| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
60,635 |
41,471 |
$8.43M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
367 |
295 |
$23K |
| 90686 |
|
2,973 |
2,448 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,372 |
25,280 |
$2K |
| 0011A |
|
22 |
21 |
$574.28 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
66 |
50 |
$475.40 |
| 90791 |
Psychiatric diagnostic evaluation |
1,165 |
855 |
$366.32 |
| 90715 |
|
843 |
684 |
$252.64 |
| 90677 |
|
312 |
303 |
$238.53 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
195 |
172 |
$209.60 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,383 |
3,914 |
$189.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
888 |
777 |
$84.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,598 |
2,202 |
$60.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
473 |
440 |
$25.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
83 |
60 |
$22.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
903 |
771 |
$18.00 |
| 81002 |
|
351 |
252 |
$11.00 |
| 0502F |
|
1,492 |
836 |
$11.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
589 |
506 |
$8.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
536 |
480 |
$8.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
695 |
593 |
$6.00 |
| 1160F |
|
6,639 |
5,594 |
$4.00 |
| 81025 |
|
1,030 |
904 |
$3.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
109 |
104 |
$3.00 |
| 1036F |
|
7,357 |
6,294 |
$2.00 |
| 3725F |
|
7,526 |
6,552 |
$2.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$1.00 |
| 3080F |
|
407 |
365 |
$0.00 |
| 3074F |
|
7,057 |
6,163 |
$0.00 |
| 99385 |
|
213 |
206 |
$0.00 |
| 3079F |
|
2,437 |
2,213 |
$0.00 |
| 3008F |
|
9,481 |
8,231 |
$0.00 |
| 96127 |
|
1,045 |
948 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,174 |
1,073 |
$0.00 |
| 3044F |
|
107 |
105 |
$0.00 |
| 3075F |
|
1,275 |
1,172 |
$0.00 |
| 90656 |
|
34 |
32 |
$0.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
80 |
71 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
88 |
76 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
57 |
49 |
$0.00 |
| 99386 |
|
12 |
12 |
$0.00 |
| 99000 |
|
21 |
18 |
$0.00 |
| 3046F |
|
58 |
50 |
$0.00 |
| 3078F |
|
6,313 |
5,546 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
129 |
123 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,133 |
1,423 |
$0.00 |
| 3077F |
|
803 |
718 |
$0.00 |
| 2028F |
|
110 |
79 |
$0.00 |
| 99201 |
|
28 |
13 |
$0.00 |
| 3051F |
|
17 |
15 |
$0.00 |