| Code | Description | Claims | Beneficiaries | Total Paid |
| T4541 |
Incontinence product, disposable underpad, large, each |
11,522 |
11,515 |
$663K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
5,679 |
5,678 |
$546K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
5,578 |
5,576 |
$524K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
886 |
886 |
$24K |
| A4927 |
Gloves, non-sterile, per 100 |
161 |
161 |
$4K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
140 |
140 |
$3K |
| A4554 |
Disposable underpads, all sizes |
17 |
17 |
$1K |