Composition |
Formula Brand Name |
Specifics |
HCPCS code |
Additional Details |
Food Ingredients |
Compleat® Pediatric Organic Blends (chicken garden blend), Nestlé |
Organic, non-GMO, no dairy, soy, corn, fortified with a vitamin/mineral to be complete nutrition |
B4149 |
Gluten-free, lactose |
Food Ingredients |
Compleat® Pediatric Organic Blends (plant based), Nestlé |
Organic, non-GMO, no dairy, soy, corn, fortified with a vitamin/mineral to be complete nutrition |
B4149 |
Gluten-free, lactose, vegan |
Food Ingredients |
Compleat® Pediatric Original Reduced Calorie 0.6, Nestlé |
Reduced calorie, non-GMO, no corn or soy, soluble and insolulble fiber |
B4149 |
Gluten-free, suitable for lactose intolerance |
Food Ingredients |
Compleat® Pediatric Original 1.0, Nestlé |
Non-GMO, no corn or soy, soluble and insolulble fiber |
B4149 |
Gluten-free, suitable for lactose intolerance |
Food Ingredients |
Compleat® Pediatric Standard 1.0, Nestlé |
Non-GMO, no dairy, soy, corn, nut |
B4160 |
Dairy, lactose, gluten free, plant-based, vegan, kosher |
Food Ingredients |
Compleat® Pediatric Standard 1.4, Nestlé |
Non-GMO, no dairy, soy, corn, nut |
B4160 |
Dairy, lactose, gluten free, plant-based, vegan, kosher |
Food Ingredients |
Nourish, Functional Formularies® |
Organic, vegan, no dairy, no nuts, no soy, no corn |
B4149 |
Gluten-free, lactose |
Food Ingredients |
PediaSure Harvest®, Abbott |
No milk, gluten, lactose, eggs, treenuts, peanuts, wheat, shellfish, or fish-containing ingredients, contains soy |
B4149 |
Gluten-free, suitable for lactose intolerance |
Food Ingredients |
Pediatric Blended Meals -Mango and Straw, Kate Farms® |
No milk, eggs, fish, shellfish,treenuts, peanuts, wheat, soybean or sesame |
|
Gluten-free, lactose-free, plant-based, vegan |
Food Ingredients |
Pediatric Blended Meals - Squash and Carrot, Kate Farms® |
No milk, eggs, fish, shellfish,treenuts, peanuts, wheat, soybean or sesame |
|
Gluten-free, lactose-free, plant-based, vegan |
Food Ingredients |
Pediatric Blended Meals - Banana and Blue, Kate Farms® |
No milk, eggs, fish, shellfish,treenuts, peanuts, wheat, soybean or sesame |
|
Gluten-free, lactose-free, plant-based, vegan |
Food Ingredients |
Real Food Blends® -Orange Chicken, Carrots, and Brown Rice, Real Food Blends® |
Free from soy, corn, dairy, peanuts, and artificial color/flavor |
B4149 |
|
Food Ingredients |
Real Food Blends® - Salmon, Oats, and Squash, Real Food Blends® |
Free from soy, corn, dairy, peanuts, and artificial color/flavor |
B4149 |
Gluten Free |
Food Ingredients |
Real Food Blends® - Quinoa, Kale and Hemp, Real Food Blends® |
Free from soy, corn, dairy, peanuts, and artificial color/flavor |
B4149 |
|
Real food ingredients |
Real Food Blends® - Beef, Potatoes, and spinach, Real Food Blends® |
Free from soy, corn, dairy, peanuts, and artificial color/flavor |
B4149 |
|
Food ingredients |
Real Food Blends®- Eggs, Apples, and Oats, Real Food Blends® |
Free from soy, corn, dairy, peanuts, and artificial color/flavor |
B4149 |
Gluten Free |
Food Ingredients |
Real Food Blends® - Turkey, Sweet Potatoes, and Peaches, Real Food Blends® |
Free from soy, corn, dairy, peanuts, and artificial color/flavor |
B4149 |
|
Organic Pea Protein |
Nourish Peptide, Functional Formularies® |
Organic, vegan, no dairy, no nuts, no soy, no corn |
B4149 |
Free of tree nuts, gluten, dairy, soy, corn and BPAs. |
Organic Pea Protein |
Nourish Peptide - Berry Medley, Functional Formularies® |
Organic, vegan, no dairy, no nuts, no soy, no corn, 8grams prebiotic vegetable fiber |
B4149 |
Free of gluten, dairy, soy, corn and BPAs. |
Organic Pea Protein; Food Ingredients |
Compleat® Pediatric Peptide 1.5, Nestlé |
Plant-based, non-GMO, MCT, soluble, insoluble fiber, no dairy, soy, nut corn |
B4161 |
Non-GMO, Vegan, Dairy-free, Lactose-free, Gluten free, Plant-Based, Kosher |
Organic Pea Protein; Food Ingredients |
Compleat® Pediatric Peptide 1.0, Nestlé |
Plant-based, non-GMO, MCT, soluble, insoluble fiber, no dairy, soy, nut corn |
B4161 |
Non-GMO, Vegan, Dairy-free, Lactose-free, Gluten free, Plant-Based, Kosher |