| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 8 | 20 | 1,360 | $160 | $993.4K |
| B9002 | Enteral nutrition infusion pump, any type | 7 | 10 | 600 | $70 | $525.6K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 8 | 10 | 510 | $90 | $407.2K |
| S9500 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and… | 1 | 10 | 930 | $150 | $239K |
| S9347 | Home infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e.g., epoprostenol); administrative services, professional pharmacy services, care… | 1 | 10 | 450 | $170 | $74.9K |
| S9501 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and… | 1 | 10 | 360 | $200 | $72.1K |
| A4213 | Syringe, sterile, 20 cc or greater, each | 2 | 10 | 330 | $20 | $33.6K |
| B4152 | Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include… | 5 | 10 | 570 | $10 | $16.1K |