| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
463,249 |
16,856 |
$40.54M |
| M0123 |
|
82,820 |
3,341 |
$6.30M |
| T2016 |
Habil res waiver per diem |
54,739 |
3,306 |
$5.64M |
| H2014 |
Skills train and dev, 15 min |
98,056 |
5,826 |
$4.12M |
| M0125 |
|
35,569 |
1,437 |
$3.34M |
| M0122 |
|
36,262 |
1,466 |
$2.63M |
| M0360 |
|
18,572 |
1,190 |
$1.84M |
| T2020 |
Day habil waiver per diem |
17,844 |
2,749 |
$1.55M |
| T2022 |
Case management, per month |
8,235 |
8,229 |
$1.48M |
| S5150 |
Unskilled respite care /15m |
13,051 |
2,011 |
$1.41M |
| M0124 |
|
9,561 |
390 |
$1.14M |
| D0120 |
|
2,233 |
2,109 |
$1.01M |
| H2019 |
Ther behav svc, per 15 min |
8,431 |
2,219 |
$1.00M |
| M0354 |
|
10,012 |
508 |
$986K |
| M0240 |
Casiri and imdev repeat |
7,067 |
1,096 |
$774K |
| M0116 |
|
22,870 |
1,464 |
$722K |
| M0167 |
|
4,381 |
164 |
$668K |
| T2025 |
Waiver service, nos |
7,404 |
1,563 |
$625K |
| M0118 |
|
12,682 |
792 |
$472K |
| T1002 |
Rn services up to 15 minutes |
4,608 |
2,224 |
$394K |
| M0113 |
|
756 |
704 |
$350K |
| M0133 |
|
2,410 |
644 |
$271K |
| M0117 |
|
5,630 |
313 |
$264K |
| M0299 |
|
3,569 |
1,818 |
$262K |
| S8990 |
Pt or manip for maint |
2,784 |
422 |
$239K |
| M0115 |
|
6,276 |
543 |
$179K |
| M0171 |
|
2,212 |
466 |
$168K |
| T1003 |
Lpn/lvn services up to 15min |
3,480 |
1,964 |
$165K |
| M0201 |
Pne flu hepb cov home admin |
5,732 |
487 |
$164K |
| M0101 |
|
361 |
316 |
$123K |
| M0298 |
|
3,136 |
1,827 |
$116K |
| M0192 |
|
757 |
238 |
$89K |
| M0143 |
|
831 |
201 |
$80K |
| M0246 |
Bamlan and etesev infus home |
929 |
180 |
$70K |
| M0135 |
|
742 |
80 |
$63K |
| M0315 |
|
1,977 |
1,888 |
$55K |
| M0198 |
|
76 |
71 |
$25K |
| M0248 |
Sotrovimab inf, home admin |
734 |
680 |
$13K |
| A9153 |
Multi-vitamin nos |
43 |
41 |
$9K |
| M0131 |
|
90 |
13 |
$7K |
| S5199 |
Personal care item nos each |
29 |
25 |
$4K |
| M0321 |
|
87 |
84 |
$3K |
| M0316 |
|
53 |
53 |
$2K |