| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5001 |
Prescription drug, brand name |
241 |
102 |
$73K |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
288 |
172 |
$68K |
| S5000 |
Prescription drug, generic |
133 |
71 |
$33K |
| H0048 |
Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
699 |
357 |
$10K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
166 |
94 |
$8K |
| 80305 |
|
697 |
357 |
$4K |
| 82075 |
|
176 |
100 |
$4K |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
190 |
124 |
$3K |
| J0572 |
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
14 |
12 |
$181.80 |