| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
13,648 |
8,678 |
$1.53M |
| T1502 |
Medication admin visit |
2,148 |
1,438 |
$596K |
| H0004 |
Alcohol and/or drug services |
14,117 |
9,898 |
$521K |
| S5000 |
Prescription drug, generic |
2,331 |
1,421 |
$500K |
| 99213 |
|
4,674 |
3,229 |
$353K |
| H0005 |
Alcohol and/or drug services |
11,818 |
8,350 |
$343K |
| H0006 |
Alcohol and/or drug services |
10,186 |
7,476 |
$237K |
| H0048 |
Spec coll non-blood:a/d test |
15,477 |
10,938 |
$223K |
| 80305 |
|
11,716 |
7,127 |
$89K |
| 90832 |
|
1,544 |
1,157 |
$68K |
| 90837 |
|
557 |
401 |
$55K |
| 99215 |
Prolong outpt/office vis |
329 |
216 |
$47K |
| 99204 |
|
235 |
213 |
$39K |
| 82075 |
|
1,955 |
1,418 |
$38K |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
791 |
557 |
$20K |
| J0571 |
Buprenorphine oral 1mg |
328 |
204 |
$15K |
| T1003 |
Lpn/lvn services up to 15min |
766 |
580 |
$15K |
| 90791 |
|
86 |
84 |
$8K |
| 90834 |
|
110 |
85 |
$8K |
| 99406 |
|
830 |
602 |
$6K |
| J0572 |
Bupren/nal up to 3mg bupreno |
213 |
143 |
$4K |
| H0001 |
Alcohol and/or drug assess |
28 |
27 |
$2K |
| 99212 |
|
17 |
17 |
$832.49 |
| 81025 |
|
115 |
101 |
$556.84 |
| 36415 |
|
64 |
61 |
$237.06 |
| 99000 |
|
167 |
115 |
$0.00 |