| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
40,004 |
11,128 |
$3.58M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
14,960 |
5,294 |
$1.72M |
| S5170 |
Home delivered meals, including preparation; per meal |
80,104 |
3,824 |
$384K |
| A4554 |
Disposable underpads, all sizes |
1,385 |
1,306 |
$87K |
| 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 |
950 |
804 |
$64K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
501 |
482 |
$38K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
678 |
611 |
$32K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
350 |
341 |
$28K |
| A4927 |
Gloves, non-sterile, per 100 |
1,591 |
1,505 |
$28K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
352 |
344 |
$27K |
| 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 |
431 |
382 |
$25K |
| T2025 |
Waiver services; not otherwise specified (nos) |
1,785 |
1,587 |
$24K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
102 |
95 |
$15K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
94 |
89 |
$8K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
13 |
12 |
$865.79 |