bid preparation worksheet - enteral

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DMEPOS Competitive Bidding Program Bid Preparation Worksheet – Round 2 Estimated Capacity & Bid Amount Calculations Enteral Nutrients, Equipment and Supplies ***Please read the important information provided on page 4 before proceeding to the page(s) for a specific competitive bidding area.*** Akron, OH 4 Albany-Schenectady-Troy, NY 5 Albuquerque, NM 5 Allentown-Bethlehem-Easton, PA-NJ 6 Asheville, NC 6 Atlanta-Sandy Springs-Marietta, GA 7 Augusta-Richmond County, GA-SC 7 Austin-Round Rock-San Marcos, TX 8 Bakersfield-Delano, CA 9 Baltimore-Towson, MD 9 Baton Rouge, LA 10 Beaumont-Port Arthur, TX 10 Birmingham-Hoover, AL 11 Boise City-Nampa, ID 11 Boston-Cambridge-Quincy, MA-NH 12 Bridgeport-Stamford-Norwalk, CT 13 Bronx-Manhattan NY CBA 13 Buffalo-Niagara Falls, NY 14 Cape Coral-Fort Myers, FL 14 Central-Chicago Metro CBA 15 Charleston-North Charleston-Summerville, SC 15 Chattanooga, TN-GA 16 Colorado Springs, CO 17 Columbia, SC 17 Columbus, OH 18 Dayton, OH 18 Deltona-Daytona Beach-Ormond Beach, FL 19 Denver-Aurora-Broomfield, CO 19 Detroit-Warren-Livonia, MI 20 El Paso, TX 21 Flint, MI 21

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DMEPOS Competitive Bidding Program

Bid Preparation Worksheet – Round 2 Estimated Capacity & Bid Amount Calculations

Enteral Nutrients, Equipment and Supplies

***Please read the important information provided on page 4 before proceeding to the page(s) for a specific competitive bidding area.***

Akron, OH 4

Albany-Schenectady-Troy, NY 5

Albuquerque, NM 5

Allentown-Bethlehem-Easton, PA-NJ 6

Asheville, NC 6

Atlanta-Sandy Springs-Marietta, GA 7

Augusta-Richmond County, GA-SC 7

Austin-Round Rock-San Marcos, TX 8

Bakersfield-Delano, CA 9

Baltimore-Towson, MD 9

Baton Rouge, LA 10

Beaumont-Port Arthur, TX 10

Birmingham-Hoover, AL 11

Boise City-Nampa, ID 11

Boston-Cambridge-Quincy, MA-NH 12

Bridgeport-Stamford-Norwalk, CT 13

Bronx-Manhattan NY CBA 13

Buffalo-Niagara Falls, NY 14

Cape Coral-Fort Myers, FL 14

Central-Chicago Metro CBA 15

Charleston-North Charleston-Summerville, SC 15

Chattanooga, TN-GA 16

Colorado Springs, CO 17

Columbia, SC 17

Columbus, OH 18

Dayton, OH 18

Deltona-Daytona Beach-Ormond Beach, FL 19

Denver-Aurora-Broomfield, CO 19

Detroit-Warren-Livonia, MI 20

El Paso, TX 21

Flint, MI 21

Fresno, CA 22

Grand Rapids-Wyoming, MI 22

Greensboro-High Point, NC 23

Greenville-Mauldin-Easley, SC 23

Hartford-West Hartford-East Hartford, CT 24

Honolulu, HI 25

Houston-Sugar Land-Baytown, TX 25

Huntington-Ashland, WV-KY-OH 26

Indiana-Chicago Metro CBA 26

Indianapolis-Carmel, IN 27

Jackson, MS 27

Jacksonville, FL 28

Knoxville, TN 29

Lakeland-Winter Haven, FL 29

Las Vegas-Paradise, NV 30

Little Rock-North Little Rock-Conway, AR 30

Los Angeles County CBA 31

Louisville/Jefferson County, KY-IN 31

McAllen-Edinburg-Mission, TX 32

Memphis, TN-MS-AR 33

Milwaukee-Waukesha-West Allis, WI 33

Minneapolis-St. Paul-Bloomington, MN-WI 34

Nashville-Davidson--Murfreesboro--Franklin, TN 34

Nassau-Brooklyn-Queens-Richmond County Metro CBA 35

New Haven-Milford, CT 35

New Orleans-Metairie-Kenner, LA 36

North East NY CBA Metro 37

North Port-Bradenton-Sarasota, FL 37

Northern NJ Metro CBA 38

Northern-Chicago Metro CBA 38

Ocala, FL 39

Oklahoma City, OK 39

Omaha-Council Bluffs, NE-IA 40

Orange County CBA 41

Oxnard-Thousand Oaks-Ventura, CA 41

Palm Bay-Melbourne-Titusville, FL 42

Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 42

Phoenix-Mesa-Glendale, AZ 43

Portland-Vancouver-Hillsboro, OR-WA 43

Poughkeepsie-Newburgh-Middletown, NY 44

Providence-New Bedford-Fall River, RI-MA 45

Raleigh-Cary, NC 45

Richmond, VA 46

Rochester, NY 46

Sacramento--Arden-Arcade--Roseville, CA 47

Salt Lake City, UT 47

San Antonio-New Braunfels, TX 48

San Diego-Carlsbad-San Marcos, CA 49

San Francisco-Oakland-Fremont, CA 49

San Jose-Sunnyvale-Santa Clara, CA 50

Scranton--Wilkes-Barre, PA 50

Seattle-Tacoma-Bellevue, WA 51

South-West-Chicago-Metro CBA 51

Southern NY Metro CBA 52

Springfield, MA 53

St. Louis, MO-IL 53

Stockton, CA 54

Suffolk County CBA 54

Syracuse, NY 55

Tampa-St. Petersburg-Clearwater, FL 55

Toledo, OH 56

Tucson, AZ 57

Tulsa, OK 57

Virginia Beach-Norfolk-Newport News, VA-NC 58

Visalia-Porterville, CA 58

Washington-Arlington-Alexandria, DC-VA-MD-WV 59

Wichita, KS 59

Worcester, MA 60

Youngstown-Warren-Boardman, OH-PA 61

Product Category: Enteral Nutrients, Equipment and Supplies

Reference Data for Background Informational

Purposes Only

Reference Data for Background Informational

Purposes Only

Bidder Data(You will enter your estimated capacity and bid amount

information in DBidS on Form B)

CBA Name HCPCSCode HCPCS Code Description Definition of

a Bidding Unit

Weight (The relative market

importance of the item in the product

category based on utilization)

2010 Beneficiary Count

(Number ofunique Medicare

beneficiaries in theCBA that receivedthe product in CY

2010)

2010 Allowed Units

(Number of unitsfor the CBA and

HCPCS code paidby Medicare in CY

2010)

Bid Limit (2012 Fee

Schedule: Bidamount must

be at or belowthis amount)

Your Cost to Purchase One (1) Unit

(Should be less than your bid

amount)

Your Bid Amount

(To provide one [1] unit as described in

Definition of a Bidding Unit;

should include cost to buy unit,

overhead and profit)

Your Estimated Capacity (Number of

units you can furnish in the

CBA for one [1]year)

Akron, OH B4150

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3587957658 114 317,460 $0.67

Akron, OH B4152

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3033857693 139 446,950 $0.55

Akron, OH B4154

Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.2432066971 53 113,325 $1.21

Akron, OH B4035Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0374194643 123 22,136 $11.56

Akron, OH B4153

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0287722516 16 29,041 $1.89

Akron, OH B4034Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0142260653 132 17,335 $6.06

Akron, OH B4155

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0071919069 8 2,918 $0.94

Akron, OH B4036Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0037422180 42 7,599 $7.94

Akron, OH B4149

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0030239542 1 1 $1.56

Akron, OH E0776BA IV Pole: Item w PEN ServicesPurchase of one (1)

new unit 0.0000913782 57 36 $101.13

Akron, OH B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000644495 33 97 $35.39

Akron, OH B9002 Enteral Nutrition Infusion Pump - With AlarmPurchase of one (1)

new unit 0.0000584484 68 31 $1,216.05

Akron, OH B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000188874 11 27 $35.39

Akron, OH B4082 Nasogastric Tubing Without StyletPurchase of one (1)

new unit 0.0000011992 1 1 $15.94

This worksheet is provided to assist you with determining your bid amount and estimated capacity for each item in the product category. This information will be entered in DBidS, the online bidding system, on Form B. Your capacity is the estimated number of units that you believe you can provide in the competitive bidding area in a calendar year. All bid amounts must be bona fide (rational and feasible for you to furnish at the bid price). You must not submit a bid for an item at a loss in order to improve your chances of winning a contract. It is important for you to consider and include your cost to purchase the item, overhead, and profit when determining a bid amount for a unit. CMS will evaluate bids to verify that they are bona fide and may ask you to submit additional information, including a rationale and invoices or other documents, to validate the bid amount. Save a copy of your completed worksheet to use if CMS requests documentation to support your bid amount. Please review the Request for Bids (RFB) instructions and fact sheets for assistance with completing your bid sheet (Form B).

