| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9012 |
Other specified case management service not elsewhere classified |
39,652 |
37,141 |
$8.38M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
68,840 |
40,065 |
$4.96M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
58,810 |
34,021 |
$3.03M |
| G0482 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed |
22,674 |
14,255 |
$2.99M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
49,991 |
33,530 |
$2.90M |
| G0483 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed |
16,675 |
9,630 |
$2.82M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,794 |
27,109 |
$1.97M |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
12,595 |
4,462 |
$1.10M |
| H0014 |
Alcohol and/or drug services; ambulatory detoxification |
8,149 |
7,331 |
$928K |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
84,254 |
9,897 |
$632K |
| G0481 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed |
6,302 |
3,939 |
$600K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
24,657 |
16,324 |
$589K |
| S0109 |
Methadone, oral, 5 mg |
68,404 |
4,157 |
$461K |
| J0572 |
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
5,592 |
2,114 |
$287K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
1,559 |
1,113 |
$87K |
| J0571 |
Buprenorphine, oral, 1 mg |
1,031 |
335 |
$75K |
| 99406 |
|
12,838 |
8,201 |
$70K |
| 81025 |
|
6,679 |
4,166 |
$40K |
| 99215 |
Prolong outpt/office vis |
243 |
141 |
$22K |
| 82075 |
|
1,467 |
992 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,414 |
1,196 |
$13K |
| 98968 |
|
419 |
290 |
$8K |
| G2087 |
Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month |
187 |
166 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
45 |
31 |
$2K |
| 98967 |
|
65 |
56 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
21 |
12 |
$320.40 |