| Code | Description | Claims | Beneficiaries | Total Paid |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,484 |
116 |
$176K |
| H2014 |
Skills training and development, per 15 minutes |
283 |
39 |
$94K |
| H0038 |
Self-help/peer services, per 15 minutes |
577 |
64 |
$86K |
| S0215 |
Non-emergency transportation; mileage, per mile |
1,008 |
85 |
$59K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
1,008 |
85 |
$13K |
| H0031 |
Mental health assessment, by non-physician |
24 |
24 |
$5K |
| T1016 |
Case management, each 15 minutes |
104 |
21 |
$3K |