| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
44,382 |
1,529 |
$4.46M |
| T1017 |
Targeted case management |
15,960 |
9,566 |
$1.46M |
| M0123 |
|
12,552 |
497 |
$956K |
| H2014 |
Skills train and dev, 15 min |
11,647 |
4,583 |
$886K |
| 99214 |
|
16,118 |
15,334 |
$830K |
| T2020 |
Day habil waiver per diem |
7,814 |
449 |
$284K |
| T1002 |
Rn services up to 15 minutes |
2,856 |
1,016 |
$186K |
| H2017 |
Psysoc rehab svc, per 15 min |
2,132 |
709 |
$172K |
| M0116 |
|
5,408 |
331 |
$171K |
| H2011 |
Crisis interven svc, 15 min |
528 |
465 |
$170K |
| M0299 |
|
2,125 |
790 |
$129K |
| M0118 |
|
2,891 |
169 |
$109K |
| M0122 |
|
1,421 |
49 |
$103K |
| H0034 |
Med trng & support per 15min |
3,690 |
2,269 |
$102K |
| 90792 |
|
496 |
491 |
$90K |
| T1003 |
Lpn/lvn services up to 15min |
3,091 |
648 |
$63K |
| M0101 |
|
463 |
408 |
$48K |
| M0298 |
|
2,569 |
648 |
$40K |
| 99212 |
|
1,636 |
1,614 |
$40K |
| M0113 |
|
79 |
72 |
$32K |
| M0171 |
|
329 |
115 |
$25K |
| T2016 |
Habil res waiver per diem |
974 |
257 |
$24K |
| H2019 |
Ther behav svc, per 15 min |
213 |
155 |
$20K |
| A9153 |
Multi-vitamin nos |
339 |
294 |
$19K |
| M0372 |
|
900 |
237 |
$15K |
| M0133 |
|
157 |
107 |
$15K |
| D0120 |
|
39 |
39 |
$14K |
| 90837 |
|
109 |
76 |
$12K |
| T2025 |
Waiver service, nos |
94 |
24 |
$7K |
| M0248 |
Sotrovimab inf, home admin |
780 |
674 |
$5K |
| 96372 |
|
497 |
441 |
$5K |
| M0315 |
|
90 |
83 |
$2K |
| H0004 |
Alcohol and/or drug services |
23 |
12 |
$1K |
| H0038 |
Self-help/peer svc per 15min |
30 |
25 |
$216.41 |