| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5102 |
Day care services, adult; per diem |
3,895 |
3,895 |
$0.00 |
| T1016 |
Case management, each 15 minutes |
506 |
330 |
$0.00 |
| 97802 |
|
32 |
32 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
43 |
$0.00 |
| T1001 |
Nursing assessment / evaluation |
107 |
100 |
$0.00 |
| 97168 |
|
48 |
47 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
129 |
82 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
195 |
65 |
$0.00 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
393 |
220 |
$0.00 |
| S9127 |
Social work visit, in the home, per diem |
76 |
60 |
$0.00 |
| S0209 |
Wheelchair van, mileage, per mile |
97 |
65 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$0.00 |
| 97803 |
|
19 |
19 |
$0.00 |
| 97164 |
|
52 |
52 |
$0.00 |
| A0130 |
Non-emergency transportation: wheelchair van |
97 |
65 |
$0.00 |