| Code | Description | Claims | Beneficiaries | Total Paid |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
231 |
218 |
$30K |
| A4554 |
Disposable underpads, all sizes |
839 |
792 |
$25K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
255 |
241 |
$12K |
| A4335 |
Incontinence supply; miscellaneous |
840 |
793 |
$4K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
16 |
12 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12 |
12 |
$1K |