| Q5103 | Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg | 2 | 10 | 1,700 | $3,190 | $5.4M |
| S9342 | Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits… | 1 | 10 | 67,550 | $20 | $1.6M |
| 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 | 10 | 1,990 | $650 | $1.3M |
| B4185 | Parenteral nutrition solution, not otherwise specified, 10 grams lipids | 1 | 10 | 2,730 | $200 | $551K |
| 99601 | The provider visits the patient at home to provide an infusion or administer a specialty drug. Use this code for up to the first two hours of a visit. | 1 | 10 | 1,150 | $120 | $379.7K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 9 | 10 | 5,520 | $60 | $343.4K |
| 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,… | 1 | 10 | 760 | $270 | $311.8K |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 1 | 10 | 870 | $260 | $228.6K |
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 2 | 10 | 220 | $910 | $206.1K |
| 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… | 2 | 10 | 610 | $170 | $157.5K |