| Code | Description | Claims | Beneficiaries | Total Paid |
| S5199 |
Personal care item, nos, each |
7,868 |
7,147 |
$788K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,925 |
1,775 |
$200K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,921 |
1,793 |
$199K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,184 |
1,128 |
$131K |
| A4554 |
Disposable underpads, all sizes |
2,895 |
2,679 |
$113K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
586 |
524 |
$57K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
513 |
464 |
$55K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
14 |
13 |
$610.48 |