| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
48,261 |
33,554 |
$4.89M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,813 |
1,376 |
$138K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,133 |
876 |
$388.63 |
| 87428 |
|
1,099 |
1,031 |
$56.74 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,372 |
18,932 |
$18.21 |
| 80053 |
Comprehensive metabolic panel |
895 |
718 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,668 |
1,443 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,128 |
902 |
$0.00 |
| 81001 |
|
309 |
243 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,945 |
1,403 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
760 |
627 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,178 |
1,041 |
$0.00 |
| 90723 |
|
177 |
155 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
606 |
562 |
$0.00 |
| 87081 |
|
646 |
600 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
31 |
$0.00 |
| 3074F |
|
513 |
440 |
$0.00 |
| 90686 |
|
241 |
184 |
$0.00 |
| 87430 |
|
248 |
237 |
$0.00 |
| 3080F |
|
144 |
128 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
18 |
18 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
243 |
184 |
$0.00 |
| 90647 |
|
191 |
158 |
$0.00 |
| 90677 |
|
85 |
77 |
$0.00 |
| 87807 |
|
193 |
177 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
87 |
82 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
66 |
46 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
13 |
$0.00 |
| 82607 |
|
12 |
12 |
$0.00 |
| 82746 |
|
12 |
12 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,121 |
1,012 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,629 |
1,415 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,670 |
1,479 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,708 |
2,814 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
856 |
478 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,393 |
1,473 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
643 |
564 |
$0.00 |
| 3078F |
|
510 |
437 |
$0.00 |
| 90670 |
|
359 |
295 |
$0.00 |
| 81025 |
|
46 |
29 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
672 |
535 |
$0.00 |
| 3077F |
|
143 |
128 |
$0.00 |
| 99201 |
|
151 |
102 |
$0.00 |
| 90633 |
|
106 |
91 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
316 |
284 |
$0.00 |
| 99173 |
|
508 |
473 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
59 |
55 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
32 |
24 |
$0.00 |
| 90710 |
|
95 |
81 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
24 |
$0.00 |
| 80061 |
Lipid panel |
32 |
32 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90734 |
|
29 |
29 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
22 |
12 |
$0.00 |
| 83655 |
|
13 |
12 |
$0.00 |