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Polymeric; Standard Volume | Polymeric; Concentrated Volume | Hydrolyzed; Standard Volume

Hydrolyzed; Concentrated Volume | Hydrolyzed; Blenderized | Elemental | Blenderized

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Polymeric; Standard Volume

Composition  Formula Brand Name, Manufacturer Features  Specifics HCPCS Code Additional Details Contains Immune Nutrients
Food Ingredients Compleat®, Nestlé Standard B4149 Gluten-Free, no soy, suitable for lactose intolerance No
Soy Protein Diabetisource AC®, Nestlé Low carbohydrate with fiber from fruits and vegetables Contains soy, no milk protein B4154 Kosher, Gluten-Free, Lactose free Yes
Milk and Soy Protein  Fibersource HN®, Nestlé High protein with fiber Contains soy B4150 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk Protein Glucerna 1.0 Cal®, Abbott Low carbohydrate with fiber Contains soy B4154 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Glucerna 1.2 Cal®, Abbott Low carbohydrate Contains soy B4154 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk Protein Impact®, Nestlé Modulating Inflammation/High Protein without fiber Contains soy B4154 Kosher, Halal, Gluten-Free, suitable for lactose intolerance Yes
Milk and Soy Protein  Isosource HN®, Nestlé High protein without fiber Contains soy B4150 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Jevity 1.0 Cal®, Abbott Standard with fiber Contains soy B4150 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Jevity 1.2 Cal®, Abbott Standard with fiber Contains soy B4150 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Nutren 1.0®, Nestlé Standard without fiber Contains soy B4150 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Nutren 1.0 Fiber®, Nestlé Standard with fiber Contains soy B4150 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Osmolite 1.0 Cal®, Abbott Standard without fiber Contains soy B4150 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk Protein Osmolite 1.2 Cal®, Abbott Standard without fiber Contains soy B4150 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Promote®, Abbott  High protein without fiber Contains soy B4150 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Promote with Fiber®, Abbott High protein with fiber Contains soy B4150 Kosher, Gluten-Free, suitable for lactose intolerance No
Pea protein Kate Farms Standard 1.0 (chocolate or vanilla), Kate Farms Standard- plant based B4150 Lactose-free, Vegan, plant-based, gluten-free, no soy, no corn, no peanuts, no tree nuts, Organic, Non-GMO, Kosher Yes

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Polymeric; Concentrated Volume

Composition  Formula Brand Name, Manufacturer Features  Specifics HCPCS Code Additional Details Contains Immune Nutrients
Milk and Soy Protein  Glucerna® 1.5 Cal, Abbott Low carbohydrate/
Concentrated		 Contains soy B4154 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Isosource® 1.5 Cal, Nestlé With fiber Contains soy B4152 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Jevity® 1.5 Cal, Abbott Concentrated with fiber Contains soy B4152 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk Protein Nepro® with CARBSTEADY®, Abbott High protein with fiber/
Low phosphorous, potassium and sodium		 Contains soy B4154 Kosher, Halal(certain flavors), Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Novasource® Renal, Nestlé High Protein without fiber/
Low phosphorous, potassium, sodium and magnesium		 Contains soy B4154 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Nutren® 1.5, Nestlé Without fiber Contains soy B4152 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Nutren® 2.0, Nestlé Without fiber Contains soy B4152 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk and Soy Protein  Osmolite® 1.5 Cal, Abbott Concentrated without fiber Contains soy B4152 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk Protein Pulmocare®, Abbott Low carbohydrate/
Increased fat without fiber		 Contains soy B4154 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Pea protein Kate Farms Standard 1.4, Kate Farms Concentrated plant based B4152 Lactose-free, Vegan, plant-based, gluten-free, no soy, no corn, no peanuts, no tree nuts, Organic, Non-GMO, Kosher Yes
Milk Protein Suplena® with CARBSTEADY®, Abbott Low protein with fiber/
Low phosphorous, potassium and sodium		 Contains soy B4154 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No
Milk Protein TwoCal® HN, Abbott Contains soy B4152 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No

