| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2010 |
Comprehensive med svc 15 min |
103,407 |
7,621 |
$715K |
| H0004 |
Alcohol and/or drug services |
15,712 |
7,941 |
$537K |
| H0020 |
Alcohol and/or drug services |
72,475 |
7,386 |
$243K |
| 80307 |
|
8,108 |
4,583 |
$192K |
| T1003 |
Lpn/lvn services up to 15min |
18,786 |
9,588 |
$169K |
| H0031 |
Mh health assess by non-md |
1,343 |
1,274 |
$134K |
| 99214 |
|
3,138 |
2,225 |
$125K |
| 82075 |
|
9,507 |
3,637 |
$88K |
| T1016 |
Case management |
8,190 |
4,408 |
$76K |
| S0215 |
Nonemerg transp mileage |
9,526 |
705 |
$72K |
| A0120 |
Noner transport mini-bus |
8,366 |
647 |
$42K |
| 99213 |
|
1,384 |
929 |
$21K |
| H0038 |
Self-help/peer svc per 15min |
1,356 |
639 |
$20K |
| A0110 |
Nonemergency transport bus |
676 |
534 |
$6K |
| G0481 |
Drug test def 8-14 classes |
29 |
23 |
$4K |
| 81025 |
|
602 |
391 |
$3K |
| 80305 |
|
2,090 |
880 |
$2K |
| 86580 |
|
786 |
525 |
$2K |
| 99215 |
Prolong outpt/office vis |
42 |
35 |
$1K |
| 99204 |
|
31 |
27 |
$567.35 |
| A0160 |
Noner transport case worker |
656 |
52 |
$75.68 |
| T1002 |
Rn services up to 15 minutes |
18 |
18 |
$0.00 |
| 36415 |
|
14 |
14 |
$0.00 |