| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2023 |
Targeted case management; per month |
5,305 |
4,728 |
$2.33M |
| T1016 |
Case management, each 15 minutes |
15,942 |
4,632 |
$845K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
4,745 |
1,238 |
$83K |
| S5130 |
Homemaker service, nos; per 15 minutes |
760 |
203 |
$40K |
| X5621 |
|
77 |
75 |
$13K |
| A0100 |
Non-emergency transportation; taxi |
99 |
25 |
$1K |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
22 |
12 |
$977.03 |