| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0311 |
Comp mgmt care coord adv ill |
6,613 |
5,044 |
$1.24M |
| 90834 |
|
23,970 |
13,720 |
$1.22M |
| H2016 |
Comp comm supp svc, per diem |
3,904 |
664 |
$668K |
| H0037 |
Comm psy sup tx pgm per diem |
2,161 |
371 |
$483K |
| S0281 |
Medical home, maintenance |
2,296 |
1,779 |
$462K |
| 90837 |
|
4,836 |
3,062 |
$440K |
| 99214 |
|
9,727 |
8,285 |
$324K |
| 99213 |
|
10,389 |
8,736 |
$233K |
| 90832 |
|
5,945 |
3,879 |
$182K |
| 90791 |
|
1,101 |
1,047 |
$105K |
| G9148 |
Medical home level 1 |
688 |
550 |
$87K |
| H0004 |
Alcohol and/or drug services |
1,147 |
522 |
$77K |
| G9150 |
Medical home level iii |
284 |
188 |
$40K |
| 96372 |
|
5,417 |
4,014 |
$37K |
| 90785 |
|
10,901 |
6,041 |
$30K |
| S0280 |
Medical home, initial plan |
151 |
120 |
$20K |
| 99205 |
Prolong outpt/office vis |
179 |
168 |
$13K |
| 99215 |
Prolong outpt/office vis |
306 |
198 |
$10K |
| S0221 |
Medical conference, 60 min |
47 |
40 |
$9K |
| 99212 |
|
381 |
335 |
$8K |
| H0038 |
Self-help/peer svc per 15min |
185 |
78 |
$8K |
| 90853 |
|
238 |
101 |
$5K |
| 90792 |
|
42 |
41 |
$4K |
| 99204 |
|
12 |
12 |
$1K |
| H0049 |
Alcohol/drug screening |
406 |
394 |
$0.00 |