| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
19,214 |
11,080 |
$2.66M |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit |
13,524 |
12,653 |
$2.59M |
| T1015 |
Clinic visit/encounter, all-inclusive |
3,365 |
2,967 |
$716K |
| D9450 |
|
3,576 |
2,609 |
$211K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
853 |
814 |
$185K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,064 |
1,511 |
$177K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
677 |
658 |
$147K |
| G0469 |
Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit |
572 |
571 |
$109K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
450 |
438 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,763 |
1,618 |
$92K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,396 |
2,305 |
$87K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
391 |
364 |
$81K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,307 |
1,129 |
$56K |
| D1206 |
Topical application of fluoride varnish |
2,911 |
2,401 |
$52K |
| D0145 |
Oral evaluation for a patient under three years of age |
3,111 |
2,518 |
$52K |
| 90791 |
Psychiatric diagnostic evaluation |
232 |
231 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,247 |
1,794 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
352 |
328 |
$19K |
| 99384 |
|
83 |
80 |
$16K |
| 99173 |
|
688 |
653 |
$15K |
| 99383 |
|
61 |
60 |
$13K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
318 |
315 |
$11K |
| 99050 |
|
186 |
182 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
232 |
228 |
$8K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
77 |
77 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
42 |
41 |
$8K |
| 99381 |
|
29 |
29 |
$6K |
| 96127 |
|
1,004 |
950 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
327 |
319 |
$5K |
| 0124A |
|
97 |
87 |
$4K |
| 99382 |
|
17 |
17 |
$4K |
| 0111A |
|
83 |
80 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
35 |
27 |
$3K |
| 90474 |
|
291 |
284 |
$2K |
| 99188 |
|
89 |
84 |
$2K |
| 92551 |
|
247 |
235 |
$2K |
| T2022 |
Case management, per month |
14 |
14 |
$2K |
| 0071A |
|
46 |
44 |
$2K |
| 97802 |
|
60 |
60 |
$2K |
| 0112A |
|
32 |
32 |
$1K |
| 0154A |
|
30 |
28 |
$1K |
| 98967 |
|
54 |
48 |
$901.26 |
| 99460 |
|
14 |
14 |
$886.20 |
| 90662 |
|
57 |
57 |
$828.10 |
| 97803 |
|
30 |
29 |
$712.20 |
| 99462 |
|
20 |
16 |
$671.00 |
| 81025 |
|
77 |
75 |
$569.25 |
| 0051A |
|
12 |
12 |
$550.44 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
12 |
$517.56 |
| 90882 |
|
17 |
15 |
$483.95 |
| 99397 |
|
24 |
24 |
$444.66 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
31 |
20 |
$438.00 |
| D0120 |
Periodic oral evaluation - established patient |
42 |
28 |
$434.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
34 |
$401.06 |
| 90651 |
|
293 |
274 |
$243.48 |
| 98966 |
|
26 |
26 |
$218.40 |
| 90686 |
|
1,462 |
1,405 |
$209.33 |
| 90620 |
|
126 |
120 |
$190.74 |
| 81002 |
|
55 |
54 |
$165.78 |
| G0008 |
Administration of influenza virus vaccine |
50 |
50 |
$164.05 |
| 81003 |
|
58 |
57 |
$112.86 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
170 |
168 |
$47.79 |
| 82947 |
|
337 |
305 |
$46.28 |
| 36416 |
|
36 |
36 |
$0.00 |
| 90696 |
|
142 |
134 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$0.00 |
| 91307 |
|
76 |
73 |
$0.00 |
| 92558 |
|
464 |
440 |
$0.00 |
| 90697 |
|
573 |
564 |
$0.00 |
| 90619 |
|
237 |
222 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
26 |
13 |
$0.00 |
| 91305 |
|
60 |
55 |
$0.00 |
| 90744 |
|
72 |
69 |
$0.00 |
| 90698 |
|
144 |
143 |
$0.00 |
| 90716 |
|
87 |
83 |
$0.00 |
| 91315 |
|
14 |
13 |
$0.00 |
| 90715 |
|
192 |
181 |
$0.00 |
| 91312 |
|
82 |
72 |
$0.00 |
| 90461 |
|
1,235 |
1,201 |
$0.00 |
| 91311 |
|
119 |
116 |
$0.00 |
| 90713 |
|
78 |
76 |
$0.00 |
| 90707 |
|
56 |
53 |
$0.00 |
| 99177 |
|
162 |
155 |
$0.00 |
| 91308 |
|
28 |
28 |
$0.00 |
| 90670 |
|
733 |
719 |
$0.00 |
| 90633 |
|
453 |
440 |
$0.00 |
| 90710 |
|
340 |
329 |
$0.00 |
| 90681 |
|
371 |
363 |
$0.00 |