| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2025 |
Waiver services; not otherwise specified (nos) |
11,514 |
11,513 |
$6K |
| T2022 |
Case management, per month |
11,597 |
11,597 |
$5K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
5,191 |
5,152 |
$992.00 |
| T2028 |
Specialized supply, not otherwise specified, waiver |
2,140 |
1,815 |
$280.91 |
| G9012 |
Other specified case management service not elsewhere classified |
26 |
12 |
$0.14 |
| T2003 |
Non-emergency transportation; encounter/trip |
208 |
208 |
$0.00 |
| S5199 |
Personal care item, nos, each |
781 |
765 |
$0.00 |
| S5170 |
Home delivered meals, including preparation; per meal |
168 |
12 |
$0.00 |
| S5151 |
Unskilled respite care, not hospice; per diem |
67 |
26 |
$0.00 |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
122 |
122 |
$0.00 |
| T1019 |
Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) |
100 |
42 |
$0.00 |
| S5165 |
Home modifications; per service |
30 |
28 |
$0.00 |