| Code | Description | Claims | Beneficiaries | Total Paid |
| T1016 |
Case management |
252,872 |
52,891 |
$14.36M |
| H2021 |
Com wrap-around sv, 15 min |
10,250 |
987 |
$983K |
| S5110 |
Family homecare training 15m |
3,423 |
1,113 |
$859K |
| T1999 |
Noc retail items andsupplies |
4,173 |
3,501 |
$478K |
| S5136 |
Adult companioncare per diem |
678 |
343 |
$468K |
| A9999 |
Dme supply or accessory, nos |
2,227 |
1,924 |
$201K |
| G0176 |
Opps/php/iop; activity thrpy |
1,060 |
319 |
$186K |
| T2041 |
Support broker waiver/15 min |
3,464 |
485 |
$165K |
| T2028 |
Special supply, nos waiver |
1,064 |
915 |
$142K |
| T2017 |
Habil res waiver 15 min |
820 |
212 |
$58K |
| S5190 |
Wellness assessment by nonph |
119 |
109 |
$23K |
| E0700 |
Safety equipment |
79 |
73 |
$13K |
| S5161 |
Emer rspns sys serv permonth |
97 |
87 |
$11K |