| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comprehensive community support services, per diem |
2,194 |
2,052 |
$5.99M |
| M0122 |
|
13,370 |
443 |
$970K |
| M0123 |
|
12,089 |
401 |
$920K |
| H2014 |
Skills training and development, per 15 minutes |
23,139 |
896 |
$606K |
| T2020 |
Day habilitation, waiver; per diem |
699 |
673 |
$377K |
| M0115 |
|
8,890 |
503 |
$275K |
| M0116 |
|
7,667 |
453 |
$261K |
| T1002 |
Rn services, up to 15 minutes |
2,611 |
1,348 |
$92K |
| M0113 |
|
183 |
178 |
$56K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
4,194 |
2,112 |
$41K |
| M0299 |
|
1,473 |
898 |
$37K |
| D0120 |
Periodic oral evaluation - established patient |
66 |
66 |
$28K |
| M0298 |
|
1,819 |
1,021 |
$16K |
| M0315 |
|
553 |
535 |
$16K |
| M0101 |
|
337 |
273 |
$15K |
| M0372 |
|
1,677 |
74 |
$13K |
| A9153 |
Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified |
141 |
136 |
$5K |
| 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 |
484 |
459 |
$2K |
| 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 |
13 |
13 |
$633.96 |