| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comprehensive community support services, per diem |
75,894 |
6,896 |
$17.15M |
| T2016 |
Habilitation, residential, waiver; per diem |
35,638 |
2,030 |
$4.29M |
| M0123 |
|
35,543 |
1,434 |
$2.71M |
| M0124 |
|
13,408 |
541 |
$1.60M |
| M0125 |
|
15,618 |
639 |
$1.47M |
| H2014 |
Skills training and development, per 15 minutes |
29,516 |
1,671 |
$1.32M |
| M0354 |
|
10,029 |
514 |
$1.27M |
| M0360 |
|
8,494 |
599 |
$938K |
| T2020 |
Day habilitation, waiver; per diem |
21,700 |
1,190 |
$796K |
| M0122 |
|
10,570 |
415 |
$767K |
| S5150 |
Unskilled respite care, not hospice; per 15 minutes |
4,125 |
696 |
$465K |
| M0116 |
|
12,054 |
688 |
$380K |
| D0120 |
Periodic oral evaluation - established patient |
707 |
650 |
$359K |
| M0117 |
|
6,973 |
359 |
$328K |
| M0118 |
|
6,731 |
377 |
$254K |
| M0240 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat doses |
2,011 |
306 |
$224K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
1,845 |
569 |
$196K |
| M0101 |
|
633 |
456 |
$106K |
| M0115 |
|
3,456 |
212 |
$100K |
| M0133 |
|
926 |
379 |
$95K |
| M0201 |
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
2,524 |
182 |
$75K |
| M0171 |
|
1,043 |
224 |
$73K |
| M0113 |
|
119 |
112 |
$58K |
| M0299 |
|
387 |
265 |
$31K |
| S5199 |
Personal care item, nos, each |
338 |
238 |
$28K |
| M0372 |
|
1,695 |
169 |
$28K |
| T2025 |
Waiver services; not otherwise specified (nos) |
333 |
63 |
$27K |
| A9153 |
Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified |
123 |
106 |
$17K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
62 |
62 |
$11K |
| M0248 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency |
580 |
576 |
$10K |
| T1002 |
Rn services, up to 15 minutes |
129 |
67 |
$7K |
| M0315 |
|
111 |
110 |
$4K |
| M0298 |
|
296 |
211 |
$4K |
| M0419 |
|
121 |
12 |
$2K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
30 |
26 |
$430.01 |
| T2003 |
Non-emergency transportation; encounter/trip |
111 |
17 |
$11.50 |