| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0004 |
Alcohol and/or drug services |
10,483 |
1,348 |
$1.41M |
| H2032 |
Activity therapy, per 15 min |
27,502 |
2,536 |
$930K |
| 97537 |
|
30,148 |
2,068 |
$603K |
| S5100 |
Adult daycare services 15min |
15,095 |
1,815 |
$439K |
| H2015 |
Comp comm supp svc, 15 min |
4,708 |
676 |
$300K |
| 96152 |
|
1,188 |
109 |
$143K |
| H2019 |
Ther behav svc, per 15 min |
975 |
132 |
$77K |
| 97110 |
|
2,118 |
739 |
$71K |
| 92507 |
|
1,258 |
439 |
$67K |
| 99283 |
|
591 |
516 |
$38K |
| 97530 |
|
1,183 |
455 |
$36K |
| 99282 |
|
550 |
500 |
$27K |
| 87633 |
|
28 |
27 |
$10K |
| 80053 |
|
1,195 |
1,067 |
$9K |
| 85025 |
|
1,483 |
1,273 |
$9K |
| 99281 |
|
191 |
179 |
$9K |
| 36415 |
|
2,505 |
1,905 |
$6K |
| 84443 |
|
435 |
416 |
$5K |
| 96374 |
|
75 |
65 |
$5K |
| T1027 |
Family training & counseling |
101 |
41 |
$4K |
| 96361 |
|
46 |
38 |
$4K |
| 99213 |
|
51 |
51 |
$4K |
| 87449 |
|
162 |
149 |
$2K |
| 92523 |
|
14 |
12 |
$2K |
| 97014 |
|
120 |
51 |
$2K |
| 99214 |
|
15 |
13 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
29 |
28 |
$1K |
| 81001 |
|
551 |
496 |
$1K |
| 97165 |
|
14 |
14 |
$1K |
| J2405 |
Ondansetron hcl injection |
180 |
158 |
$670.35 |
| 84439 |
|
94 |
92 |
$617.90 |
| 96372 |
|
17 |
14 |
$584.22 |
| 87088 |
|
91 |
88 |
$539.00 |
| 83036 |
|
105 |
101 |
$524.93 |
| 71046 |
|
60 |
53 |
$522.85 |
| G2211 |
Complex e/m visit add on |
34 |
30 |
$414.61 |
| J3010 |
Fentanyl citrate injection |
92 |
74 |
$307.07 |
| 84703 |
|
37 |
37 |
$286.69 |
| J1885 |
Ketorolac tromethamine inj |
64 |
56 |
$192.09 |
| 80048 |
|
17 |
14 |
$115.73 |
| 90662 |
|
15 |
15 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
13 |
13 |
$0.00 |
| G0008 |
Admin influenza virus vac |
17 |
17 |
$0.00 |
| 90732 |
|
13 |
13 |
$0.00 |