| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
71,724 |
50,478 |
$9.96M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,123 |
1,020 |
$74K |
| 0011A |
|
144 |
115 |
$6K |
| 0012A |
|
122 |
102 |
$5K |
| 90686 |
|
3,603 |
2,975 |
$3K |
| 0001A |
|
30 |
30 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32,129 |
23,944 |
$904.17 |
| 0002A |
|
12 |
12 |
$505.68 |
| 36415 |
Collection of venous blood by venipuncture |
538 |
398 |
$405.90 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
46 |
20 |
$356.13 |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,497 |
2,533 |
$284.88 |
| 90677 |
|
320 |
302 |
$283.72 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
577 |
502 |
$250.25 |
| 90715 |
|
620 |
552 |
$218.62 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,180 |
3,082 |
$212.00 |
| 81025 |
|
2,200 |
1,870 |
$187.81 |
| 0503F |
|
84 |
61 |
$150.00 |
| 0502F |
|
3,938 |
2,215 |
$130.20 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,566 |
2,150 |
$95.61 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
37 |
26 |
$84.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,545 |
2,976 |
$79.09 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,717 |
2,297 |
$63.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,427 |
2,077 |
$59.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,685 |
2,311 |
$45.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,024 |
6,101 |
$45.00 |
| 90656 |
|
154 |
139 |
$41.28 |
| 99173 |
|
485 |
432 |
$21.00 |
| 2028F |
|
300 |
266 |
$11.00 |
| 1160F |
|
17,663 |
15,085 |
$2.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
513 |
492 |
$1.00 |
| 3075F |
|
2,282 |
2,101 |
$1.00 |
| 1036F |
|
15,040 |
12,808 |
$1.00 |
| 3008F |
|
18,394 |
15,867 |
$1.00 |
| 3079F |
|
3,854 |
3,513 |
$1.00 |
| 3725F |
|
12,955 |
11,241 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,929 |
1,460 |
$0.00 |
| 3078F |
|
12,554 |
10,912 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
13 |
13 |
$0.00 |
| 3077F |
|
1,165 |
1,050 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
630 |
495 |
$0.00 |
| 90648 |
|
38 |
33 |
$0.00 |
| 81002 |
|
423 |
311 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
187 |
138 |
$0.00 |
| 3046F |
|
13 |
13 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
150 |
141 |
$0.00 |
| 90633 |
|
14 |
13 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
29 |
29 |
$0.00 |
| 90734 |
|
18 |
13 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
50 |
46 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,375 |
1,954 |
$0.00 |
| 3074F |
|
13,450 |
11,635 |
$0.00 |
| 3080F |
|
382 |
348 |
$0.00 |
| 96127 |
|
2,530 |
2,356 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
19 |
16 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
100 |
99 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
208 |
182 |
$0.00 |
| 0500F |
|
15 |
13 |
$0.00 |
| 99384 |
|
73 |
67 |
$0.00 |
| 99381 |
|
12 |
12 |
$0.00 |
| 3044F |
|
55 |
54 |
$0.00 |
| 99383 |
|
105 |
97 |
$0.00 |
| 90723 |
|
18 |
16 |
$0.00 |
| 59430 |
|
13 |
13 |
$0.00 |
| 99385 |
|
12 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
58 |
56 |
$0.00 |
| 90680 |
|
14 |
12 |
$0.00 |