| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
21,431 |
7,768 |
$2.45M |
| 99199 |
Unlisted special service, procedure or report |
71,617 |
68,710 |
$343K |
| A4554 |
Disposable underpads, all sizes |
1,053 |
1,023 |
$58K |
| 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 |
582 |
544 |
$37K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
363 |
351 |
$32K |
| A4335 |
Incontinence supply; miscellaneous |
1,352 |
1,323 |
$27K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
434 |
400 |
$24K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
262 |
259 |
$23K |
| 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 |
387 |
351 |
$22K |
| A4927 |
Gloves, non-sterile, per 100 |
502 |
492 |
$5K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
42 |
39 |
$4K |