| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
32,467 |
24,585 |
$4.35M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,368 |
1,049 |
$91K |
| 0012A |
|
253 |
253 |
$11K |
| 0002A |
|
168 |
167 |
$7K |
| 0001A |
|
164 |
164 |
$7K |
| 0011A |
|
161 |
161 |
$7K |
| 90651 |
|
966 |
835 |
$3K |
| 90686 |
|
2,413 |
2,166 |
$1K |
| 90670 |
|
256 |
217 |
$976.00 |
| 90633 |
|
247 |
217 |
$404.43 |
| 90734 |
|
165 |
121 |
$260.30 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,882 |
9,421 |
$85.00 |
| 96127 |
|
6,032 |
5,176 |
$81.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
685 |
592 |
$77.87 |
| 90715 |
|
129 |
102 |
$43.70 |
| 99408 |
|
530 |
450 |
$41.71 |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,080 |
4,043 |
$31.48 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,413 |
2,149 |
$31.00 |
| 90656 |
|
20 |
19 |
$20.64 |
| 90688 |
|
12 |
12 |
$17.84 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,320 |
2,903 |
$17.00 |
| 99173 |
|
3,641 |
3,251 |
$7.45 |
| 81025 |
|
313 |
256 |
$5.17 |
| 1160F |
|
7,392 |
6,268 |
$2.00 |
| 1036F |
|
6,651 |
5,505 |
$2.00 |
| 3725F |
|
3,705 |
3,057 |
$1.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,309 |
1,200 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,989 |
1,640 |
$0.00 |
| 81002 |
|
192 |
171 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,260 |
1,126 |
$0.00 |
| 1159F |
|
6,876 |
5,817 |
$0.00 |
| 3078F |
|
6,459 |
5,698 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
258 |
229 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
180 |
158 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
87 |
86 |
$0.00 |
| 90461 |
|
1,105 |
894 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
416 |
355 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
49 |
$0.00 |
| 90621 |
|
34 |
34 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
14 |
14 |
$0.00 |
| 0502F |
|
55 |
37 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 99382 |
|
14 |
14 |
$0.00 |
| 3074F |
|
6,672 |
5,848 |
$0.00 |
| 3079F |
|
878 |
787 |
$0.00 |
| 3075F |
|
410 |
372 |
$0.00 |
| 3008F |
|
9,904 |
8,384 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
526 |
473 |
$0.00 |
| 87428 |
|
255 |
251 |
$0.00 |
| 90723 |
|
88 |
76 |
$0.00 |
| 99383 |
|
174 |
154 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,179 |
1,061 |
$0.00 |
| 1126F |
|
143 |
116 |
$0.00 |
| 90680 |
|
14 |
12 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
28 |
28 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
406 |
372 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
68 |
65 |
$0.00 |
| 96161 |
|
157 |
144 |
$0.00 |
| 92551 |
|
130 |
130 |
$0.00 |
| 85018 |
|
170 |
153 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
97 |
97 |
$0.00 |
| 99384 |
|
32 |
27 |
$0.00 |
| 90647 |
|
14 |
12 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
50 |
34 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
21 |
21 |
$0.00 |