| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2017 |
Psysoc rehab svc, per 15 min |
44,015 |
3,609 |
$4.95M |
| 99199 |
|
13,875 |
2,778 |
$1.75M |
| T1016 |
Case management |
6,550 |
5,529 |
$1.12M |
| H0039 |
Asser com tx face-face/15min |
5,968 |
751 |
$224K |
| T1999 |
Noc retail items andsupplies |
1,028 |
777 |
$190K |
| 90834 |
|
3,257 |
1,878 |
$183K |
| T1017 |
Targeted case management |
2,091 |
1,590 |
$164K |
| A9999 |
Dme supply or accessory, nos |
1,004 |
765 |
$148K |
| S9484 |
Crisis intervention per hour |
2,643 |
1,211 |
$129K |
| 99213 |
|
4,156 |
3,653 |
$58K |
| Q3014 |
Telehealth facility fee |
4,047 |
3,551 |
$38K |
| 90837 |
|
181 |
83 |
$17K |
| 99212 |
|
703 |
668 |
$11K |
| H2011 |
Crisis interven svc, 15 min |
156 |
99 |
$9K |
| 90832 |
|
207 |
108 |
$9K |
| T2028 |
Special supply, nos waiver |
43 |
41 |
$8K |
| H0022 |
Alcohol and/or drug interven |
151 |
88 |
$6K |
| H0030 |
Alcohol and/or drug hotline |
111 |
93 |
$3K |
| T2025 |
Waiver service, nos |
27 |
27 |
$1K |
| 99214 |
|
41 |
38 |
$383.87 |