| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
264,523 |
183,208 |
$39.39M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
5,850 |
4,940 |
$393K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
67 |
65 |
$63K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
12 |
12 |
$13K |
| 90651 |
|
3,988 |
3,762 |
$10K |
| 91322 |
|
63 |
63 |
$7K |
| 0011A |
|
311 |
307 |
$7K |
| 90670 |
|
3,778 |
3,518 |
$7K |
| 0012A |
|
153 |
150 |
$6K |
| 90734 |
|
491 |
397 |
$6K |
| 90686 |
|
15,090 |
14,253 |
$6K |
| 0124A |
|
112 |
91 |
$4K |
| 0001A |
|
84 |
84 |
$4K |
| 0002A |
|
83 |
83 |
$3K |
| 90677 |
|
686 |
664 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
101,052 |
80,851 |
$2K |
| 90716 |
|
190 |
158 |
$1K |
| 90633 |
|
3,105 |
2,951 |
$1K |
| 90656 |
|
946 |
933 |
$1K |
| 90715 |
|
3,025 |
2,772 |
$1K |
| 90680 |
|
592 |
506 |
$1K |
| 90723 |
|
836 |
701 |
$1K |
| 59430 |
|
196 |
183 |
$1K |
| 0503F |
|
1,702 |
1,498 |
$901.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
27 |
$830.20 |
| 90647 |
|
4,158 |
3,924 |
$793.55 |
| 0500F |
|
1,608 |
1,534 |
$749.70 |
| 81025 |
|
4,021 |
3,702 |
$687.37 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28,463 |
25,005 |
$637.98 |
| 90750 |
|
690 |
645 |
$632.99 |
| 0502F |
|
15,093 |
8,922 |
$620.40 |
| 90621 |
|
1,041 |
1,022 |
$415.59 |
| 90707 |
|
139 |
115 |
$361.26 |
| 96127 |
|
36,728 |
31,319 |
$259.62 |
| 90710 |
|
115 |
92 |
$208.81 |
| 90694 |
|
74 |
72 |
$165.99 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33,235 |
24,825 |
$149.93 |
| 90700 |
|
70 |
62 |
$142.40 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,186 |
1,867 |
$87.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,348 |
3,215 |
$70.66 |
| S5190 |
Wellness assessment, performed by non-physician |
1,299 |
1,278 |
$69.24 |
| 90696 |
|
92 |
77 |
$58.07 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,504 |
7,846 |
$36.00 |
| 90688 |
|
256 |
212 |
$35.70 |
| 90674 |
|
366 |
349 |
$29.23 |
| 1160F |
|
72,869 |
61,606 |
$22.02 |
| 1036F |
|
56,884 |
45,205 |
$18.00 |
| 96161 |
|
4,815 |
4,244 |
$18.00 |
| 1159F |
|
67,649 |
57,093 |
$16.00 |
| 3725F |
|
37,734 |
31,044 |
$16.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
671 |
594 |
$13.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,789 |
2,584 |
$11.00 |
| 3008F |
|
84,783 |
73,089 |
$4.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
8,103 |
7,722 |
$3.00 |
| 99173 |
|
15,490 |
14,741 |
$2.47 |
| 81002 |
|
2,458 |
2,334 |
$2.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
9,646 |
9,081 |
$2.00 |
| 3079F |
|
9,620 |
8,910 |
$2.00 |
| 58300 |
|
120 |
110 |
$2.00 |
| 3075F |
|
5,234 |
4,924 |
$2.00 |
| 90791 |
Psychiatric diagnostic evaluation |
4,268 |
3,711 |
$1.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
17,195 |
12,103 |
$1.00 |
| 3078F |
|
53,035 |
47,036 |
$1.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,399 |
8,902 |
$1.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,849 |
7,251 |
$1.00 |
| 1126F |
|
8,336 |
7,800 |
$1.00 |
| 3074F |
|
55,881 |
49,299 |
$1.00 |
| 99385 |
|
522 |
511 |
$1.00 |
| 90681 |
|
2,144 |
2,075 |
$0.11 |
| 80305 |
|
1,007 |
709 |
$0.01 |
| 90746 |
|
194 |
152 |
$0.01 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,779 |
1,715 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,531 |
9,679 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
3,079 |
2,964 |
$0.00 |
| 99382 |
|
168 |
165 |
$0.00 |
| 99408 |
|
3,306 |
2,728 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
420 |
384 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,316 |
1,253 |
$0.00 |
| 11981 |
|
106 |
105 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,248 |
2,167 |
$0.00 |
| 90461 |
|
5,893 |
5,435 |
$0.00 |
| 3077F |
|
2,709 |
2,506 |
$0.00 |
| 2026F |
|
412 |
359 |
$0.00 |
| 83655 |
|
13 |
13 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
455 |
445 |
$0.00 |
| 90653 |
|
66 |
64 |
$0.00 |
| 96381 |
|
14 |
14 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
537 |
534 |
$0.00 |
| 69210 |
|
27 |
27 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
370 |
317 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,898 |
1,718 |
$0.00 |
| 1125F |
|
2,561 |
2,367 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
10,504 |
9,469 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,800 |
4,574 |
$0.00 |
| 99381 |
|
1,130 |
1,108 |
$0.00 |
| 85018 |
|
4,655 |
4,431 |
$0.00 |
| 99383 |
|
615 |
604 |
$0.00 |
| 82962 |
|
1,070 |
973 |
$0.00 |
| 99384 |
|
640 |
619 |
$0.00 |
| 92250 |
|
480 |
423 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
137 |
136 |
$0.00 |
| 87428 |
|
2,080 |
2,051 |
$0.00 |
| 3080F |
|
1,043 |
970 |
$0.00 |
| 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 |
39 |
38 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
78 |
61 |
$0.00 |
| 92551 |
|
836 |
825 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
158 |
153 |
$0.00 |
| 93000 |
|
193 |
193 |
$0.00 |
| 87807 |
|
30 |
30 |
$0.00 |
| 99386 |
|
25 |
25 |
$0.00 |
| 90732 |
|
44 |
43 |
$0.00 |
| 99406 |
|
14 |
12 |
$0.00 |