| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
33,221 |
15,345 |
$4.60M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
13,965 |
9,324 |
$3.20M |
| T2021 |
Day habilitation, waiver; per 15 minutes |
20,607 |
894 |
$2.22M |
| S5125 |
Attendant care services; per 15 minutes |
11,239 |
553 |
$897K |
| S5102 |
Day care services, adult; per diem |
5,619 |
372 |
$207K |
| 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 |
840 |
742 |
$57K |
| A4554 |
Disposable underpads, all sizes |
1,290 |
1,230 |
$55K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
400 |
386 |
$26K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
297 |
283 |
$26K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
296 |
278 |
$20K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
351 |
327 |
$15K |
| 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 |
123 |
94 |
$9K |
| 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 |
12 |
12 |
$1K |