| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2017 |
Habil res waiver 15 min |
10,779 |
3,697 |
$32.27M |
| S5145 |
Child fostercare th per diem |
147,844 |
5,041 |
$28.10M |
| T2013 |
Habil ed waiver per hour |
4,166 |
1,765 |
$20.64M |
| T2021 |
Day habil waiver per 15 min |
10,361 |
3,570 |
$9.57M |
| H2020 |
Ther behav svc, per diem |
49,332 |
5,409 |
$9.11M |
| T2016 |
Habil res waiver per diem |
28,862 |
900 |
$8.13M |
| H0032 |
Mh svc plan dev by non-md |
18,334 |
16,396 |
$6.60M |
| H0040 |
Assert comm tx pgm per diem |
32,963 |
3,788 |
$5.11M |
| T1016 |
Case management |
85,987 |
16,653 |
$3.90M |
| S5102 |
Adult day care per diem |
16,885 |
503 |
$3.73M |
| H2012 |
Behav hlth day treat, per hr |
39,001 |
2,265 |
$2.58M |
| H2019 |
Ther behav svc, per 15 min |
68,705 |
4,012 |
$2.29M |
| S5100 |
Adult daycare services 15min |
2,687 |
717 |
$1.92M |
| T2032 |
Res care, nos waiver/month |
1,363 |
1,239 |
$1.15M |
| H0046 |
Mental health service, nos |
6,948 |
2,440 |
$1.11M |
| H2032 |
Activity therapy, per 15 min |
4,843 |
722 |
$1.11M |
| 99214 |
|
5,402 |
4,375 |
$633K |
| 90837 |
|
6,712 |
3,221 |
$572K |
| 99215 |
Prolong outpt/office vis |
2,047 |
1,710 |
$376K |
| 97153 |
|
3,974 |
456 |
$309K |
| T2002 |
N-et; per diem |
2,775 |
2,575 |
$283K |
| T2003 |
N-et; encounter/trip |
6,009 |
4,391 |
$215K |
| 99213 |
|
1,951 |
1,611 |
$145K |
| 90847 |
|
2,134 |
1,246 |
$136K |
| Q3014 |
Telehealth facility fee |
4,616 |
3,657 |
$102K |
| 90791 |
|
981 |
936 |
$100K |
| 90846 |
|
1,096 |
707 |
$69K |
| 97155 |
|
707 |
243 |
$43K |
| 90834 |
|
425 |
292 |
$27K |
| 99205 |
Prolong outpt/office vis |
134 |
114 |
$21K |
| S0215 |
Nonemerg transp mileage |
3,857 |
622 |
$19K |
| 90832 |
|
415 |
252 |
$17K |
| 97156 |
|
183 |
79 |
$10K |
| G2212 |
Prolong outpt/office vis |
90 |
88 |
$8K |
| 90853 |
|
167 |
66 |
$3K |
| 99212 |
|
19 |
16 |
$1K |
| 99408 |
|
18 |
18 |
$401.04 |
| H0036 |
Comm psy face-face per 15min |
658 |
118 |
$0.00 |
| T2023 |
Targeted case mgmt per month |
12 |
12 |
$0.00 |