| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
16,439 |
5,917 |
$1.80M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
12,219 |
5,001 |
$1.60M |
| 99199 |
Unlisted special service, procedure or report |
27,537 |
22,181 |
$131K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
541 |
451 |
$29K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
255 |
226 |
$13K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
328 |
274 |
$8K |