General Notes

* The bidding units defined in this worksheet are for bidding purposes ONLY. Please carefully review the definition of a bidding unit for each HCPCS (Healthcare Common Procedure Coding System) code and make sure you submit your bid amount correctly. Do NOT submit a rental bid amount when the definition of the bidding unit is for the purchase of a new item. The definition of a bidding unit (purchase or rental) is not necessarily an indication that this is how payment will be made for the item under the competitive bidding program.

* In all situations where a competitive bidding area (CBA) covers more than one state, the fee schedule amount for the state with the highest allowed charges (the Medicare approved amount paid for an item) for items subject to competitive bidding is used as the bid limit.

* 2010 Beneficiary Count may exceed 2010 Allowed Units because the beneficiary used the item for less than 10 months. (For bidding purposes, 10 months of rental are calculated as one unit) * Items that are currently paid on a monthly rental basis will continue to be paid on a monthly rental basis under the competitive bidding program

How Purchase Bids Will Be Converted to Rental Payments

* Capped Rental Durable Medical Equipment (DME) except power wheelchairs - single payment amount for rental months 1 - 3 based on 10 percent of purchase bids and single payment amount for rental months 4 - 13 based on 7.5 percent of purchase bids

* Power Wheelchairs - single payment amount for rental months 1 - 3 based on 15 percent of purchase bids and single payment amount for rental months 4 - 13 based on 6 percent of purchase bids * Enteral Nutrition Equipment - single payment amount for rental months 1 - 3 based on 10 percent of purchase bids and single payment amount for rental months 4 - 15 based on 7.5 percent of purchase bid

* Inexpensive or Routinely Purchased (IRP) DME - single payment amount for rental based on 10 percent of purchase of bids

The order in which HCPCS codes are presented in this worksheet is NOT NECESSARILY the order in which they will appear in Form B in DBidS. It is important that you CAREFULLY REVIEW THE DATA YOU ENTER IN DBIDS FOR ACCURACY.

DMEPOS Competitive Bidding Bid Preparation Worksheet - Round 2Estimated Capacity & Bid Amount Calculations

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Akron, OH B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Akron, OH B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Akron, OH B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Albany-Schenectady-Troy, NY B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 173 413,046 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Albany-Schenectady-Troy, NY B4152 = 1 Unit new unit 0.3033857693 72 203,347 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Albany-Schenectady-Troy, NY B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 47 124,335 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Albany-Schenectady-Troy, NY B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 190 38,357 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Albany-Schenectady-Troy, NY B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 22 41,841 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Albany-Schenectady-Troy, NY B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 89 10,916 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Albany-Schenectady-Troy, NY B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 38 9,034 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Albany-Schenectady-Troy, NY B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 17 3,148 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Albany-Schenectady-Troy, NY B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Albany-Schenectady-Troy, NY E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 125 85 $101.13Purchase of one (1)

Albany-Schenectady-Troy, NY B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 40 61 $35.39Purchase of one (1)

Albany-Schenectady-Troy, NY B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 124 56 $1,216.05Purchase of one (1)

Albany-Schenectady-Troy, NY B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 12 21 $35.39Purchase of one (1)

Albany-Schenectady-Troy, NY B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Albany-Schenectady-Troy, NY B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Albany-Schenectady-Troy, NY B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Albany-Schenectady-Troy, NY B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Albuquerque, NM B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 58 166,454 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Albuquerque, NM B4152 = 1 Unit new unit 0.3033857693 51 131,171 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Albuquerque, NM B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 26 70,243 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Albuquerque, NM B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 75 14,927 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Albuquerque, NM B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 9 19,112 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Albuquerque, NM B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 50 6,352 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Albuquerque, NM B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 12 7,442 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Albuquerque, NM B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 12 1,723 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Albuquerque, NM B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 11,615 $1.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Albuquerque, NM E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 49 28 $101.13

Purchase of one (1) Albuquerque, NM B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 4 12 $35.39

Purchase of one (1) Albuquerque, NM B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 40 19 $1,216.05

Purchase of one (1) Albuquerque, NM B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 8 24 $35.39

Purchase of one (1) Albuquerque, NM B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 55 $15.94

Purchase of one (1) Albuquerque, NM B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Albuquerque, NM B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 10 $2.45

Purchase of one (1) Albuquerque, NM B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 203 509,362 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4152 = 1 Unit new unit 0.3033857693 81 214,696 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 49 161,490 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 200 37,498 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 15 28,738 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 105 12,874 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 13 2,700 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 29 3,716 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 99 50 $101.13Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 36 69 $35.39Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 122 59 $1,216.05Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 3 7 $35.39Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Allentown-Bethlehem-Easton, PA-NJ B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Asheville, NC B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 51 108,342 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Asheville, NC B4152 = 1 Unit new unit 0.3033857693 90 225,072 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Asheville, NC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 19 40,535 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Asheville, NC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 66 7,347 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Asheville, NC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 14,030 $1.89

CBA Name HCPCSCode HCPCS Code Description Definition of

a Bidding Unit

Weight (The relative market

importance of the item in the product

category based on utilization)

2010Beneficiary

Count(Number of

unique Medicarebeneficiaries in theCBA that receivedthe product in CY

2010)

2010 AllowedUnits

(Number of unitsfor the CBA and

HCPCS code paidby Medicare in CY

2010)

Bid Limit(2012 Fee

Schedule: Bidamount must

be at or belowthis amount)

Your Cost to Purchase One (1) Unit

(Should be less than your bid

amount)

Your BidAmount

(To provide one [1] unit as described in

Definition of a Bidding Unit;

should include cost to buy unit,

overhead and profit)

Your EstimatedCapacity(Number of

units you can furnish in the

CBA for one [1]year)

Asheville, NC B4034Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0142260653 67 9,529 $6.06

Asheville, NC B4155

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0071919069 13 11,562 $0.94

Asheville, NC B4036Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0037422180 5 1,078 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, Includes

Asheville, NC B4149Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0030239542 1 1 $1.56

Asheville, NC E0776BA IV Pole: Item w PEN ServicesPurchase of one (1)

new unit 0.0000913782 50 26 $101.13

Asheville, NC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000644495 10 30 $35.39

Asheville, NC B9002 Enteral Nutrition Infusion Pump - With AlarmPurchase of one (1)

new unit 0.0000584484 50 19 $1,216.05

Asheville, NC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000188874 3 17 $35.39

Asheville, NC B4082 Nasogastric Tubing Without StyletPurchase of one (1)

new unit 0.0000011992 1 1 $15.94

Asheville, NC B4081 Nasogastric Tubing With StyletPurchase of one (1)

new unit 0.0000010696 1 1 $21.44

Asheville, NC B4083 Stomach Tube - Levine TypePurchase of one (1)

new unit 0.0000003049 1 1 $2.45

Asheville, NC B9000 Enteral Nutrition Infusion Pump - Without AlarmPurchase of one (1)

new unit 0.0000001702 1 1 $1,216.05

Atlanta-Sandy Springs-Marietta, GA B4150

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3587957658 619 1,476,817 $0.67

Atlanta-Sandy Springs-Marietta, GA B4152

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3033857693 412 1,054,818 $0.55

Atlanta-Sandy Springs-Marietta, GA B4154

Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.2432066971 476 1,097,859 $1.21

Atlanta-Sandy Springs-Marietta, GA B4035Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0374194643 948 148,684 $11.56

Atlanta-Sandy Springs-Marietta, GA B4153

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0287722516 69 122,263 $1.89

Atlanta-Sandy Springs-Marietta, GA B4034Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0142260653 484 61,738 $6.06

Atlanta-Sandy Springs-Marietta, GA B4155

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0071919069 65 15,750 $0.94

Atlanta-Sandy Springs-Marietta, GA B4036Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0037422180 69 10,369 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, Includes

Atlanta-Sandy Springs-Marietta, GA B4149Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0030239542 4 14,641 $1.56

Atlanta-Sandy Springs-Marietta, GA E0776BA IV Pole: Item w PEN ServicesPurchase of one (1)

new unit 0.0000913782 677 348 $101.13

Atlanta-Sandy Springs-Marietta, GA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000644495 36 60 $35.39

Atlanta-Sandy Springs-Marietta, GA B9002 Enteral Nutrition Infusion Pump - With AlarmPurchase of one (1)

new unit 0.0000584484 618 258 $1,216.05

Atlanta-Sandy Springs-Marietta, GA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000188874 14 29 $35.39

Atlanta-Sandy Springs-Marietta, GA B4082 Nasogastric Tubing Without StyletPurchase of one (1)

new unit 0.0000011992 1 1 $15.94

Atlanta-Sandy Springs-Marietta, GA B4081 Nasogastric Tubing With StyletPurchase of one (1)

new unit 0.0000010696 1 1 $21.44

Atlanta-Sandy Springs-Marietta, GA B4083 Stomach Tube - Levine TypePurchase of one (1)

new unit 0.0000003049 1 1 $2.45

Atlanta-Sandy Springs-Marietta, GA B9000 Enteral Nutrition Infusion Pump - Without AlarmPurchase of one (1)

new unit 0.0000001702 1 1 $1,216.05

Augusta-Richmond County, GA-SC B4150

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3587957658 134 325,282 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Augusta-Richmond County, GA-SC B4152 = 1 Unit new unit 0.3033857693 65 177,224 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Augusta-Richmond County, GA-SC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 81 220,312 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Augusta-Richmond County, GA-SC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 156 27,251 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Augusta-Richmond County, GA-SC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 6 8,650 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Augusta-Richmond County, GA-SC B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 76 10,541 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Augusta-Richmond County, GA-SC B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 32 7,127 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Augusta-Richmond County, GA-SC B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 17 3,054 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Augusta-Richmond County, GA-SC B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Augusta-Richmond County, GA-SC E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 105 62 $101.13Purchase of one (1)

