| 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… | 10,110 | $30 | $303.2K |
| B4154 | Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or… | 6,160 | $50 | $301.7K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 12,470 | $20 | $236.9K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 5,470 | $20 | $87.5K |
| A4554 | Disposable underpads, all sizes | 1,140 | $40 | $44.3K |
| A4314 | Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) | 9,530 | $1 | $38.1K |
| 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… | 760 | $50 | $35.7K |
| A4414 | Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each | 2,560 | $10 | $30.7K |
| A5063 | Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each | 2,160 | $10 | $28.1K |
| T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | 500 | $50 | $27.2K |