| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2315 |
Injection, naltrexone, depot form, 1 mg |
1,216 |
1,176 |
$1.66M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,558 |
2,107 |
$177K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,413 |
1,051 |
$59K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,706 |
1,481 |
$53K |
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
107 |
25 |
$50K |
| 80305 |
|
3,230 |
2,545 |
$26K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,829 |
1,742 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
125 |
125 |
$11K |
| 99205 |
Prolong outpt/office vis |
79 |
76 |
$10K |
| S9976 |
Lodging, per diem, not otherwise classified |
108 |
26 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
244 |
212 |
$7K |
| 90837 |
Psychotherapy, 53 minutes with patient |
61 |
44 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
310 |
285 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
33 |
32 |
$2K |
| 90686 |
|
12 |
12 |
$176.05 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$64.75 |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
20 |
13 |
$0.00 |