| Code | Description | Claims | Beneficiaries | Total Paid |
| T4535 |
Disposable liner/shield/pad |
42,692 |
39,743 |
$1.72M |
| T4541 |
Large disposable underpad |
45,446 |
43,244 |
$1.59M |
| T4527 |
Adult size pull-on lg |
19,519 |
18,112 |
$1.56M |
| T4526 |
Adult size pull-on med |
18,500 |
17,253 |
$1.33M |
| T4543 |
Adult disp brief/diap abv xl |
7,969 |
7,442 |
$1.31M |
| T4528 |
Adult size pull-on xl |
15,313 |
14,385 |
$1.30M |
| T4523 |
Adult size brief/diaper lg |
10,528 |
10,042 |
$1.02M |
| T4522 |
Adult size brief/diaper med |
9,904 |
9,570 |
$924K |
| A4927 |
Non-sterile gloves |
53,754 |
51,339 |
$811K |
| T4525 |
Adult size pull-on sm |
5,123 |
4,870 |
$363K |
| T4521 |
Adult size brief/diaper sm |
3,790 |
3,722 |
$345K |
| T4524 |
Adult size brief/diaper xl |
3,475 |
3,223 |
$326K |
| T4537 |
Reusable underpad bed size |
4,625 |
4,365 |
$309K |
| T4544 |
Adlt disp und/pull on abv xl |
921 |
874 |
$185K |
| T2029 |
Special med equip, noswaiver |
5,770 |
5,039 |
$136K |
| A9999 |
Dme supply or accessory, nos |
784 |
756 |
$62K |
| T4533 |
Youth size brief/diaper |
155 |
155 |
$14K |
| T1999 |
Noc retail items andsupplies |
97 |
82 |
$5K |
| A4520 |
Incontinence garment anytype |
22 |
20 |
$471.12 |