| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 71,460 | $60 | $4M |
| E0601 | Continuous positive airway pressure (CPAP) device | 63,120 | $30 | $1.8M |
| B4161 | Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding… | 1,680 | $840 | $1.4M |
| E2402 | Negative pressure wound therapy electrical pump, stationary or portable | 1,990 | $630 | $1.3M |
| K0001 | Standard wheelchair | 48,370 | $20 | $1.1M |
| E0470 | Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive… | 10,280 | $70 | $740.2K |
| E0562 | Humidifier, heated, used with positive airway pressure device | 74,860 | $10 | $673.7K |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | 67,010 | $10 | $670.1K |
| B4160 | Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,… | 4,930 | $120 | $591K |
| E0471 | Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive… | 2,960 | $200 | $585.7K |