| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
80,714 |
59,270 |
$10.08M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,307 |
805 |
$104K |
| 99000 |
|
2,223 |
2,045 |
$52K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
18 |
18 |
$17K |
| 90651 |
|
619 |
541 |
$1K |
| 59430 |
|
41 |
41 |
$600.00 |
| 90734 |
|
551 |
497 |
$525.60 |
| 90710 |
|
288 |
232 |
$435.14 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33,139 |
26,638 |
$222.64 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
35 |
32 |
$221.83 |
| 90633 |
|
522 |
391 |
$188.33 |
| 90620 |
|
43 |
33 |
$177.15 |
| 90715 |
|
1,154 |
1,007 |
$141.22 |
| 81025 |
|
4,291 |
3,609 |
$136.77 |
| 90716 |
|
27 |
15 |
$129.30 |
| 90696 |
|
267 |
219 |
$112.66 |
| 90707 |
|
28 |
16 |
$75.04 |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,352 |
1,777 |
$60.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,517 |
10,873 |
$36.67 |
| 90688 |
|
329 |
184 |
$30.00 |
| 90756 |
|
48 |
29 |
$30.00 |
| 90648 |
|
347 |
210 |
$16.51 |
| 81002 |
|
2,301 |
1,900 |
$5.20 |
| 90744 |
|
70 |
43 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,338 |
1,074 |
$0.00 |
| 90686 |
|
1,938 |
1,701 |
$0.00 |
| 90697 |
|
28 |
26 |
$0.00 |
| 0500F |
|
726 |
644 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
399 |
395 |
$0.00 |
| 99383 |
|
305 |
237 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
466 |
423 |
$0.00 |
| 3074F |
|
169 |
168 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
747 |
726 |
$0.00 |
| 0503F |
|
228 |
179 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
718 |
616 |
$0.00 |
| 90656 |
|
240 |
234 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
700 |
559 |
$0.00 |
| 99384 |
|
108 |
70 |
$0.00 |
| 90723 |
|
162 |
88 |
$0.00 |
| 3080F |
|
156 |
153 |
$0.00 |
| 82962 |
|
12 |
12 |
$0.00 |
| 3079F |
|
204 |
203 |
$0.00 |
| 20610 |
|
283 |
163 |
$0.00 |
| 2000F |
|
31 |
31 |
$0.00 |
| 90698 |
|
80 |
60 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
41 |
24 |
$0.00 |
| 90732 |
|
12 |
12 |
$0.00 |
| 3075F |
|
74 |
74 |
$0.00 |
| 58300 |
|
27 |
26 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,987 |
2,546 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
260 |
222 |
$0.00 |
| 0502F |
|
4,613 |
2,868 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
878 |
765 |
$0.00 |
| 90670 |
|
629 |
427 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,763 |
1,483 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
952 |
840 |
$0.00 |
| 3077F |
|
207 |
205 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
224 |
188 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,191 |
950 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
182 |
179 |
$0.00 |
| 3078F |
|
95 |
94 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
295 |
208 |
$0.00 |
| 80305 |
|
1,524 |
1,276 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,174 |
1,262 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
633 |
615 |
$0.00 |
| 90681 |
|
42 |
38 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,506 |
1,259 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
114 |
80 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
801 |
568 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
88 |
87 |
$0.00 |
| 59025 |
Fetal non-stress test |
44 |
28 |
$0.00 |
| 90658 |
|
59 |
57 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
28 |
26 |
$0.00 |
| 90671 |
|
71 |
57 |
$0.00 |
| 99382 |
|
23 |
15 |
$0.00 |
| 4145F |
|
12 |
12 |
$0.00 |
| 90700 |
|
28 |
13 |
$0.00 |