| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
190,276 |
131,134 |
$28.43M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
3,840 |
3,122 |
$255K |
| 99000 |
|
2,633 |
2,151 |
$61K |
| 0011A |
|
2,297 |
2,260 |
$56K |
| 0012A |
|
1,367 |
1,344 |
$54K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
42 |
41 |
$36K |
| 0001A |
|
236 |
233 |
$10K |
| 90686 |
|
11,781 |
10,697 |
$7K |
| 0002A |
|
109 |
109 |
$5K |
| 0124A |
|
133 |
104 |
$5K |
| 90651 |
|
2,521 |
2,297 |
$4K |
| 0004A |
|
48 |
48 |
$2K |
| 0503F |
|
1,886 |
1,623 |
$2K |
| 0064A |
|
45 |
45 |
$2K |
| 0072A |
|
37 |
37 |
$2K |
| 90734 |
|
331 |
245 |
$1K |
| 90621 |
|
504 |
441 |
$1K |
| 0071A |
|
25 |
25 |
$1K |
| 0013A |
|
21 |
21 |
$884.94 |
| 59430 |
|
104 |
103 |
$750.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56,733 |
46,586 |
$724.53 |
| 90715 |
|
2,007 |
1,883 |
$516.58 |
| 90674 |
|
107 |
106 |
$461.99 |
| 90710 |
|
150 |
113 |
$428.74 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
42,781 |
31,859 |
$425.50 |
| 81025 |
|
2,386 |
2,231 |
$416.38 |
| 96127 |
|
23,386 |
19,700 |
$352.40 |
| 90633 |
|
2,920 |
2,689 |
$348.02 |
| 90694 |
|
15 |
13 |
$298.08 |
| 90677 |
|
204 |
204 |
$298.04 |
| 90670 |
|
4,009 |
3,615 |
$221.76 |
| 90700 |
|
122 |
81 |
$178.96 |
| 0502F |
|
13,446 |
8,190 |
$151.30 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,999 |
2,866 |
$141.32 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,009 |
9,951 |
$130.10 |
| 90647 |
|
4,046 |
3,740 |
$124.26 |
| 90696 |
|
128 |
91 |
$106.26 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,150 |
1,069 |
$86.20 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,904 |
5,530 |
$66.30 |
| 1036F |
|
40,670 |
31,395 |
$57.00 |
| 1160F |
|
52,092 |
42,696 |
$44.00 |
| 90656 |
|
95 |
95 |
$41.28 |
| 96161 |
|
3,888 |
3,478 |
$41.00 |
| 3725F |
|
24,136 |
19,327 |
$28.00 |
| 81002 |
|
2,450 |
2,235 |
$22.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,406 |
8,176 |
$19.00 |
| 82962 |
|
1,995 |
1,765 |
$18.97 |
| 1159F |
|
47,941 |
39,115 |
$18.00 |
| 90461 |
|
5,221 |
4,697 |
$18.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
386 |
344 |
$15.00 |
| 76830 |
Ultrasound, transvaginal |
22 |
12 |
$15.00 |
| 99173 |
|
10,668 |
9,846 |
$14.90 |
| 3008F |
|
61,346 |
51,722 |
$14.00 |
| 90723 |
|
315 |
271 |
$6.40 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,644 |
8,041 |
$6.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
10,761 |
7,456 |
$5.00 |
| 85018 |
|
1,955 |
1,781 |
$4.01 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,280 |
3,006 |
$4.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,199 |
3,953 |
$3.00 |
| 90791 |
Psychiatric diagnostic evaluation |
3,216 |
2,701 |
$2.00 |
| 3074F |
|
39,505 |
33,912 |
$2.00 |
| 99386 |
|
27 |
26 |
$2.00 |
| 99385 |
|
302 |
291 |
$2.00 |
| 0500F |
|
1,741 |
1,680 |
$2.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,343 |
7,544 |
$1.00 |
| 3078F |
|
36,622 |
31,707 |
$1.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,033 |
957 |
$1.00 |
| 3079F |
|
6,676 |
5,987 |
$1.00 |
| 1125F |
|
1,413 |
1,324 |
$1.00 |
| 99384 |
|
613 |
571 |
$1.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,036 |
2,890 |
$1.00 |
| 90681 |
|
2,512 |
2,332 |
$0.05 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
603 |
579 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
45 |
45 |
$0.00 |
| 80305 |
|
322 |
194 |
$0.00 |
| 2026F |
|
89 |
88 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
453 |
424 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,780 |
6,344 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,220 |
1,190 |
$0.00 |
| 69210 |
|
271 |
206 |
$0.00 |
| 3077F |
|
1,485 |
1,340 |
$0.00 |
| 99382 |
|
161 |
130 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
476 |
460 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,464 |
1,409 |
$0.00 |
| 99408 |
|
327 |
236 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
443 |
440 |
$0.00 |
| 90750 |
|
116 |
111 |
$0.00 |
| 90746 |
|
30 |
25 |
$0.00 |
| 90707 |
|
98 |
63 |
$0.00 |
| 11981 |
|
38 |
38 |
$0.00 |
| 1126F |
|
3,384 |
3,144 |
$0.00 |
| 99381 |
|
1,385 |
1,354 |
$0.00 |
| 3080F |
|
856 |
763 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
113 |
113 |
$0.00 |
| 99383 |
|
706 |
638 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,980 |
5,395 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
883 |
871 |
$0.00 |
| 92551 |
|
826 |
807 |
$0.00 |
| 90716 |
|
116 |
80 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
187 |
181 |
$0.00 |
| 87807 |
|
101 |
100 |
$0.00 |
| 3075F |
|
3,179 |
2,920 |
$0.00 |
| 76801 |
|
78 |
63 |
$0.00 |
| 87428 |
|
851 |
836 |
$0.00 |
| 90474 |
|
13 |
13 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
17 |
12 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| 99406 |
|
35 |
24 |
$0.00 |
| 92250 |
|
95 |
94 |
$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 |
17 |
12 |
$0.00 |
| 58300 |
|
29 |
29 |
$0.00 |
| 90680 |
|
90 |
77 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
41 |
38 |
$0.00 |
| 93000 |
|
15 |
15 |
$0.00 |
| G0268 |
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing |
24 |
13 |
$0.00 |
| 86580 |
|
14 |
12 |
$0.00 |