| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,918 |
13,292 |
$1.83M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,452 |
893 |
$110K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
355 |
301 |
$105.99 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,835 |
2,114 |
$1.40 |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,076 |
1,637 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
527 |
421 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,955 |
4,463 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,838 |
1,521 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
84 |
66 |
$0.00 |
| 87070 |
|
83 |
80 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
1,099 |
784 |
$0.00 |
| 3074F |
|
154 |
137 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
562 |
480 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
387 |
289 |
$0.00 |
| 87428 |
|
485 |
469 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
31 |
27 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
99 |
92 |
$0.00 |
| 87807 |
|
12 |
12 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
26 |
25 |
$0.00 |
| 87430 |
|
21 |
20 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
49 |
41 |
$0.00 |
| 81003 |
|
58 |
49 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
114 |
68 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
93 |
29 |
$0.00 |
| 3078F |
|
153 |
136 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
96 |
62 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
246 |
236 |
$0.00 |
| 99201 |
|
136 |
102 |
$0.00 |
| 80061 |
Lipid panel |
16 |
16 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$0.00 |