| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
271,883 |
137,402 |
$20.60M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
8,925 |
4,352 |
$643K |
| S5190 |
Wellness assessment, performed by non-physician |
148 |
147 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,097 |
15,372 |
$127.50 |
| 90698 |
|
4,490 |
3,036 |
$70.40 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13,805 |
9,536 |
$66.93 |
| 90744 |
|
2,123 |
1,298 |
$51.20 |
| 90633 |
|
2,787 |
1,983 |
$38.40 |
| 90707 |
|
901 |
620 |
$19.20 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,946 |
6,494 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
13,800 |
6,050 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
1,316 |
357 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
125,125 |
71,377 |
$0.00 |
| 90680 |
|
1,634 |
1,541 |
$0.00 |
| 90677 |
|
653 |
610 |
$0.00 |
| 90697 |
|
765 |
723 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
906 |
532 |
$0.00 |
| 90696 |
|
734 |
511 |
$0.00 |
| 90716 |
|
647 |
486 |
$0.00 |
| 90651 |
|
1,113 |
795 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,122 |
668 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
4,214 |
2,683 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,200 |
1,021 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
429 |
292 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
787 |
678 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
320 |
316 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
43 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
987 |
888 |
$0.00 |
| 90674 |
|
869 |
844 |
$0.00 |
| 90656 |
|
27 |
20 |
$0.00 |
| 96119 |
|
62 |
38 |
$0.00 |
| 90686 |
|
1,011 |
983 |
$0.00 |
| 90619 |
|
238 |
227 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
14 |
14 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
312 |
263 |
$0.00 |
| 96132 |
|
62 |
40 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
730 |
390 |
$0.00 |
| 90474 |
|
61 |
31 |
$0.00 |
| 99381 |
|
13 |
13 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
53 |
50 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
26,316 |
9,611 |
$0.00 |
| 90715 |
|
1,483 |
1,018 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,072 |
5,432 |
$0.00 |
| 90734 |
|
633 |
400 |
$0.00 |
| 99177 |
|
855 |
716 |
$0.00 |
| 90682 |
|
147 |
145 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,784 |
3,271 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,059 |
4,313 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,007 |
1,433 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
1,288 |
1,151 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
915 |
651 |
$0.00 |
| 90710 |
|
755 |
527 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
637 |
416 |
$0.00 |
| J7614 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
295 |
208 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
4,005 |
2,316 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,395 |
2,441 |
$0.00 |
| 99307 |
|
221 |
183 |
$0.00 |
| 90670 |
|
1,746 |
1,711 |
$0.00 |
| 96118 |
|
62 |
54 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
30 |
30 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,436 |
5,832 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
317 |
311 |
$0.00 |
| 90461 |
|
39 |
39 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
102 |
99 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
118 |
47 |
$0.00 |
| 90785 |
|
228 |
60 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
54 |
54 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
38 |
37 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
15 |
15 |
$0.00 |