| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1019 |
Personal care ser per 15 min |
1,201,461 |
51,528 |
$42.71M |
| S5130 |
Homaker service nos per 15m |
863,434 |
52,160 |
$25.31M |
| S5150 |
Unskilled respite care /15m |
259,189 |
13,219 |
$12.32M |
| S5135 |
Adult companioncare per 15m |
251,043 |
14,690 |
$7.67M |
| T1004 |
Nsg aide service up to 15min |
87,711 |
4,167 |
$3.74M |
| S9122 |
Home health aide or certifie |
27,985 |
1,244 |
$700K |
| A5120 |
Skin barrier, wipe or swab |
18,431 |
12,112 |
$336K |
| T4527 |
Adult size pull-on lg |
6,964 |
4,865 |
$214K |
| T4526 |
Adult size pull-on med |
5,936 |
4,303 |
$190K |
| A4554 |
Disposable underpads |
11,412 |
7,187 |
$152K |
| T1005 |
Respite care service 15 min |
4,356 |
346 |
$90K |
| T4535 |
Disposable liner/shield/pad |
3,406 |
2,598 |
$80K |
| T4528 |
Adult size pull-on xl |
2,607 |
1,721 |
$80K |
| A4927 |
Non-sterile gloves |
5,355 |
3,620 |
$61K |
| T4523 |
Adult size brief/diaper lg |
1,013 |
826 |
$36K |
| T4524 |
Adult size brief/diaper xl |
750 |
574 |
$24K |
| S5199 |
Personal care item nos each |
3,187 |
1,875 |
$11K |
| T4543 |
Adult disp brief/diap abv xl |
121 |
79 |
$8K |
| B4150 |
Ef complet w/intact nutrient |
441 |
206 |
$8K |
| T4522 |
Adult size brief/diaper med |
435 |
296 |
$7K |
| B4152 |
Ef calorie dense>/=1.5kcal |
309 |
133 |
$7K |
| B4154 |
Ef spec metabolic noninherit |
159 |
84 |
$7K |
| T4525 |
Adult size pull-on sm |
119 |
90 |
$4K |
| T4541 |
Large disposable underpad |
42 |
42 |
$1K |
| 99211 |
|
23 |
13 |
$400.00 |
| Q5001 |
Hospice or home hlth in home |
40 |
24 |
$0.00 |