| 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… | 2,100 | $1,110 | $2.3M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 4,860 | $200 | $972K |
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 1,490 | $620 | $929.8K |
| E0445 | Oximeter device for measuring blood oxygen levels non-invasively | 9,330 | $80 | $737.1K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 3,850 | $140 | $543.3K |
| B9002 | Enteral nutrition infusion pump, any type | 7,780 | $70 | $537K |
| E0424 | Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing | 2,940 | $180 | $513.8K |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 930 | $360 | $332.4K |
| A4624 | Tracheal suction catheter, any type other than closed system, each | 4,200 | $70 | $272.7K |
| 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,… | 1,350 | $200 | $267.9K |