| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
1,041 |
717 |
$1.88M |
| T1017 |
Targeted case management |
20,242 |
13,173 |
$1.52M |
| T1027 |
Family training & counseling |
13,807 |
6,004 |
$1.42M |
| H2014 |
Skills train and dev, 15 min |
21,487 |
5,126 |
$1.20M |
| M0123 |
|
6,129 |
203 |
$467K |
| H2011 |
Crisis interven svc, 15 min |
1,586 |
1,167 |
$453K |
| 92507 |
|
1,057 |
637 |
$159K |
| T2020 |
Day habil waiver per diem |
2,105 |
248 |
$137K |
| 90791 |
|
1,283 |
1,217 |
$130K |
| 97530 |
|
1,214 |
582 |
$129K |
| M0115 |
|
2,804 |
214 |
$82K |
| M0116 |
|
2,156 |
138 |
$73K |
| 99214 |
|
1,183 |
1,141 |
$60K |
| 97110 |
|
259 |
157 |
$49K |
| T1002 |
Rn services up to 15 minutes |
1,210 |
576 |
$41K |
| T2016 |
Habil res waiver per diem |
331 |
50 |
$22K |
| M0299 |
|
609 |
349 |
$22K |
| T1003 |
Lpn/lvn services up to 15min |
1,542 |
505 |
$20K |
| 99213 |
|
438 |
433 |
$20K |
| M0298 |
|
1,083 |
393 |
$13K |
| Q3014 |
Telehealth facility fee |
589 |
580 |
$13K |
| M0372 |
|
487 |
48 |
$6K |
| 99212 |
|
188 |
180 |
$6K |
| H2017 |
Psysoc rehab svc, per 15 min |
43 |
12 |
$5K |
| 97116 |
|
42 |
25 |
$3K |
| D0120 |
|
13 |
12 |
$3K |
| 99215 |
Prolong outpt/office vis |
29 |
29 |
$2K |
| 97165 |
|
14 |
14 |
$2K |
| M0307 |
|
20 |
13 |
$791.93 |