| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2017 |
Psysoc rehab svc, per 15 min |
46,909 |
4,005 |
$6.30M |
| 99199 |
|
18,441 |
3,422 |
$1.63M |
| H0039 |
Asser com tx face-face/15min |
32,555 |
3,326 |
$1.52M |
| T1016 |
Case management |
5,625 |
5,008 |
$1.31M |
| S9484 |
Crisis intervention per hour |
6,211 |
2,053 |
$351K |
| T1017 |
Targeted case management |
3,021 |
2,679 |
$234K |
| 90837 |
|
1,893 |
877 |
$117K |
| T1999 |
Noc retail items andsupplies |
550 |
540 |
$90K |
| A0080 |
Noninterest escort in non er |
177 |
138 |
$57K |
| 99214 |
|
1,742 |
1,519 |
$52K |
| A9999 |
Dme supply or accessory, nos |
234 |
196 |
$39K |
| T2003 |
N-et; encounter/trip |
290 |
198 |
$26K |
| H0022 |
Alcohol and/or drug interven |
358 |
221 |
$22K |
| S0215 |
Nonemerg transp mileage |
65 |
52 |
$22K |
| S5170 |
Homedelivered prepared meal |
80 |
75 |
$22K |
| 97530 |
|
118 |
66 |
$12K |
| H2011 |
Crisis interven svc, 15 min |
140 |
122 |
$11K |
| S5190 |
Wellness assessment by nonph |
28 |
28 |
$3K |
| 97112 |
|
72 |
36 |
$3K |
| 90834 |
|
22 |
13 |
$940.05 |
| 99213 |
|
35 |
30 |
$699.55 |