Augusta-Richmond County, GA-SC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 8 9 $35.39Purchase of one (1)

Augusta-Richmond County, GA-SC B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 99 40 $1,216.05Purchase of one (1)

Augusta-Richmond County, GA-SC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 6 10 $35.39Purchase of one (1)

Augusta-Richmond County, GA-SC B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Augusta-Richmond County, GA-SC B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Augusta-Richmond County, GA-SC B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Augusta-Richmond County, GA-SC B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 206 541,961 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4152 = 1 Unit new unit 0.3033857693 157 444,203 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 148 334,896 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 241 41,820 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 17 47,179 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 173 19,598 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 41 8,844 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 82 15,209 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1,230 $1.56Purchase of one (1)

Austin-Round Rock-San Marcos, TX E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 169 98 $101.13Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 38 84 $35.39Purchase of one (1)

Austin-Round Rock-San Marcos, TX B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 141 60 $1,216.05Purchase of one (1)

Austin-Round Rock-San Marcos, TX B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 7 13 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Austin-Round Rock-San Marcos, TX B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Austin-Round Rock-San Marcos, TX B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Austin-Round Rock-San Marcos, TX B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Austin-Round Rock-San Marcos, TX B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Bakersfield-Delano, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 107 264,521 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Bakersfield-Delano, CA B4152 = 1 Unit new unit 0.3033857693 68 181,030 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Bakersfield-Delano, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 82 199,731 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bakersfield-Delano, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 167 30,116 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Bakersfield-Delano, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 25,662 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bakersfield-Delano, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 87 11,597 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Bakersfield-Delano, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 13 2,128 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bakersfield-Delano, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 5 462 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Bakersfield-Delano, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Bakersfield-Delano, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 128 68 $101.13Purchase of one (1)

Bakersfield-Delano, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 40 87 $35.39Purchase of one (1)

Bakersfield-Delano, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 112 41 $1,216.05Purchase of one (1)

Bakersfield-Delano, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 6 12 $35.39Purchase of one (1)

Bakersfield-Delano, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Bakersfield-Delano, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Bakersfield-Delano, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Bakersfield-Delano, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Baltimore-Towson, MD B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 428 1,100,450 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Baltimore-Towson, MD B4152 = 1 Unit new unit 0.3033857693 574 1,486,585 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Baltimore-Towson, MD B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 308 746,622 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Baltimore-Towson, MD B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 698 117,999 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Baltimore-Towson, MD B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 31 73,012 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Baltimore-Towson, MD B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 501 66,133 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Baltimore-Towson, MD B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 92 19,412 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Baltimore-Towson, MD B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 134 15,551 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Baltimore-Towson, MD B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1,166 $1.56Purchase of one (1)

Baltimore-Towson, MD E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 401 209 $101.13Purchase of one (1)

Baltimore-Towson, MD B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 97 177 $35.39Purchase of one (1)

Baltimore-Towson, MD B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 438 188 $1,216.05Purchase of one (1)

Baltimore-Towson, MD B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 26 51 $35.39Purchase of one (1)

Baltimore-Towson, MD B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 5 $15.94Purchase of one (1)

Baltimore-Towson, MD B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Baltimore-Towson, MD B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Baltimore-Towson, MD B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 2 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Baton Rouge, LA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 201 578,432 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Baton Rouge, LA B4152 = 1 Unit new unit 0.3033857693 118 353,808 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Baton Rouge, LA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 202 520,686 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Baton Rouge, LA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 224 38,092 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Baton Rouge, LA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 30 67,974 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Baton Rouge, LA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 260 38,772 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Baton Rouge, LA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 24 4,547 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Baton Rouge, LA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 11 1,918 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Baton Rouge, LA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Baton Rouge, LA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 200 115 $101.13Purchase of one (1)

Baton Rouge, LA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 8 22 $35.39Purchase of one (1)

Baton Rouge, LA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 129 50 $1,216.05Purchase of one (1)

Baton Rouge, LA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 3 9 $35.39Purchase of one (1)

Baton Rouge, LA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Baton Rouge, LA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Baton Rouge, LA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Baton Rouge, LA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Beaumont-Port Arthur, TX B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 81 195,500 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Beaumont-Port Arthur, TX B4152 = 1 Unit new unit 0.3033857693 53 122,804 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Beaumont-Port Arthur, TX B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 88 241,759 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Beaumont-Port Arthur, TX B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 130 22,399 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Beaumont-Port Arthur, TX B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 23,344 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Beaumont-Port Arthur, TX B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 66 8,721 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Beaumont-Port Arthur, TX B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 13 1,871 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Beaumont-Port Arthur, TX B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 8 1,021 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Beaumont-Port Arthur, TX B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Beaumont-Port Arthur, TX E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 119 69 $101.13Purchase of one (1)

Beaumont-Port Arthur, TX B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 2 5 $35.39Purchase of one (1)

Beaumont-Port Arthur, TX B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 85 33 $1,216.05Purchase of one (1)

Beaumont-Port Arthur, TX B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 1 1 $35.39Purchase of one (1)

Beaumont-Port Arthur, TX B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Beaumont-Port Arthur, TX B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Beaumont-Port Arthur, TX B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Beaumont-Port Arthur, TX B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Birmingham-Hoover, AL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 160 415,204 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Birmingham-Hoover, AL B4152 = 1 Unit new unit 0.3033857693 185 490,761 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Birmingham-Hoover, AL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 148 369,636 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Birmingham-Hoover, AL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 265 44,525 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Birmingham-Hoover, AL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 18 28,854 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Birmingham-Hoover, AL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 207 31,045 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Birmingham-Hoover, AL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 27 5,302 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Birmingham-Hoover, AL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 6 1,217 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Birmingham-Hoover, AL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 95 $1.56Purchase of one (1)

Birmingham-Hoover, AL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 199 119 $101.13Purchase of one (1)

Birmingham-Hoover, AL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 42 104 $35.39Purchase of one (1)

Birmingham-Hoover, AL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 173 72 $1,216.05Purchase of one (1)

Birmingham-Hoover, AL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 7 18 $35.39Purchase of one (1)

Birmingham-Hoover, AL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Birmingham-Hoover, AL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Birmingham-Hoover, AL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Birmingham-Hoover, AL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Boise City-Nampa, ID B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 67 187,074 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Boise City-Nampa, ID B4152 = 1 Unit new unit 0.3033857693 43 102,119 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Boise City-Nampa, ID B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 8 12,258 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Boise City-Nampa, ID B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 59 11,347 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Boise City-Nampa, ID B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 9 8,775 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Boise City-Nampa, ID B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 31 3,353 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Boise City-Nampa, ID B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 1 32 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Boise City-Nampa, ID B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 25 3,906 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Boise City-Nampa, ID B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 3,816 $1.56Purchase of one (1)

Boise City-Nampa, ID E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 59 32 $101.13Purchase of one (1)

Boise City-Nampa, ID B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 4 20 $35.39Purchase of one (1)

Boise City-Nampa, ID B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 37 18 $1,216.05Purchase of one (1)

Boise City-Nampa, ID B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 5 12 $35.39Purchase of one (1)

Boise City-Nampa, ID B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Boise City-Nampa, ID B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Boise City-Nampa, ID B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Boise City-Nampa, ID B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 683 1,946,813 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4152 = 1 Unit new unit 0.3033857693 529 1,473,691 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 237 640,834 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 977 194,452 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 65 163,104 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 381 49,029 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 112 27,322 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 109 13,879 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 4 15,431 $1.56Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 601 393 $101.13Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 119 277 $35.39Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 596 268 $1,216.05Purchase of one (1)

Boston-Cambridge-Quincy, MA-NH B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 42 80 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Boston-Cambridge-Quincy, MA-NH B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Boston-Cambridge-Quincy, MA-NH B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Boston-Cambridge-Quincy, MA-NH B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 3 $2.45

Purchase of one (1) Boston-Cambridge-Quincy, MA-NH B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 180 478,733 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4152 = 1 Unit new unit 0.3033857693 81 200,407 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 93 293,036 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 257 51,809 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 13 24,174 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 73 9,651 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 19 3,919 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 6 467 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 4 15,208 $1.56Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 125 72 $101.13Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 19 36 $35.39Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 159 70 $1,216.05Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 4 $35.39Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Bridgeport-Stamford-Norwalk, CT B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Bronx-Manhattan NY CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 726 1,904,528 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Bronx-Manhattan NY CBA B4152 = 1 Unit new unit 0.3033857693 569 1,534,745 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Bronx-Manhattan NY CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 663 1,780,559 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bronx-Manhattan NY CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 1,443 290,031 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Bronx-Manhattan NY CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 87 190,659 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bronx-Manhattan NY CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 296 38,840 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Bronx-Manhattan NY CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 527 146,331 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Bronx-Manhattan NY CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 96 14,366 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Bronx-Manhattan NY CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 3 9,062 $1.56Purchase of one (1)

