| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
3,811 |
3,660 |
$40.53M |
| H2022 |
Community-based wrap-around services, per diem |
5,555 |
2,113 |
$20.37M |
| S5140 |
Foster care, adult; per diem |
1,166 |
1,068 |
$0.00 |
| S5150 |
Unskilled respite care, not hospice; per 15 minutes |
9,437 |
771 |
$0.00 |
| S5151 |
Unskilled respite care, not hospice; per diem |
1,448 |
320 |
$0.00 |
| S0215 |
Non-emergency transportation; mileage, per mile |
547 |
397 |
$0.00 |
| T2016 |
Habilitation, residential, waiver; per diem |
633 |
349 |
$0.00 |
| T2021 |
Day habilitation, waiver; per 15 minutes |
10,061 |
670 |
$0.00 |
| T1016 |
Case management, each 15 minutes |
31,488 |
2,034 |
$0.00 |