| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
57,994 |
42,407 |
$8.12M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
54 |
41 |
$4K |
| 0011A |
|
42 |
42 |
$2K |
| 0012A |
|
37 |
37 |
$2K |
| 99000 |
|
3,133 |
1,562 |
$375.36 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
37,434 |
28,980 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,142 |
10,739 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,782 |
2,104 |
$0.00 |
| 3008F |
|
5,518 |
4,607 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
247 |
247 |
$0.00 |
| 97802 |
|
1,908 |
1,529 |
$0.00 |
| 3074F |
|
779 |
719 |
$0.00 |
| 80376 |
|
1,882 |
747 |
$0.00 |
| 99406 |
|
8,120 |
6,619 |
$0.00 |
| 90686 |
|
244 |
194 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
143 |
111 |
$0.00 |
| 3079F |
|
320 |
306 |
$0.00 |
| 1036F |
|
295 |
235 |
$0.00 |
| 3075F |
|
112 |
108 |
$0.00 |
| 36416 |
|
17 |
13 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
23 |
12 |
$0.00 |
| 3080F |
|
17 |
16 |
$0.00 |
| 98960 |
|
1,789 |
1,577 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,809 |
1,635 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,468 |
883 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,868 |
1,632 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
194 |
192 |
$0.00 |
| 4004F |
|
663 |
614 |
$0.00 |
| 3077F |
|
18 |
16 |
$0.00 |
| 80306 |
|
162 |
156 |
$0.00 |
| 3078F |
|
659 |
612 |
$0.00 |
| 81025 |
|
85 |
47 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
637 |
579 |
$0.00 |
| 83037 |
|
32 |
28 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
47 |
47 |
$0.00 |