| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
8,524 |
5,755 |
$1.43M |
| H2015 |
Comp comm supp svc, 15 min |
6,457 |
3,803 |
$649K |
| T2025 |
Waiver service, nos |
1,332 |
12 |
$4K |
| 99214 |
|
762 |
422 |
$0.00 |
| 90834 |
|
1,158 |
701 |
$0.00 |
| 99213 |
|
144 |
136 |
$0.00 |
| Q3014 |
Telehealth facility fee |
122 |
114 |
$0.00 |
| H0040 |
Assert comm tx pgm per diem |
73 |
21 |
$0.00 |
| 90792 |
|
14 |
14 |
$0.00 |
| H0038 |
Self-help/peer svc per 15min |
870 |
181 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
19 |
17 |
$0.00 |
| T2016 |
Habil res waiver per diem |
514 |
473 |
$0.00 |
| 90853 |
|
1,293 |
487 |
$0.00 |
| 90791 |
|
138 |
132 |
$0.00 |
| 99214GT |
|
12 |
12 |
$0.00 |
| H0020 |
Alcohol and/or drug services |
1,873 |
97 |
$0.00 |
| 99212 |
|
47 |
32 |
$0.00 |
| 90837 |
|
1,413 |
513 |
$0.00 |
| H2022 |
Com wrap-around sv, per diem |
37 |
14 |
$0.00 |
| S9484 |
Crisis intervention per hour |
176 |
28 |
$0.00 |
| H0020CR |
|
144 |
23 |
$0.00 |
| 90832 |
|
29 |
13 |
$0.00 |
| 90853GT |
|
20 |
12 |
$0.00 |