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Hydrolyzed; Standard Volume

Composition  Formula Brand Name, Manufacturer Features  Specifics HCPCS Code Additional Details Contains Immune Nutrients
Organic Pea protein Peptide 1.0, Kate Farms Hydrolyzed pean protein, contains fiber B4153 Lactose-free, Vegan, plant-based, gluten-free, no soy, no corn, no peanuts, no tree nuts, Organic, Non-GMO, Kosher
Whey Protein Peptamen®, Nestlé High percentage small peptides 70% of fat from MCT, no added fiber  Contains soy B4153 Gluten-Free, suitable for lactose intolerance No
Whey Protein Peptamen AF®, Nestlé Modulating Inflammation/
High Protein with fiber		 Contains soy B4153 Gluten-Free, suitable for lactose intolerance Yes 
Whey Protein Peptamen® Intense VHP, Nestlé Modulating Inflammation/
Very High Protein with fiber		 Contains soy B4153 Gluten-Free, suitable for lactose intolerance Yes 
Whey Protein Peptamen® with Prebio1TM, Nestlé High Protein/70% of fat from MCT and with fiber Contains soy B4153 Gluten-Free, suitable for lactose intolerance No
Milk Protein Perative®, Abbott High Protein/
Contains Arginine		 Contains soy B4153 Kosher, Halal, Gluten-Free, suitable for lactose intolerance Yes
Milk Protein Vital® 1.0 Cal, Abbott B4153 Gluten-Free, suitable for lactose intolerance Yes
Milk Protein Vital® AF 1.2 Cal, Abbott Modulating Inflammation/
Increased Protein		 B4153 Gluten-Free, suitable for lactose intolerance Yes
Milk Protein Vital® HP, Abbott Modulating Inflammation/
High Protein without fiber		 B4153 Gluten-Free, suitable for lactose intolerance Yes

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Hydrolyzed; Concentrated Volume

Composition  Formula Brand Name, Manufacturer Features  Specifics HCPCS Code Additional Details Contains Immune Nutrients
Milk Protein Impact® Peptide 1.5, Nestlé Modulating Inflammation/
High Protein		 Contains soy B4153 Gluten-Free, suitable for lactose intolerance Yes
Organic Pea Protein Peptide 1.5, Kate Farms Hydrolyzed pea protein, contains fiber B5153 Lactose-free, Vegan, plant-based, gluten-free, no soy, no corn, no peanuts, no tree nuts, Organic, Non-GMO, Kosher
Whey Protein Peptamen® 1.5, Nestlé 70% of fat from MCT  Contains soy B4153 Gluten-Free, suitable for lactose intolerance No
Pea protein Compleat® Peptide 1.5, Nestlé hydrolyzed pea protein and MCT oil, contains fiber B4153 Gluten-Free, no soy, suitable for lactose intolerance, Non-GMO No
Whey Protein Peptamen® 1.5 with PrebioTM, Nestlé 70% of fat from MCT and with fiber Contains soy B4153 Gluten-Free, suitable for lactose intolerance No
Pea protein Peptide 1.5® (plain), Kate Farms Plant based B4153 Lactose-free, Vegan, Plant-based, gluten-free, no corn, no nuts, no soy, Organic, Non-GMO, Kosher  No
Milk Protein Pivot® 1.5, Abbott Modulating inflammation/
High Protein		 Contains soy B4153 Halal, Gluten-Free, suitable for lactose intolerance Yes
Milk Protein Renalcal®, Nestlé Very low protein withour fiber/
Low phosphorous, potassium and magnesium		 B4154 Kosher, Gluten-Free, suitable for lactose intolerance No
Milk Protein Vital® 1.5 Cal, Abbott B4153 Gluten-Free, suitable for lactose intolerance No
Milk Protein Vital® Peptide 1.5 Cal, Abbott B4161 Kosher, Halal, Gluten-Free, suitable for lactose intolerance No

