| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
19,295 |
2,541 |
$2.18M |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,356 |
2,094 |
$655K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
27,245 |
3,827 |
$245K |
| H2036 |
Alcohol and/or other drug treatment program, per diem |
2,332 |
301 |
$180K |
| A0425 |
Ground mileage, per statute mile |
27,027 |
3,813 |
$134K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
276 |
276 |
$117K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,780 |
907 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
299 |
262 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
267 |
241 |
$20K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
592 |
517 |
$9K |
| 99201 |
|
114 |
114 |
$3K |