| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2016 |
Habil res waiver per diem |
883 |
756 |
$3.67M |
| T1017 |
Targeted case management |
14,061 |
12,652 |
$2.23M |
| T2021 |
Day habil waiver per 15 min |
3,370 |
2,297 |
$1.59M |
| T2019 |
Habil sup empl waiver 15min |
1,304 |
1,075 |
$791K |
| T2003 |
N-et; encounter/trip |
2,159 |
1,802 |
$260K |
| H2019 |
Ther behav svc, per 15 min |
742 |
362 |
$232K |
| T2004 |
N-et; commerc carrier pass |
3,500 |
2,793 |
$121K |
| H2021 |
Com wrap-around sv, 15 min |
955 |
816 |
$102K |
| T1019 |
Personal care ser per 15 min |
839 |
649 |
$69K |
| T2028 |
Special supply, nos waiver |
426 |
342 |
$25K |
| V2799 |
Misc vision item or service |
107 |
96 |
$20K |
| S5130 |
Homaker service nos per 15m |
66 |
46 |
$8K |
| T2029 |
Special med equip, noswaiver |
14 |
13 |
$679.00 |