| Code | Description | Claims | Beneficiaries | Total Paid |
| A4554 |
Disposable underpads, all sizes |
4,947 |
4,930 |
$178K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,272 |
1,268 |
$169K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,238 |
1,237 |
$156K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,542 |
1,534 |
$150K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,953 |
3,941 |
$129K |
| A4335 |
Incontinence supply; miscellaneous |
5,989 |
5,969 |
$32K |