| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
20,286 |
15,023 |
$2.29M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
70 |
51 |
$5K |
| 90686 |
|
35 |
19 |
$6.40 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,341 |
2,742 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
55 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
107 |
87 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
29 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
58 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
37 |
27 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
58 |
58 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
29 |
28 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,630 |
1,314 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,136 |
6,788 |
$0.00 |
| 96127 |
|
100 |
68 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
233 |
216 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
13 |
$0.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
14 |
14 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
26 |
13 |
$0.00 |