| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2017 |
Psysoc rehab svc, per 15 min |
82,551 |
5,386 |
$8.43M |
| 99199 |
|
19,182 |
3,752 |
$2.00M |
| T1016 |
Case management |
15,507 |
4,567 |
$1.19M |
| S9484 |
Crisis intervention per hour |
7,973 |
2,487 |
$330K |
| 90837 |
|
4,512 |
2,061 |
$214K |
| H0039 |
Asser com tx face-face/15min |
9,115 |
644 |
$141K |
| T2015 |
Habil prevoc waiver per hr |
1,187 |
113 |
$63K |
| T1017 |
Targeted case management |
1,494 |
901 |
$51K |
| 99214 |
|
2,466 |
1,706 |
$49K |
| S5170 |
Homedelivered prepared meal |
1,966 |
155 |
$44K |
| A9999 |
Dme supply or accessory, nos |
426 |
353 |
$42K |
| 99215 |
Prolong outpt/office vis |
1,057 |
725 |
$25K |
| T2003 |
N-et; encounter/trip |
989 |
117 |
$23K |
| S0215 |
Nonemerg transp mileage |
1,308 |
119 |
$20K |
| T2028 |
Special supply, nos waiver |
33 |
25 |
$14K |
| H0030 |
Alcohol and/or drug hotline |
346 |
200 |
$6K |
| T2013 |
Habil ed waiver per hour |
65 |
27 |
$5K |
| S9445 |
Pt education noc individ |
15 |
15 |
$5K |
| 90791 |
|
36 |
25 |
$2K |
| 90834 |
|
71 |
35 |
$2K |
| 90792 |
|
13 |
12 |
$2K |
| Q3014 |
Telehealth facility fee |
75 |
52 |
$718.21 |
| 92507 |
|
26 |
12 |
$340.65 |
| 99211 |
|
12 |
12 |
$76.72 |
| 97530 |
|
20 |
12 |
$0.00 |