| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
180,072 |
133,236 |
$15.12M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,172 |
807 |
$69K |
| S5190 |
Wellness assessment, performed by non-physician |
845 |
790 |
$92.30 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,029 |
1,652 |
$72.72 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
53,794 |
43,410 |
$48.89 |
| 90647 |
|
3,697 |
3,469 |
$0.00 |
| 90723 |
|
3,677 |
3,510 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,932 |
1,541 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
502 |
440 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60,834 |
47,959 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,079 |
4,587 |
$0.00 |
| 90656 |
|
401 |
367 |
$0.00 |
| 90686 |
|
3,488 |
3,169 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,027 |
1,238 |
$0.00 |
| 90716 |
|
1,094 |
1,034 |
$0.00 |
| 87807 |
|
1,804 |
1,365 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
659 |
588 |
$0.00 |
| 90696 |
|
862 |
842 |
$0.00 |
| 90651 |
|
732 |
706 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
69 |
69 |
$0.00 |
| 90677 |
|
41 |
35 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
381 |
333 |
$0.00 |
| 90474 |
|
296 |
274 |
$0.00 |
| 90732 |
|
36 |
16 |
$0.00 |
| 90620 |
|
47 |
45 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
49 |
42 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$0.00 |
| 99384 |
|
18 |
17 |
$0.00 |
| 99383 |
|
77 |
64 |
$0.00 |
| 99381 |
|
29 |
29 |
$0.00 |
| 99406 |
|
13 |
13 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
16 |
13 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
17 |
16 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
15 |
15 |
$0.00 |
| 81002 |
|
4,212 |
3,403 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17,089 |
12,525 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
10,489 |
8,561 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,721 |
2,492 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
2,221 |
2,128 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,600 |
2,992 |
$0.00 |
| 90681 |
|
2,277 |
2,162 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,440 |
2,985 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13,109 |
10,185 |
$0.00 |
| 90461 |
|
11,089 |
7,824 |
$0.00 |
| 90670 |
|
4,075 |
3,880 |
$0.00 |
| 90710 |
|
1,158 |
1,122 |
$0.00 |
| 90715 |
|
964 |
946 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,342 |
1,961 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
11,480 |
9,765 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,759 |
1,184 |
$0.00 |
| 90633 |
|
2,425 |
2,356 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
402 |
295 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,600 |
5,737 |
$0.00 |
| 81025 |
|
678 |
526 |
$0.00 |
| 90734 |
|
1,070 |
1,031 |
$0.00 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
421 |
280 |
$0.00 |
| 90707 |
|
1,040 |
1,010 |
$0.00 |
| 90700 |
|
1,290 |
1,240 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,584 |
1,517 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
273 |
269 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
2,892 |
2,766 |
$0.00 |
| 69209 |
|
12 |
12 |
$0.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
104 |
82 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
14 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
155 |
56 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
37 |
36 |
$0.00 |
| 95251 |
|
27 |
27 |
$0.00 |
| 99382 |
|
17 |
16 |
$0.00 |