| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5130 |
Homemaker service, nos; per 15 minutes |
51,790 |
3,026 |
$8.52M |
| S5102 |
Day care services, adult; per diem |
3,690 |
3,575 |
$2.06M |
| T2003 |
Non-emergency transportation; encounter/trip |
35,644 |
2,528 |
$1.52M |
| S5135 |
Companion care, adult (e.g., iadl/adl); per 15 minutes |
9,267 |
757 |
$1.08M |
| T2015 |
Habilitation, prevocational, waiver; per hour |
2,630 |
222 |
$94K |
| S5199 |
Personal care item, nos, each |
791 |
790 |
$59K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
151 |
151 |
$12K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
24 |
24 |
$2K |
| A4554 |
Disposable underpads, all sizes |
57 |
51 |
$2K |