| Code | Description | Claims | Beneficiaries | Total Paid |
| T2016 |
Habil res waiver per diem |
6,877 |
6,651 |
$21.66M |
| T2020 |
Day habil waiver per diem |
7,312 |
5,136 |
$5.50M |
| T2025 |
Waiver service, nos |
6,510 |
6,237 |
$2.37M |
| S0281 |
Medical home, maintenance |
6,398 |
6,178 |
$2.12M |
| T2014 |
Habil prevoc waiver, per d |
1,271 |
1,248 |
$423K |
| T2017 |
Habil res waiver 15 min |
468 |
422 |
$313K |
| T2028 |
Special supply, nos waiver |
5,906 |
5,717 |
$254K |
| T1016 |
Case management |
737 |
356 |
$59K |
| A9900 |
Supply/accessory/service |
372 |
265 |
$31K |
| T2018 |
Habil sup empl waiver/diem |
103 |
98 |
$11K |
| T2019 |
Habil sup empl waiver 15min |
105 |
102 |
$7K |
| A0425 |
Ground mileage |
19 |
17 |
$2K |
| A0100 |
Nonemergency transport taxi |
45 |
18 |
$255.64 |