| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
45,996 |
23,002 |
$6.93M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
8,308 |
4,716 |
$1.48M |
| A4554 |
Disposable underpads, all sizes |
924 |
894 |
$67K |
| 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 |
374 |
349 |
$38K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
147 |
143 |
$16K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
267 |
254 |
$15K |
| 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 |
43 |
37 |
$4K |
| 99199 |
Unlisted special service, procedure or report |
254 |
194 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
12 |
12 |
$195.06 |
| 99501 |
|
13 |
12 |
$0.00 |