| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0280 |
Medical home, initial plan |
136,260 |
89,532 |
$16.56M |
| 90837 |
|
59,898 |
34,396 |
$4.18M |
| 90834 |
|
49,706 |
34,111 |
$2.39M |
| 99213 |
|
52,355 |
40,167 |
$1.79M |
| 90791 |
|
17,859 |
13,296 |
$1.54M |
| 99214 |
|
34,753 |
25,307 |
$1.54M |
| 90792 |
|
7,498 |
5,651 |
$579K |
| 90832 |
|
14,649 |
10,428 |
$512K |
| H2017 |
Psysoc rehab svc, per 15 min |
4,853 |
655 |
$477K |
| 99215 |
Prolong outpt/office vis |
5,176 |
4,059 |
$215K |
| H0038 |
Self-help/peer svc per 15min |
3,656 |
1,249 |
$178K |
| 99212 |
|
5,136 |
3,884 |
$168K |
| 99232 |
|
2,577 |
1,262 |
$79K |
| H0033 |
Oral med adm direct observe |
528 |
312 |
$61K |
| 99222 |
|
838 |
598 |
$44K |
| 90847 |
|
486 |
267 |
$43K |
| 99223 |
Prolong inpt eval add15 m |
415 |
300 |
$42K |
| 99238 |
|
1,002 |
822 |
$38K |
| 90853 |
|
1,269 |
361 |
$37K |
| 99231 |
|
1,337 |
712 |
$29K |
| 96372 |
|
8,155 |
6,665 |
$19K |
| 99442 |
|
1,486 |
1,341 |
$11K |
| H0049 |
Alcohol/drug screening |
1,086 |
822 |
$5K |
| H0034 |
Med trng & support per 15min |
344 |
300 |
$4K |
| 99211 |
|
65 |
65 |
$2K |
| 99239 |
|
37 |
28 |
$1K |
| 90836 |
|
43 |
41 |
$1K |
| 3008F |
|
9,490 |
6,775 |
$1K |
| 36415 |
|
456 |
439 |
$862.53 |
| 90846 |
|
12 |
12 |
$689.44 |
| 99221 |
|
13 |
12 |
$179.94 |
| G9010 |
Mccd, risk adj, level 4 |
64,043 |
47,537 |
$176.89 |
| G9005 |
Mccd, risk adj, maintenance |
78,556 |
53,741 |
$0.16 |
| G9007 |
Mccd, sch team conf |
28,092 |
20,949 |
$0.06 |
| G9004 |
Mccd, risk adj lo, initial |
37,094 |
26,455 |
$0.05 |
| G9006 |
Mccd, home monitoring |
17,934 |
14,517 |
$0.03 |
| 3074F |
|
1,770 |
1,169 |
$0.00 |
| 3075F |
|
246 |
215 |
$0.00 |
| 3079F |
|
206 |
183 |
$0.00 |
| G9011 |
Mccd, risk adj, level 5 |
14,301 |
10,889 |
$0.00 |
| 3078F |
|
1,936 |
1,282 |
$0.00 |
| S9485 |
Crisis intervention mental h |
9,089 |
7,645 |
$0.00 |
| 80305 |
|
13 |
12 |
$0.00 |