| 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… | 35,170 | $500 | $17.6M |
| 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,… | 47,440 | $170 | $8M |
| T4534 | Youth sized disposable incontinence product, protective underwear/pull-on, each | 26,560 | $130 | $3.5M |
| T4530 | Pediatric sized disposable incontinence product, brief/diaper, large size, each | 22,910 | $120 | $2.8M |
| B4154 | Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or… | 18,210 | $110 | $2.1M |
| T4532 | Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each | 14,450 | $140 | $2M |
| 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… | 15,890 | $120 | $2M |
| 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… | 14,040 | $130 | $1.8M |
| T4522 | Adult sized disposable incontinence product, brief/diaper, medium, each | 12,070 | $100 | $1.2M |
| T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | 20,990 | $60 | $1.2M |