| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2031 |
Assist living waiver/diem |
8,056 |
6,827 |
$13.01M |
| T2033 |
Res, nos waiver per diem |
4,541 |
4,019 |
$8.39M |
| S5125 |
Attendant care service /15m |
12,545 |
4,695 |
$6.25M |
| H0018 |
Alcohol and/or drug services |
3,694 |
523 |
$1.60M |
| H2014 |
Skills train and dev, 15 min |
10,983 |
1,605 |
$952K |
| T1016 |
Case management |
20,173 |
7,065 |
$811K |
| H0004 |
Alcohol and/or drug services |
5,801 |
2,907 |
$545K |
| S5140 |
Adult foster care per diem |
199 |
183 |
$319K |
| H0015 |
Alcohol and/or drug services |
1,167 |
258 |
$300K |
| S5150 |
Unskilled respite care /15m |
1,120 |
565 |
$300K |
| H0031 |
Mh health assess by non-md |
1,177 |
1,118 |
$224K |
| S5102 |
Adult day care per diem |
1,226 |
205 |
$175K |
| H2010 |
Comprehensive med svc 15 min |
3,759 |
632 |
$165K |
| H0038 |
Self-help/peer svc per 15min |
4,688 |
1,000 |
$141K |
| H2012 |
Behav hlth day treat, per hr |
3,320 |
485 |
$120K |
| H2027 |
Psychoed svc, per 15 min |
2,051 |
410 |
$107K |
| 99213 |
|
1,702 |
1,634 |
$106K |
| S5170 |
Homedelivered prepared meal |
771 |
501 |
$87K |
| E0676 |
Inter limb compress dev nos |
131 |
125 |
$69K |
| 99214 |
|
575 |
548 |
$59K |
| S0215 |
Nonemerg transp mileage |
1,400 |
210 |
$30K |
| S5135 |
Adult companioncare per 15m |
370 |
234 |
$25K |
| A0120 |
Noner transport mini-bus |
1,283 |
199 |
$21K |
| 99284 |
|
78 |
72 |
$19K |
| H0002 |
Alcohol and/or drug screenin |
573 |
561 |
$18K |
| 99283 |
|
86 |
79 |
$13K |
| 90792 |
|
78 |
64 |
$12K |
| S5110 |
Family homecare training 15m |
315 |
193 |
$10K |
| 99204 |
|
110 |
107 |
$7K |
| 94060 |
|
215 |
210 |
$7K |
| H0020 |
Alcohol and/or drug services |
399 |
118 |
$7K |
| 99285 |
|
47 |
43 |
$5K |
| S9485 |
Crisis intervention mental h |
20 |
12 |
$5K |
| 99233 |
Prolong inpt eval add15 m |
101 |
14 |
$4K |
| 99282 |
|
30 |
22 |
$3K |
| 94640 |
|
214 |
208 |
$2K |
| 00731 |
|
32 |
15 |
$2K |
| 99386 |
|
13 |
13 |
$2K |
| 90837 |
|
24 |
13 |
$2K |
| 99222 |
|
13 |
13 |
$2K |
| 99385 |
|
14 |
14 |
$2K |
| 90834 |
|
19 |
13 |
$1K |
| 99232 |
|
28 |
12 |
$921.76 |
| 96372 |
|
16 |
14 |
$846.88 |
| 94664 |
|
65 |
63 |
$594.39 |
| 71046 |
|
15 |
15 |
$309.16 |
| 93010 |
|
27 |
25 |
$101.62 |
| 80305 |
|
69 |
58 |
$37.14 |
| 99324 |
|
109 |
88 |
$0.00 |
| 2000F |
|
41 |
39 |
$0.00 |
| 80053 |
|
98 |
83 |
$0.00 |
| 2010F |
|
41 |
39 |
$0.00 |
| 85025 |
|
106 |
89 |
$0.00 |
| 90674 |
|
215 |
80 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
31 |
27 |
$0.00 |
| 96374 |
|
54 |
42 |
$0.00 |
| 81001 |
|
66 |
51 |
$0.00 |
| G0008 |
Admin influenza virus vac |
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 lang/oral interpreter |
1,141 |
573 |
$0.00 |
| 81003 |
|
12 |
12 |
$0.00 |
| 1159F |
|
77 |
73 |
$0.00 |
| T1003 |
Lpn/lvn services up to 15min |
511 |
104 |
$0.00 |
| 93005 |
|
21 |
17 |
$0.00 |