| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 25 | 30 | 2,590 | $110 | $1.4M |
| E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | 20 | 40 | 860 | $450 | $660.3K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 7 | 200 | 1,950 | $90 | $492K |
| 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… | 20 | 30 | 1,310 | $110 | $298K |
| 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… | 26 | 30 | 1,020 | $80 | $291.3K |
| E0601 | Continuous positive airway pressure (CPAP) device | 66 | 140 | 2,000 | $50 | $209.5K |
| B9002 | Enteral nutrition infusion pump, any type | 20 | 20 | 1,020 | $70 | $125.9K |
| A7030 | Full face mask used with positive airway pressure device, each | 30 | 100 | 540 | $80 | $123.4K |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | 8 | 110 | 1,800 | $20 | $90.7K |
| E0562 | Humidifier, heated, used with positive airway pressure device | 58 | 120 | 1,690 | $20 | $84.4K |