| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5125 |
Attendant care services; per 15 minutes |
196,141 |
6,941 |
$19.32M |
| T2013 |
Habilitation, educational, waiver; per hour |
23,164 |
858 |
$3.06M |
| S5150 |
Unskilled respite care, not hospice; per 15 minutes |
12,268 |
1,193 |
$645K |
| 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 |
3,260 |
2,545 |
$233K |
| 99509 |
Home visit for assistance with activities of daily living and personal care |
4,119 |
129 |
$170K |
| A4554 |
Disposable underpads, all sizes |
3,732 |
2,945 |
$137K |
| 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 |
1,332 |
898 |
$92K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
2,288 |
1,750 |
$44K |
| T2021 |
Day habilitation, waiver; per 15 minutes |
171 |
12 |
$25K |
| A4927 |
Gloves, non-sterile, per 100 |
1,364 |
957 |
$19K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
604 |
410 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
80 |
49 |
$4K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
50 |
24 |
$2K |
| T2025 |
Waiver services; not otherwise specified (nos) |
227 |
113 |
$1K |