| Code | Description | Claims | Beneficiaries | Total Paid |
| G0156 |
Hhcp-svs of aide,ea 15 min |
4,862 |
1,192 |
$5.09M |
| S5130 |
Homaker service nos per 15m |
31,145 |
5,742 |
$3.23M |
| T1019 |
Personal care ser per 15 min |
16,802 |
3,050 |
$3.07M |
| S5135 |
Adult companioncare per 15m |
18,271 |
3,385 |
$1.19M |
| S5170 |
Homedelivered prepared meal |
33,849 |
6,473 |
$1.18M |
| G0299 |
Hhs/hospice of rn ea 15 min |
3,967 |
1,367 |
$345K |
| S5175 |
Laundry serv,ext,prof,/order |
6,960 |
1,641 |
$181K |
| S5120 |
Chore services per 15 min |
910 |
396 |
$138K |
| S5161 |
Emer rspns sys serv permonth |
3,426 |
3,414 |
$85K |
| A9279 |
Monitoring feature/devicenoc |
1,486 |
1,485 |
$73K |
| A0425 |
Ground mileage |
7,651 |
2,077 |
$47K |
| T2003 |
N-et; encounter/trip |
132 |
49 |
$10K |
| S5165 |
Home modifications per serv |
12 |
12 |
$6K |