| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,657 |
5,793 |
$1.35M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
1,103 |
583 |
$150K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
689 |
689 |
$133K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
579 |
579 |
$111K |
| 90834 |
Psychotherapy, 45 minutes with patient |
847 |
502 |
$77K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
303 |
303 |
$53K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,445 |
1,435 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,088 |
2,070 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
99 |
95 |
$20K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
456 |
441 |
$10K |
| 0071A |
|
292 |
292 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
729 |
729 |
$9K |
| 90832 |
Psychotherapy, 30 minutes with patient |
186 |
148 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
37 |
37 |
$7K |
| 90791 |
Psychiatric diagnostic evaluation |
38 |
29 |
$5K |
| 81002 |
|
927 |
888 |
$2K |
| 0072A |
|
55 |
55 |
$2K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
14 |
14 |
$2K |
| 87400 |
|
84 |
83 |
$860.60 |
| 0001A |
|
13 |
13 |
$578.50 |
| 0111A |
|
12 |
12 |
$453.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
26 |
$337.96 |
| 85018 |
|
58 |
58 |
$139.94 |
| 91311 |
|
12 |
12 |
$0.00 |
| 91307 |
|
353 |
344 |
$0.00 |