Bronx-Manhattan NY CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 1,265 839 $101.13Purchase of one (1)

Bronx-Manhattan NY CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 163 252 $35.39Purchase of one (1)

Bronx-Manhattan NY CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 917 441 $1,216.05Purchase of one (1)

Bronx-Manhattan NY CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 2 $35.39Purchase of one (1)

Bronx-Manhattan NY CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Bronx-Manhattan NY CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Bronx-Manhattan NY CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Bronx-Manhattan NY CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Buffalo-Niagara Falls, NY B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 168 467,137 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Buffalo-Niagara Falls, NY B4152 = 1 Unit new unit 0.3033857693 179 524,643 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Buffalo-Niagara Falls, NY B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 59 150,299 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Buffalo-Niagara Falls, NY B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 239 51,216 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Buffalo-Niagara Falls, NY B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 22 57,943 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Buffalo-Niagara Falls, NY B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 159 26,515 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Buffalo-Niagara Falls, NY B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 44 13,111 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Buffalo-Niagara Falls, NY B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 51 7,610 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Buffalo-Niagara Falls, NY B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 3,016 $1.56Purchase of one (1)

Buffalo-Niagara Falls, NY E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 138 78 $101.13Purchase of one (1)

Buffalo-Niagara Falls, NY B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 70 182 $35.39Purchase of one (1)

Buffalo-Niagara Falls, NY B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 132 59 $1,216.05Purchase of one (1)

Buffalo-Niagara Falls, NY B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 13 31 $35.39Purchase of one (1)

Buffalo-Niagara Falls, NY B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Buffalo-Niagara Falls, NY B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Buffalo-Niagara Falls, NY B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Buffalo-Niagara Falls, NY B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Cape Coral-Fort Myers, FL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 106 229,771 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Cape Coral-Fort Myers, FL B4152 = 1 Unit new unit 0.3033857693 87 189,525 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Cape Coral-Fort Myers, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 27 71,771 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Cape Coral-Fort Myers, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 60 11,012 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Cape Coral-Fort Myers, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 33,409 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Cape Coral-Fort Myers, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 104 12,322 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Cape Coral-Fort Myers, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 6 900 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Cape Coral-Fort Myers, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 42 3,938 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Cape Coral-Fort Myers, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Cape Coral-Fort Myers, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 70 29 $101.13Purchase of one (1)

Cape Coral-Fort Myers, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 5 5 $35.39Purchase of one (1)

Cape Coral-Fort Myers, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 37 15 $1,216.05Purchase of one (1)

Cape Coral-Fort Myers, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 3 7 $35.39Purchase of one (1)

Cape Coral-Fort Myers, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Cape Coral-Fort Myers, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Cape Coral-Fort Myers, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Cape Coral-Fort Myers, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Central-Chicago Metro CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 1,792 4,389,800 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Central-Chicago Metro CBA B4152 = 1 Unit new unit 0.3033857693 948 2,423,058 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Central-Chicago Metro CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 1,308 2,910,660 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Central-Chicago Metro CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 2,534 400,840 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Central-Chicago Metro CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 80 153,818 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Central-Chicago Metro CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 895 114,886 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Central-Chicago Metro CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 584 115,002 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Central-Chicago Metro CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 444 61,174 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Central-Chicago Metro CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 6 17,179 $1.56Purchase of one (1)

Central-Chicago Metro CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 2,345 1,296 $101.13Purchase of one (1)

Central-Chicago Metro CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 142 317 $35.39Purchase of one (1)

Central-Chicago Metro CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 1,937 831 $1,216.05Purchase of one (1)

Central-Chicago Metro CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 39 93 $35.39Purchase of one (1)

Central-Chicago Metro CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 2 $15.94Purchase of one (1)

Central-Chicago Metro CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Central-Chicago Metro CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Central-Chicago Metro CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 124 346,510 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4152 = 1 Unit new unit 0.3033857693 77 198,463 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 108 253,257 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 187 35,090 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 9 15,900 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 100 12,925 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 28 10,808 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 2 275 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Charleston-North Charleston-Summerville, SC E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 143 89 $101.13Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 39 76 $35.39Purchase of one (1)

Charleston-North Charleston-Summerville, SC B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 119 47 $1,216.05Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 6 $35.39Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Charleston-North Charleston-Summerville, SC B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Charleston-North Charleston-Summerville, SC B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Chattanooga, TN-GA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 101 268,988 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Chattanooga, TN-GA B4152 = 1 Unit new unit 0.3033857693 63 119,817 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Chattanooga, TN-GA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 75 154,112 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Chattanooga, TN-GA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 154 22,832 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Chattanooga, TN-GA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 16 33,007 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Chattanooga, TN-GA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 92 10,615 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Chattanooga, TN-GA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 13 4,294 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Chattanooga, TN-GA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 7 984 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Chattanooga, TN-GA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Chattanooga, TN-GA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 125 67 $101.13Purchase of one (1)

Chattanooga, TN-GA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 14 45 $35.39Purchase of one (1)

Chattanooga, TN-GA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 110 42 $1,216.05Purchase of one (1)

Chattanooga, TN-GA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 7 16 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Chattanooga, TN-GA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Chattanooga, TN-GA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Chattanooga, TN-GA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Chattanooga, TN-GA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Colorado Springs, CO B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 45 95,956 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Colorado Springs, CO B4152 = 1 Unit new unit 0.3033857693 50 92,036 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Colorado Springs, CO B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 15 31,473 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Colorado Springs, CO B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 53 8,070 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Colorado Springs, CO B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 6 9,082 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Colorado Springs, CO B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 39 5,118 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Colorado Springs, CO B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 2 63 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Colorado Springs, CO B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 3 362 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Colorado Springs, CO B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 5,276 $1.56Purchase of one (1)

Colorado Springs, CO E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 43 19 $101.13Purchase of one (1)

Colorado Springs, CO B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 3 8 $35.39Purchase of one (1)

Colorado Springs, CO B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 42 14 $1,216.05Purchase of one (1)

Colorado Springs, CO B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 4 5 $35.39Purchase of one (1)

Colorado Springs, CO B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Colorado Springs, CO B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Colorado Springs, CO B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Colorado Springs, CO B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Columbia, SC B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 120 280,430 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Columbia, SC B4152 = 1 Unit new unit 0.3033857693 114 305,150 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Columbia, SC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 99 206,520 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Columbia, SC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 204 34,600 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Columbia, SC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 22 38,565 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Columbia, SC B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 119 14,448 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Columbia, SC B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 33 10,153 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Columbia, SC B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 11 1,369 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Columbia, SC B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 7,335 $1.56Purchase of one (1)

Columbia, SC E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 131 74 $101.13Purchase of one (1)

Columbia, SC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 38 49 $35.39Purchase of one (1)

Columbia, SC B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 130 52 $1,216.05Purchase of one (1)

Columbia, SC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 4 8 $35.39Purchase of one (1)

Columbia, SC B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Columbia, SC B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Columbia, SC B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Columbia, SC B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Columbus, OH B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 234 598,456 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Columbus, OH B4152 = 1 Unit new unit 0.3033857693 227 654,979 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Columbus, OH B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 100 271,328 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Columbus, OH B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 330 59,319 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Columbus, OH B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 44 88,493 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Columbus, OH B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 210 27,593 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Columbus, OH B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 43 9,955 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Columbus, OH B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 43 8,820 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Columbus, OH B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 594 $1.56Purchase of one (1)

Columbus, OH E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 138 66 $101.13Purchase of one (1)

Columbus, OH B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 63 195 $35.39Purchase of one (1)

Columbus, OH B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 207 87 $1,216.05Purchase of one (1)

Columbus, OH B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 14 46 $35.39Purchase of one (1)

Columbus, OH B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Columbus, OH B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Columbus, OH B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Columbus, OH B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Dayton, OH B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 192 416,552 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Dayton, OH B4152 = 1 Unit new unit 0.3033857693 112 319,897 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Dayton, OH B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 100 208,985 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Dayton, OH B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 240 39,613 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Dayton, OH B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 18 30,595 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Dayton, OH B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 147 17,815 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Dayton, OH B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 16 2,162 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Dayton, OH B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 14 1,069 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Dayton, OH B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1,730 $1.56Purchase of one (1)

Dayton, OH E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 126 63 $101.13Purchase of one (1)

Dayton, OH B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 43 99 $35.39Purchase of one (1)

Dayton, OH B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 172 71 $1,216.05Purchase of one (1)

Dayton, OH B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 9 17 $35.39Purchase of one (1)

