| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
73,622 |
50,811 |
$5.51M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,397 |
915 |
$99K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,394 |
10,508 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32,876 |
24,700 |
$8K |
| S5190 |
Wellness assessment, performed by non-physician |
597 |
526 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,601 |
4,841 |
$219.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,271 |
2,779 |
$193.75 |
| 81003 |
|
4,769 |
3,156 |
$133.36 |
| 0502F |
|
3,233 |
1,478 |
$88.20 |
| 81025 |
|
1,058 |
863 |
$2.58 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,368 |
1,232 |
$0.00 |
| 90670 |
|
875 |
784 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
572 |
526 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
962 |
860 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
518 |
453 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
648 |
586 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,072 |
777 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
358 |
310 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
777 |
681 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
332 |
318 |
$0.00 |
| 17110 |
|
29 |
26 |
$0.00 |
| 90715 |
|
459 |
385 |
$0.00 |
| 90710 |
|
34 |
25 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
178 |
148 |
$0.00 |
| 90682 |
|
286 |
282 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
236 |
134 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
71 |
53 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,333 |
1,128 |
$0.00 |
| 90734 |
|
244 |
198 |
$0.00 |
| 90633 |
|
113 |
103 |
$0.00 |
| 3078F |
|
66 |
61 |
$0.00 |
| 90461 |
|
46 |
28 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
39 |
29 |
$0.00 |
| 90681 |
|
63 |
56 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
12 |
12 |
$0.00 |
| 90723 |
|
503 |
458 |
$0.00 |
| 96127 |
|
464 |
442 |
$0.00 |
| 90677 |
|
124 |
111 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
81 |
63 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,230 |
1,025 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,114 |
985 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
123 |
114 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
776 |
708 |
$0.00 |
| 87807 |
|
34 |
33 |
$0.00 |
| 3074F |
|
80 |
72 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
424 |
390 |
$0.00 |
| 90647 |
|
454 |
407 |
$0.00 |
| 90656 |
|
138 |
131 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
189 |
151 |
$0.00 |
| 90686 |
|
977 |
759 |
$0.00 |
| 3079F |
|
54 |
52 |
$0.00 |
| 90697 |
|
39 |
38 |
$0.00 |
| 99406 |
|
49 |
46 |
$0.00 |
| 90696 |
|
28 |
27 |
$0.00 |
| 90651 |
|
137 |
123 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
54 |
42 |
$0.00 |
| 82962 |
|
15 |
12 |
$0.00 |
| 3075F |
|
14 |
14 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
24 |
13 |
$0.00 |