| Code | Description | Claims | Beneficiaries | Total Paid |
| S5199 |
Personal care item, nos, each |
5,798 |
5,185 |
$333K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,186 |
1,157 |
$107K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,142 |
1,120 |
$92K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
994 |
962 |
$89K |
| A4554 |
Disposable underpads, all sizes |
2,162 |
2,108 |
$81K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
413 |
405 |
$12K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12 |
12 |
$1K |