Dayton, OH B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Dayton, OH B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Dayton, OH B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Dayton, OH B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 41 73,985 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4152 = 1 Unit new unit 0.3033857693 86 259,115 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 55 97,520 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 90 12,777 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 8 8,698 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 67 8,481 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 5 1,257 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 12 1,740 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 75 40 $101.13Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 5 10 $35.39Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 67 25 $1,216.05Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 1 1 $35.39Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Deltona-Daytona Beach-Ormond Beach, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Denver-Aurora-Broomfield, CO B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 123 348,597 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Denver-Aurora-Broomfield, CO B4152 = 1 Unit new unit 0.3033857693 166 452,724 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Denver-Aurora-Broomfield, CO B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 50 132,114 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Denver-Aurora-Broomfield, CO B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 165 28,002 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Denver-Aurora-Broomfield, CO B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 15 16,774 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Denver-Aurora-Broomfield, CO B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 110 15,045 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Denver-Aurora-Broomfield, CO B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 30 4,120 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Denver-Aurora-Broomfield, CO B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 44 6,641 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Denver-Aurora-Broomfield, CO B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 4 3,016 $1.56Purchase of one (1)

Denver-Aurora-Broomfield, CO E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 95 55 $101.13Purchase of one (1)

Denver-Aurora-Broomfield, CO B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 18 67 $35.39Purchase of one (1)

Denver-Aurora-Broomfield, CO B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 106 44 $1,216.05Purchase of one (1)

Denver-Aurora-Broomfield, CO B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 16 63 $35.39Purchase of one (1)

Denver-Aurora-Broomfield, CO B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Denver-Aurora-Broomfield, CO B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Denver-Aurora-Broomfield, CO B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Denver-Aurora-Broomfield, CO B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Detroit-Warren-Livonia, MI B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 1,185 2,916,308 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Detroit-Warren-Livonia, MI B4152 = 1 Unit new unit 0.3033857693 982 2,788,606 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Detroit-Warren-Livonia, MI B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 778 1,733,229 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Detroit-Warren-Livonia, MI B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 1,875 321,857 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Detroit-Warren-Livonia, MI B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 114 216,837 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Detroit-Warren-Livonia, MI B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 756 100,465 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Detroit-Warren-Livonia, MI B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 206 37,665 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Detroit-Warren-Livonia, MI B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 294 42,941 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Detroit-Warren-Livonia, MI B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 7 17,104 $1.56Purchase of one (1)

Detroit-Warren-Livonia, MI E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 950 526 $101.13Purchase of one (1)

Detroit-Warren-Livonia, MI B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 181 524 $35.39Purchase of one (1)

Detroit-Warren-Livonia, MI B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 1,282 560 $1,216.05Purchase of one (1)

Detroit-Warren-Livonia, MI B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 36 88 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Detroit-Warren-Livonia, MI B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 5 $15.94

Purchase of one (1) Detroit-Warren-Livonia, MI B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Detroit-Warren-Livonia, MI B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Detroit-Warren-Livonia, MI B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

El Paso, TX B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 186 534,466 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

El Paso, TX B4152 = 1 Unit new unit 0.3033857693 50 158,639 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

El Paso, TX B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 100 224,072 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

El Paso, TX B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 222 38,766 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

El Paso, TX B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 37 97,566 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

El Paso, TX B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 126 21,184 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

El Paso, TX B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 21 4,688 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

El Paso, TX B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 5 671 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

El Paso, TX B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

El Paso, TX E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 147 80 $101.13Purchase of one (1)

El Paso, TX B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 19 56 $35.39Purchase of one (1)

El Paso, TX B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 140 53 $1,216.05Purchase of one (1)

El Paso, TX B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 3 $35.39Purchase of one (1)

El Paso, TX B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

El Paso, TX B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

El Paso, TX B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

El Paso, TX B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Flint, MI B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 52 128,773 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Flint, MI B4152 = 1 Unit new unit 0.3033857693 140 372,365 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Flint, MI B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 53 133,980 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Flint, MI B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 139 22,765 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Flint, MI B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 11,726 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Flint, MI B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 101 13,808 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Flint, MI B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 27 6,768 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Flint, MI B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 22 3,143 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Flint, MI B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 130 $1.56Purchase of one (1)

Flint, MI E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 69 40 $101.13Purchase of one (1)

Flint, MI B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 20 513 $35.39Purchase of one (1)

Flint, MI B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 85 35 $1,216.05Purchase of one (1)

Flint, MI B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 5 14 $35.39Purchase of one (1)

Flint, MI B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Flint, MI B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 2 $21.44Purchase of one (1)

Flint, MI B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Flint, MI B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Fresno, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 195 499,025 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Fresno, CA B4152 = 1 Unit new unit 0.3033857693 66 190,444 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Fresno, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 121 297,788 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Fresno, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 180 31,395 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Fresno, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 11 19,705 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Fresno, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 153 25,962 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Fresno, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 21 4,557 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Fresno, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 54 7,809 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Fresno, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 3 11,035 $1.56Purchase of one (1)

Fresno, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 151 84 $101.13Purchase of one (1)

Fresno, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 14 30 $35.39Purchase of one (1)

Fresno, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 138 62 $1,216.05Purchase of one (1)

Fresno, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 16 33 $35.39Purchase of one (1)

Fresno, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Fresno, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Fresno, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 4 $2.45Purchase of one (1)

Fresno, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Grand Rapids-Wyoming, MI B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 150 383,230 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Grand Rapids-Wyoming, MI B4152 = 1 Unit new unit 0.3033857693 97 300,603 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Grand Rapids-Wyoming, MI B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 21 37,087 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Grand Rapids-Wyoming, MI B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 173 30,109 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Grand Rapids-Wyoming, MI B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 15 26,182 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Grand Rapids-Wyoming, MI B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 74 9,325 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Grand Rapids-Wyoming, MI B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 21 4,004 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Grand Rapids-Wyoming, MI B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 26 3,363 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Grand Rapids-Wyoming, MI B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Grand Rapids-Wyoming, MI E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 88 42 $101.13Purchase of one (1)

Grand Rapids-Wyoming, MI B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 21 87 $35.39Purchase of one (1)

Grand Rapids-Wyoming, MI B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 122 53 $1,216.05Purchase of one (1)

Grand Rapids-Wyoming, MI B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 12 29 $35.39Purchase of one (1)

Grand Rapids-Wyoming, MI B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Grand Rapids-Wyoming, MI B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Grand Rapids-Wyoming, MI B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Grand Rapids-Wyoming, MI B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Greensboro-High Point, NC B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 119 315,218 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Greensboro-High Point, NC B4152 = 1 Unit new unit 0.3033857693 95 227,015 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Greensboro-High Point, NC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 61 163,294 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Greensboro-High Point, NC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 136 24,238 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Greensboro-High Point, NC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 6 6,020 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Greensboro-High Point, NC B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 95 13,017 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Greensboro-High Point, NC B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 52 13,841 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Greensboro-High Point, NC B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 4 204 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Greensboro-High Point, NC B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Greensboro-High Point, NC E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 96 55 $101.13Purchase of one (1)

Greensboro-High Point, NC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 14 22 $35.39Purchase of one (1)

Greensboro-High Point, NC B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 82 33 $1,216.05Purchase of one (1)

Greensboro-High Point, NC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 6 11 $35.39Purchase of one (1)

Greensboro-High Point, NC B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Greensboro-High Point, NC B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 10 $21.44Purchase of one (1)

Greensboro-High Point, NC B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Greensboro-High Point, NC B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Greenville-Mauldin-Easley, SC B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 101 241,195 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid LimitUnits (To provide one [1] Estimated

(The relative market Count (2012 Fee to Purchase unit as described in HCPCS Definition of importance of the item in (Number of units Capacity(Number ofCBA Name HCPCS Code Description Schedule: Bid

for the CBA and One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare amount mustHCPCS code paid (Should be less Bidding Unit; units you can

category based on beneficiaries in the be at or belowby Medicare in CY than your bid should include cost furnish in the

utilization) CBA that received this amount)2010) amount) to buy unit, CBA for one [1]the product in CY overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Greenville-Mauldin-Easley, SC B4152 = 1 Unit new unit 0.3033857693 121 249,256 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Greenville-Mauldin-Easley, SC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 37 93,152 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Greenville-Mauldin-Easley, SC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 142 22,491 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Greenville-Mauldin-Easley, SC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 13 16,312 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Greenville-Mauldin-Easley, SC B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 108 12,758 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Greenville-Mauldin-Easley, SC B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 18 2,751 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Greenville-Mauldin-Easley, SC B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 9 1,259 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Greenville-Mauldin-Easley, SC B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 7,567 $1.56Purchase of one (1)

Greenville-Mauldin-Easley, SC E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 103 50 $101.13Purchase of one (1)

Greenville-Mauldin-Easley, SC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 33 40 $35.39Purchase of one (1)

Greenville-Mauldin-Easley, SC B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 93 37 $1,216.05Purchase of one (1)

Greenville-Mauldin-Easley, SC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 3 $35.39Purchase of one (1)

Greenville-Mauldin-Easley, SC B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Greenville-Mauldin-Easley, SC B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Greenville-Mauldin-Easley, SC B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Greenville-Mauldin-Easley, SC B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 226 590,009 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4152 = 1 Unit new unit 0.3033857693 160 423,855 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 78 216,615 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 318 61,734 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 9 20,334 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 109 13,835 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 17 3,631 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 16 2,270 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 96 $1.56Purchase of one (1)

