| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
11,449 |
859 |
$985K |
| A0425 |
Ground mileage, per statute mile |
11,720 |
833 |
$58K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
6,399 |
524 |
$57K |
| 99215 |
Prolong outpt/office vis |
124 |
86 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
81 |
67 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
109 |
82 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23 |
17 |
$2K |