| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
14,566 |
4,521 |
$1.42M |
| A4554 |
Disposable underpads, all sizes |
416 |
380 |
$21K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
185 |
177 |
$12K |
| 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 |
225 |
146 |
$8K |
| 99199 |
Unlisted special service, procedure or report |
12 |
12 |
$57.12 |