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Table 6A: Selected Diagnoses and Services Rendered

Indiana Data

X

26 Awardees

Line Diagnostic Category Applicable ICD-10-CM Code or Value Set Object Identifier (OID) Number of Visits by Diagnosis Regardless of Primacy (a) Number of Patients with Diagnosis (b) Visits per Patient
Selected Infectious and Parasitic Diseases
1-2. Symptomatic/Asymptomatic human immunodeficiency virus (HIV) B20, B97.35, O98.7-, Z21 OID: 2.16.840.1.113883.3.464.1003.120.12.1003 2,592 1,352 1.92
3. Tuberculosis ICD-10: A15- through A19-, B90-, J65, O98.0-,P37.0 OID: 2.16.840.1.113762.1.4.1146.451 140 102 1.37
4. Sexually transmitted infections (gonococcal infections and venereal diseases) A50- through A64-, A69.0, A69.1, A69.8, A69.9 OID: 2.16.840.1.113883.3.464.1003.112.11.1003 5,591 4,168 1.34
4a. Hepatitis B ICD-10: B16.0 through B16.2, B16.9, B18.0, B18.1, B19.1- OID: 2.16.840.1.113883.3.67.1.101.1.271 997 564 1.77
4b. Hepatitis C ICD-10: B17.1-, B18.2, B19.2- OID: 2.16.840.1.113762.1.4.1222.30 3,228 1,859 1.74
4c. Novel coronavirus (SARS-CoV-2) disease ICD-10: U07.1 OID: 2.16.840.1.113762.1.4.1248.139 4,222 3,915 1.08
4d. Long COVID ICD-10: U09, U09.9 OID: 2.16.840.1.113762.1.4.1178.98 180 147 1.22
Selected Diseases of the Respiratory System
5. Asthma ICD-10: J45- OID: 2.16.840.1.113883.3.526.2.60 55,411 35,862 1.55
6. Chronic lower respiratory diseases J40 (count J40 only when code U07.1 is not present), J41- through J44-, J47-, J4A- 38,917 20,928 1.86
6a. Respiratory conditions related to COVID-19 J12.82, J12.89, J20.8, J40, J22, J98.8, J80 (count codes listed only when code U07.1 is also present) OID: 2.16.840.1.113762.1.4.1029.374 127 117 1.09
Selected Other Medical Conditions
7. Abnormal breast findings, female ICD-10: C50.01-, C50.11-, C50.21-, C50.31-, C50.41-, C50.51-, C50.61-, C50.81-, C50.91-, C79.81, D05-, D24., D48.6, D49.3, N60- through N65-, R92- 12,826 10,136 1.27
8. Abnormal cervical findings C53-, C79.82, D06-, N87.0, N87.1, N87.9, R87.61- (exclude R87.615 and R87.616), R87.629, R87.810, R87.820 5,106 3,692 1.38
9. Diabetes mellitus ICD-10: E08- through E13-, O24- (exclude O24.4-) OID: 2.16.840.1.113762.1.4.1219.35 187,515 68,127 2.75
10. Heart disease (selected) ICD-10: I01-, I02- (exclude I02.9), I20- through I25-, I27-, I28-, I30- through I52-, Q24- 38,708 22,265 1.74
11. Hypertension I10- through I16-, O10-, O11- OID: 2.16.840.1.113762.1.4.1222.1547 (Includes all codes other than O11-) 275,661 123,704 2.23
12. Contact dermatitis and other eczema ICD-10: H01.13-, L20.89, L23- through L25-, L30- (exclude L30.1, L30.3, L30.4, L30.5) 28,857 23,899 1.21
13. Dehydration ICD-10: E86- 978 906 1.08
14. Exposure to heat or cold ICD-10: T33-, T34-, T67-, T68-, T69-, W92-, W93-, X30-, X31-, X32- 220 186 1.18
14a. Overweight and obesity ICD-10: E66-, Z68- (exclude Z68.1, Z68.20 through Z68.24, Z68.51, Z68.52) OID: 2.16.840.1.113762.1.4.1222.35 (includes all E66- codes except E66.3) 221,526 126,228 1.75
Selected Childhood Conditions (limited to ages 0 through 17)
15. Otitis media and Eustachian tube disorders ICD-10: H65- through H69-, H72- 27,156 19,237 1.41
