| Code | Description | Claims | Beneficiaries | Total Paid |
| S5130 |
Homaker service nos per 15m |
39,344 |
7,427 |
$7.82M |
| T1019 |
Personal care ser per 15 min |
27,773 |
5,006 |
$4.68M |
| S5135 |
Adult companioncare per 15m |
5,015 |
1,237 |
$2.23M |
| S5170 |
Homedelivered prepared meal |
57,624 |
10,190 |
$1.72M |
| G0299 |
Hhs/hospice of rn ea 15 min |
4,518 |
1,980 |
$337K |
| G0156 |
Hhcp-svs of aide,ea 15 min |
150 |
49 |
$90K |
| S5161 |
Emer rspns sys serv permonth |
3,122 |
3,119 |
$83K |
| S5165 |
Home modifications per serv |
137 |
137 |
$38K |
| H0046 |
Mental health service, nos |
747 |
743 |
$29K |
| S5175 |
Laundry serv,ext,prof,/order |
497 |
174 |
$17K |
| S5120 |
Chore services per 15 min |
57 |
12 |
$7K |
| T1023 |
Program intake assessment |
39 |
39 |
$4K |