| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1017 |
Targeted case management |
837,961 |
165,221 |
$56.91M |
| T1016 |
Case management |
9,893 |
5,312 |
$1.47M |
| T2004 |
N-et; commerc carrier pass |
2,556 |
1,440 |
$872K |
| T4528 |
Adult size pull-on xl |
8,198 |
7,586 |
$858K |
| T4527 |
Adult size pull-on lg |
7,739 |
7,281 |
$572K |
| A0110 |
Nonemergency transport bus |
4,762 |
2,896 |
$447K |
| T4541 |
Large disposable underpad |
7,222 |
6,738 |
$428K |
| T4526 |
Adult size pull-on med |
5,683 |
5,358 |
$374K |
| T4535 |
Disposable liner/shield/pad |
6,102 |
5,648 |
$356K |
| T4523 |
Adult size brief/diaper lg |
2,347 |
2,204 |
$174K |
| A4335 |
Incontinence supply |
3,251 |
3,058 |
$160K |
| T2003 |
N-et; encounter/trip |
760 |
382 |
$118K |
| T4522 |
Adult size brief/diaper med |
711 |
665 |
$56K |
| T4525 |
Adult size pull-on sm |
710 |
677 |
$48K |
| E1399 |
Durable medical equipment mi |
627 |
595 |
$37K |
| T1001 |
Nursing assessment/evaluatn |
416 |
148 |
$33K |
| B4150 |
Ef complet w/intact nutrient |
180 |
171 |
$33K |
| A0100 |
Nonemergency transport taxi |
672 |
566 |
$25K |
| S9445 |
Pt education noc individ |
573 |
186 |
$24K |
| A4927 |
Non-sterile gloves |
448 |
432 |
$22K |
| B4152 |
Ef calorie dense>/=1.5kcal |
78 |
73 |
$11K |
| A6212 |
Foam drg <=16 sq in w/border |
41 |
38 |
$7K |
| B9998 |
Enteral supp not otherwise c |
82 |
74 |
$7K |
| A4357 |
Bedside drainage bag |
181 |
171 |
$3K |
| A6260 |
Wound cleanser any type/size |
71 |
64 |
$3K |
| 99600 |
|
62 |
16 |
$3K |
| A4213 |
20+ cc syringe only |
105 |
93 |
$3K |
| T1999 |
Noc retail items andsupplies |
33 |
32 |
$2K |
| T4544 |
Adlt disp und/pull on abv xl |
13 |
13 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
81 |
80 |
$2K |
| A4245 |
Alcohol wipes per box |
68 |
64 |
$392.74 |