| Code | Description | Claims | Beneficiaries | Total Paid |
| S5140 |
Foster care, adult; per diem |
608 |
481 |
$1.05M |
| T2022 |
Case management, per month |
3,195 |
3,195 |
$162K |
| S5170 |
Home delivered meals, including preparation; per meal |
659 |
659 |
$143K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
139 |
138 |
$15K |
| H0046 |
Mental health services, not otherwise specified |
582 |
372 |
$12K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
61 |
61 |
$9K |