Hartford-West Hartford-East Hartford, CT E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 162 106 $101.13Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 52 96 $35.39Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 182 79 $1,216.05Purchase of one (1)

Hartford-West Hartford-East Hartford, CT B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 4 6 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Hartford-West Hartford-East Hartford, CT B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Hartford-West Hartford-East Hartford, CT B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Hartford-West Hartford-East Hartford, CT B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Hartford-West Hartford-East Hartford, CT B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Honolulu, HI B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 370 1,028,049 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Honolulu, HI B4152 = 1 Unit new unit 0.3033857693 68 195,688 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Honolulu, HI B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 89 199,825 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Honolulu, HI B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 146 32,135 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Honolulu, HI B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 4 6,230 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Honolulu, HI B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 35 5,509 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Honolulu, HI B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 10 1,929 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Honolulu, HI B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 311 64,061 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Honolulu, HI B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Honolulu, HI E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 209 127 $101.13Purchase of one (1)

Honolulu, HI B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 127 292 $35.39Purchase of one (1)

Honolulu, HI B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 57 24 $1,216.05Purchase of one (1)

Honolulu, HI B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 6 18 $35.39Purchase of one (1)

Honolulu, HI B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 4 17 $15.94Purchase of one (1)

Honolulu, HI B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Honolulu, HI B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Honolulu, HI B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 927 2,273,613 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4152 = 1 Unit new unit 0.3033857693 588 1,485,754 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 778 1,685,019 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 1,229 189,213 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 62 132,280 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 769 101,909 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 146 36,127 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 185 22,033 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 3 6,427 $1.56Purchase of one (1)

Houston-Sugar Land-Baytown, TX E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 897 472 $101.13Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 58 126 $35.39Purchase of one (1)

Houston-Sugar Land-Baytown, TX B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 798 317 $1,216.05Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 30 105 $35.39Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 22 $15.94Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Houston-Sugar Land-Baytown, TX B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Houston-Sugar Land-Baytown, TX B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 5 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 55 166,132 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4152 = 1 Unit new unit 0.3033857693 58 149,940 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 51 104,055 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 79 12,177 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 7,225 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 45 4,571 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 3 796 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 9 1,417 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Huntington-Ashland, WV-KY-OH E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 53 28 $101.13Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 9 40 $35.39Purchase of one (1)

Huntington-Ashland, WV-KY-OH B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 59 25 $1,216.05Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 5 12 $35.39Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 25 $15.94Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Huntington-Ashland, WV-KY-OH B4083 Stomach Tube - Levine Type new unit 0.0000003049 2 11 $2.45Purchase of one (1)

Huntington-Ashland, WV-KY-OH B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Indiana-Chicago Metro CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 239 626,073 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Indiana-Chicago Metro CBA B4152 = 1 Unit new unit 0.3033857693 142 407,004 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Indiana-Chicago Metro CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 178 389,205 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Indiana-Chicago Metro CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 289 50,079 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Indiana-Chicago Metro CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 8 14,818 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Indiana-Chicago Metro CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 189 21,920 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Indiana-Chicago Metro CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 37 8,790 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Indiana-Chicago Metro CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 42 4,023 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Indiana-Chicago Metro CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Indiana-Chicago Metro CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 241 139 $101.13Purchase of one (1)

Indiana-Chicago Metro CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 14 24 $35.39Purchase of one (1)

Indiana-Chicago Metro CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 209 101 $1,216.05Purchase of one (1)

Indiana-Chicago Metro CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 7 54 $35.39Purchase of one (1)

Indiana-Chicago Metro CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Indiana-Chicago Metro CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Indiana-Chicago Metro CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Indiana-Chicago Metro CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Indianapolis-Carmel, IN B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 293 729,180 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Indianapolis-Carmel, IN B4152 = 1 Unit new unit 0.3033857693 216 548,630 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Indianapolis-Carmel, IN B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 169 420,706 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Indianapolis-Carmel, IN B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 388 66,956 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Indianapolis-Carmel, IN B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 43 98,372 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Indianapolis-Carmel, IN B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 263 35,444 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Indianapolis-Carmel, IN B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 37 7,599 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Indianapolis-Carmel, IN B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 32 3,127 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Indianapolis-Carmel, IN B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 4 4,879 $1.56Purchase of one (1)

Indianapolis-Carmel, IN E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 283 172 $101.13Purchase of one (1)

Indianapolis-Carmel, IN B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 30 59 $35.39Purchase of one (1)

Indianapolis-Carmel, IN B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 266 126 $1,216.05Purchase of one (1)

Indianapolis-Carmel, IN B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 26 207 $35.39Purchase of one (1)

Indianapolis-Carmel, IN B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 2 13 $15.94Purchase of one (1)

Indianapolis-Carmel, IN B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 5 $21.44Purchase of one (1)

Indianapolis-Carmel, IN B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Indianapolis-Carmel, IN B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Jackson, MS B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 179 469,387 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Jackson, MS B4152 = 1 Unit new unit 0.3033857693 167 500,872 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Jackson, MS B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 216 590,268 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Jackson, MS B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 296 55,498 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Jackson, MS B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 12 19,386 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Jackson, MS B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 228 34,325 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Jackson, MS B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 49 8,975 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Jackson, MS B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 17 2,885 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Jackson, MS B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 6 11,393 $1.56Purchase of one (1)

Jackson, MS E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 242 159 $101.13Purchase of one (1)

Jackson, MS B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 25 45 $35.39Purchase of one (1)

Jackson, MS B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 205 98 $1,216.05Purchase of one (1)

Jackson, MS B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 3 5 $35.39Purchase of one (1)

Jackson, MS B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Jackson, MS B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Jackson, MS B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Jackson, MS B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Jacksonville, FL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 207 539,435 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Jacksonville, FL B4152 = 1 Unit new unit 0.3033857693 248 630,355 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Jacksonville, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 225 507,986 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Jacksonville, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 396 63,365 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Jacksonville, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 15 35,162 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Jacksonville, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 214 28,838 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Jacksonville, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 62 9,886 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Jacksonville, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 53 6,701 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Jacksonville, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 60 $1.56Purchase of one (1)

Jacksonville, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 354 198 $101.13Purchase of one (1)

Jacksonville, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 6 19 $35.39Purchase of one (1)

Jacksonville, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 245 100 $1,216.05Purchase of one (1)

Jacksonville, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 3 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Jacksonville, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 2 80 $15.94

Purchase of one (1) Jacksonville, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Jacksonville, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Jacksonville, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 13 4 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Knoxville, TN B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 134 303,682 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Knoxville, TN B4152 = 1 Unit new unit 0.3033857693 85 238,281 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Knoxville, TN B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 77 153,709 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Knoxville, TN B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 180 29,687 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Knoxville, TN B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 9 19,628 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Knoxville, TN B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 94 12,141 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Knoxville, TN B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 20 4,026 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Knoxville, TN B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 8 1,028 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Knoxville, TN B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Knoxville, TN E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 118 80 $101.13Purchase of one (1)

Knoxville, TN B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 16 41 $35.39Purchase of one (1)

Knoxville, TN B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 119 53 $1,216.05Purchase of one (1)

Knoxville, TN B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 6 22 $35.39Purchase of one (1)

Knoxville, TN B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Knoxville, TN B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Knoxville, TN B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Knoxville, TN B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Lakeland-Winter Haven, FL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 116 268,578 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Lakeland-Winter Haven, FL B4152 = 1 Unit new unit 0.3033857693 80 194,611 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Lakeland-Winter Haven, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 82 211,207 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Lakeland-Winter Haven, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 147 23,580 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Lakeland-Winter Haven, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 9 6,828 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Lakeland-Winter Haven, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 107 12,287 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Lakeland-Winter Haven, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 9 2,218 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Lakeland-Winter Haven, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 8 1,677 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Lakeland-Winter Haven, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Lakeland-Winter Haven, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 113 60 $101.13Purchase of one (1)

Lakeland-Winter Haven, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 1 2 $35.39Purchase of one (1)

Lakeland-Winter Haven, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 106 49 $1,216.05Purchase of one (1)

Lakeland-Winter Haven, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 1 2 $35.39Purchase of one (1)

Lakeland-Winter Haven, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Lakeland-Winter Haven, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Lakeland-Winter Haven, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Lakeland-Winter Haven, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Las Vegas-Paradise, NV B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 237 585,358 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Las Vegas-Paradise, NV B4152 = 1 Unit new unit 0.3033857693 121 337,551 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Las Vegas-Paradise, NV B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 124 287,989 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Las Vegas-Paradise, NV B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 303 51,912 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Las Vegas-Paradise, NV B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 21 59,975 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Las Vegas-Paradise, NV B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 169 20,521 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Las Vegas-Paradise, NV B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 43 5,809 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Las Vegas-Paradise, NV B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 20 2,593 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Las Vegas-Paradise, NV B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1,341 $1.56Purchase of one (1)

Las Vegas-Paradise, NV E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 245 142 $101.13Purchase of one (1)

Las Vegas-Paradise, NV B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 38 47 $35.39Purchase of one (1)

