| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
103,733 |
63,082 |
$7.45M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
756 |
559 |
$48K |
| 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 |
1,180 |
936 |
$6K |
| S5190 |
Wellness assessment, performed by non-physician |
388 |
323 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$856.89 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,671 |
17,990 |
$375.14 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29,261 |
18,263 |
$291.88 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,410 |
536 |
$176.88 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
735 |
543 |
$137.34 |
| 90715 |
|
1,240 |
795 |
$33.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,714 |
1,794 |
$25.98 |
| 90670 |
|
765 |
274 |
$12.80 |
| 90723 |
|
2,221 |
1,627 |
$12.80 |
| G0008 |
Administration of influenza virus vaccine |
781 |
270 |
$6.40 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
737 |
500 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,565 |
3,230 |
$0.00 |
| 90633 |
|
1,614 |
1,121 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,076 |
2,874 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
487 |
471 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
474 |
382 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
298 |
242 |
$0.00 |
| 90734 |
|
640 |
441 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
2,583 |
1,855 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
577 |
396 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
4,417 |
2,353 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,205 |
936 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,142 |
1,554 |
$0.00 |
| 99173 |
|
824 |
660 |
$0.00 |
| 90710 |
|
373 |
278 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
1,087 |
1,026 |
$0.00 |
| 90700 |
|
122 |
84 |
$0.00 |
| 90681 |
|
914 |
684 |
$0.00 |
| 0502F |
|
179 |
112 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
92 |
56 |
$0.00 |
| 99242 |
|
345 |
243 |
$0.00 |
| 90671 |
|
94 |
93 |
$0.00 |
| 90707 |
|
81 |
77 |
$0.00 |
| 99382 |
|
13 |
12 |
$0.00 |
| 99245 |
|
14 |
14 |
$0.00 |
| 90647 |
|
2,294 |
1,650 |
$0.00 |
| 90716 |
|
106 |
74 |
$0.00 |
| 92551 |
|
780 |
634 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
609 |
377 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
598 |
327 |
$0.00 |
| 99406 |
|
1,403 |
573 |
$0.00 |
| 90651 |
|
748 |
539 |
$0.00 |
| 99243 |
|
73 |
70 |
$0.00 |
| 90686 |
|
464 |
218 |
$0.00 |
| 90677 |
|
108 |
94 |
$0.00 |
| 90696 |
|
333 |
252 |
$0.00 |
| 99383 |
|
86 |
83 |
$0.00 |
| 99381 |
|
170 |
120 |
$0.00 |
| 99384 |
|
12 |
12 |
$0.00 |
| 90619 |
|
106 |
106 |
$0.00 |
| 90656 |
|
204 |
183 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
667 |
176 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
95 |
18 |
$0.00 |
| 90688 |
|
585 |
145 |
$0.00 |
| 90732 |
|
88 |
16 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
29 |
29 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
26 |
14 |
$0.00 |