| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99509 |
Home visit for assistance with activities of daily living and personal care |
72,747 |
2,420 |
$3.05M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,167 |
1,991 |
$337K |
| A4554 |
Disposable underpads, all sizes |
4,931 |
4,526 |
$282K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,446 |
1,367 |
$235K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,136 |
1,018 |
$154K |
| A4927 |
Gloves, non-sterile, per 100 |
6,598 |
6,023 |
$131K |
| A4335 |
Incontinence supply; miscellaneous |
6,455 |
5,937 |
$48K |
| 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 |
33 |
30 |
$8K |
| L0631 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
18 |
14 |
$7K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
13 |
12 |
$3K |