| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
782,745 |
546,618 |
$120.02M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
14,200 |
11,330 |
$1.07M |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
645 |
297 |
$591K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
514 |
374 |
$236K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
5,914 |
3,855 |
$190K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
368 |
243 |
$144K |
| 90651 |
|
21,552 |
18,712 |
$76K |
| 0012A |
|
1,111 |
1,109 |
$46K |
| 99000 |
|
1,967 |
1,917 |
$46K |
| 0011A |
|
1,192 |
1,192 |
$44K |
| 90734 |
|
18,647 |
16,293 |
$30K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
98 |
75 |
$27K |
| 90670 |
|
16,084 |
12,505 |
$21K |
| 59430 |
|
3,606 |
3,012 |
$21K |
| 0001A |
|
379 |
379 |
$16K |
| 0124A |
|
275 |
253 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
284,770 |
225,566 |
$9K |
| 90710 |
|
8,522 |
7,275 |
$9K |
| 90716 |
|
7,361 |
5,883 |
$8K |
| 90620 |
|
3,939 |
3,456 |
$8K |
| 90633 |
|
16,016 |
13,228 |
$7K |
| 90698 |
|
12,360 |
9,803 |
$7K |
| 0154A |
|
175 |
137 |
$6K |
| 0002A |
|
152 |
152 |
$6K |
| 90686 |
|
51,509 |
43,008 |
$5K |
| 91322 |
|
51 |
51 |
$5K |
| 59025 |
Fetal non-stress test |
500 |
118 |
$4K |
| 90688 |
|
2,649 |
1,552 |
$4K |
| 90707 |
|
7,287 |
5,812 |
$4K |
| 90715 |
|
18,545 |
16,080 |
$4K |
| 90696 |
|
7,370 |
6,415 |
$3K |
| 90680 |
|
5,293 |
4,270 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
11,104 |
9,392 |
$2K |
| 90621 |
|
1,189 |
1,091 |
$2K |
| 0500F |
|
3,818 |
3,384 |
$2K |
| 90744 |
|
7,821 |
6,242 |
$2K |
| 91320 |
|
38 |
37 |
$1K |
| 90480 |
|
49 |
49 |
$1K |
| 90700 |
|
4,229 |
3,574 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
144,664 |
122,697 |
$965.53 |
| 90713 |
|
1,275 |
1,062 |
$946.33 |
| 90681 |
|
5,004 |
4,257 |
$905.65 |
| 90723 |
|
3,266 |
2,695 |
$793.87 |
| 0134A |
|
15 |
15 |
$654.00 |
| 0052A |
|
15 |
15 |
$652.20 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
71,002 |
58,900 |
$630.73 |
| 90648 |
|
4,683 |
3,757 |
$414.92 |
| 90685 |
|
1,192 |
647 |
$324.23 |
| 58300 |
|
1,227 |
1,074 |
$264.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
18,351 |
17,055 |
$171.30 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
7,970 |
5,906 |
$168.35 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
98,277 |
80,220 |
$162.34 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17,599 |
15,275 |
$88.03 |
| 11981 |
|
802 |
757 |
$88.00 |
| 81025 |
|
30,917 |
27,061 |
$75.76 |
| S5190 |
Wellness assessment, performed by non-physician |
8,807 |
4,443 |
$69.02 |
| 90647 |
|
1,283 |
1,097 |
$65.26 |
| 36415 |
Collection of venous blood by venipuncture |
18,378 |
9,536 |
$50.50 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
5,046 |
3,649 |
$32.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
27,665 |
18,724 |
$29.48 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
11,358 |
10,110 |
$25.50 |
| 86580 |
|
4,492 |
3,585 |
$4.00 |
| 85018 |
|
8,841 |
7,598 |
$2.32 |
| 82962 |
|
4,652 |
3,849 |
$1.68 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,000 |
891 |
$1.18 |
| 99386 |
|
2,921 |
2,295 |
$0.00 |
| 99385 |
|
5,236 |
4,082 |
$0.00 |
| 1125F |
|
34,352 |
