| Code | Description | Claims | Beneficiaries | Total Paid |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,224 |
1,220 |
$145K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,042 |
3,003 |
$131K |
| A4554 |
Disposable underpads, all sizes |
3,210 |
3,203 |
$124K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
345 |
332 |
$65K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
597 |
597 |
$57K |
| A4335 |
Incontinence supply; miscellaneous |
5,781 |
5,761 |
$33K |