| T4534 | Youth sized disposable incontinence product, protective underwear/pull-on, each | 20,290 | $110 | $2.2M |
| 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,… | 11,830 | $150 | $1.7M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 5,800 | $290 | $1.7M |
| 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… | 1,890 | $620 | $1.2M |
| T4530 | Pediatric sized disposable incontinence product, brief/diaper, large size, each | 10,640 | $80 | $861.9K |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 1,450 | $460 | $664.6K |
| B9002 | Enteral nutrition infusion pump, any type | 9,790 | $70 | $645.9K |
| T4525 | Adult sized disposable incontinence product, protective underwear/pull-on, small size, each | 6,190 | $100 | $644.2K |
| B4150 | Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100… | 3,790 | $140 | $545.2K |
| T4521 | Adult sized disposable incontinence product, brief/diaper, small, each | 6,290 | $80 | $496.7K |