Las Vegas-Paradise, NV B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 219 102 $1,216.05Purchase of one (1)

Las Vegas-Paradise, NV B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 13 33 $35.39Purchase of one (1)

Las Vegas-Paradise, NV B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Las Vegas-Paradise, NV B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 2 $21.44Purchase of one (1)

Las Vegas-Paradise, NV B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Las Vegas-Paradise, NV B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 155 410,357 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4152 = 1 Unit new unit 0.3033857693 161 428,632 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 107 247,881 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 273 45,951 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 27 72,890 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 117 15,924 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 43 6,643 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 53 10,782 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 4,797 $1.56Purchase of one (1)

Little Rock-North Little Rock-Conway, AR E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 127 69 $101.13Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 13 74 $35.39Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 153 56 $1,216.05Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 3 $35.39Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Little Rock-North Little Rock-Conway, AR B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Los Angeles County CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 2,762 6,863,670 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Los Angeles County CBA B4152 = 1 Unit new unit 0.3033857693 1,400 3,488,440 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Los Angeles County CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 3,167 7,877,170 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Los Angeles County CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 5,294 991,309 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Los Angeles County CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 128 243,954 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Los Angeles County CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 1,390 218,638 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Los Angeles County CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 811 139,647 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Los Angeles County CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 93 16,129 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Los Angeles County CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 15 45,560 $1.56Purchase of one (1)

Los Angeles County CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 4,987 3,285 $101.13Purchase of one (1)

Los Angeles County CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 502 932 $35.39Purchase of one (1)

Los Angeles County CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 3,571 1,632 $1,216.05Purchase of one (1)

Los Angeles County CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 22 50 $35.39Purchase of one (1)

Los Angeles County CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 4 18 $15.94Purchase of one (1)

Los Angeles County CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 5 34 $21.44Purchase of one (1)

Los Angeles County CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 2 13 $2.45Purchase of one (1)

Los Angeles County CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Louisville/Jefferson County, KY-IN B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 276 631,316 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Louisville/Jefferson County, KY-IN B4152 = 1 Unit new unit 0.3033857693 186 545,701 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Louisville/Jefferson County, KY-IN B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 141 342,236 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Louisville/Jefferson County, KY-IN B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 394 71,005 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Louisville/Jefferson County, KY-IN B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 44 104,015 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Louisville/Jefferson County, KY-IN B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 179 19,337 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Louisville/Jefferson County, KY-IN B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 58 19,387 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Louisville/Jefferson County, KY-IN B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 24 3,348 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Louisville/Jefferson County, KY-IN B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1,081 $1.56Purchase of one (1)

Louisville/Jefferson County, KY-IN E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 206 112 $101.13Purchase of one (1)

Louisville/Jefferson County, KY-IN B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 51 118 $35.39Purchase of one (1)

Louisville/Jefferson County, KY-IN B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 254 104 $1,216.05Purchase of one (1)

Louisville/Jefferson County, KY-IN B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 14 39 $35.39Purchase of one (1)

Louisville/Jefferson County, KY-IN B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Louisville/Jefferson County, KY-IN B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Louisville/Jefferson County, KY-IN B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Louisville/Jefferson County, KY-IN B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

McAllen-Edinburg-Mission, TX B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 202 477,260 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

McAllen-Edinburg-Mission, TX B4152 = 1 Unit new unit 0.3033857693 80 207,522 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

McAllen-Edinburg-Mission, TX B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 368 978,061 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

McAllen-Edinburg-Mission, TX B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 431 73,611 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

McAllen-Edinburg-Mission, TX B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 8 10,479 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

McAllen-Edinburg-Mission, TX B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 183 26,837 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

McAllen-Edinburg-Mission, TX B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 59 7,984 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

McAllen-Edinburg-Mission, TX B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 9 1,709 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

McAllen-Edinburg-Mission, TX B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

McAllen-Edinburg-Mission, TX E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 312 177 $101.13Purchase of one (1)

McAllen-Edinburg-Mission, TX B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 8 18 $35.39Purchase of one (1)

McAllen-Edinburg-Mission, TX B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 227 88 $1,216.05Purchase of one (1)

McAllen-Edinburg-Mission, TX B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 11 18 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) McAllen-Edinburg-Mission, TX B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) McAllen-Edinburg-Mission, TX B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) McAllen-Edinburg-Mission, TX B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) McAllen-Edinburg-Mission, TX B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Memphis, TN-MS-AR B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 279 680,923 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Memphis, TN-MS-AR B4152 = 1 Unit new unit 0.3033857693 284 884,815 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Memphis, TN-MS-AR B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 354 946,179 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Memphis, TN-MS-AR B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 458 90,291 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Memphis, TN-MS-AR B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 13 15,675 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Memphis, TN-MS-AR B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 379 56,150 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Memphis, TN-MS-AR B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 117 21,607 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Memphis, TN-MS-AR B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 41 5,932 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Memphis, TN-MS-AR B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Memphis, TN-MS-AR E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 358 240 $101.13Purchase of one (1)

Memphis, TN-MS-AR B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 43 74 $35.39Purchase of one (1)

Memphis, TN-MS-AR B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 267 117 $1,216.05Purchase of one (1)

Memphis, TN-MS-AR B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 16 41 $35.39Purchase of one (1)

Memphis, TN-MS-AR B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Memphis, TN-MS-AR B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Memphis, TN-MS-AR B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Memphis, TN-MS-AR B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 300 869,230 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4152 = 1 Unit new unit 0.3033857693 165 396,888 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 82 218,187 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 257 48,291 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 11 28,220 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 96 11,066 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 28 7,298 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 177 30,068 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid LimitUnits (To provide one [1] Estimated

(The relative market Count (2012 Fee to Purchase unit as described in HCPCS Definition of importance of the item in (Number of units Capacity(Number ofCBA Name HCPCS Code Description Schedule: Bid

for the CBA and One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare amount mustHCPCS code paid (Should be less Bidding Unit; units you can

category based on beneficiaries in the be at or belowby Medicare in CY than your bid should include cost furnish in the

utilization) CBA that received this amount)2010) amount) to buy unit, CBA for one [1]the product in CY overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 8,521 $1.56Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 281 178 $101.13Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 37 347 $35.39Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 168 74 $1,216.05Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 28 157 $35.39Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Milwaukee-Waukesha-West Allis, WI B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 399 1,076,471 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4152 = 1 Unit new unit 0.3033857693 263 740,352 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 50 110,026 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 416 81,822 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 43 108,997 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 141 18,462 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 45 9,025 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 157 23,379 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 8 25,743 $1.56Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 199 105 $101.13Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 70 381 $35.39Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 255 116 $1,216.05Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 93 293 $35.39Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Minneapolis-St. Paul-Bloomington, MN-WI B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, Fats

Nashville-Davidson--Murfreesboro--Franklin, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1) TN B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 212 489,820 $0.67

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And

Nashville-Davidson--Murfreesboro--Franklin, Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1) TN B4152 = 1 Unit new unit 0.3033857693 192 564,246 $0.55

Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates,

Nashville-Davidson--Murfreesboro--Franklin, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1) TN B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 150 387,598 $1.21Nashville-Davidson--Murfreesboro--Franklin, Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1) TN B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 346 60,470 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideNashville-Davidson--Murfreesboro--Franklin, Chain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1) TN B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 30 70,214 $1.89Nashville-Davidson--Murfreesboro--Franklin, Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1) TN B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 209 29,592 $6.06

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine),

Nashville-Davidson--Murfreesboro--Franklin, Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1) TN B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 42 11,958 $0.94Nashville-Davidson--Murfreesboro--Franklin, Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1) TN B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 17 1,840 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesNashville-Davidson--Murfreesboro--Franklin, Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1) TN B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 2,888 $1.56Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 262 154 $101.13Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 44 99 $35.39Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 215 92 $1,216.05Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 27 72 $35.39Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Nashville-Davidson--Murfreesboro--Franklin, Purchase of one (1) TN B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsNassau-Brooklyn-Queens-Richmond County Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1) Metro CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 1,623 4,022,607 $0.67

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And

Nassau-Brooklyn-Queens-Richmond County Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1) Metro CBA B4152 = 1 Unit new unit 0.3033857693 1,106 2,913,469 $0.55

Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates,

Nassau-Brooklyn-Queens-Richmond County Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1) Metro CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 1,979 5,116,850 $1.21Nassau-Brooklyn-Queens-Richmond County Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1) Metro CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 3,605 698,296 $11.56

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideNassau-Brooklyn-Queens-Richmond County Chain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1) Metro CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 295 608,783 $1.89Nassau-Brooklyn-Queens-Richmond County Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1) Metro CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 706 96,800 $6.06

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine),

Nassau-Brooklyn-Queens-Richmond County Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1) Metro CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 1,274 374,213 $0.94Nassau-Brooklyn-Queens-Richmond County Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1) Metro CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 147 17,876 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesNassau-Brooklyn-Queens-Richmond County Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1) Metro CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 8 13,587 $1.56Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 2,849 1,851 $101.13Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 446 693 $35.39Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 2,368 1,146 $1,216.05Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 17 25 $35.39Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 2 13 $15.94Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Nassau-Brooklyn-Queens-Richmond County Purchase of one (1) Metro CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 3 2 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

