| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2016 |
Habil res waiver per diem |
2,614 |
2,498 |
$10.98M |
| T1017 |
Targeted case management |
30,505 |
29,106 |
$4.84M |
| T2003 |
N-et; encounter/trip |
12,861 |
9,940 |
$3.23M |
| T2021 |
Day habil waiver per 15 min |
2,200 |
1,665 |
$1.48M |
| T1019 |
Personal care ser per 15 min |
1,312 |
1,224 |
$865K |
| T2019 |
Habil sup empl waiver 15min |
786 |
727 |
$566K |
| S5130 |
Homaker service nos per 15m |
1,121 |
954 |
$538K |
| S5150 |
Unskilled respite care /15m |
3,310 |
348 |
$283K |
| V2799 |
Misc vision item or service |
537 |
501 |
$220K |
| T2028 |
Special supply, nos waiver |
2,623 |
2,454 |
$173K |
| T2004 |
N-et; commerc carrier pass |
1,848 |
1,761 |
$166K |
| H2019 |
Ther behav svc, per 15 min |
1,076 |
592 |
$94K |
| S5151 |
Unskilled respitecare /diem |
483 |
104 |
$68K |
| H2021 |
Com wrap-around sv, 15 min |
99 |
92 |
$29K |