| 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… | 7 | 10 | 750 | $440 | $1.1M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 11 | 20 | 2,410 | $130 | $1.1M |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 9 | 10 | 1,540 | $310 | $655.5K |
| T4522 | Adult sized disposable incontinence product, brief/diaper, medium, each | 9 | 10 | 990 | $80 | $551.9K |
| 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,… | 9 | 20 | 1,260 | $130 | $442.9K |
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 4 | 10 | 130 | $560 | $361.6K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 1 | 140 | 5,290 | $40 | $300.2K |
| E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | 6 | 30 | 530 | $230 | $286.9K |
| B9002 | Enteral nutrition infusion pump, any type | 11 | 20 | 1,440 | $80 | $239.4K |
| 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… | 13 | 20 | 1,000 | $70 | $169.2K |