| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comprehensive community support services, per diem |
124,441 |
6,243 |
$24.42M |
| H2014 |
Skills training and development, per 15 minutes |
54,578 |
2,843 |
$3.14M |
| M0150 |
|
15,473 |
613 |
$2.49M |
| M0152 |
|
11,388 |
444 |
$1.99M |
| T2020 |
Day habilitation, waiver; per diem |
28,375 |
1,421 |
$1.28M |
| M0167 |
|
5,422 |
202 |
$878K |
| M0123 |
|
10,962 |
415 |
$835K |
| M0116 |
|
28,327 |
958 |
$828K |
| M0125 |
|
8,589 |
328 |
$808K |
| M0118 |
|
16,974 |
612 |
$584K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
5,608 |
1,327 |
$376K |
| T1002 |
Rn services, up to 15 minutes |
14,079 |
3,131 |
$345K |
| M0122 |
|
3,814 |
135 |
$277K |
| D0120 |
Periodic oral evaluation - established patient |
638 |
589 |
$261K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
13,703 |
3,035 |
$225K |
| M0117 |
|
4,811 |
181 |
$201K |
| M0299 |
|
6,014 |
1,502 |
$179K |
| M0115 |
|
5,968 |
215 |
$164K |
| M0113 |
|
391 |
371 |
$138K |
| M0133 |
|
697 |
304 |
$101K |
| M0101 |
|
939 |
778 |
$47K |
| M0298 |
|
3,313 |
749 |
$42K |
| M0315 |
|
868 |
825 |
$25K |
| A9153 |
Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified |
1,026 |
957 |
$24K |
| M0248 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency |
2,031 |
1,754 |
$8K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
60 |
59 |
$4K |
| S5199 |
Personal care item, nos, each |
33 |
30 |
$279.09 |
| M0249 |
Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose |
37 |
32 |
$29.63 |