| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
17,667 |
7,726 |
$2.41M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
699 |
665 |
$253K |
| T2025 |
Waiver services; not otherwise specified (nos) |
2,387 |
2,170 |
$92K |
| A4554 |
Disposable underpads, all sizes |
669 |
616 |
$28K |
| 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 |
257 |
228 |
$15K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
250 |
230 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
71 |
65 |
$7K |
| 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 |
98 |
80 |
$5K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
25 |
25 |
$2K |