| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
12,031 |
5,849 |
$1.72M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
3,520 |
2,017 |
$635K |
| A4554 |
Disposable underpads, all sizes |
229 |
228 |
$9K |
| 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 |
100 |
94 |
$8K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
72 |
70 |
$5K |
| 99199 |
Unlisted special service, procedure or report |
257 |
257 |
$1K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
26 |
25 |
$794.32 |