| Code | Description | Claims | Beneficiaries | Total Paid |
| T1030 |
Nursing care, in the home, by registered nurse, per diem |
2,807 |
291 |
$198K |
| S5130 |
Homemaker service, nos; per 15 minutes |
3,049 |
202 |
$99K |
| 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) |
421 |
28 |
$34K |
| T1004 |
Services of a qualified nursing aide, up to 15 minutes |
254 |
13 |
$23K |