| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
82,963 |
61,068 |
$11.70M |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
457 |
266 |
$411K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
2,070 |
1,598 |
$106K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,259 |
22,744 |
$7K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
220 |
162 |
$6K |
| 0012A |
|
103 |
89 |
$4K |
| 0502F |
|
13,359 |
5,800 |
$4K |
| 90651 |
|
1,912 |
1,588 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,244 |
7,271 |
$3K |
| 0011A |
|
100 |
91 |
$3K |
| 90670 |
|
2,761 |
2,429 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
36 |
12 |
$2K |
| 90734 |
|
1,115 |
979 |
$2K |
| 59025 |
Fetal non-stress test |
356 |
164 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,351 |
3,102 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,200 |
3,897 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,311 |
4,851 |
$1K |
| 91320 |
|
51 |
51 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
1,022 |
846 |
$1K |
| 90710 |
|
499 |
439 |
$939.22 |
| 90480 |
|
66 |
66 |
$915.00 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
38 |
13 |
$896.40 |
| 90658 |
|
1,393 |
1,033 |
$880.40 |
| 90620 |
|
351 |
322 |
$791.38 |
| 0001A |
|
18 |
18 |
$758.52 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
158 |
118 |
$721.50 |
| 90715 |
|
1,142 |
978 |
$661.34 |
| 90633 |
|
1,487 |
1,282 |
$589.84 |
| 0124A |
|
14 |
14 |
$585.20 |
| 90686 |
|
2,723 |
2,550 |
$543.81 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,891 |
3,524 |
$539.42 |
| 90680 |
|
1,953 |
1,750 |
$525.85 |
| 90723 |
|
1,687 |
1,517 |
$507.40 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,411 |
1,323 |
$395.10 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,709 |
1,276 |
$353.28 |
| 90648 |
|
2,261 |
2,015 |
$306.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12,138 |
10,440 |
$305.55 |
| 90707 |
|
333 |
267 |
$296.51 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,992 |
3,598 |
$288.55 |
| 81025 |
|
3,326 |
2,799 |
$288.26 |
| 90696 |
|
373 |
334 |
$281.09 |
| 90688 |
|
851 |
791 |
$265.85 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
769 |
710 |
$256.95 |
| 81000 |
|
8,413 |
2,884 |
$248.08 |
| 85018 |
|
4,832 |
4,345 |
$245.68 |
| 90716 |
|
336 |
272 |
$224.83 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,569 |
2,285 |
$203.75 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
564 |
430 |
$199.16 |
| 91322 |
|
16 |
16 |
$160.00 |
| 87081 |
|
582 |
484 |
$156.60 |
| 59430 |
|
610 |
539 |
$134.30 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,492 |
4,690 |
$132.00 |
| 99381 |
|
258 |
233 |
$91.90 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,431 |
1,109 |
$90.20 |
| 99201 |
|
109 |
107 |
$87.05 |
| 90700 |
|
210 |
178 |
$83.88 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,145 |
1,483 |
$79.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
72 |
71 |
$47.77 |
| 90473 |
|
1,339 |
1,191 |
$28.00 |
| 90649 |
|
14 |
12 |
$25.60 |
| 90698 |
|
153 |
128 |
$25.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
177 |
161 |
$24.30 |
| 82948 |
|
428 |
337 |
$20.64 |
| 96127 |
|
148 |
135 |
$14.60 |
| 99173 |
|
78 |
54 |
$7.45 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
18 |
12 |
$0.04 |
| 3078F |
|
337 |
313 |
$0.00 |
| 90461 |
|
187 |
184 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
56 |
56 |
$0.00 |
| 3077F |
|
96 |
92 |
$0.00 |
| 81002 |
|
31 |
30 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,152 |
1,145 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
26 |
26 |
$0.00 |
| 96381 |
|
12 |
12 |
$0.00 |
| 90677 |
|
279 |
275 |
$0.00 |
| 3074F |
|
276 |
257 |
$0.00 |
| 4010F |
|
137 |
129 |
$0.00 |
| 90619 |
|
136 |
133 |
$0.00 |
| 0500F |
|
254 |
216 |
$0.00 |
| 90656 |
|
338 |
332 |
$0.00 |
| 1036F |
|
417 |
398 |
$0.00 |
| 1126F |
|
18 |
16 |
$0.00 |
| 3075F |
|
103 |
101 |
$0.00 |
| 2000F |
|
307 |
284 |
$0.00 |
| 90474 |
|
56 |
54 |
$0.00 |
| 3044F |
|
27 |
26 |
$0.00 |
| 90657 |
|
87 |
81 |
$0.00 |
| 3008F |
|
1,484 |
1,379 |
$0.00 |
| 3079F |
|
113 |
111 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$0.00 |
| 58300 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12 |
12 |
$0.00 |
| 90647 |
|
32 |
32 |
$0.00 |
| 90744 |
|
25 |
14 |
$0.00 |