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Hydrolyzed; Blenderized

Composition  Formula Brand Name, Manufacturer Features  Specifics HCPCS Code Additional Details Contains Immune Nutrients
Organic Hydrolyzed Pea Protein Liquid Hope Peptide, Functional Formularies Whole food, hydrolyzed pea protein with MCT oil, contains fiber B4153 Organic, Gluten-free, dairy free, no soy, no corn, Non-GMO, plant-based, suitable for lactose intolerance
Organic Hydrolyzed Pea Protein Liquid Hope® Peptide High Protein, Functional Formularies Contains fiber, contains MCT, plant-based B4153 Gluten-Free, Dairy-Free, Organic, Non-GMO, no corn, no soy  No

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Elemental 

Composition  Formula Brand Name, Manufacturer Features  Specifics HCPCS Code Additional Details Contains Immune Nutrients
100% Free AA Tolerex®, Nestlé Low fat/low protein, fiber free, powder B4153 Kosher, Gluten-Free, Lactose-Free No
100% Free AA Vivonex® Plus, Nestlé Low fat/Fiber Free, contains BCAA's, powder Contains soy B4153 Kosher, Gluten-Free, Lactose-Free No
100% Free AA Vivonex® RTF, Nestlé Low fat/fiber free B4153 Kosher, Gluten-Free, Lactose-Free No
100% Free AA Vivonex® T.E.N., Nestlé Low Fat/fiber free, powder B4153 Kosher, Gluten-Free, Lactose-Free No

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Blenderized

Composition  Formula Brand Name, Manufacturer Features  Specifics HCPCS Code Additional Details Contains Immune Nutrients
Blenderized-whole foods Compleat Organic Blends® Chicken Garden Blend or Plant Based, Nestlé Standard B4149 (pending) Gluten-Free, Lactose-Free, Organic, Non-GMO, no dairy, no soy, no corn No
Blenderized -whole foods Compleat Organic Blends® Plant Based, Nestlé Standard B4149 (pending) Gluten-Free, Lactose-Free, Organic, Non-GMO, no dairy, no soy, no corn, plant-based No
Blenderized - whole foods Liquid Hope®, Functional Formularies B4149 Organic, Gluten-free, dairy free, no soy, no corn, Non-GMO, plant-based, suitable for lactose intolerance No
Blenderized - whole foods Real Food Blends® -Orange Chicken, Carrots, and Brown, RiceReal Food Blends® B4149 Free from soy, corn, dairy, peanuts No
Blenderized - whole foods Real Food Blends® - Salmon, Oats, and Squash, RiceReal Food Blends® B4149 Free from soy, corn, dairy, peanuts.  Oats are gluten-free No
Blenderized - whole foods Real Food Blends® - Quinoa, Kale and Hemp, RiceReal Food Blends® B4149 Free from soy, corn, dairy, peanuts No
Blenderized - whole foods Real Food Blends® - Beef, Potatoes, and Spinach, RiceReal Food Blends® B4149 Free from soy, corn, dairy, peanuts No
Blenderized - whole foods Real Food Blends®- Eggs, Apples, and Oats, RiceReal Food Blends® B4149 Free from soy, corn, dairy, peanuts.  Oats are gluten-free No
Blenderized - whole foods Real Food Blends® - Turkey, Sweet Potatoes, and Peaches, RiceReal Food Blends® B4149 Free from soy, corn, dairy, peanuts.  Oats are gluten-free No
Blenderized-dehydrated foods Kale, Quinoa & Berries, Whole Story Meals Powdered form; protein from sunflower seeds, flax seeds,  and rice protein. B4149 Vegan, Gluten free, Soy Free, Dairy Free, Egg Free, Corn Free, Lactose Free. No
Blenderized-dehydrated foods Chicken, Peas & Carrots, Whole Story Meals powdered form B4149 Gluten free, Soy Free, Dairy Free, Egg Free, Corn Free, Lactose Free. No
Blenderized - dehydrated foods Restore - Renal Support, Whole Story Meals Low in protein, potassium, phosphorus, and sodium.  Plant-based with protein from millet, sunflower seeds, and flaxseeds.  Contains fiber. B4149 Gluten-Free, Soy-Free, Dairy-Free, Egg-Free, Corn-Free, Lactose-Free. No

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