| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1017 |
Targeted case management |
66,202 |
60,304 |
$12.88M |
| T2004 |
N-et; commerc carrier pass |
25,725 |
22,605 |
$2.86M |
| T2028 |
Special supply, nos waiver |
46,854 |
39,531 |
$1.63M |
| V2799 |
Misc vision item or service |
2,751 |
2,110 |
$1.20M |
| S5130 |
Homaker service nos per 15m |
3,122 |
2,285 |
$811K |
| S5199 |
Personal care item nos each |
5,751 |
4,537 |
$614K |
| T2003 |
N-et; encounter/trip |
4,379 |
3,192 |
$267K |
| T2035 |
Utility services waiver |
534 |
371 |
$185K |
| H2019 |
Ther behav svc, per 15 min |
399 |
233 |
$59K |
| S5165 |
Home modifications per serv |
23 |
13 |
$33K |
| T2029 |
Special med equip, noswaiver |
63 |
30 |
$12K |
| T1016 |
Case management |
1,007 |
570 |
$5K |
| A0110 |
Nonemergency transport bus |
31 |
31 |
$1K |