| 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 |
3,466 |
476 |
$379K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
6,696 |
985 |
$60K |
| 90834 |
Psychotherapy, 45 minutes with patient |
571 |
113 |
$52K |
| A0425 |
Ground mileage, per statute mile |
6,703 |
985 |
$33K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
12 |
12 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
26 |
$480.00 |
| 99201 |
|
12 |
12 |
$295.56 |