| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
14,039 |
7,436 |
$2.38M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
2,276 |
1,213 |
$376K |
| A4554 |
Disposable underpads, all sizes |
762 |
750 |
$42K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
214 |
210 |
$17K |
| 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 |
413 |
398 |
$16K |
| 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 |
293 |
288 |
$7K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
368 |
359 |
$6K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
62 |
62 |
$6K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
12 |
12 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
41 |
40 |
$732.42 |