| 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… | 16,900 | $120 | $1.9M |
| T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | 17,620 | $90 | $1.5M |
| T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | 15,080 | $90 | $1.4M |
| B4154 | Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or… | 13,040 | $80 | $990.8K |
| T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | 8,910 | $110 | $962.3K |
| T4523 | Adult sized disposable incontinence product, brief/diaper, large, each | 8,340 | $100 | $859.4K |
| T4541 | Incontinence product, disposable underpad, large, each | 25,010 | $30 | $850.4K |
| A4927 | Gloves, non-sterile, per 100 | 26,180 | $30 | $654.5K |
| 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… | 4,350 | $120 | $517.1K |
| T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | 11,820 | $40 | $508.4K |