| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2002 |
N-et; per diem |
1,071,645 |
124,947 |
$17.72M |
| 90791 |
|
44 |
23 |
$128.54 |
| 90832 |
|
155 |
84 |
$62.41 |
| 90837 |
|
305 |
171 |
$0.00 |
| H0032 |
Mh svc plan dev by non-md |
296 |
137 |
$0.00 |
| H0034 |
Med trng & support per 15min |
52 |
24 |
$0.00 |
| H0036 |
Comm psy face-face per 15min |
219 |
36 |
$0.00 |
| H2021 |
Com wrap-around sv, 15 min |
28 |
14 |
$0.00 |
| H2017 |
Psysoc rehab svc, per 15 min |
133 |
26 |
$0.00 |
| H2012 |
Behav hlth day treat, per hr |
459 |
78 |
$0.00 |
| A0120 |
Noner transport mini-bus |
268 |
65 |
$0.00 |
| 90834 |
|
88 |
50 |
$0.00 |
| H0004 |
Alcohol and/or drug services |
111 |
80 |
$0.00 |
| 90847 |
|
48 |
26 |
$0.00 |
| H0040 |
Assert comm tx pgm per diem |
232 |
21 |
$0.00 |