EN Modular Products

Powder

Composition	Modular Brand Name	Features	Specifics	HCPCS Code	Additional Details
Amino acids	Arginaid®, Nestle Health Science	L-arginine (4.5 g/serving)		B4155	Lactose-free, gluten-free, sugar-free, kosher
Amino acids	Argiment®, Medtrition	L-arginine (7.5 g) and L-glutamine (10 g)/serving (svg)		B4155
Amino acids	Complete Amino Acid Mix, Nutricia	Essential and non-essential amino acids; 4.1 g/svg
Amino acids	Essential Amino Acid Mix, Nutricia	Essential amino acids
Amino Acids	Single Amino Acids®, Nutricia	Individual amino acids; protien content variable
L-Glutamine	Glutasolve®, Nestlé Health Science	15g/svg		B4155	Lactose-free, gluten-free, kosher
L-Glutamine	GlutaMent®, Medtrition	10 g/svg		B4155
Collagen dipeptide	PUSH Collagen Dipeptide Concentrate, Global Health	5 g protein/svg	Contains pineapple and sucralose	Not billable
Hydrolyzed collagen	Juven®, Abbott	Contains arginine (7 g/svg), glutamine (7 g/svg), beta-hydrox-beta-methyl-butyrate, zinc, vitamins C, E and B12; 2.5 g protein/svg		B4155
Whey protein	Beneprotein®, Nestlé Health Science	6 g protein/svg	Contains milk and soy	B4155	Gluten-free, suitable for lactose intolerance, kosher
Whey protein	Active® Protein powder, Medline	6 g protein/svg
Whey protein	ProCel® Protein powder, Whey, unflavored, Global Health	5 g protein/svg	Contains lactose and soy	B4155
Whey protein	RenaMent®, Medtrition	10 g protein/svg; low sodium, potassium and phosphorous	Contains milk	B4155
Whey protein	Vital Cuisine® ProPass®, Hormel	6 g protein/svg	Contains lactose and soy
Whey and casein protein	ProSource® Protein Powder, Medtrition	6 g protein/svg	Contins milk and soy	B4155
Whey protein/amino acids	Argiment® AT, Medtrition	Contains a prebiotic, arginine , glutamine, zinc, copper and vitamin C; 10 g protein/svg	Contains milk	B4155
Whey protein/arginine	Argitein®, Medtrition	5 g protein/svg; 4.5 g L-arginine/svg	Contains milk	B4155	Sugar-free
Prebiotic and probiotic	Diff-Stat®, Nutricia	Fructo-oligosaccharides; saccharomyces boulardii, bacillus coagulans	Contains milk and sucralose	No code
Soluble fiber	Banatrol® Plus with Prebiotic, Medline	Banana flakes; 2 g/svg; prebiotics		B4104
Soluble fiber	FiberCel® Fiber Powder, Global Health	5 g fiber/svg		B4155	Lactose-free, gluten-free
Soluble fiber	Nutrisource® Fiber, Nestlé Health Science	Partially hydrolyzed guar gum, 3 g/svg		B4104	Lactose-free, gluten-free, suitable for a low FODMAP (Fermentable Oligo-, Di-, Mono-saccharides And Polyols) diet, kosher
Soluble fiber	Vital Cuisine® Fiber Basics®, Hormel	3 g fiber/svg
Soluble fiber/transgalacto-oligosaccharide	Banatrol Plus®, Medtrition	Banana flakes; 2 g fiber/svg; transalacto-oligosaccharide	Contains milk	B4104
Transgalacto-oligosaccharide	FloraFuel®, Medtrition	Transgalacto-oligosaccharide, soluble fiber, 3 g/svg	Contains milk	B4105
Vitamins/minerals	Phlexy-Vits®, Nutricia	Multi vitamin and mineral supplement
Vitamins/minerals	VitaMent®, Medtrition	Multi vitamin and mineral supplement		B9153
	UtyMax®, Medtrition	Cranberry concentrate	Contains sucralose	B4101
Energy and protein	RenaMent®, Medtrition	Whey protein 10 g and 230 kcals/svg	Contains milk	B4155
Protein-free energy	DuoCal®, Nutricia	492 kcals/100 g
Glucose polymers	Polycal, Nutricia

