| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,219 |
4,513 |
$803K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
691 |
432 |
$34K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,190 |
751 |
$2K |
| 90734 |
|
104 |
77 |
$12.97 |
| 90620 |
|
311 |
243 |
$0.42 |
| 99173 |
|
1,038 |
932 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
239 |
234 |
$0.00 |
| 81025 |
|
165 |
134 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
454 |
390 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
81 |
81 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
74 |
51 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
35 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,659 |
2,188 |
$0.00 |
| 90656 |
|
100 |
98 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
508 |
339 |
$0.00 |
| 96127 |
|
947 |
851 |
$0.00 |
| 90619 |
|
40 |
39 |
$0.00 |
| 90686 |
|
18 |
18 |
$0.00 |
| 90651 |
|
13 |
12 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
236 |
223 |
$0.00 |
| 85018 |
|
30 |
30 |
$0.00 |
| 90688 |
|
13 |
13 |
$0.00 |