| Code | Description | Claims | Beneficiaries | Total Paid |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,703 |
1,703 |
$124K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
584 |
584 |
$92K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,701 |
1,701 |
$89K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
427 |
427 |
$81K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
457 |
457 |
$71K |
| A4927 |
Gloves, non-sterile, per 100 |
1,704 |
1,704 |
$27K |