| Code | Description | Claims | Beneficiaries | Total Paid |
| G0156 |
Hhcp-svs of aide,ea 15 min |
21,661 |
5,034 |
$17.91M |
| S5130 |
Homaker service nos per 15m |
44,669 |
8,111 |
$4.72M |
| T1019 |
Personal care ser per 15 min |
18,708 |
2,357 |
$3.19M |
| S5170 |
Homedelivered prepared meal |
90,732 |
9,301 |
$1.75M |
| S5102 |
Adult day care per diem |
9,173 |
1,293 |
$1.62M |
| T2003 |
N-et; encounter/trip |
8,497 |
1,219 |
$846K |
| S5175 |
Laundry serv,ext,prof,/order |
15,141 |
3,731 |
$466K |
| S5161 |
Emer rspns sys serv permonth |
12,919 |
12,841 |
$328K |
| G0299 |
Hhs/hospice of rn ea 15 min |
2,370 |
1,304 |
$209K |
| S5101 |
Adult day care per half day |
358 |
111 |
$32K |
| T1020 |
Personal care ser per diem |
16,629 |
671 |
$32K |
| S5135 |
Adult companioncare per 15m |
395 |
75 |
$32K |
| A9279 |
Monitoring feature/devicenoc |
402 |
402 |
$20K |
| H0046 |
Mental health service, nos |
391 |
383 |
$12K |
| G9001 |
Mccd, initial rate |
128 |
128 |
$10K |
| S5165 |
Home modifications per serv |
13 |
12 |
$7K |
| T1023 |
Program intake assessment |
33 |
33 |
$3K |
| T2022 |
Case management, per month |
26 |
26 |
$1K |
| G9002 |
Mccd,maintenance rate |
128 |
128 |
$100.80 |