| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
240,069 |
171,301 |
$33.69M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,027 |
650 |
$83K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
111,841 |
84,560 |
$61K |
| 90670 |
|
9,690 |
7,774 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38,109 |
32,457 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12,737 |
10,360 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12,637 |
10,458 |
$15K |
| 90723 |
|
8,083 |
6,533 |
$14K |
| 90680 |
|
7,137 |
5,776 |
$11K |
| 90651 |
|
3,845 |
3,387 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,979 |
6,008 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12,719 |
10,353 |
$8K |
| 90716 |
|
2,971 |
2,444 |
$8K |
| 0502F |
|
11,811 |
6,686 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,640 |
4,110 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13,706 |
11,386 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,626 |
3,209 |
$5K |
| 90707 |
|
2,940 |
2,415 |
$5K |
| 90734 |
|
3,198 |
2,840 |
$5K |
| 90633 |
|
6,267 |
5,196 |
$5K |
| 90647 |
|
7,882 |
6,348 |
$5K |
| 90710 |
|
2,807 |
2,351 |
$5K |
| 59430 |
|
326 |
298 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
823 |
479 |
$4K |
| 90696 |
|
2,672 |
2,255 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,332 |
892 |
$3K |
| 0500F |
|
2,011 |
1,748 |
$2K |
| 90700 |
|
2,644 |
2,172 |
$2K |
| 99381 |
|
2,816 |
2,526 |
$2K |
| 99383 |
|
736 |
673 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,453 |
2,205 |
$1K |
| D1206 |
Topical application of fluoride varnish |
2,538 |
2,084 |
$1K |
| 90685 |
|
1,936 |
1,597 |
$1K |
| 90715 |
|
1,959 |
1,749 |
$923.25 |
| 99384 |
|
351 |
316 |
$833.68 |
| 99201 |
|
179 |
153 |
$815.90 |
| 0503F |
|
1,448 |
1,184 |
$810.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
458 |
372 |
$741.70 |
| 99382 |
|
96 |
83 |
$690.55 |
| 81025 |
|
6,020 |
4,762 |
$425.72 |
| 90686 |
|
5,095 |
4,400 |
$401.81 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
161 |
148 |
$333.50 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
391 |
366 |
$308.50 |
| 81002 |
|
3,391 |
2,896 |
$250.22 |
| 82962 |
|
6,373 |
5,129 |
$207.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,200 |
929 |
$204.10 |
| 99385 |
|
125 |
103 |
$139.21 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,676 |
3,929 |
$119.70 |
| 96150 |
|
340 |
250 |
$112.21 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
89 |
67 |
$112.16 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,252 |
1,124 |
$110.55 |
| 99000 |
|
956 |
769 |
$23.46 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
329 |
261 |
$15.65 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
118 |
92 |
$6.85 |
| 85018 |
|
971 |
838 |
$4.64 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
102 |
91 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
344 |
307 |
$0.00 |
| 99420 |
|
201 |
165 |
$0.00 |
| 90648 |
|
192 |
171 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
420 |
186 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
117 |
105 |
$0.00 |
| 99442 |
|
34 |
28 |
$0.00 |
| 59425 |
|
88 |
82 |
$0.00 |
| 59426 |
|
106 |
76 |
$0.00 |
| 97803 |
|
29 |
27 |
$0.00 |
| 96152 |
|
14 |
12 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
329 |
186 |
$0.00 |
| 90674 |
|
661 |
611 |
$0.00 |
| 87590 |
|
65 |
44 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
126 |
123 |
$0.00 |
| 90656 |
|
74 |
71 |
$0.00 |
| 96164 |
|
64 |
29 |
$0.00 |
| 88142 |
|
39 |
25 |
$0.00 |
| 87490 |
|
69 |
45 |
$0.00 |
| 99441 |
|
158 |
133 |
$0.00 |
| 96156 |
|
18 |
18 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14 |
14 |
$0.00 |