| Code | Description | Claims | Beneficiaries | Total Paid |
| T1003 |
Lpn/lvn services up to 15min |
261,948 |
13,323 |
$112.35M |
| S9124 |
Nursing care, in the home; b |
112,885 |
5,655 |
$48.59M |
| T1002 |
Rn services up to 15 minutes |
90,224 |
6,935 |
$41.92M |
| S9123 |
Nursing care in home rn |
32,349 |
2,634 |
$14.47M |
| T1019 |
Personal care ser per 15 min |
71,981 |
3,675 |
$6.05M |
| E0603 |
Electric breast pump |
4,463 |
4,357 |
$668K |
| T1000 |
Private duty/independent nsg |
1,320 |
68 |
$487K |
| K1005 |
Disp col sto bag breast milk |
1,086 |
945 |
$36K |
| A4287 |
Disp col sto bag breast milk |
381 |
381 |
$22K |
| A4285 |
Replcmnt breast pump bottle |
88 |
66 |
$673.50 |
| A4284 |
Replcmnt breast pump shield |
89 |
64 |
$554.92 |
| A4281 |
Replacement breastpump tube |
89 |
63 |
$484.00 |
| A4283 |
Replacement breastpump cap |
18 |
15 |
$59.40 |