| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 2,730 | $280 | $775.6K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 5,410 | $100 | $524.6K |
| 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… | 770 | $460 | $355.3K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 12,870 | $30 | $347.4K |
| 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,… | 2,240 | $140 | $304.6K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 470 | $30 | $14.9K |
| 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… | 30 | $190 | $5.7K |
| T1999 | Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" | 310 | $10 | $4.3K |
| B9002 | Enteral nutrition infusion pump, any type | 30 | $100 | $3K |
| A4213 | Syringe, sterile, 20 cc or greater, each | 2,660 | $1 | $2.7K |