| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1017 |
Targeted case management, each 15 minutes |
837,961 |
165,221 |
$56.91M |
| T1016 |
Case management, each 15 minutes |
9,893 |
5,312 |
$1.47M |
| T2004 |
Non-emergency transport; commercial carrier, multi-pass |
2,556 |
1,440 |
$872K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,198 |
7,586 |
$858K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
7,739 |
7,281 |
$572K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
4,762 |
2,896 |
$447K |
| T4541 |
Incontinence product, disposable underpad, large, each |
7,222 |
6,738 |
$428K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,683 |
5,358 |
$374K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,102 |
5,648 |
$356K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,347 |
2,204 |
$174K |
| A4335 |
Incontinence supply; miscellaneous |
3,251 |
3,058 |
$160K |
| T2003 |
Non-emergency transportation; encounter/trip |
760 |
382 |
$118K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
711 |
665 |
$56K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
710 |
677 |
$48K |
| E1399 |
Durable medical equipment, miscellaneous |
627 |
595 |
$37K |
| T1001 |
Nursing assessment / evaluation |
416 |
148 |
$33K |
| 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 |
180 |
171 |
$33K |
| A0100 |
Non-emergency transportation; taxi |
672 |
566 |
$25K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
573 |
186 |
$24K |
| A4927 |
Gloves, non-sterile, per 100 |
448 |
432 |
$22K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
78 |
73 |
$11K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
41 |
38 |
$7K |
| B9998 |
Noc for enteral supplies |
82 |
74 |
$7K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
181 |
171 |
$3K |
| A6260 |
Wound cleansers, any type, any size |
71 |
64 |
$3K |
| 99600 |
Unlisted home visit service or procedure |
62 |
16 |
$3K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
105 |
93 |
$3K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
33 |
32 |
$2K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
13 |
13 |
$2K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
81 |
80 |
$2K |
| A4245 |
Alcohol wipes, per box |
68 |
64 |
$392.74 |