| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9150 |
Non-prescription drugs |
224,153 |
224,100 |
$3.54M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
151 |
129 |
$10K |
| S5120 |
Chore services; per 15 minutes |
102 |
54 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
85 |
83 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23 |
21 |
$134.95 |
| 90756 |
|
799 |
754 |
$46.32 |
| S9977 |
Meals, per diem, not otherwise specified |
168 |
134 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
12 |
$0.00 |
| S0209 |
Wheelchair van, mileage, per mile |
1,422 |
277 |
$0.00 |
| T2003 |
Non-emergency transportation; encounter/trip |
1,305 |
401 |
$0.00 |
| A0130 |
Non-emergency transportation: wheelchair van |
1,422 |
277 |
$0.00 |
| S0215 |
Non-emergency transportation; mileage, per mile |
1,305 |
401 |
$0.00 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
47 |
39 |
$0.00 |