| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1019 |
Personal care ser per 15 min |
401,161 |
29,450 |
$18.33M |
| S5130 |
Homaker service nos per 15m |
227,910 |
28,328 |
$14.62M |
| S5102 |
Adult day care per diem |
188,584 |
12,623 |
$10.08M |
| T2003 |
N-et; encounter/trip |
162,640 |
12,070 |
$6.99M |
| S5135 |
Adult companioncare per 15m |
132,207 |
23,907 |
$6.89M |
| H0043 |
Supported housing, per diem |
73,219 |
6,301 |
$6.60M |
| S5140 |
Adult foster care per diem |
44,107 |
2,570 |
$6.33M |
| T2022 |
Case management, per month |
46,104 |
45,076 |
$2.45M |
| S5170 |
Homedelivered prepared meal |
125,684 |
9,494 |
$1.99M |
| S5101 |
Adult day care per half day |
26,138 |
2,715 |
$988K |
| S5175 |
Laundry serv,ext,prof,/order |
18,963 |
4,451 |
$880K |
| T1020 |
Personal care ser per diem |
196,457 |
15,545 |
$840K |
| S5161 |
Emer rspns sys serv permonth |
31,453 |
31,436 |
$823K |
| H0046 |
Mental health service, nos |
14,055 |
13,529 |
$328K |
| T1023 |
Program intake assessment |
3,551 |
3,379 |
$241K |
| S5165 |
Home modifications per serv |
2,443 |
2,258 |
$203K |
| T1013 |
Sign lang/oral interpreter |
3,351 |
1,783 |
$185K |
| A0425 |
Ground mileage |
3,231 |
1,247 |
$16K |
| S5100 |
Adult daycare services 15min |
249 |
78 |
$13K |
| S0280 |
Medical home, initial plan |
102 |
102 |
$12K |
| 90837 |
|
457 |
193 |
$8K |
| T2025 |
Waiver service, nos |
238 |
40 |
$8K |
| S5120 |
Chore services per 15 min |
49 |
15 |
$4K |
| 99339 |
|
121 |
121 |
$3K |
| 99429 |
|
18 |
18 |
$3K |
| 90832 |
|
167 |
102 |
$2K |
| A0100 |
Nonemergency transport taxi |
70 |
12 |
$2K |
| S5121 |
Chore services per diem |
29 |
13 |
$1K |
| 99437 |
|
29 |
29 |
$480.00 |
| A9901 |
Delivery/set up/dispensing |
3,451 |
3,441 |
$0.00 |
| T2024 |
Serv asmnt/care plan waiver |
4,737 |
3,931 |
$0.00 |
| G9004 |
Mccd, risk adj lo, initial |
489 |
321 |
$0.00 |
| T2038 |
Comm trans waiver/service |
750 |
607 |
$0.00 |
| G9919 |
Scrn nd pos nd prov of rec |
607 |
607 |
$0.00 |
| G9011 |
Mccd, risk adj, level 5 |
13,779 |
11,361 |
$0.00 |
| G9920 |
Scrning perf and negative |
26 |
26 |
$0.00 |
| G9007 |
Mccd, sch team conf |
843 |
673 |
$0.00 |
| G0506 |
Comp asses care plan ccm svc |
1,187 |
852 |
$0.00 |
| G9005 |
Mccd, risk adj, maintenance |
29,905 |
17,973 |
$0.00 |
| 90834 |
|
17 |
12 |
$0.00 |