| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
132,143 |
102,111 |
$20.02M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
4,256 |
1,916 |
$295K |
| D0999 |
Unspecified diagnostic procedure, by report |
393 |
294 |
$10K |
| 0012A |
|
232 |
172 |
$9K |
| 0011A |
|
229 |
197 |
$8K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,063 |
1,459 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42,020 |
38,438 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44,216 |
38,735 |
$4K |
| 0064A |
|
77 |
73 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,534 |
3,536 |
$3K |
| 0124A |
|
55 |
45 |
$2K |
| 91322 |
|
15 |
15 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,644 |
1,563 |
$2K |
| 90480 |
|
27 |
15 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,078 |
3,899 |
$1K |
| 0004A |
|
17 |
17 |
$716.38 |
| 0002A |
|
16 |
13 |
$674.24 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
2,627 |
1,120 |
$488.42 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,167 |
3,122 |
$443.97 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,170 |
2,944 |
$432.00 |
| 90791 |
Psychiatric diagnostic evaluation |
402 |
364 |
$370.33 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,671 |
7,967 |
$211.30 |
| 90636 |
|
224 |
222 |
$199.40 |
| 90832 |
Psychotherapy, 30 minutes with patient |
774 |
583 |
$178.59 |
| 96127 |
|
10,093 |
9,637 |
$172.04 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
198 |
195 |
$171.30 |
| 90750 |
|
468 |
461 |
$136.96 |
| 90686 |
|
572 |
569 |
$117.43 |
| 90651 |
|
1,088 |
1,065 |
$109.96 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,155 |
4,009 |
$107.91 |
| 99385 |
|
49 |
49 |
$104.96 |
| 90677 |
|
785 |
773 |
$89.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,166 |
5,093 |
$82.09 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
514 |
503 |
$72.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,723 |
1,669 |
$68.00 |
| 90715 |
|
1,200 |
1,182 |
$61.93 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
784 |
754 |
$54.07 |
| 90739 |
|
461 |
458 |
$33.42 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
2,750 |
2,612 |
$18.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
254 |
252 |
$15.70 |
| 81003 |
|
2,016 |
1,850 |
$15.26 |
| 86703 |
|
4,791 |
4,711 |
$11.84 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
271 |
268 |
$6.80 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,186 |
2,148 |
$1.11 |
| 3008F |
|
20,815 |
19,522 |
$0.00 |
| 3048F |
|
245 |
239 |
$0.00 |
| 3075F |
|
1,630 |
1,575 |
$0.00 |
| 4010F |
|
2,011 |
1,882 |
$0.00 |
| 3079F |
|
2,467 |
2,374 |
$0.00 |
| 3080F |
|
1,556 |
1,493 |
$0.00 |
| 3500F |
|
943 |
931 |
$0.00 |
| 3074F |
|
3,230 |
3,061 |
$0.00 |
| 3353F |
|
624 |
605 |
$0.00 |
| 90674 |
|
731 |
721 |
$0.00 |
| 99406 |
|
26 |
26 |
$0.00 |
| 3044F |
|
753 |
717 |
$0.00 |
| 1036F |
|
2,288 |
2,133 |
$0.00 |
| 1126F |
|
74 |
70 |
$0.00 |
| 99383 |
|
12 |
12 |
$0.00 |
| 90632 |
|
49 |
49 |
$0.00 |
| 90619 |
|
300 |
289 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
85 |
85 |
$0.00 |
| 90732 |
|
12 |
12 |
$0.00 |
| 3052F |
|
12 |
12 |
$0.00 |
| 93000 |
|
13 |
13 |
$0.00 |
| 3049F |
|
16 |
14 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
21 |
18 |
$0.00 |
| 81025 |
|
3,264 |
3,178 |
$0.00 |
| 4274F |
|
4,239 |
4,076 |
$0.00 |
| 3078F |
|
2,912 |
2,765 |
$0.00 |
| 90611 |
|
197 |
196 |
$0.00 |
| 82948 |
|
234 |
229 |
$0.00 |
| 3046F |
|
315 |
293 |
$0.00 |
| 1159F |
|
1,357 |
1,248 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
398 |
366 |
$0.00 |
| 4040F |
|
4,208 |
4,042 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
399 |
394 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,506 |
1,485 |
$0.00 |
| 3077F |
|
2,082 |
1,992 |
$0.00 |
| 3051F |
|
173 |
171 |
$0.00 |
| 90661 |
|
722 |
714 |
$0.00 |
| 99173 |
|
14 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
17 |
$0.00 |
| 0502F |
|
144 |
98 |
$0.00 |
| 1160F |
|
1,361 |
1,251 |
$0.00 |
| 80305 |
|
28 |
26 |
$0.00 |
| 90734 |
|
96 |
96 |
$0.00 |
| 46607 |
|
13 |
13 |
$0.00 |
| 90756 |
|
31 |
30 |
$0.00 |
| 90707 |
|
32 |
31 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
52 |
52 |
$0.00 |
| J1380 |
Injection, estradiol valerate, up to 10 mg |
14 |
14 |
$0.00 |