| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2023 |
Targeted case management; per month |
19,940 |
19,817 |
$10.21M |
| T1016 |
Case management, each 15 minutes |
114,589 |
33,650 |
$6.80M |
| H0040 |
Assertive community treatment program, per diem |
19,481 |
1,994 |
$3.56M |
| H0019 |
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem |
551 |
463 |
$1.60M |
| S5120 |
Chore services; per 15 minutes |
4,006 |
1,211 |
$272K |
| T2003 |
Non-emergency transportation; encounter/trip |
5,764 |
4,313 |
$215K |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
2,846 |
701 |
$88K |
| S0215 |
Non-emergency transportation; mileage, per mile |
1,753 |
253 |
$45K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
1,685 |
660 |
$42K |
| A0180 |
Non-emergency transportation: ancillary: lodging-recipient |
29 |
27 |
$4K |
| A0190 |
Non-emergency transportation: ancillary: meals-recipient |
199 |
128 |
$3K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
86 |
81 |
$3K |
| S5130 |
Homemaker service, nos; per 15 minutes |
33 |
12 |
$1K |
| X5621 |
|
41 |
39 |
$0.00 |