| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2016 |
Comp comm supp svc, per diem |
121,323 |
24,677 |
$63.63M |
| T2016 |
Habil res waiver per diem |
82,110 |
4,771 |
$11.49M |
| M0123 |
|
116,747 |
4,703 |
$8.89M |
| H2014 |
Skills train and dev, 15 min |
176,220 |
9,835 |
$8.30M |
| M0125 |
|
49,634 |
2,002 |
$4.67M |
| M0124 |
|
32,041 |
1,282 |
$3.82M |
| M0122 |
|
51,088 |
2,056 |
$3.71M |
| T2020 |
Day habil waiver per diem |
84,494 |
5,118 |
$3.43M |
| M0354 |
|
18,806 |
965 |
$3.11M |
| M0360 |
|
23,037 |
1,665 |
$2.70M |
| S5150 |
Unskilled respite care /15m |
19,295 |
2,552 |
$2.40M |
| M0116 |
|
47,275 |
2,832 |
$1.61M |
| M0240 |
Casiri and imdev repeat |
10,307 |
1,210 |
$1.23M |
| D0120 |
|
2,845 |
2,672 |
$1.17M |
| M0118 |
|
27,409 |
1,457 |
$1.08M |
| M0117 |
|
18,594 |
939 |
$913K |
| M0150 |
|
4,860 |
195 |
$787K |
| T2025 |
Waiver service, nos |
10,506 |
2,126 |
$754K |
| H2019 |
Ther behav svc, per 15 min |
5,164 |
1,423 |
$658K |
| M0113 |
|
1,165 |
1,043 |
$511K |
| T1003 |
Lpn/lvn services up to 15min |
13,308 |
7,174 |
$453K |
| M0115 |
|
14,133 |
913 |
$431K |
| T1002 |
Rn services up to 15 minutes |
15,719 |
9,777 |
$419K |
| S8990 |
Pt or manip for maint |
4,162 |
692 |
$311K |
| M0171 |
|
3,749 |
769 |
$273K |
| M0201 |
Pne flu hepb cov home admin |
8,847 |
747 |
$260K |
| M0101 |
|
2,521 |
1,986 |
$257K |
| S5199 |
Personal care item nos each |
2,862 |
2,711 |
$205K |
| M0419 |
|
8,580 |
853 |
$183K |
| M0133 |
|
1,565 |
528 |
$175K |
| M0372 |
|
5,153 |
492 |
$159K |
| M0143 |
|
1,248 |
233 |
$142K |
| A9153 |
Multi-vitamin nos |
1,346 |
1,284 |
$140K |
| M0315 |
|
2,931 |
2,839 |
$89K |
| M0299 |
|
4,059 |
2,927 |
$78K |
| M0246 |
Bamlan and etesev infus home |
1,134 |
249 |
$77K |
| D9220 |
|
61 |
61 |
$72K |
| M0298 |
|
5,771 |
3,603 |
$64K |
| M0248 |
Sotrovimab inf, home admin |
5,523 |
5,265 |
$45K |
| M0131 |
|
239 |
54 |
$19K |
| M0307 |
|
384 |
228 |
$17K |
| M0135 |
|
118 |
26 |
$10K |
| M0317 |
|
50 |
50 |
$5K |
| M0198 |
|
15 |
14 |
$3K |
| M0306 |
|
132 |
87 |
$3K |
| M0316 |
|
47 |
46 |
$2K |
| M0321 |
|
68 |
65 |
$2K |