| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9008 |
Mccd,phys coor-care ovrsght |
19,656 |
10,248 |
$4.08M |
| G9012 |
Other specified case mgmt |
9,970 |
4,539 |
$2.52M |
| H0043 |
Supported housing, per diem |
586 |
225 |
$263K |
| 99213 |
|
1,705 |
1,649 |
$242K |
| 87591 |
|
5,014 |
4,342 |
$140K |
| 87491 |
|
4,948 |
4,291 |
$139K |
| H2016 |
Comp comm supp svc, per diem |
228 |
113 |
$102K |
| 99212 |
|
776 |
770 |
$83K |
| 87389 |
|
2,145 |
1,914 |
$41K |
| J3490 |
Drugs unclassified injection |
583 |
485 |
$25K |
| 99401 |
|
1,244 |
1,216 |
$23K |
| J7307 |
Etonogestrel implant system |
13 |
13 |
$11K |
| 86592 |
|
2,996 |
2,745 |
$10K |
| 81025 |
|
2,857 |
2,786 |
$8K |
| 87210 |
|
1,005 |
1,001 |
$3K |
| 99402 |
|
85 |
85 |
$3K |
| 99214 |
|
12 |
12 |
$3K |
| 11981 |
|
12 |
12 |
$2K |
| 11976 |
|
53 |
27 |
$2K |
| A4267 |
Male condom |
575 |
562 |
$2K |
| 99403 |
|
40 |
40 |
$2K |
| S5199 |
Personal care item nos each |
373 |
362 |
$867.68 |
| 81003 |
|
401 |
333 |
$709.30 |
| 81001 |
|
243 |
237 |
$649.97 |
| 81015 |
|
131 |
104 |
$292.30 |
| S4993 |
Contraceptive pills for bc |
12 |
12 |
$103.00 |