| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0280 |
Medical home, initial plan |
524,011 |
456,456 |
$80.75M |
| 90834 |
|
493,860 |
190,768 |
$32.18M |
| H0037 |
Comm psy sup tx pgm per diem |
205,437 |
30,443 |
$18.15M |
| H0043 |
Supported housing, per diem |
132,022 |
4,023 |
$12.18M |
| H0019 |
Alcohol and/or drug services |
3,156 |
2,675 |
$8.89M |
| 99213 |
|
200,590 |
160,614 |
$7.56M |
| H2016 |
Comp comm supp svc, per diem |
74,640 |
4,435 |
$7.27M |
| 99214 |
|
86,369 |
59,840 |
$4.47M |
| H2015 |
Comp comm supp svc, 15 min |
4,367 |
2,924 |
$3.79M |
| 90847 |
|
56,462 |
31,131 |
$3.67M |
| H2020 |
Ther behav svc, per diem |
1,887 |
1,736 |
$3.62M |
| 90791 |
|
40,834 |
31,486 |
$3.30M |
| T2048 |
Bh ltc res r&b, per diem |
378 |
338 |
$3.02M |
| 90792 |
|
21,660 |
17,239 |
$1.77M |
| T2034 |
Crisis interven waiver/diem |
3,957 |
659 |
$1.58M |
| 90832 |
|
39,572 |
24,894 |
$1.55M |
| 90837 |
|
16,309 |
8,428 |
$1.49M |
| S5145 |
Child fostercare th per diem |
1,388 |
1,303 |
$866K |
| 90846 |
|
14,349 |
9,745 |
$841K |
| H2017 |
Psysoc rehab svc, per 15 min |
14,009 |
1,360 |
$726K |
| 99212 |
|
19,147 |
15,977 |
$574K |
| H0016 |
Alcohol and/or drug services |
2,131 |
1,520 |
$413K |
| 90853 |
|
4,643 |
1,316 |
$97K |
| 80305 |
|
2,721 |
1,429 |
$22K |
| H0049 |
Alcohol/drug screening |
905 |
571 |
$18K |
| H2018 |
Psysoc rehab svc, per diem |
139 |
29 |
$13K |
| H2000 |
Comp multidisipln evaluation |
226 |
145 |
$11K |
| 99215 |
Prolong outpt/office vis |
243 |
222 |
$11K |
| H0033 |
Oral med adm direct observe |
66 |
54 |
$9K |
| H0038 |
Self-help/peer svc per 15min |
133 |
89 |
$4K |
| 90836 |
|
158 |
133 |
$4K |
| 3074F |
|
11,407 |
8,159 |
$4K |
| 3078F |
|
8,008 |
5,756 |
$3K |
| 3079F |
|
4,591 |
3,633 |
$2K |
| H0036 |
Comm psy face-face per 15min |
54 |
13 |
$2K |
| 3080F |
|
2,963 |
2,481 |
$1K |
| 3077F |
|
2,864 |
2,384 |
$1K |
| 3075F |
|
2,376 |
1,884 |
$600.00 |
| G9010 |
Mccd, risk adj, level 4 |
430,174 |
321,015 |
$184.81 |
| 90833 |
|
16 |
12 |
$160.00 |
| G9005 |
Mccd, risk adj, maintenance |
125,090 |
101,570 |
$2.43 |
| G9004 |
Mccd, risk adj lo, initial |
89,121 |
71,501 |
$0.82 |
| G9011 |
Mccd, risk adj, level 5 |
18,290 |
13,472 |
$0.01 |
| S9485 |
Crisis intervention mental h |
127 |
92 |
$0.00 |
| G9006 |
Mccd, home monitoring |
8,785 |
7,555 |
$0.00 |
| G9007 |
Mccd, sch team conf |
5,770 |
4,424 |
$0.00 |
| 3044F |
|
1,475 |
512 |
$0.00 |