109 PEDIASURE ® 1.5 CAL WITH FIBER HCPCS Code B4160 www.AbbottNutrition.com PediaSure ® 1.5 Cal with Fiber Ingredients Vanilla Water, Corn Maltodextrin, Blend of Vegetable Oils (High Oleic Safflower, Soy, Medium Chain Triglycerides), Milk Protein Concentrate, Soy Protein Isolate, Short-chain Fructooligosaccharides, Less than 0.5% of: Vitamins & Minerals (Potassium Citrate, Potassium Chloride, Magnesium Phosphate, Calcium Phosphate, Ascorbic Acid, Choline Chloride, Calcium Carbonate, Potassium Phosphate, Ferrous Sulfate, dl-Alpha- Tocopheryl Acetate, Zinc Sulfate, Niacinamide, Calcium Pantothenate, Manganese Sulfate, Thiamine Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Vitamin A Palmitate, Copper Sulfate, Folic Acid, Chromium Chloride, Potassium Iodide, Sodium Molybdate, Sodium Selenate, Biotin, Phylloquinone, Vitamin D3, Vitamin B12), Oat Fiber, Natural & Artificial Flavors, Soy Fiber, Cellulose Gel, Soy Lecithin, Tuna Oil † , Monoglycerides, Cellulose Gum, Potassium Hydroxide, Carrageenan, Inositol, Taurine, Sucralose, Salt, L-Carnitine, Lutein. † Source of DHA. Contains milk and soy ingredients. Nutrition Information Vanilla 8 fl oz 1 L 1.5 L Protein, g 14 59 89 Total Fat, g 16 68 101 Saturated Fat, g 3.5 14 21 Polyunsaturated Fat, g 5 20 30 Monounsaturated Fat, g 7 30 45 Trans Fat, g 0 0 1 Cholesterol, mg 10 40 60 Total Carbohydrate, g 39 166 249 Dietary Fiber, g 3 13 19 scFOS, g 1.7 7 10.8 Total Sugars, g 3 11 17 Added Sugars, g 3 10 15 L-Carnitine, mg 4.0 17 25 Taurine, mg 18 76 114 Water, mL 185 780 1170 Calories 350 1500 2250 Vitamin A, mcg RAE 140 590 884 Vitamin D, mcg 6.0 25 38 Vitamin E, mg 3.0 13 19 Vitamin K, mcg 18 76 114 Vitamin C, mg 23 97 146 Folate, mcg DFE 60 253 380 Folic Acid, mcg 36 152 227 Vit B1 (Thiamin), mg 0.3 1.3 2 Vit B2 (Riboflavin), mg 0.33 1.4 2 Vitamin B6, mg 0.34 1.4 2 Vitamin B12, mcg 0.48 2.0 3.0 Niacin, mg NE 3.2 14 20 Choline, mg 80 338 507 Biotin, mcg 8.0 34 51 Pantothenic Acid, mg 1.3 5.5 8 Inositol, mg 20 84 127 Vanilla 8 fl oz 1 L 1.5 L Sodium, mg 90 380 570 Sodium, mEq 3.9 16.5 25 Potassium, mg 470 1980 2970 Potassium, mEq 12.1 51 76 Chloride, mg 230 970 1455 Chloride, mEq 6.5 27 41 Calcium, mg 330 1390 2085 Calcium, mEq 16.5 70 104 Phosphorus, mg 250 1050 1575 Magnesium, mg 40 169 254 Magnesium, mEq 3.3 14 21 Iodine, mcg 23 97 146 Manganese, mg 0.46 1.9 3 Copper, mg 0.14 0.59 1 Zinc, mg 1.7 7.2 11 Iron, mg 2.7 11 17 Selenium, mcg 8.0 34 51 Chromium, mcg 9.0 38 57 Molybdenum, mcg 9.0 38 57 Free Water, % 78.2 78 78 Vanilla Caloric Density, Cal/mL 1.5 Protein, % Cal 16 Carbohydrate, % Cal 43 Fat, % Cal 41 Omega-6:Omega-3* 10:1* MCT:LCT 10:90 Total Cal:g Nitrogen 158:1 Nonprotein Cal:g Nitrogen 133:1 Osmolality, mOsm/kg H2O 425 Renal Solute Load, mOsm/L 413 (PRSL) Recommended Tube Size for Gravity/Pump Feeding (Fr) 10/10 Technical Data * Product contains DHA (32 mg DHA/8 fl oz).