| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
1,683 |
1,282 |
$3.55M |
| T2016 |
Habil res waiver per diem |
18,499 |
858 |
$2.23M |
| M0360 |
|
5,791 |
327 |
$690K |
| H2014 |
Skills train and dev, 15 min |
17,421 |
912 |
$640K |
| M0123 |
|
6,704 |
253 |
$510K |
| S5150 |
Unskilled respite care /15m |
2,088 |
266 |
$238K |
| T2020 |
Day habil waiver per diem |
3,614 |
400 |
$190K |
| H2019 |
Ther behav svc, per 15 min |
1,904 |
681 |
$155K |
| T2025 |
Waiver service, nos |
1,322 |
320 |
$108K |
| M0116 |
|
3,022 |
198 |
$98K |
| M0240 |
Casiri and imdev repeat |
286 |
37 |
$35K |
| M0201 |
Pne flu hepb cov home admin |
742 |
77 |
$21K |
| M0171 |
|
220 |
51 |
$17K |
| M0133 |
|
246 |
108 |
$16K |
| T1002 |
Rn services up to 15 minutes |
76 |
54 |
$6K |
| D0120 |
|
14 |
14 |
$4K |
| M0299 |
|
32 |
27 |
$1K |
| M0315 |
|
12 |
12 |
$352.90 |