| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
19,401 |
8,262 |
$2.63M |
| T2041 |
Supports brokerage, self-directed, waiver; per 15 minutes |
2,077 |
930 |
$253K |
| 99199 |
|
48,997 |
48,086 |
$234K |
| 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 |
514 |
485 |
$39K |
| 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 |
279 |
252 |
$18K |
| A4554 |
Disposable underpads, all sizes |
309 |
272 |
$13K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
17 |
14 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
20 |
13 |
$1K |