| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
61,017 |
40,335 |
$4.35M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,439 |
738 |
$107K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29,713 |
22,107 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,489 |
6,910 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
4,943 |
2,233 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,636 |
1,234 |
$486.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,293 |
1,057 |
$333.45 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,933 |
1,655 |
$235.20 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
35 |
31 |
$14.50 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
24 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
114 |
91 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
723 |
714 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
24 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
88 |
76 |
$0.00 |
| 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 |
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
170 |
131 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
16 |
13 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
64 |
64 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
44 |
27 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
76 |
39 |
$0.00 |