Liquid

Composition	Modular Brand Name	Features	Specifics	HCPCS Code	Additional Details
Lipid	Microlipid™, Nestlé Health Science	67.5 kcals, 7.5g fat/15 mL	Contains soy ingredient	B4155	Lactose-free, gluten-free, kosher
Lipid	MCT Oil®, Nestlé Health Science	115 kcals,14g fat/15 mL	No soy	B4155	Lactose-free, gluten-free, kosher
Energy and Protein	Benecalorie®, Nestlé Health Science	330 kcal & 7 g protein/1.5 fl oz svg, vitamins C & E	Contains milk and sucralose	B4155	Gluten-free, suitable for lactose intolerance, kosher
L-Arginine	Vital Cuisine® L-Emental®, Hormel	Antioxidants and zinc; 4.5 g arginine/svg
Collagen/amino acids	ProSource® TF, Medtrition	11 g protein/svg		B4155	Lactose-free, gluten-free
Hydrolyzed collagen	Liquacel® Liquid Protein, Global Health	Contains arginine;16 g protein/svg		B4155
Hydrolyzed collagen	ProMod®, Abbott	10 g protein/svg		B4155	Lactose-free, gluten-free
Hydrolyzed collagen	Pro-Stat® Renal Care, Nutricia	15 g protein/svg; contains fructo-oligosaccharides 3 g/svg	Contains sucralose	B4155	Sugar-free
Hydrolyzed collagen	Pro-Stat® Sugar Free, Nutricia	15 g protein/svg	Contains sucralose	B4155	Sugar-free
Hydrolyzed collagen	Pro-Stat® Sugar Free AWC, Nutricia	17 g protein/svg; contains arginine, citrulline and cysteine	Contains sucralose	B4155	Sugar-free
Hydrolyzed collagen	ProT Gold, OP2 Labs	17.5 g protein/svg; added arginine, cysteine, glutamine, histidine, methionine, taurine and tryptophan	Contains sucralose	B4155
Hyrdrolyzed collagen/whey protein	Active® Liquid Protein, Regular and Sugar Free, Medline	16 g protein/svg		B4155	Lactose-free, gluten-free
Hydrolyzed collagen/whey protein	Active® Liquid Protein, sugar-free, Critical Care, Medline	Contains arginine, zinc and vitamin C;21 g protein/svg		B4155
Hydrolyzed collagen/whey protein	Active® TF Enteral Liquid Protein Nutritional Supplement, Medline	11 g protein/svg		B4155	Sugar-free, Lactose-free, gluten-free
Hydrolyzed collagen/whey protein	ProHeal® Critical Care, DermaRite	17 g protein/svg; contains arginine and vitamin C		B4155
Hydrolyzed collagen/whey protein	ProHeal® Liquid Protein, DermaRite	15 g protein/svg		B4155	Sugar-free; lactose-free and gluten-free
Hydrolyzed collagen/whey protein	ProSource® NoCarb, Medtrition	15 g/svg; no carbohydrate	Contains milk	B4155
Hydrolyzed collagen/whey protein	ProSource® Plus, Medtrition	15 g protein/svg	Contains milk	B4155
Hydrolyzed collagen/whey protein/arginine	ProSource® ZAC, Medtrition	21 g protein/svg w/3.2 g arginine; contains vitamine C and zinc	Contains milk, sucralose and acesulfame	B4155	Sugar-free
Hydrolyzed collagen/whey protein/medium chain triglycerides	XtraCal Plus, Medtrition	14 g protein/svg; 230 kcals/svg	Contains milk	B4155
Hydrolyzed whey	Pro-Stat® MAX, Nutricia	11 g protein/svg		B4155	Sugar-free
Glucose polymers	Polycal®, Nutricia	18.6 carbohydrateg/svg		B4155
Medium chain triglyderides	Liquigen®, Nutricia	Medium chain triglyceride oil; 15 g/oz		B4155
Soluble fiber	FiberHeal®, DermaRite	15 g fiber/svg; contains fructo-oligosaccharides
Soluble fiber	Fiber Stat®, Nutricia	15 g fiber/svg; fructo-oligosaccharides		B4104
Soluble fiber	HyFiber®, Medtrition	12 g fibersvg; contains fructo-oligosaccharides		B4104
	UTIHeal®, DermaRite	Cranberry concentrate, vitamins C and D, fructo-oligosaccharides
	UTI-Stat®, Nutricia	Cranberry concentrate, vitamin C, fructo-oligosaccharides	Contains sucralose and acesulfame	B4104