| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2023 |
Targeted case mgmt per month |
19,940 |
19,817 |
$10.21M |
| T1016 |
Case management |
114,589 |
33,650 |
$6.80M |
| H0040 |
Assert comm tx pgm per diem |
19,481 |
1,994 |
$3.56M |
| H0019 |
Alcohol and/or drug services |
551 |
463 |
$1.60M |
| S5120 |
Chore services per 15 min |
4,006 |
1,211 |
$272K |
| T2003 |
N-et; encounter/trip |
5,764 |
4,313 |
$215K |
| A0080 |
Noninterest escort in non er |
2,846 |
701 |
$88K |
| S0215 |
Nonemerg transp mileage |
1,753 |
253 |
$45K |
| A0090 |
Interest escort in non er |
1,685 |
660 |
$42K |
| A0180 |
Noner transport lodgng recip |
29 |
27 |
$4K |
| A0190 |
Noner transport meals recip |
199 |
128 |
$3K |
| A0110 |
Nonemergency transport bus |
86 |
81 |
$3K |
| S5130 |
Homaker service nos per 15m |
33 |
12 |
$1K |
| X5621 |
|
41 |
39 |
$0.00 |