| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2022 |
Case management, per month |
82,065 |
82,032 |
$34.70M |
| H2015 |
Comprehensive community support services, per 15 minutes |
38,904 |
2,806 |
$2.88M |
| T2033 |
Residential care, not otherwise specified (nos), waiver; per diem |
21,924 |
744 |
$2.25M |
| T1003 |
Lpn/lvn services, up to 15 minutes |
7,828 |
2,487 |
$310K |
| A0130 |
Non-emergency transportation: wheelchair van |
1,163 |
302 |
$82K |
| T1016 |
Case management, each 15 minutes |
901 |
251 |
$55K |
| S0215 |
Non-emergency transportation; mileage, per mile |
6,585 |
1,035 |
$31K |
| S5170 |
Home delivered meals, including preparation; per meal |
2,983 |
140 |
$25K |
| T2003 |
Non-emergency transportation; encounter/trip |
356 |
96 |
$20K |
| S5120 |
Chore services; per 15 minutes |
301 |
76 |
$14K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
73 |
73 |
$12K |
| T2004 |
Non-emergency transport; commercial carrier, multi-pass |
73 |
71 |
$2K |