| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
48,219 |
33,751 |
$5.20M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
968 |
538 |
$62K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
944 |
744 |
$847.92 |
| 90651 |
|
92 |
74 |
$434.22 |
| 90633 |
|
225 |
195 |
$131.56 |
| 90734 |
|
115 |
106 |
$130.75 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,906 |
1,490 |
$125.96 |
| 90686 |
|
420 |
374 |
$69.89 |
| 90715 |
|
75 |
71 |
$32.05 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,417 |
1,957 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
863 |
742 |
$0.00 |
| 87428 |
|
2,008 |
1,895 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,935 |
1,706 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,401 |
1,201 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30,044 |
22,321 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
1,685 |
1,462 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
460 |
314 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
38 |
38 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,041 |
1,798 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
746 |
621 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
598 |
518 |
$0.00 |
| 3080F |
|
143 |
131 |
$0.00 |
| 90677 |
|
195 |
188 |
$0.00 |
| 3074F |
|
447 |
392 |
$0.00 |
| 90647 |
|
130 |
117 |
$0.00 |
| 87088 |
|
34 |
28 |
$0.00 |
| 87430 |
|
270 |
251 |
$0.00 |
| 87070 |
|
306 |
289 |
$0.00 |
| 90723 |
|
130 |
106 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
58 |
44 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
62 |
55 |
$0.00 |
| 87807 |
|
164 |
151 |
$0.00 |
| 87081 |
|
260 |
178 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
83 |
74 |
$0.00 |
| 90697 |
|
76 |
69 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
52 |
52 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
27 |
18 |
$0.00 |
| 86376 |
|
13 |
13 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
25 |
24 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
56 |
38 |
$0.00 |
| 81003 |
|
1,275 |
994 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,760 |
895 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,172 |
1,052 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
854 |
748 |
$0.00 |
| 90681 |
|
26 |
24 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
317 |
287 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,490 |
2,118 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
787 |
674 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
841 |
714 |
$0.00 |
| 3078F |
|
444 |
389 |
$0.00 |
| 90670 |
|
319 |
280 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
418 |
368 |
$0.00 |
| 3077F |
|
146 |
134 |
$0.00 |
| 81025 |
|
172 |
139 |
$0.00 |
| 99201 |
|
166 |
117 |
$0.00 |
| 90710 |
|
44 |
39 |
$0.00 |
| 99173 |
|
251 |
217 |
$0.00 |
| 80061 |
Lipid panel |
39 |
28 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
72 |
60 |
$0.00 |