| Code | Description | Claims | Beneficiaries | Total Paid |
| T4541 |
Incontinence product, disposable underpad, large, each |
814 |
805 |
$46K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
910 |
833 |
$37K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
24 |
24 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
13 |
$814.66 |
| E0245 |
Tub stool or bench |
13 |
13 |
$715.91 |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
17 |
17 |
$573.76 |