701 |
2,209 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
276 |
268 |
$0.00 |
| Z6304 |
|
149 |
149 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
52 |
$0.00 |
| 4004F |
|
12 |
12 |
$0.00 |
| 90681 |
|
43 |
39 |
$0.00 |
| Z6400 |
|
38 |
38 |
$0.00 |
| 96160 |
|
362 |
350 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
364 |
314 |
$0.00 |
| 90648 |
|
195 |
176 |
$0.00 |
| Z6202 |
|
50 |
50 |
$0.00 |
| 90734 |
|
74 |
70 |
$0.00 |
| 90461 |
|
63 |
63 |
$0.00 |
| Z6208 |
|
15 |
15 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
147 |
147 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
261 |
194 |
$0.00 |
| Z6300 |
|
27 |
27 |
$0.00 |
| G9920 |
Screening performed and negative |
67 |
67 |
$0.00 |
| 59426 |
|
106 |
50 |
$0.00 |
| Z6414 |
|
12 |
12 |
$0.00 |
| Z6308 |
|
13 |
13 |
$0.00 |
| 90473 |
|
13 |
12 |
$0.00 |