| Code | Description | Claims | Beneficiaries | Total Paid |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,265 |
2,201 |
$92K |
| A4927 |
Gloves, non-sterile, per 100 |
5,297 |
5,068 |
$86K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
729 |
717 |
$74K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
411 |
385 |
$40K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
407 |
389 |
$35K |