| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management |
21,137 |
10,449 |
$2.40M |
| A9999 |
Dme supply or accessory, nos |
3,872 |
3,712 |
$823K |
| S9484 |
Crisis intervention per hour |
6,614 |
1,746 |
$307K |
| T2028 |
Special supply, nos waiver |
856 |
825 |
$267K |
| T1005 |
Respite care service 15 min |
842 |
443 |
$232K |
| S5190 |
Wellness assessment by nonph |
914 |
862 |
$226K |
| H0039 |
Asser com tx face-face/15min |
6,573 |
486 |
$105K |
| T1017 |
Targeted case management |
2,345 |
1,876 |
$91K |
| 97530 |
|
892 |
411 |
$63K |
| 99214 |
|
2,275 |
1,591 |
$41K |
| S0215 |
Nonemerg transp mileage |
531 |
210 |
$40K |
| 92507 |
|
595 |
288 |
$37K |
| S9125 |
Respite care, in the home, p |
41 |
25 |
$12K |
| T2007 |
Non-emer transport wait time |
450 |
196 |
$11K |
| A0080 |
Noninterest escort in non er |
137 |
77 |
$7K |
| 99215 |
Prolong outpt/office vis |
148 |
128 |
$735.13 |