| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
13,443 |
10,526 |
$2.25M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
316 |
276 |
$21K |
| 90686 |
|
897 |
864 |
$235.53 |
| 81025 |
|
74 |
72 |
$42.22 |
| 90656 |
|
40 |
37 |
$20.64 |
| 1160F |
|
3,904 |
3,162 |
$10.00 |
| 1159F |
|
3,424 |
2,720 |
$10.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,912 |
4,908 |
$10.00 |
| 96127 |
|
789 |
731 |
$1.00 |
| 1036F |
|
2,127 |
1,787 |
$1.00 |
| 90647 |
|
538 |
497 |
$0.06 |
| 90670 |
|
430 |
374 |
$0.03 |
| 90681 |
|
206 |
194 |
$0.03 |
| 90633 |
|
393 |
357 |
$0.02 |
| 90651 |
|
284 |
265 |
$0.02 |
| 90832 |
Psychotherapy, 30 minutes with patient |
216 |
190 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
827 |
764 |
$0.00 |
| 3078F |
|
2,696 |
2,403 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
713 |
638 |
$0.00 |
| 83655 |
|
117 |
117 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,124 |
1,060 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
71 |
71 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
987 |
964 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,207 |
1,127 |
$0.00 |
| 99173 |
|
1,481 |
1,380 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
805 |
767 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
272 |
263 |
$0.00 |
| 90461 |
|
629 |
616 |
$0.00 |
| 90715 |
|
46 |
45 |
$0.00 |
| 0502F |
|
138 |
95 |
$0.00 |
| 81002 |
|
40 |
40 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
125 |
120 |
$0.00 |
| 3725F |
|
487 |
415 |
$0.00 |
| 90621 |
|
62 |
59 |
$0.00 |
| 85018 |
|
1,097 |
1,048 |
$0.00 |
| 92551 |
|
415 |
405 |
$0.00 |
| 3074F |
|
2,759 |
2,452 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
646 |
626 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
810 |
759 |
$0.00 |
| 99381 |
|
40 |
40 |
$0.00 |
| 3008F |
|
4,633 |
4,109 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
548 |
513 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
245 |
215 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
376 |
347 |
$0.00 |
| 96161 |
|
213 |
186 |
$0.00 |
| 1126F |
|
45 |
43 |
$0.00 |
| 3079F |
|
117 |
112 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
43 |
41 |
$0.00 |
| 0500F |
|
49 |
45 |
$0.00 |
| 3075F |
|
33 |
33 |
$0.00 |
| 99383 |
|
12 |
12 |
$0.00 |
| 87428 |
|
55 |
55 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
39 |
38 |
$0.00 |
| 0503F |
|
25 |
25 |
$0.00 |