| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
34,337 |
1,547 |
$4.20M |
| H2014 |
Skills train and dev, 15 min |
28,006 |
11,844 |
$2.23M |
| T1017 |
Targeted case management |
22,142 |
13,984 |
$1.69M |
| H2017 |
Psysoc rehab svc, per 15 min |
17,935 |
4,621 |
$1.65M |
| M0123 |
|
6,937 |
233 |
$528K |
| M0122 |
|
7,231 |
243 |
$525K |
| T2016 |
Habil res waiver per diem |
4,399 |
307 |
$430K |
| H0034 |
Med trng & support per 15min |
12,996 |
3,092 |
$267K |
| T2020 |
Day habil waiver per diem |
3,625 |
313 |
$212K |
| M0116 |
|
5,661 |
279 |
$196K |
| H0020 |
Alcohol and/or drug services |
11,283 |
774 |
$194K |
| T1002 |
Rn services up to 15 minutes |
2,228 |
996 |
$140K |
| 90791 |
|
833 |
819 |
$115K |
| 99214 |
|
3,261 |
3,091 |
$105K |
| D0120 |
|
237 |
211 |
$95K |
| M0299 |
|
1,085 |
530 |
$50K |
| 99213 |
|
1,590 |
1,487 |
$38K |
| H0038 |
Self-help/peer svc per 15min |
949 |
359 |
$32K |
| 99212 |
|
2,475 |
2,241 |
$28K |
| 96372 |
|
1,669 |
1,304 |
$22K |
| M0113 |
|
32 |
26 |
$21K |
| 90792 |
|
142 |
141 |
$19K |
| 99215 |
Prolong outpt/office vis |
297 |
293 |
$15K |
| M0101 |
|
308 |
239 |
$14K |
| T1003 |
Lpn/lvn services up to 15min |
820 |
317 |
$10K |
| 99231 |
|
577 |
172 |
$9K |
| H2032 |
Activity therapy, per 15 min |
148 |
24 |
$7K |
| M0315 |
|
83 |
79 |
$4K |
| M0298 |
|
229 |
134 |
$3K |
| M0248 |
Sotrovimab inf, home admin |
611 |
561 |
$3K |
| A9153 |
Multi-vitamin nos |
27 |
25 |
$1K |
| 99202 |
|
16 |
16 |
$460.63 |
| 99211 |
|
12 |
12 |
$37.66 |