| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1019 |
Personal care ser per 15 min |
1,733,537 |
68,029 |
$123.79M |
| T2022 |
Case management, per month |
101,850 |
101,849 |
$35.84M |
| H2015 |
Comp comm supp svc, 15 min |
91,026 |
4,409 |
$4.73M |
| S5170 |
Homedelivered prepared meal |
552,324 |
24,612 |
$4.73M |
| S5121 |
Chore services per diem |
37,441 |
11,717 |
$3.42M |
| T2003 |
N-et; encounter/trip |
35,709 |
4,865 |
$1.97M |
| S5165 |
Home modifications per serv |
564 |
508 |
$1.90M |
| S5161 |
Emer rspns sys serv permonth |
26,580 |
26,491 |
$655K |
| T2024 |
Serv asmnt/care plan waiver |
1,628 |
1,615 |
$354K |
| G9012 |
Other specified case mgmt |
723 |
282 |
$88K |
| E0245 |
Tub stool or bench |
1,055 |
1,055 |
$75K |
| B4150 |
Ef complet w/intact nutrient |
224 |
224 |
$46K |
| E0241 |
Bath tub wall rail |
172 |
172 |
$20K |
| S5199 |
Personal care item nos each |
417 |
401 |
$12K |
| E0244 |
Toilet seat raised |
151 |
151 |
$9K |
| S5160 |
Emer response sys instal&tst |
197 |
196 |
$5K |
| T1999 |
Noc retail items andsupplies |
13 |
13 |
$956.00 |
| A4335 |
Incontinence supply |
12 |
12 |
$890.00 |