| Code | Description | Claims | Beneficiaries | Total Paid |
| H0033 |
Oral medication administration, direct observation |
313 |
159 |
$44K |
| H0047 |
Alcohol and/or other drug abuse services, not otherwise specified |
195 |
79 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
614 |
203 |
$994.22 |
| G9012 |
Other specified case management service not elsewhere classified |
126 |
53 |
$243.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
75 |
20 |
$0.00 |