| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5125 |
Attendant care services; per 15 minutes |
45,627 |
2,210 |
$4.90M |
| T1016 |
Case management, each 15 minutes |
14,808 |
6,142 |
$1.95M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
5,581 |
2,829 |
$925K |
| S5170 |
Home delivered meals, including preparation; per meal |
8,418 |
434 |
$64K |
| A4554 |
Disposable underpads, all sizes |
655 |
618 |
$37K |
| 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 |
663 |
563 |
$37K |
| 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 |
522 |
471 |
$22K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
368 |
338 |
$21K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
323 |
305 |
$19K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
295 |
229 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
261 |
242 |
$3K |
| 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 |
25 |
24 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
12 |
$674.40 |