| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
46,288 |
39,388 |
$6.72M |
| 00003 |
Internal/system code - not a standard HCPCS code |
35,681 |
30,369 |
$6.61M |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,006 |
1,710 |
$150K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,972 |
19,453 |
$122K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,173 |
1,985 |
$79K |
| V2020 |
Frames, purchases |
3,435 |
2,267 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,681 |
1,313 |
$37K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,525 |
990 |
$29K |
| 92015 |
Determination of refractive state |
4,663 |
2,951 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,963 |
3,771 |
$13K |
| 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 |
3,732 |
3,254 |
$13K |
| 90686 |
|
646 |
525 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,053 |
868 |
$9K |
| 92551 |
|
3,708 |
2,794 |
$8K |
| 90746 |
|
128 |
106 |
$8K |
| 90832 |
Psychotherapy, 30 minutes with patient |
223 |
82 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
420 |
232 |
$5K |
| 0012A |
|
70 |
70 |
$5K |
| 0011A |
|
65 |
65 |
$4K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
158 |
146 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
601 |
367 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
519 |
422 |
$3K |
| 0072A |
|
34 |
34 |
$2K |
| 99000 |
|
6,309 |
4,541 |
$2K |
| G9920 |
Screening performed and negative |
773 |
650 |
$2K |
| 59425 |
|
122 |
88 |
$2K |
| 99215 |
Prolong outpt/office vis |
345 |
316 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
824 |
593 |
$2K |
| 0004A |
|
20 |
20 |
$1K |
| 0071A |
|
18 |
18 |
$1K |
| 0054A |
|
15 |
15 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
191 |
105 |
$927.90 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
84 |
44 |
$838.00 |
| 0002A |
|
12 |
12 |
$804.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,206 |
910 |
$774.50 |
| 81025 |
|
538 |
469 |
$724.86 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
775 |
589 |
$561.35 |
| 85018 |
|
6,310 |
4,789 |
$373.39 |
| J3490 |
Unclassified drugs |
20 |
14 |
$294.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,057 |
4,706 |
$193.96 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
412 |
294 |
$159.41 |
| V2750 |
Anti-reflective coating, per lens |
369 |
158 |
$82.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,281 |
1,794 |
$53.50 |
| 81003 |
|
386 |
276 |
$27.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
269 |
73 |
$18.78 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
167 |
154 |
$16.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
139 |
100 |
$6.99 |
| 99173 |
|
3,732 |
2,800 |
$2.41 |
| 3074F |
|
2,346 |
2,257 |
$0.00 |
| 3075F |
|
523 |
510 |
$0.00 |
| 3008F |
|
3,362 |
3,195 |
$0.00 |
| 36416 |
|
2,936 |
2,462 |
$0.00 |
| 3079F |
|
1,058 |
1,027 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,224 |
1,208 |
$0.00 |
| 3080F |
|
263 |
170 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
73 |
73 |
$0.00 |
| 1111F |
|
686 |
622 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
148 |
58 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
151 |
63 |
$0.00 |
| Z1034 |
|
217 |
169 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
24 |
13 |
$0.00 |
| 3077F |
|
566 |
394 |
$0.00 |
| 1159F |
|
12,737 |
8,774 |
$0.00 |
| 96160 |
|
794 |
697 |
$0.00 |
| 1160F |
|
12,737 |
8,774 |
$0.00 |
| 3078F |
|
1,937 |
1,871 |
$0.00 |
| 99242 |
|
115 |
67 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
122 |
100 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
38 |
26 |
$0.00 |
| 98942 |
|
191 |
170 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
15 |
15 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$0.00 |
| 90473 |
|
12 |
12 |
$0.00 |