| Code | Description | Claims | Beneficiaries | Total Paid |
| T2021 |
Day habilitation, waiver; per 15 minutes |
33,840 |
2,606 |
$6.28M |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
757 |
749 |
$131K |
| 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) |
527 |
84 |
$21K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
140 |
12 |
$4K |