| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2015 |
Comp comm supp svc, 15 min |
695,984 |
29,101 |
$61.89M |
| T1019 |
Personal care ser per 15 min |
337,475 |
13,772 |
$34.87M |
| T2022 |
Case management, per month |
34,615 |
34,610 |
$22.92M |
| T1000 |
Private duty/independent nsg |
13,178 |
455 |
$8.62M |
| H2016 |
Comp comm supp svc, per diem |
50,712 |
2,144 |
$4.43M |
| S5170 |
Homedelivered prepared meal |
300,206 |
12,368 |
$2.93M |
| T2033 |
Res, nos waiver per diem |
21,330 |
1,028 |
$2.48M |
| A0130 |
Noner transport wheelch van |
8,821 |
1,976 |
$943K |
| S0215 |
Nonemerg transp mileage |
29,691 |
4,806 |
$641K |
| S5121 |
Chore services per diem |
7,113 |
1,952 |
$573K |
| S0209 |
Wc van mileage per mi |
8,682 |
1,951 |
$565K |
| S5100 |
Adult daycare services 15min |
5,119 |
495 |
$517K |
| T2003 |
N-et; encounter/trip |
7,394 |
1,530 |
$466K |
| S5161 |
Emer rspns sys serv permonth |
12,480 |
12,480 |
$407K |
| T2025 |
Waiver service, nos |
2,834 |
2,571 |
$373K |
| T5999 |
Supply, nos |
59 |
47 |
$209K |
| B4150 |
Ef complet w/intact nutrient |
35,642 |
1,553 |
$154K |
| T2029 |
Special med equip, noswaiver |
840 |
835 |
$43K |
| T1003 |
Lpn/lvn services up to 15min |
972 |
155 |
$20K |
| T2024 |
Serv asmnt/care plan waiver |
81 |
81 |
$16K |
| T2032 |
Res care, nos waiver/month |
48 |
43 |
$10K |
| S9445 |
Pt education noc individ |
241 |
149 |
$5K |