| Code | Description | Claims | Beneficiaries | Total Paid |
| S0215 |
Nonemerg transp mileage |
37,606 |
13,045 |
$3.76M |
| H2016 |
Comp comm supp svc, per diem |
10,932 |
5,584 |
$3.09M |
| T1016 |
Case management |
49,184 |
19,862 |
$1.36M |
| H2015 |
Comp comm supp svc, 15 min |
9,080 |
4,658 |
$961K |
| A0120 |
Noner transport mini-bus |
37,581 |
13,042 |
$777K |
| H0038 |
Self-help/peer svc per 15min |
11,016 |
5,997 |
$640K |
| H2014 |
Skills train and dev, 15 min |
6,083 |
3,096 |
$622K |
| H0004 |
Alcohol and/or drug services |
6,124 |
3,097 |
$589K |
| A0160 |
Noner transport case worker |
14,149 |
7,555 |
$170K |
| S5150 |
Unskilled respite care /15m |
796 |
385 |
$163K |
| S5151 |
Unskilled respitecare /diem |
192 |
168 |
$48K |
| H0031 |
Mh health assess by non-md |
32 |
32 |
$5K |