28,473 |
$0.00 |
| 99384 |
|
2,622 |
2,059 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29,334 |
25,383 |
$0.00 |
| 90732 |
|
430 |
394 |
$0.00 |
| 96156 |
|
622 |
514 |
$0.00 |
| 93000 |
|
877 |
860 |
$0.00 |
| 99381 |
|
3,572 |
3,125 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,762 |
1,177 |
$0.00 |
| 3080F |
|
25,140 |
21,386 |
$0.00 |
| 3079F |
|
72,013 |
62,144 |
$0.00 |
| 3075F |
|
39,182 |
34,859 |
$0.00 |
| 99383 |
|
3,532 |
2,688 |
$0.00 |
| 1126F |
|
194,385 |
157,655 |
$0.00 |
| 58301 |
|
404 |
385 |
$0.00 |
| 3074F |
|
193,472 |
151,338 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
730 |
568 |
$0.00 |
| 57454 |
|
204 |
200 |
$0.00 |
| 90381 |
|
411 |
328 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
11,968 |
7,392 |
$0.00 |
| 90697 |
|
2,745 |
2,619 |
$0.00 |
| 90677 |
|
5,991 |
5,746 |
$0.00 |
| 96380 |
|
380 |
378 |
$0.00 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
345 |
294 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
352 |
230 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
144 |
104 |
$0.00 |
| 58100 |
|
52 |
51 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
14 |
14 |
$0.00 |
| 90474 |
|
64 |
63 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
25 |
25 |
$0.00 |
| 91319 |
|
15 |
15 |
$0.00 |
| 1111F |
|
119 |
118 |
$0.00 |
| 90656 |
|
7,291 |
6,723 |
$0.00 |
| 90660 |
|
69 |
64 |
$0.00 |
| 90674 |
|
88 |
86 |
$0.00 |
| G0406 |
Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth |
45 |
45 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
34 |
34 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
33 |
17 |
$0.00 |
| 3078F |
|
172,905 |
135,943 |
$0.00 |
| 81002 |
|
20,700 |
15,930 |
$0.00 |
| 99382 |
|
1,862 |
1,192 |
$0.00 |
| 1160F |
|
5,811 |
4,688 |
$0.00 |
| 1159F |
|
5,814 |
4,689 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13,267 |
12,320 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31,089 |
28,690 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12,267 |
10,163 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,147 |
889 |
$0.00 |
| 0502F |
|
24,402 |
13,480 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
4,558 |
3,298 |
$0.00 |
| 90672 |
|
206 |
149 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
3,582 |
3,247 |
$0.00 |
| 69210 |
|
1,004 |
885 |
$0.00 |
| 3077F |
|
36,434 |
30,873 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
1,250 |
1,103 |
$0.00 |
| 11982 |
|
232 |
227 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35,377 |
32,159 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,935 |
1,701 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
19,888 |
16,491 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,052 |
1,517 |
$0.00 |
| 83655 |
|
560 |
529 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30,929 |
26,957 |
$0.00 |
| 90750 |
|
1,488 |
1,465 |
$0.00 |
| 99397 |
|
826 |
800 |
$0.00 |
| 90461 |
|
39,401 |
29,849 |
$0.00 |
| 90746 |
|
464 |
413 |
$0.00 |
| 90671 |
|
1,188 |
1,088 |
$0.00 |
| 85014 |
|
710 |
560 |
$0.00 |
| 90380 |
|
206 |
180 |
$0.00 |
| 99453 |
|
29 |
29 |
$0.00 |
| 11721 |
|
15 |
14 |
$0.00 |
| 85610 |
|
18 |
17 |
$0.00 |
| 96381 |
|
13 |
13 |
$0.00 |
| 99201 |
|
20 |
16 |
$0.00 |