| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
31,002 |
6,748 |
$1.55M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
4,434 |
1,387 |
$330K |
| S5170 |
Home delivered meals, including preparation; per meal |
47,902 |
2,320 |
$151K |
| A4554 |
Disposable underpads, all sizes |
1,707 |
1,321 |
$82K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
765 |
577 |
$61K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
702 |
540 |
$53K |
| 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 |
787 |
618 |
$50K |
| 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 |
572 |
438 |
$44K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
589 |
410 |
$31K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
936 |
727 |
$29K |