| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management |
273,073 |
41,244 |
$12.60M |
| T2028 |
Special supply, nos waiver |
2,798 |
2,236 |
$591K |
| A9999 |
Dme supply or accessory, nos |
6,537 |
5,622 |
$462K |
| S5150 |
Unskilled respite care /15m |
3,340 |
475 |
$298K |
| T2013 |
Habil ed waiver per hour |
2,975 |
800 |
$160K |
| S9445 |
Pt education noc individ |
816 |
297 |
$76K |
| T1999 |
Noc retail items andsupplies |
557 |
510 |
$70K |
| G0176 |
Opps/php/iop; activity thrpy |
927 |
294 |
$63K |
| T2027 |
Spec childcare waiver 15 min |
1,180 |
124 |
$58K |
| S5165 |
Home modifications per serv |
13 |
12 |
$51K |
| S0215 |
Nonemerg transp mileage |
3,066 |
504 |
$36K |
| S5162 |
Emer rspns system purchase |
71 |
62 |
$4K |
| S5161 |
Emer rspns sys serv permonth |
47 |
40 |
$2K |