| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
31,952 |
19,231 |
$3.77M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
3,828 |
1,942 |
$260K |
| 0011A |
|
42 |
42 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,613 |
8,119 |
$940.06 |
| 0012A |
|
28 |
28 |
$890.28 |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,029 |
3,739 |
$303.75 |
| 90791 |
Psychiatric diagnostic evaluation |
598 |
497 |
$191.16 |
| 96127 |
|
3,153 |
2,400 |
$26.60 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,832 |
1,287 |
$5.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,152 |
1,257 |
$5.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
32 |
30 |
$1.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
39 |
39 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
69 |
57 |
$0.00 |
| 3078F |
|
1,327 |
1,243 |
$0.00 |
| 81002 |
|
170 |
160 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
345 |
332 |
$0.00 |
| 1160F |
|
1,440 |
1,202 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
481 |
380 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
35 |
35 |
$0.00 |
| 1159F |
|
1,444 |
1,205 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
70 |
53 |
$0.00 |
| 3725F |
|
1,451 |
1,252 |
$0.00 |
| 99173 |
|
83 |
82 |
$0.00 |
| 3077F |
|
14 |
13 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90785 |
|
16 |
14 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
27 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,044 |
4,994 |
$0.00 |
| 85018 |
|
202 |
193 |
$0.00 |
| 3008F |
|
1,970 |
1,808 |
$0.00 |
| 3074F |
|
1,491 |
1,377 |
$0.00 |
| 3079F |
|
296 |
279 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
671 |
564 |
$0.00 |
| 1036F |
|
2,285 |
1,880 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
233 |
228 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
84 |
81 |
$0.00 |
| 90657 |
|
12 |
12 |
$0.00 |
| 90686 |
|
227 |
220 |
$0.00 |
| 3075F |
|
26 |
24 |
$0.00 |
| 90656 |
|
28 |
27 |
$0.00 |
| 99383 |
|
23 |
19 |
$0.00 |
| 99384 |
|
12 |
12 |
$0.00 |