| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2031 |
Assisted living; waiver, per diem |
8,056 |
6,827 |
$13.01M |
| T2033 |
Residential care, not otherwise specified (nos), waiver; per diem |
4,541 |
4,019 |
$8.39M |
| S5125 |
Attendant care services; per 15 minutes |
12,545 |
4,695 |
$6.25M |
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
3,694 |
523 |
$1.60M |
| H2014 |
Skills training and development, per 15 minutes |
10,983 |
1,605 |
$952K |
| T1016 |
Case management, each 15 minutes |
20,173 |
7,065 |
$811K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
5,801 |
2,907 |
$545K |
| S5140 |
Foster care, adult; per diem |
199 |
183 |
$319K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
1,167 |
258 |
$300K |
| S5150 |
Unskilled respite care, not hospice; per 15 minutes |
1,120 |
565 |
$300K |
| H0031 |
Mental health assessment, by non-physician |
1,177 |
1,118 |
$224K |
| S5102 |
Day care services, adult; per diem |
1,226 |
205 |
$175K |
| H2010 |
Comprehensive medication services, per 15 minutes |
3,759 |
632 |
$165K |
| H0038 |
Self-help/peer services, per 15 minutes |
4,688 |
1,000 |
$141K |
| H2012 |
Behavioral health day treatment, per hour |
3,320 |
485 |
$120K |
| H2027 |
Psychoeducational service, per 15 minutes |
2,051 |
410 |
$107K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,702 |
1,634 |
$106K |
| S5170 |
Home delivered meals, including preparation; per meal |
771 |
501 |
$87K |
| E0676 |
Intermittent limb compression device (includes all accessories), not otherwise specified |
131 |
125 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
575 |
548 |
$59K |
| S0215 |
Non-emergency transportation; mileage, per mile |
1,400 |
210 |
$30K |
| S5135 |
Companion care, adult (e.g., iadl/adl); per 15 minutes |
370 |
234 |
$25K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
1,283 |
199 |
$21K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
78 |
72 |
$19K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
573 |
561 |
$18K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
86 |
79 |
$13K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
78 |
64 |
$12K |
| S5110 |
Home care training, family; per 15 minutes |
315 |
193 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
110 |
107 |
$7K |
| 94060 |
|
215 |
210 |
$7K |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
399 |
118 |
$7K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
47 |
43 |
$5K |
| S9485 |
Crisis intervention mental health services, per diem |
20 |
12 |
$5K |
| 99233 |
Prolong inpt eval add15 m |
101 |
14 |
$4K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
30 |
22 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
214 |
208 |
$2K |
| 00731 |
|
32 |
15 |
$2K |
| 99386 |
|
13 |
13 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
24 |
13 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
13 |
13 |
$2K |
| 99385 |
|
14 |
14 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
19 |
13 |
$1K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
28 |
12 |
$921.76 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16 |
14 |
$846.88 |
| 94664 |
|
65 |
63 |
$594.39 |
| 71046 |
Radiologic examination, chest; 2 views |
15 |
15 |
$309.16 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
27 |
25 |
$101.62 |
| 80305 |
|
69 |
58 |
$37.14 |
| 99324 |
|
109 |
88 |
$0.00 |
| 2000F |
|
41 |
39 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
98 |
83 |
$0.00 |
| 2010F |
|
41 |
39 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
106 |
89 |
$0.00 |
| 90674 |
|
215 |
80 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
31 |
27 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
54 |
42 |
$0.00 |
| 81001 |
|
66 |
51 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
215 |
80 |
$0.00 |
| 1170F |
|
12 |
12 |
$0.00 |
| 84484 |
|
16 |
12 |
$0.00 |
| 99304 |
|
413 |
381 |
$0.00 |
| 3074F |
|
12 |
12 |
$0.00 |
| 3008F |
|
14 |
13 |
$0.00 |
| 99307 |
|
494 |
453 |
$0.00 |
| 99334 |
|
373 |
264 |
$0.00 |
| 3078F |
|
45 |
43 |
$0.00 |
| 1160F |
|
77 |
73 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
1,141 |
573 |
$0.00 |
| 81003 |
|
12 |
12 |
$0.00 |
| 1159F |
|
77 |
73 |
$0.00 |
| T1003 |
Lpn/lvn services, up to 15 minutes |
511 |
104 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21 |
17 |
$0.00 |