| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
11,558 |
5,596 |
$1.69M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
10,384 |
4,668 |
$1.36M |
| 99199 |
Unlisted special service, procedure or report |
8,652 |
7,722 |
$41K |
| A4927 |
Gloves, non-sterile, per 100 |
729 |
530 |
$6K |
| A4554 |
Disposable underpads, all sizes |
166 |
102 |
$4K |
| 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 |
38 |
24 |
$941.63 |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
46 |
30 |
$0.00 |