| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
635 |
434 |
$1.07M |
| 99214 |
|
17,276 |
16,530 |
$989K |
| H2032 |
Activity therapy, per 15 min |
9,926 |
1,043 |
$598K |
| M0122 |
|
5,205 |
194 |
$378K |
| H2015 |
Comp comm supp svc, 15 min |
2,834 |
992 |
$318K |
| M0123 |
|
2,965 |
108 |
$226K |
| 90791 |
|
1,070 |
1,056 |
$145K |
| T2020 |
Day habil waiver per diem |
3,025 |
191 |
$95K |
| M0116 |
|
3,146 |
186 |
$94K |
| 99215 |
Prolong outpt/office vis |
846 |
814 |
$83K |
| T2016 |
Habil res waiver per diem |
449 |
28 |
$54K |
| 90792 |
|
262 |
259 |
$41K |
| M0240 |
Casiri and imdev repeat |
212 |
24 |
$31K |
| 96372 |
|
1,382 |
1,200 |
$20K |
| M0299 |
|
350 |
138 |
$15K |
| T1002 |
Rn services up to 15 minutes |
254 |
85 |
$11K |
| H0038 |
Self-help/peer svc per 15min |
300 |
109 |
$6K |
| 90837 |
|
45 |
26 |
$5K |
| H2021 |
Com wrap-around sv, 15 min |
155 |
74 |
$4K |
| T2025 |
Waiver service, nos |
54 |
12 |
$3K |
| 99213 |
|
65 |
65 |
$3K |
| 90834 |
|
21 |
12 |
$2K |
| 96130 |
|
16 |
14 |
$727.73 |
| 96131 |
|
16 |
14 |
$527.99 |
| 96137 |
|
16 |
14 |
$352.08 |
| 96136 |
|
16 |
14 |
$295.51 |
| T1017 |
Targeted case management |
39 |
20 |
$0.00 |