| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
113,909 |
80,618 |
$16.37M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,003 |
832 |
$68K |
| 90651 |
|
2,773 |
2,478 |
$9K |
| 0011A |
|
302 |
286 |
$8K |
| 90686 |
|
11,030 |
9,353 |
$5K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
13 |
13 |
$5K |
| 0012A |
|
106 |
106 |
$4K |
| 90734 |
|
815 |
641 |
$4K |
| 0001A |
|
75 |
75 |
$3K |
| 90710 |
|
455 |
359 |
$3K |
| 90621 |
|
1,169 |
1,063 |
$2K |
| 91322 |
|
13 |
13 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
47,678 |
38,794 |
$2K |
| 90670 |
|
2,657 |
2,385 |
$1K |
| 90633 |
|
1,831 |
1,660 |
$779.95 |
| 90715 |
|
1,491 |
1,306 |
$767.36 |
| 90696 |
|
441 |
345 |
$585.07 |
| 90688 |
|
168 |
142 |
$549.36 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,248 |
5,671 |
$384.20 |
| 90716 |
|
370 |
307 |
$372.46 |
| 90791 |
Psychiatric diagnostic evaluation |
1,587 |
946 |
$366.32 |
| 81025 |
|
1,707 |
1,587 |
$319.21 |
| 90677 |
|
13 |
13 |
$288.66 |
| 90647 |
|
2,436 |
2,234 |
$262.39 |
| 90723 |
|
1,056 |
915 |
$239.45 |
| 90700 |
|
288 |
262 |
$210.84 |
| 90680 |
|
801 |
725 |
$172.18 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,019 |
8,775 |
$130.75 |
| 96127 |
|
18,543 |
15,376 |
$95.20 |
| 90707 |
|
334 |
280 |
$77.32 |
| 90674 |
|
28 |
28 |
$72.15 |
| 96161 |
|
4,487 |
3,922 |
$58.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12,317 |
10,360 |
$53.00 |
| 0502F |
|
8,764 |
5,190 |
$46.10 |
| 90461 |
|
5,680 |
4,923 |
$45.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,706 |
2,513 |
$32.14 |
| 90656 |
|
93 |
90 |
$20.64 |
| 90681 |
|
1,030 |
935 |
$16.76 |
| 85018 |
|
4,531 |
4,116 |
$11.60 |
| 1036F |
|
24,734 |
19,782 |
$10.00 |
| 1160F |
|
31,180 |
25,635 |
$4.00 |
| 1159F |
|
28,563 |
23,328 |
$2.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,791 |
5,242 |
$1.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,486 |
4,170 |
$1.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,733 |
4,217 |
$1.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,154 |
3,309 |
$1.00 |
| 3725F |
|
8,367 |
7,335 |
$1.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
25 |
$0.00 |
| 3074F |
|
21,261 |
18,305 |
$0.00 |
| 1126F |
|
9,172 |
8,258 |
$0.00 |
| 0500F |
|
811 |
786 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
460 |
436 |
$0.00 |
| 3079F |
|
1,927 |
1,737 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,488 |
1,437 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,217 |
2,994 |
$0.00 |
| 3075F |
|
1,010 |
931 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
133 |
132 |
$0.00 |
| 87428 |
|
284 |
279 |
$0.00 |
| 1125F |
|
1,830 |
1,706 |
$0.00 |
| 92551 |
|
333 |
329 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,790 |
1,633 |
$0.00 |
| 3008F |
|
34,073 |
28,420 |
$0.00 |
| 76801 |
|
197 |
184 |
$0.00 |
| 99381 |
|
434 |
409 |
$0.00 |
| 82962 |
|
448 |
381 |
$0.00 |
| 0503F |
|
314 |
278 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
107 |
82 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
110 |
83 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
99 |
32 |
$0.00 |
| 59430 |
|
15 |
15 |
$0.00 |
| 92250 |
|
21 |
19 |
$0.00 |
| 3080F |
|
43 |
38 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
17 |
15 |
$0.00 |
| 99385 |
|
15 |
15 |
$0.00 |
| 3078F |
|
20,610 |
17,829 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,165 |
1,085 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,711 |
5,249 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,297 |
1,229 |
$0.00 |
| 81002 |
|
718 |
649 |
$0.00 |
| 99173 |
|
12,670 |
11,421 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
163 |
163 |
$0.00 |
| 3077F |
|
321 |
293 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
137 |
119 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
533 |
491 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
37 |
37 |
$0.00 |
| 99408 |
|
1,410 |
1,162 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
287 |
275 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
339 |
328 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
105 |
94 |
$0.00 |
| 90750 |
|
12 |
12 |
$0.00 |
| 11981 |
|
14 |
13 |
$0.00 |
| 2026F |
|
21 |
19 |
$0.00 |
| 90746 |
|
17 |
13 |
$0.00 |