16. Selected perinatal/neonatal medical conditions ICD-10: A33, P19-, P22- through P29- (exclude P29.3-), P35- through P96- (exclude P54-, P91.6-, P92-, P96.81), Q86- 6,360 4,251 1.50
17. Lack of expected normal physiological development (such as delayed milestone, failure to gain weight, failure to thrive); nutritional deficiencies in children only. Does not include sexual or mental development. ICD-10: E40- through E46-, E50- through E63-, P92-, R62- (exclude R62.7), R63.3- (exclude R63.39) 20,906 14,274 1.46
Selected Mental Health Conditions and Substance Use Disorders
18. Alcohol-related disorders ICD-10: F10-, G62.1, K70-, O99.31- 41,528 13,121 3.17
19. Other substance-related disorders (excluding tobacco use disorders) ICD-10: F11- through F19- (exclude F17-), G62.0, O99.32- 75,076 19,023 3.95
19a. Tobacco use disorder ICD-10: F17-, O99.33-, Z72.0 76,433 42,676 1.79
20a. Depression and other mood disorders ICD-10: F30- through F39- 357,781 95,326 3.75
20b. Anxiety disorders, including post-traumatic stress disorder (PTSD) ICD-10: F06.4, F40- through F42-, F43.0, F43.1-, F43.8-, F93.0 416,692 115,734 3.60
20c. Attention deficit and disruptive behavior disorders ICD-10: F90- through F91- 151,127 41,166 3.67
20d. Other mental disorders, excluding drug or alcohol dependence ICD-10: F01- through F09- (exclude F06.4), F20- through F29-, F43- through F48- (exclude F43.0- and F43.1-), F50- through F99- (exclude F55-, F84.2, F90-, F91-, F93.0, F98-), O99.34-, R45.1, R45.2, R45.5, R45.6, R45.7, R45.81, R45.82, R48.0 178,679 67,914 2.63
20e. Human trafficking ICD-10: T74.5- through T74.6-, T76.5- through T76.6-, Z04.81, Z04.82, Z62.813, Z91.42 - - -
20f. Intimate partner violence ICD-10: T74.11-, T74.21-, T74.31-, Z69.11 196 162 1.21
Line Diagnostic Category Applicable ICD-10-CM, CPT-4/I/II/PLA, or HCPCS Code Number of Visits (a) Number of Patients (b) Visits per Patient
Selected Diagnostic Tests/Screening/Preventive Services
21. HIV test CPT-4: 86689, 86701 through 86703, 87389 through 87391, 87534 through 87539, 87806 HCPCS: G0432 through G0435, G0475 OID: 2.16.840.1.113762.1.4.1056.50 91,912 65,622 1.40
21a. Hepatitis B test CPT-4: 80074, 86704 through 86707, 87340, 87341, 87350, 87467, 87912 HCPCS: G0499 24,764 23,425 1.06
21b. Hepatitis C test CPT-4: 80074, 86803, 86804, 87520 through 87522, 87902 HCPCS: G0472 49,530 47,388 1.05
21c. Novel coronavirus (SARS-CoV-2) diagnostic test CPT-4: 87426, 87428, 87635, 87636, 87637, 87811 HCPCS: U0001, U0002 CPT PLA: 0202U, 0223U, 0225U, 0240U, 0241U 41,905 36,081 1.16
21d. Novel coronavirus (SARS-CoV-2) antibody test ICD-10: Z01.84 CPT-4: 86318, 86328, 86408, 86409, 86413, 86769 CPT PLA: 0224U, 0226U 165 143 1.15
21e. Pre-Exposure Prophylaxis (PrEP)-associated prescribing and management ICD-10: Z29.81 1,433 652 2.20
22. Mammogram ICD-10: Z12.31 CPT-4: 77061, 77062, 77063, 77065, 77066, 77067 HCPCS: G0279 36,205 32,573 1.11
23. Pap test ICD-10: R87.619, R87.629, Z01.41-, Z01.42, Z12.4 (exclude Z01.411 and Z01.419) CPT-4: 88141 through 88153, 88155, 88164 through 88167, 88174, 88175 HCPCS: G0123, G0143, G0144, G0145, G0147, G0148, P3000 38,388 35,068 1.09
