| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9475 |
Ambulatory setting substance abuse treatment or detoxification services, per diem |
1,220 |
155 |
$134K |
| T2022 |
Case management, per month |
2,539 |
418 |
$63K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
674 |
79 |
$53K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
198 |
32 |
$22K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
17 |
17 |
$6K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
496 |
106 |
$4K |
| A0425 |
Ground mileage, per statute mile |
496 |
106 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31 |
26 |
$496.00 |
| 99201 |
|
15 |
15 |
$369.45 |