| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
61,412 |
44,832 |
$4.86M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
827 |
475 |
$51K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23,302 |
18,175 |
$4K |
| 90686 |
|
2,032 |
1,817 |
$4K |
| 90651 |
|
411 |
364 |
$3K |
| 90670 |
|
1,475 |
1,291 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,640 |
13,752 |
$2K |
| 90734 |
|
415 |
377 |
$2K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
506 |
297 |
$2K |
| 90723 |
|
1,179 |
1,039 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,190 |
1,882 |
$834.24 |
| 90633 |
|
571 |
508 |
$793.04 |
| 0011A |
|
16 |
16 |
$667.82 |
| 0012A |
|
12 |
12 |
$505.68 |
| 90648 |
|
1,658 |
1,445 |
$407.03 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,189 |
1,958 |
$311.48 |
| 90715 |
|
341 |
312 |
$289.67 |
| 90710 |
|
172 |
160 |
$208.81 |
| 90680 |
|
751 |
660 |
$202.89 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,388 |
1,104 |
$144.70 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,105 |
1,012 |
$76.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
424 |
334 |
$64.32 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,524 |
1,324 |
$62.81 |
| 90696 |
|
166 |
160 |
$57.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
872 |
771 |
$16.18 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,112 |
709 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
504 |
464 |
$0.00 |
| 90716 |
|
28 |
27 |
$0.00 |
| 90677 |
|
237 |
215 |
$0.00 |
| 90656 |
|
175 |
169 |
$0.00 |
| 99441 |
|
48 |
48 |
$0.00 |
| 87428 |
|
268 |
258 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
959 |
899 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
442 |
323 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
66 |
66 |
$0.00 |
| 99442 |
|
18 |
18 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
81 |
79 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$0.00 |
| 90707 |
|
25 |
24 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
59 |
58 |
$0.00 |
| 81003 |
|
46 |
44 |
$0.00 |
| 90681 |
|
15 |
13 |
$0.00 |
| 90700 |
|
26 |
26 |
$0.00 |