| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
305,180 |
221,995 |
$42.37M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
3,428 |
2,257 |
$240K |
| 90651 |
|
4,561 |
3,937 |
$26K |
| 90734 |
|
3,375 |
2,705 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
158,333 |
122,604 |
$22K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
42 |
14 |
$22K |
| 90716 |
|
5,188 |
4,238 |
$19K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
26 |
13 |
$16K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
4,253 |
3,463 |
$11K |
| 90707 |
|
4,945 |
4,014 |
$11K |
| 90688 |
|
1,785 |
1,461 |
$10K |
| 90670 |
|
6,428 |
5,000 |
$10K |
| 90696 |
|
2,021 |
1,663 |
$5K |
| 90633 |
|
4,420 |
3,570 |
$4K |
| 90715 |
|
3,099 |
2,687 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
256 |
177 |
$3K |
| 90700 |
|
2,024 |
1,630 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,739 |
6,123 |
$1K |
| 90647 |
|
5,614 |
4,549 |
$1K |
| 90723 |
|
5,980 |
4,837 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
9,485 |
5,933 |
$996.61 |
| 90713 |
|
636 |
585 |
$758.61 |
| 90837 |
Psychotherapy, 53 minutes with patient |
744 |
656 |
$685.26 |
| 90686 |
|
7,548 |
6,302 |
$641.59 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
4,260 |
3,755 |
$513.90 |
| 99349 |
|
2,756 |
1,742 |
$503.10 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24,880 |
20,233 |
$496.30 |
| 11721 |
|
26 |
12 |
$405.03 |
| 90681 |
|
3,173 |
2,616 |
$382.30 |
| 90671 |
|
946 |
913 |
$350.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
6,250 |
5,543 |
$341.95 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
6,621 |
5,630 |
$325.94 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,124 |
5,362 |
$318.75 |
| 90685 |
|
1,215 |
1,010 |
$260.77 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,568 |
5,665 |
$155.85 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
7,905 |
6,949 |
$96.45 |
| 99397 |
|
28 |
24 |
$85.65 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,317 |
7,942 |
$64.30 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,231 |
912 |
$44.20 |
| 99385 |
|
1,566 |
1,480 |
$32.15 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,192 |
7,840 |
$30.40 |
| 86580 |
|
1,075 |
829 |
$29.22 |
| 90744 |
|
142 |
113 |
$25.39 |
| 93000 |
|
1,082 |
1,022 |
$25.23 |
| 85018 |
|
24,846 |
21,023 |
$9.28 |
| 69209 |
|
181 |
164 |
$7.99 |
| 81002 |
|
2,242 |
1,795 |
$7.80 |
| 81025 |
|
1,453 |
1,291 |
$7.74 |
| 81003 |
|
1,172 |
1,146 |
$4.36 |
| 3078F |
|
34,521 |
32,170 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,799 |
7,118 |
$0.00 |
| 3046F |
|
2,632 |
2,269 |
$0.00 |
| 0502F |
|
12,153 |
6,615 |
$0.00 |
| 99348 |
|
402 |
383 |
$0.00 |
| 3077F |
|
2,796 |
2,599 |
$0.00 |
| 82948 |
|
3,430 |
2,939 |
$0.00 |
| 3051F |
|
1,124 |
1,029 |
$0.00 |
| 3045F |
|
791 |
569 |
$0.00 |
| 99382 |
|
504 |
410 |
$0.00 |
| 85610 |
|
411 |
156 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
373 |
233 |
$0.00 |
| 94664 |
|
388 |
251 |
$0.00 |
| 69210 |
|
475 |
380 |
$0.00 |
| 1160F |
|
38,885 |
35,221 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,486 |
7,284 |
$0.00 |
| 80305 |
|
292 |
253 |
$0.00 |
| 1159F |
|
38,301 |
34,683 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
12 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
4,498 |
3,468 |
$0.00 |
| A4267 |
Contraceptive supply, condom, male, each |
22 |
14 |
$0.00 |
| 15850 |
|
36 |
27 |
$0.00 |
| 11981 |
|
39 |
39 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
288 |
287 |
$0.00 |
| 3044F |
|
3,512 |
2,965 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,216 |
837 |
$0.00 |
| 99386 |
|
450 |
435 |
$0.00 |
| 58300 |
|
140 |
125 |
$0.00 |
| 99381 |
|
2,047 |
1,806 |
$0.00 |
| 3080F |
|
1,840 |
1,714 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
153 |
144 |
$0.00 |
| 99383 |
|
1,643 |
1,488 |
$0.00 |
| 3079F |
|
8,519 |
8,039 |
$0.00 |
| 3074F |
|
38,745 |
35,833 |
$0.00 |
| 99384 |
|
1,357 |
1,224 |
$0.00 |
| 90619 |
|
2,101 |
2,061 |
$0.00 |
| 1126F |
|
15,192 |
14,486 |
$0.00 |
| 0500F |
|
1,655 |
1,477 |
$0.00 |
| 3052F |
|
636 |
564 |
$0.00 |
| 94760 |
|
587 |
398 |
$0.00 |
| 1125F |
|
3,841 |
3,699 |
$0.00 |
| 3075F |
|
3,549 |
3,387 |
$0.00 |
| 0503F |
|
1,054 |
790 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
369 |
232 |
$0.00 |
| 88142 |
|
17 |
14 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
197 |
192 |
$0.00 |
| 1170F |
|
772 |
750 |
$0.00 |
| 58301 |
|
14 |
12 |
$0.00 |
| 90474 |
|
19 |
19 |
$0.00 |
| 90656 |
|
743 |
677 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
30 |
$0.00 |