| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2015 |
Comprehensive community support services, per 15 minutes |
928,062 |
26,379 |
$50.41M |
| H2016 |
Comprehensive community support services, per diem |
1,040,714 |
21,961 |
$42.25M |
| T2022 |
Case management, per month |
63,563 |
61,561 |
$28.78M |
| T1000 |
Private duty / independent nursing service(s) - licensed, up to 15 minutes |
26,814 |
1,016 |
$11.59M |
| T2033 |
Residential care, not otherwise specified (nos), waiver; per diem |
125,869 |
2,813 |
$5.86M |
| A0130 |
Non-emergency transportation: wheelchair van |
13,540 |
5,220 |
$1.90M |
| S5170 |
Home delivered meals, including preparation; per meal |
179,323 |
7,356 |
$1.31M |
| S5100 |
Day care services, adult; per 15 minutes |
13,031 |
1,006 |
$891K |
| T2011 |
Preadmission screening and resident review (pasrr) level ii evaluation, per evaluation |
431 |
431 |
$459K |
| T2025 |
Waiver services; not otherwise specified (nos) |
3,956 |
3,646 |
$456K |
| T1002 |
Rn services, up to 15 minutes |
8,808 |
2,589 |
$439K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,619 |
3,433 |
$313K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
8,268 |
8,250 |
$209K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
4,096 |
1,088 |
$187K |
| T1016 |
Case management, each 15 minutes |
1,161 |
546 |
$79K |
| S0215 |
Non-emergency transportation; mileage, per mile |
4,354 |
941 |
$48K |
| T1017 |
Targeted case management, each 15 minutes |
139 |
128 |
$18K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
358 |
352 |
$16K |