| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
113,598 |
87,708 |
$16.12M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
3,865 |
2,424 |
$297K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,107 |
3,855 |
$137.20 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61,013 |
50,593 |
$23.76 |
| 90647 |
|
2,343 |
2,117 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,316 |
1,456 |
$0.00 |
| 90619 |
|
736 |
693 |
$0.00 |
| 0500F |
|
553 |
541 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,138 |
1,061 |
$0.00 |
| 90723 |
|
2,249 |
2,074 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
99 |
95 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,138 |
4,780 |
$0.00 |
| 76801 |
|
45 |
45 |
$0.00 |
| 90716 |
|
634 |
617 |
$0.00 |
| 90680 |
|
1,371 |
1,291 |
$0.00 |
| 90651 |
|
1,473 |
1,382 |
$0.00 |
| 90696 |
|
576 |
567 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
831 |
792 |
$0.00 |
| 90677 |
|
511 |
507 |
$0.00 |
| 90686 |
|
2,182 |
2,069 |
$0.00 |
| 96127 |
|
1,678 |
1,471 |
$0.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
170 |
122 |
$0.00 |
| 93000 |
|
421 |
409 |
$0.00 |
| 3080F |
|
98 |
95 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
518 |
488 |
$0.00 |
| 3079F |
|
161 |
161 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
26 |
26 |
$0.00 |
| 99383 |
|
294 |
289 |
$0.00 |
| 87428 |
|
1,082 |
1,059 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
159 |
152 |
$0.00 |
| 3075F |
|
54 |
54 |
$0.00 |
| 90656 |
|
238 |
238 |
$0.00 |
| 90620 |
|
133 |
133 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
205 |
118 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
488 |
484 |
$0.00 |
| 99384 |
|
91 |
90 |
$0.00 |
| 99381 |
|
176 |
172 |
$0.00 |
| 3074F |
|
82 |
81 |
$0.00 |
| 0503F |
|
14 |
14 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
19 |
19 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,049 |
944 |
$0.00 |
| 81002 |
|
3,937 |
3,509 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,665 |
3,260 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,947 |
7,073 |
$0.00 |
| 90715 |
|
1,349 |
1,301 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,456 |
4,063 |
$0.00 |
| 81025 |
|
3,894 |
3,438 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,537 |
1,485 |
$0.00 |
| 90710 |
|
765 |
742 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,526 |
1,501 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,906 |
3,442 |
$0.00 |
| 90649 |
|
188 |
186 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,199 |
2,084 |
$0.00 |
| 90734 |
|
856 |
836 |
$0.00 |
| 90670 |
|
2,451 |
2,257 |
$0.00 |
| 90707 |
|
554 |
541 |
$0.00 |
| 90700 |
|
556 |
546 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
754 |
726 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,107 |
2,913 |
$0.00 |
| 0502F |
|
4,289 |
2,805 |
$0.00 |
| 90633 |
|
1,990 |
1,898 |
$0.00 |
| 90681 |
|
244 |
239 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,048 |
3,744 |
$0.00 |
| 96160 |
|
607 |
539 |
$0.00 |
| 99382 |
|
73 |
72 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
310 |
265 |
$0.00 |
| 3077F |
|
168 |
165 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
152 |
96 |
$0.00 |
| 99201 |
|
134 |
128 |
$0.00 |
| 59025 |
Fetal non-stress test |
429 |
173 |
$0.00 |
| 99401 |
|
368 |
134 |
$0.00 |
| 90713 |
|
31 |
29 |
$0.00 |
| 3078F |
|
54 |
53 |
$0.00 |
| 86703 |
|
14 |
14 |
$0.00 |