| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2010 |
Comprehensive med svc 15 min |
384,957 |
21,325 |
$2.95M |
| H0004 |
Alcohol and/or drug services |
41,243 |
20,316 |
$2.09M |
| H0031 |
Mh health assess by non-md |
6,110 |
5,742 |
$808K |
| T1003 |
Lpn/lvn services up to 15min |
53,091 |
28,471 |
$597K |
| 99214 |
|
11,646 |
8,543 |
$583K |
| S0215 |
Nonemerg transp mileage |
39,809 |
4,165 |
$579K |
| H0038 |
Self-help/peer svc per 15min |
17,674 |
9,580 |
$489K |
| T1016 |
Case management |
27,037 |
17,036 |
$476K |
| 80307 |
|
22,410 |
12,611 |
$445K |
| G0481 |
Drug test def 8-14 classes |
2,638 |
1,693 |
$367K |
| H0020 |
Alcohol and/or drug services |
95,648 |
11,473 |
$338K |
| A0120 |
Noner transport mini-bus |
37,095 |
4,023 |
$249K |
| 82075 |
|
21,553 |
9,463 |
$180K |
| 99204 |
|
1,868 |
1,698 |
$113K |
| 99213 |
|
3,718 |
2,694 |
$83K |
| H0015 |
Alcohol and/or drug services |
306 |
50 |
$50K |
| T1002 |
Rn services up to 15 minutes |
4,457 |
3,234 |
$35K |
| 99205 |
Prolong outpt/office vis |
397 |
353 |
$28K |
| A0110 |
Nonemergency transport bus |
864 |
656 |
$17K |
| H0002 |
Alcohol and/or drug screenin |
974 |
910 |
$14K |
| 81025 |
|
4,643 |
2,708 |
$14K |
| G0482 |
Drug test def 15-21 classes |
71 |
65 |
$13K |
| G0480 |
Drug test def 1-7 classes |
90 |
66 |
$5K |
| H2016 |
Comp comm supp svc, per diem |
19 |
12 |
$3K |
| 86580 |
|
1,063 |
778 |
$3K |
| 80305 |
|
5,027 |
3,076 |
$2K |
| 90792 |
|
13 |
12 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$611.35 |
| 99211 |
|
57 |
56 |
$296.01 |
| 36415 |
|
67 |
54 |
$96.83 |
| 80100 |
|
344 |
93 |
$0.00 |
| 86592 |
|
20 |
12 |
$0.00 |
| 80102 |
|
71 |
42 |
$0.00 |