| Code | Description | Claims | Beneficiaries | Total Paid |
| S5125 |
Attendant care services; per 15 minutes |
12,873 |
5,389 |
$23.14M |
| T1005 |
Respite care services, up to 15 minutes |
1,156 |
1,078 |
$1.39M |
| A0160 |
Non-emergency transportation: per mile - case worker or social worker |
6,025 |
4,014 |
$943K |
| T1016 |
Case management, each 15 minutes |
2,283 |
2,262 |
$483K |
| T2021 |
Day habilitation, waiver; per 15 minutes |
4,687 |
4,589 |
$352K |
| T2024 |
Service assessment/plan of care development, waiver |
2,861 |
1,601 |
$179K |
| T1002 |
Rn services, up to 15 minutes |
1,844 |
1,823 |
$57K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
820 |
258 |
$32K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
24 |
24 |
$2K |