| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
39,929 |
22,889 |
$2.91M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
66 |
58 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,545 |
8,401 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,041 |
8,123 |
$918.47 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,255 |
499 |
$266.84 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,995 |
774 |
$155.49 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
465 |
383 |
$104.15 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
24 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
78 |
29 |
$0.00 |
| 90715 |
|
42 |
28 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
245 |
223 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
315 |
275 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
151 |
150 |
$0.00 |
| 81003 |
|
43 |
39 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
163 |
131 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
199 |
140 |
$0.00 |
| 83655 |
|
29 |
29 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
168 |
40 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
14 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
17 |
16 |
$0.00 |
| 90686 |
|
135 |
70 |
$0.00 |
| 88738 |
|
34 |
34 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
24 |
12 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
29 |
28 |
$0.00 |