| Code | Description | Claims | Beneficiaries | Total Paid |
| T1016 |
Case management, each 15 minutes |
7,181 |
1,950 |
$136K |
| T2023 |
Targeted case management; per month |
246 |
246 |
$60K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
1,428 |
391 |
$34K |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
493 |
125 |
$7K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
448 |
437 |
$6K |
| A0190 |
Non-emergency transportation: ancillary: meals-recipient |
144 |
101 |
$1K |