| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
958 |
415 |
$170K |
| H0014 |
Alcohol and/or drug services; ambulatory detoxification |
464 |
198 |
$105K |
| H0033 |
Oral medication administration, direct observation |
544 |
238 |
$66K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,239 |
489 |
$53K |
| H0047 |
Alcohol and/or other drug abuse services, not otherwise specified |
88 |
86 |
$25K |
| 80305 |
|
2,973 |
948 |
$14K |
| 99484 |
|
426 |
403 |
$12K |
| 59025 |
Fetal non-stress test |
297 |
118 |
$10K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
102 |
67 |
$8K |
| 76820 |
|
108 |
69 |
$8K |
| H2010 |
Comprehensive medication services, per 15 minutes |
119 |
30 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
56 |
42 |
$4K |
| 76830 |
Ultrasound, transvaginal |
53 |
37 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
31 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
41 |
35 |
$2K |
| 81025 |
|
523 |
340 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
13 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
519 |
392 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
37 |
27 |
$940.41 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
60 |
36 |
$780.60 |
| 99406 |
|
148 |
98 |
$648.12 |
| 96127 |
|
63 |
45 |
$284.87 |
| 0503F |
|
36 |
26 |
$30.00 |
| 0502F |
|
1,650 |
884 |
$10.00 |
| 3725F |
|
22 |
16 |
$0.00 |
| 0501F |
|
15 |
13 |
$0.00 |