| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management |
2,443,406 |
448,901 |
$35.41M |
| 99214 |
|
211,343 |
183,482 |
$7.13M |
| H0004 |
Alcohol and/or drug services |
70,245 |
29,211 |
$2.66M |
| T1002 |
Rn services up to 15 minutes |
155,068 |
108,882 |
$2.66M |
| H0031 |
Mh health assess by non-md |
29,586 |
27,976 |
$2.66M |
| 99213 |
|
42,515 |
36,605 |
$1.75M |
| H2014 |
Skills train and dev, 15 min |
96,742 |
32,732 |
$1.15M |
| A0110 |
Nonemergency transport bus |
25,901 |
23,863 |
$840K |
| H0038 |
Self-help/peer svc per 15min |
97,662 |
40,430 |
$760K |
| H2027 |
Psychoed svc, per 15 min |
37,224 |
23,622 |
$377K |
| 90792 |
|
3,302 |
3,008 |
$368K |
| 99215 |
Prolong outpt/office vis |
4,489 |
3,797 |
$325K |
| H0034 |
Med trng & support per 15min |
50,492 |
11,524 |
$181K |
| S0215 |
Nonemerg transp mileage |
7,724 |
6,152 |
$121K |
| H0002 |
Alcohol and/or drug screenin |
5,733 |
4,078 |
$103K |
| 90791 |
|
369 |
343 |
$64K |
| 36415 |
|
20,426 |
17,358 |
$58K |
| 99396 |
|
655 |
532 |
$50K |
| 99212 |
|
2,781 |
2,447 |
$46K |
| S5110 |
Family homecare training 15m |
4,800 |
2,111 |
$43K |
| 99395 |
|
458 |
346 |
$35K |
| H2017 |
Psysoc rehab svc, per 15 min |
1,004 |
611 |
$22K |
| 99205 |
Prolong outpt/office vis |
144 |
122 |
$17K |
| 99348 |
|
506 |
454 |
$16K |
| 93000 |
|
792 |
677 |
$13K |
| 99443 |
|
611 |
586 |
$12K |
| H2025 |
Supp maint employ, 15 min |
1,198 |
761 |
$10K |
| 90471 |
|
551 |
474 |
$9K |
| 90688 |
|
709 |
428 |
$7K |
| A0100 |
Nonemergency transport taxi |
2,491 |
1,996 |
$7K |
| A0160 |
Noner transport case worker |
2,447 |
1,958 |
$6K |
| 99203 |
|
93 |
84 |
$5K |
| H0025 |
Alcohol and/or drug preventi |
2,896 |
1,419 |
$5K |
| 99204 |
|
51 |
28 |
$4K |
| 99442 |
|
620 |
553 |
$2K |
| 99441 |
|
341 |
173 |
$2K |
| 96372 |
|
93 |
84 |
$1K |
| 99202 |
|
19 |
17 |
$831.24 |
| H0023 |
Alcohol and/or drug outreach |
78 |
72 |
$778.20 |
| 99242 |
|
12 |
12 |
$770.19 |
| 99211 |
|
192 |
173 |
$763.54 |
| T1019 |
Personal care ser per 15 min |
8,367 |
6,721 |
$585.51 |
| 90686 |
|
83 |
39 |
$541.04 |
| G0008 |
Admin influenza virus vac |
47 |
42 |
$285.60 |
| A0120 |
Noner transport mini-bus |
11,852 |
8,663 |
$233.08 |
| T1013 |
Sign lang/oral interpreter |
101 |
39 |
$214.50 |
| Q0091 |
Obtaining screen pap smear |
27 |
27 |
$206.26 |
| 81002 |
|
63 |
57 |
$178.74 |
| H0001 |
Alcohol and/or drug assess |
20 |
17 |
$32.31 |
| 1036F |
|
12,963 |
11,058 |
$9.64 |
| G9921 |
No or part scrn nd rng or os |
18 |
14 |
$0.00 |
| 99349 |
|
32 |
30 |
$0.00 |
| 4004F |
|
9,376 |
7,941 |
$0.00 |
| 90749 |
|
54 |
51 |
$0.00 |
| 90833 |
|
107 |
102 |
$0.00 |
| G9920 |
Scrning perf and negative |
67 |
40 |
$0.00 |