| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
30,649 |
25,861 |
$5.29M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
262 |
232 |
$18K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
350 |
343 |
$211.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,135 |
1,106 |
$31.40 |
| 90686 |
|
14 |
13 |
$25.43 |
| 1036F |
|
8,680 |
7,965 |
$4.00 |
| 1160F |
|
16,543 |
14,639 |
$4.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,649 |
1,510 |
$3.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,143 |
10,931 |
$2.00 |
| 96127 |
|
1,450 |
1,389 |
$0.00 |
| 99383 |
|
665 |
618 |
$0.00 |
| 3008F |
|
19,928 |
17,799 |
$0.00 |
| 90620 |
|
13 |
13 |
$0.00 |
| 3074F |
|
12,934 |
11,911 |
$0.00 |
| 99384 |
|
579 |
543 |
$0.00 |
| 3075F |
|
176 |
166 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
6,584 |
6,314 |
$0.00 |
| 99381 |
|
326 |
322 |
$0.00 |
| 90381 |
|
37 |
35 |
$0.00 |
| 93000 |
|
68 |
66 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
192 |
191 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
27 |
27 |
$0.00 |
| 90680 |
|
89 |
79 |
$0.00 |
| 3079F |
|
618 |
588 |
$0.00 |
| 90677 |
|
129 |
116 |
$0.00 |
| 87428 |
|
175 |
159 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
206 |
205 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
106 |
102 |
$0.00 |
| 90656 |
|
313 |
292 |
$0.00 |
| 90697 |
|
34 |
30 |
$0.00 |
| 90716 |
|
20 |
18 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,201 |
3,093 |
$0.00 |
| 81002 |
|
179 |
173 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,788 |
3,339 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,408 |
2,320 |
$0.00 |
| 3078F |
|
12,620 |
11,635 |
$0.00 |
| 3725F |
|
4,664 |
4,450 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,857 |
2,756 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
294 |
285 |
$0.00 |
| 90380 |
|
39 |
33 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
132 |
116 |
$0.00 |
| 90633 |
|
73 |
68 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
111 |
111 |
$0.00 |
| 99382 |
|
208 |
197 |
$0.00 |
| 99188 |
|
36 |
33 |
$0.00 |
| 90700 |
|
17 |
17 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90649 |
|
19 |
19 |
$0.00 |
| 90707 |
|
19 |
17 |
$0.00 |