| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
70,832 |
42,782 |
$5.56M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,117 |
594 |
$79K |
| S5190 |
Wellness assessment, performed by non-physician |
74 |
74 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,692 |
1,257 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39,520 |
24,709 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,825 |
3,607 |
$0.00 |
| 90651 |
|
160 |
117 |
$0.00 |
| 90723 |
|
16 |
16 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
833 |
345 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
28 |
28 |
$0.00 |
| 90677 |
|
155 |
141 |
$0.00 |
| 90744 |
|
383 |
289 |
$0.00 |
| 90686 |
|
590 |
572 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90698 |
|
876 |
688 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
43 |
42 |
$0.00 |
| 90619 |
|
75 |
63 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
45 |
45 |
$0.00 |
| 90680 |
|
267 |
248 |
$0.00 |
| 90674 |
|
247 |
230 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
203 |
159 |
$0.00 |
| 90696 |
|
83 |
74 |
$0.00 |
| 90647 |
|
34 |
34 |
$0.00 |
| 90620 |
|
29 |
24 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$0.00 |
| 90474 |
|
14 |
13 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,428 |
3,615 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,932 |
2,321 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,264 |
1,025 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
763 |
462 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
434 |
409 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,478 |
1,903 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,405 |
703 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
94 |
89 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,054 |
1,656 |
$0.00 |
| 90670 |
|
572 |
544 |
$0.00 |
| 90461 |
|
21 |
21 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
93 |
85 |
$0.00 |
| 90715 |
|
289 |
207 |
$0.00 |
| 90710 |
|
66 |
58 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
26 |
25 |
$0.00 |
| 90633 |
|
285 |
197 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
26 |
26 |
$0.00 |
| 90734 |
|
112 |
77 |
$0.00 |