| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
438,174 |
11,507 |
$58.91M |
| T1015 |
Clinic service |
936,688 |
51,762 |
$55.74M |
| 97530 |
|
244,962 |
58,116 |
$15.59M |
| 92507 |
|
225,280 |
51,655 |
$15.54M |
| 97110 |
|
174,410 |
39,889 |
$10.79M |
| A0120 |
Noner transport mini-bus |
205,561 |
17,497 |
$6.76M |
| 90837 |
|
26,366 |
11,817 |
$2.33M |
| H2019 |
Ther behav svc, per 15 min |
8,821 |
2,730 |
$756K |
| 90834 |
|
8,848 |
4,939 |
$545K |
| T1019 |
Personal care ser per 15 min |
25,683 |
1,126 |
$506K |
| 96112 |
|
4,728 |
3,505 |
$353K |
| T1023 |
Program intake assessment |
1,966 |
1,441 |
$130K |
| 90832 |
|
3,039 |
1,838 |
$129K |
| S5170 |
Homedelivered prepared meal |
29,881 |
1,065 |
$115K |
| 90853 |
|
2,745 |
888 |
$107K |
| H2017 |
Psysoc rehab svc, per 15 min |
2,526 |
812 |
$104K |
| 99213 |
|
2,898 |
2,437 |
$86K |
| 97153 |
|
750 |
82 |
$84K |
| T1027 |
Family training & counseling |
2,630 |
1,026 |
$80K |
| 90846 |
|
1,039 |
717 |
$73K |
| T2028 |
Special supply, nos waiver |
696 |
355 |
$52K |
| T2025 |
Waiver service, nos |
176 |
147 |
$39K |
| 99367 |
|
546 |
403 |
$24K |
| 97532 |
|
965 |
51 |
$24K |
| 97535 |
|
847 |
52 |
$18K |
| 90847 |
|
226 |
134 |
$16K |
| 90791 |
|
134 |
98 |
$11K |
| 90792 |
|
103 |
91 |
$10K |
| H2027 |
Psychoed svc, per 15 min |
141 |
124 |
$8K |
| 97155 |
|
107 |
24 |
$8K |
| 90885 |
|
112 |
97 |
$7K |
| 92523 |
|
120 |
70 |
$7K |
| 99212 |
|
267 |
207 |
$5K |
| 97161 |
|
97 |
67 |
$4K |
| S0220 |
Medical conference by physic |
81 |
38 |
$3K |
| 97165 |
|
58 |
40 |
$3K |
| 97163 |
|
25 |
13 |
$3K |
| 97167 |
|
44 |
27 |
$2K |
| 97003 |
|
20 |
13 |
$2K |
| 99214 |
|
39 |
32 |
$2K |
| T1017 |
Targeted case management |
17 |
12 |
$187.50 |