| Code | Description | Claims | Beneficiaries | Total Paid |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,865 |
1,864 |
$218K |
| A4554 |
Disposable underpads, all sizes |
4,053 |
4,051 |
$155K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,414 |
2,409 |
$69K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
472 |
472 |
$51K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
311 |
311 |
$39K |
| A4335 |
Incontinence supply; miscellaneous |
4,992 |
4,983 |
$28K |
| K0001 |
Standard wheelchair |
130 |
130 |
$682.05 |
| E0570 |
Nebulizer, with compressor |
24 |
24 |
$138.88 |