| 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… | 5 | 10 | 4,070 | $520 | $2.1M |
| B9998 | Noc for enteral supplies | 4 | 10 | 8,890 | $190 | $2M |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 5 | 10 | 2,840 | $410 | $1.5M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 5 | 20 | 920 | $230 | $1.4M |
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 2 | 10 | 1,020 | $800 | $1.3M |
| A9999 | Miscellaneous dme supply or accessory, not otherwise specified | 3 | 10 | 410 | $230 | $1M |
| S8189 | Tracheostomy supply, not otherwise classified | 3 | 10 | 1,380 | $220 | $726.4K |
| E0482 | Cough stimulating device, alternating positive and negative airway pressure | 3 | 10 | 2,350 | $330 | $722.6K |
| E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | 8 | 20 | 530 | $490 | $707.8K |
| B4153 | Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 4 | 10 | 870 | $630 | $641.9K |