| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2017 |
Habil res waiver 15 min |
66,281 |
2,269 |
$9.01M |
| T2025 |
Waiver service, nos |
57,149 |
4,445 |
$4.34M |
| H0038 |
Self-help/peer svc per 15min |
64,450 |
7,507 |
$3.47M |
| T1003 |
Lpn/lvn services up to 15min |
24,449 |
6,743 |
$3.15M |
| 90837 |
|
38,714 |
26,155 |
$3.11M |
| T2033 |
Res, nos waiver per diem |
12,171 |
420 |
$2.51M |
| H0039 |
Asser com tx face-face/15min |
25,386 |
4,358 |
$2.38M |
| T1016 |
Case management |
28,744 |
10,314 |
$2.17M |
| H0031 |
Mh health assess by non-md |
17,967 |
16,732 |
$2.09M |
| 90834 |
|
22,547 |
17,021 |
$1.47M |
| 99214 |
|
24,244 |
20,136 |
$1.40M |
| H2017 |
Psysoc rehab svc, per 15 min |
21,345 |
10,379 |
$1.32M |
| 90792 |
|
10,467 |
9,288 |
$1.14M |
| T2028 |
Special supply, nos waiver |
7,472 |
4,909 |
$1.04M |
| 99213 |
|
23,509 |
19,770 |
$1.02M |
| T1002 |
Rn services up to 15 minutes |
11,975 |
9,407 |
$574K |
| H0004 |
Alcohol and/or drug services |
12,371 |
3,239 |
$540K |
| H2015 |
Comp comm supp svc, 15 min |
8,881 |
4,192 |
$508K |
| 99215 |
Prolong outpt/office vis |
6,649 |
5,203 |
$463K |
| 90832 |
|
12,561 |
9,969 |
$425K |
| T1001 |
Nursing assessment/evaluatn |
4,779 |
4,493 |
$402K |
| 99212 |
|
12,339 |
10,297 |
$351K |
| H0032 |
Mh svc plan dev by non-md |
4,545 |
4,176 |
$335K |
| H0015 |
Alcohol and/or drug services |
3,007 |
449 |
$205K |
| 90833 |
|
6,016 |
5,687 |
$203K |
| Q3014 |
Telehealth facility fee |
8,057 |
7,290 |
$110K |
| H2014 |
Skills train and dev, 15 min |
3,071 |
986 |
$92K |
| 90847 |
|
1,001 |
802 |
$75K |
| 90791 |
|
2,696 |
1,943 |
$63K |
| 96372 |
|
957 |
766 |
$22K |
| H0018 |
Alcohol and/or drug services |
122 |
15 |
$12K |
| 90785 |
|
2,252 |
2,136 |
$9K |
| H0025 |
Alcohol and/or drug preventi |
114 |
54 |
$7K |
| T1015 |
Clinic service |
68 |
67 |
$6K |
| 99211 |
|
341 |
334 |
$4K |
| 90846 |
|
52 |
50 |
$3K |
| 90853 |
|
718 |
318 |
$2K |
| 99442 |
|
715 |
635 |
$0.00 |
| 99443 |
|
337 |
292 |
$0.00 |