| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
1,444 |
1,319 |
$203K |
| H0037 |
Comm psy sup tx pgm per diem |
1,633 |
182 |
$138K |
| H0005 |
Alcohol and/or drug services |
2,910 |
854 |
$56K |
| H0004 |
Alcohol and/or drug services |
5,111 |
3,332 |
$52K |
| H2012 |
Behav hlth day treat, per hr |
855 |
73 |
$45K |
| 90837 |
|
2,913 |
2,019 |
$13K |
| 99443 |
|
1,675 |
1,302 |
$11K |
| 90686 |
|
445 |
420 |
$8K |
| 99214 |
|
705 |
613 |
$5K |
| 90471 |
|
198 |
189 |
$3K |
| H0038 |
Self-help/peer svc per 15min |
1,514 |
622 |
$3K |
| T1016 |
Case management |
1,687 |
830 |
$2K |
| 99213 |
|
172 |
164 |
$2K |
| 0064A |
|
158 |
125 |
$2K |
| H0031 |
Mh health assess by non-md |
859 |
850 |
$2K |
| 99442 |
|
383 |
283 |
$2K |
| 90846 |
|
429 |
295 |
$1K |
| 90792 |
|
87 |
87 |
$1K |
| 90847 |
|
718 |
475 |
$1K |
| 90715 |
|
58 |
57 |
$1K |
| 90834 |
|
947 |
780 |
$1K |
| 90688 |
|
80 |
67 |
$1K |
| 90480 |
|
27 |
27 |
$948.97 |
| J1050 |
Medroxyprogesterone acetate |
53 |
53 |
$865.73 |
| 90672 |
|
28 |
28 |
$616.65 |
| H2010 |
Comprehensive med svc 15 min |
352 |
283 |
$521.01 |
| 90853 |
|
228 |
90 |
$401.94 |
| 90734 |
|
14 |
13 |
$351.22 |
| 90651 |
|
15 |
15 |
$329.40 |
| 90633 |
|
15 |
15 |
$307.44 |
| 90832 |
|
514 |
246 |
$293.16 |
| 90656 |
|
17 |
16 |
$283.92 |
| 0134A |
|
17 |
15 |
$280.00 |
| 99211 |
|
13 |
12 |
$196.56 |
| 0124A |
|
20 |
14 |
$160.00 |
| S4993 |
Contraceptive pills for bc |
16 |
16 |
$145.25 |
| 99441 |
|
33 |
26 |
$103.60 |
| 90791 |
|
42 |
42 |
$99.25 |
| H2023 |
Supported employ, per 15 min |
879 |
299 |
$50.64 |
| G0008 |
Admin influenza virus vac |
76 |
60 |
$39.65 |
| 90662 |
|
13 |
13 |
$19.11 |
| H0039 |
Asser com tx face-face/15min |
109 |
12 |
$0.00 |
| H2021 |
Com wrap-around sv, 15 min |
180 |
98 |
$0.00 |
| H2014 |
Skills train and dev, 15 min |
56 |
31 |
$0.00 |
| H0032 |
Mh svc plan dev by non-md |
13 |
13 |
$0.00 |