| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,682 |
6,159 |
$730K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
95 |
55 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,268 |
1,850 |
$106.49 |
| 90686 |
|
30 |
14 |
$69.89 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,372 |
2,514 |
$0.00 |
| 96127 |
|
177 |
154 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
13 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
21 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
84 |
73 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
82 |
77 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
28 |
$0.00 |