| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 7 | 10 | 740 | $180 | $1.3M |
| 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… | 3 | 10 | 860 | $310 | $1.1M |
| B9002 | Enteral nutrition infusion pump, any type | 4 | 10 | 5,350 | $30 | $983.8K |
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 2 | 10 | 320 | $620 | $598K |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 3 | 10 | 880 | $240 | $588.4K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 8 | 50 | 2,950 | $50 | $530.1K |
| 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,… | 2 | 10 | 990 | $110 | $419.9K |
| 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… | 5 | 10 | 1,430 | $110 | $318.9K |
| A4351 | Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each | 3 | 10 | 1,760 | $120 | $308.9K |
| T4523 | Adult sized disposable incontinence product, brief/diaper, large, each | 5 | 10 | 1,830 | $100 | $270.4K |