24. Selected immunizations: hepatitis A; haemophilus influenzae B (HiB); pneumococcal, diphtheria, tetanus, pertussis (DTaP) (DTP) (DT); measles, mumps, rubella (MMR); poliovirus; varicella; hepatitis B CPT-4: 90371, 90389, 90396, 90632, 90633, 90634, 90636, 90644, 90645, 90646, 90647, 90648, 90669, 90670, 90671, 90677, 90684, 90696, 90698, 90700, 90701, 90702, 90703, 90704, 90705, 90706, 90707, 90708, 90710, 90712, 90713, 90714, 90715, 90716, 90720, 90721, 90723, 90730, 90731, 90732, 90739, 90740, 90743, 90744, 90745, 90746, 90747, 90748, 90759 141,748 100,401 1.41
24a. Seasonal flu vaccine CPT-4: 90630, 90653, 90654, 90656, 90657, 90658, 90659, 90660, 90661, 90662, 90672, 90673, 90674, 90682, 90685, 90686, 90687, 90688, 90694, 90724, 90756 100,508 90,698 1.11
24b. Coronavirus (SARS-CoV-2) vaccine CPT-4: 91300 through 91322 12,439 11,848 1.05
25. Contraceptive management ICD-10: Z30- 60,078 35,092 1.71
26. Health supervision of infant or child (ages 0 through 11) ICD-10: Z00.1-, Z76.1, Z76.2 CPT-4: 99381 through 99383, 99391 through 99393 227,320 135,283 1.68
26a. Childhood lead test screening (9 to 72 months) ICD-10: Z13.88, CPT-4: 83655 20,882 18,975 1.10
26b. Screening, Brief Intervention, and Referral to Treatment (SBIRT) CPT-4: 99408, 99409, HCPCS: G0396, G0397, G0443, H0050 18,190 9,790 1.86
26c. Smoke and tobacco use cessation counseling ICD-10: Z71.6 CPT-4: 99406, 99407 HCPCS: G9906 194,683 69,964 2.78
26c2. Tobacco use cessation pharmacotherapies OID: 2.16.840.1.113883.3.526.3.1190 49,009 25,982 1.89
26c3. Medications for opioid use disorder (MOUD) OID: 2.16.840.1.113762.1.4.1046.269 25,894 5,432 4.77
26d. Comprehensive and intermediate eye exams CPT-4: 92002, 92004, 92012, 92014 18,819 17,192 1.09
26e. Childhood development screenings and evaluations ICD-10: Z13.4- CPT-4: 96110, 96112, 96113, 96127 43,865 30,985 1.42
26f. Alzheimer's disease and related dementias (ADRD) screening CPT-4: 99483 OID: 2.16.840.1.113883.3.526.3.1006 50,693 5,187 9.77
Line Service Category Applicable ADA Code Number of Visits (a) Number of Patients (b) Visits per Patient
Selected Dental Services
27. Emergency services CDT: D0140, D9110 21,708 19,731 1.10
28. Oral exams CDT: D0120, D0145, D0150, D0160, D0170, D0171, D0180 85,028 70,902 1.20
29. Prophylaxis–adult or child CDT: D1110, D1120 58,703 45,605 1.29
30. Sealants CDT: D1351 7,145 5,846 1.22
31. Fluoride treatment–adult or child CDT: D1206, D1208, CPT-4: 99188 42,002 33,911 1.24
32. Restorative services CDT: D21xx through D29xx 46,404 27,511 1.69
33. Oral surgery (extractions and other surgical procedures) CDT: D7xxx 16,308 11,574 1.41
34. Rehabilitative services (Endo, Perio, Prostho, Ortho) CDT: D3xxx, D4xxx, D5xxx, D6xxx, D8xxx 26,486 16,646 1.59

Footnotes

'-' Data cannot be calculated or has been suppressed for confidentiality purposes.

'**' Patient Support Services are listed as Enabling Services in the 2025 UDS Manual.

Cells that are shaded blue represent data that was not reported or null values.

View Detailed UDS Footnotes

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