| Code | Description | Claims | Beneficiaries | Total Paid |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
5,302 |
3,248 |
$417K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
3,574 |
2,048 |
$165K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
274 |
259 |
$29K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
325 |
206 |
$22K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
85 |
69 |
$8K |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
41 |
40 |
$1K |