New Haven-Milford, CT B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 122 337,582 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

New Haven-Milford, CT B4152 = 1 Unit new unit 0.3033857693 83 263,360 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

New Haven-Milford, CT B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 76 210,531 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

New Haven-Milford, CT B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 210 41,525 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

New Haven-Milford, CT B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 14 26,195 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

New Haven-Milford, CT B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 58 7,831 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

New Haven-Milford, CT B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 12 3,325 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

New Haven-Milford, CT B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 11 803 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

New Haven-Milford, CT B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 3,912 $1.56Purchase of one (1)

New Haven-Milford, CT E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 125 78 $101.13Purchase of one (1)

New Haven-Milford, CT B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 21 44 $35.39Purchase of one (1)

New Haven-Milford, CT B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 128 56 $1,216.05Purchase of one (1)

New Haven-Milford, CT B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 4 6 $35.39Purchase of one (1)

New Haven-Milford, CT B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

New Haven-Milford, CT B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

New Haven-Milford, CT B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

New Haven-Milford, CT B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 240 642,959 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4152 = 1 Unit new unit 0.3033857693 195 593,218 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 246 658,460 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 330 50,135 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 40 58,700 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 307 47,281 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 43 11,244 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 14 1,936 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 4 1,726 $1.56Purchase of one (1)

New Orleans-Metairie-Kenner, LA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 236 130 $101.13Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 6 16 $35.39Purchase of one (1)

New Orleans-Metairie-Kenner, LA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 197 83 $1,216.05Purchase of one (1)

New Orleans-Metairie-Kenner, LA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 8 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) New Orleans-Metairie-Kenner, LA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) New Orleans-Metairie-Kenner, LA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) New Orleans-Metairie-Kenner, LA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) New Orleans-Metairie-Kenner, LA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

North East NY CBA Metro B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 312 762,031 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

North East NY CBA Metro B4152 = 1 Unit new unit 0.3033857693 271 736,204 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

North East NY CBA Metro B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 343 952,253 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

North East NY CBA Metro B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 668 132,579 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

North East NY CBA Metro B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 57 117,360 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

North East NY CBA Metro B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 194 27,519 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

North East NY CBA Metro B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 202 52,545 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

North East NY CBA Metro B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 34 4,684 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

North East NY CBA Metro B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 7,402 $1.56Purchase of one (1)

North East NY CBA Metro E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 527 323 $101.13Purchase of one (1)

North East NY CBA Metro B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 112 164 $35.39Purchase of one (1)

North East NY CBA Metro B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 466 209 $1,216.05Purchase of one (1)

North East NY CBA Metro B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 7 14 $35.39Purchase of one (1)

North East NY CBA Metro B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

North East NY CBA Metro B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

North East NY CBA Metro B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

North East NY CBA Metro B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 107 196,720 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4152 = 1 Unit new unit 0.3033857693 144 397,546 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 70 178,795 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 146 22,260 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 14 29,441 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 125 14,035 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 17 2,700 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 17 2,599 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 5,722 $1.56Purchase of one (1)

North Port-Bradenton-Sarasota, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 119 60 $101.13Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 3 6 $35.39Purchase of one (1)

North Port-Bradenton-Sarasota, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 108 41 $1,216.05Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 4 8 $35.39Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

North Port-Bradenton-Sarasota, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

North Port-Bradenton-Sarasota, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Northern NJ Metro CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 672 1,666,709 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Northern NJ Metro CBA B4152 = 1 Unit new unit 0.3033857693 591 1,463,872 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Northern NJ Metro CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 618 1,503,066 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Northern NJ Metro CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 1,171 202,544 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Northern NJ Metro CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 87 180,169 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Northern NJ Metro CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 601 85,879 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Northern NJ Metro CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 264 55,808 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Northern NJ Metro CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 67 7,353 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Northern NJ Metro CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 9 18,490 $1.56Purchase of one (1)

Northern NJ Metro CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 947 555 $101.13Purchase of one (1)

Northern NJ Metro CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 107 184 $35.39Purchase of one (1)

Northern NJ Metro CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 855 386 $1,216.05Purchase of one (1)

Northern NJ Metro CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 5 6 $35.39Purchase of one (1)

Northern NJ Metro CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Northern NJ Metro CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Northern NJ Metro CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Northern NJ Metro CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 4 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Northern-Chicago Metro CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 189 484,334 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Northern-Chicago Metro CBA B4152 = 1 Unit new unit 0.3033857693 148 407,413 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Northern-Chicago Metro CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 111 257,659 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Northern-Chicago Metro CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 253 40,964 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Northern-Chicago Metro CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 23 48,002 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Northern-Chicago Metro CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 126 16,284 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Northern-Chicago Metro CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 43 7,070 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Northern-Chicago Metro CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 66 7,720 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Northern-Chicago Metro CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Northern-Chicago Metro CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 210 111 $101.13Purchase of one (1)

Northern-Chicago Metro CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 25 224 $35.39Purchase of one (1)

Northern-Chicago Metro CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 180 77 $1,216.05Purchase of one (1)

Northern-Chicago Metro CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 6 44 $35.39Purchase of one (1)

Northern-Chicago Metro CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Northern-Chicago Metro CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 30 $21.44Purchase of one (1)

Northern-Chicago Metro CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Northern-Chicago Metro CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Ocala, FL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 41 94,589 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Ocala, FL B4152 = 1 Unit new unit 0.3033857693 78 213,974 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Ocala, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 33 84,067 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Ocala, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 58 10,828 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Ocala, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 3 3,768 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Ocala, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 75 9,275 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Ocala, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 12 2,802 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Ocala, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 9 919 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Ocala, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Ocala, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 55 28 $101.13Purchase of one (1)

Ocala, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 1 1 $35.39Purchase of one (1)

Ocala, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 42 16 $1,216.05Purchase of one (1)

Ocala, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 1 1 $35.39Purchase of one (1)

Ocala, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Ocala, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Ocala, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Ocala, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Oklahoma City, OK B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 161 402,841 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Oklahoma City, OK B4152 = 1 Unit new unit 0.3033857693 152 434,464 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Oklahoma City, OK B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 128 302,201 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Oklahoma City, OK B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 223 36,206 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Oklahoma City, OK B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 35 77,031 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Oklahoma City, OK B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 202 30,365 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Oklahoma City, OK B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 17 1,349 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Oklahoma City, OK B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 28 3,176 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Oklahoma City, OK B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 5 13,810 $1.56Purchase of one (1)

Oklahoma City, OK E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 144 75 $101.13Purchase of one (1)

Oklahoma City, OK B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 36 77 $35.39Purchase of one (1)

Oklahoma City, OK B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 128 53 $1,216.05Purchase of one (1)

Oklahoma City, OK B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 14 41 $35.39Purchase of one (1)

Oklahoma City, OK B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Oklahoma City, OK B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Oklahoma City, OK B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Oklahoma City, OK B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 148 354,942 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4152 = 1 Unit new unit 0.3033857693 118 261,698 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 42 82,958 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 179 27,613 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 8,366 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 97 13,006 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 15 2,840 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 6 935 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Omaha-Council Bluffs, NE-IA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 74 39 $101.13Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 18 32 $35.39Purchase of one (1)

Omaha-Council Bluffs, NE-IA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 102 41 $1,216.05Purchase of one (1)

Omaha-Council Bluffs, NE-IA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 19 27 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Omaha-Council Bluffs, NE-IA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Omaha-Council Bluffs, NE-IA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Omaha-Council Bluffs, NE-IA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Omaha-Council Bluffs, NE-IA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 2 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Orange County CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 711 1,824,059 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Orange County CBA B4152 = 1 Unit new unit 0.3033857693 373 997,760 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Orange County CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 577 1,391,143 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Orange County CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 1,122 213,041 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Orange County CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 36 75,886 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Orange County CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 399 62,928 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Orange County CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 109 17,215 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Orange County CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 36 5,394 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Orange County CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Orange County CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 1,030 687 $101.13Purchase of one (1)

Orange County CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 57 153 $35.39Purchase of one (1)

Orange County CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 776 348 $1,216.05Purchase of one (1)

Orange County CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 53 123 $35.39Purchase of one (1)

Orange County CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Orange County CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 8 $21.44Purchase of one (1)

Orange County CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Orange County CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 179 467,811 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4152 = 1 Unit new unit 0.3033857693 91 220,370 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 95 213,720 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 223 37,559 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 10 31,013 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 119 18,553 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 29 3,687 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 9 1,809 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid LimitUnits (To provide one [1] Estimated

(The relative market Count (2012 Fee to Purchase unit as described in HCPCS Definition of importance of the item in (Number of units Capacity(Number ofCBA Name HCPCS Code Description Schedule: Bid

for the CBA and One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare amount mustHCPCS code paid (Should be less Bidding Unit; units you can

category based on beneficiaries in the be at or belowby Medicare in CY than your bid should include cost furnish in the

utilization) CBA that received this amount)2010) amount) to buy unit, CBA for one [1]the product in CY overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 10,310 $1.56Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 186 106 $101.13Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 26 40 $35.39Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 154 63 $1,216.05Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 4 8 $35.39Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 3 $21.44Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Oxnard-Thousand Oaks-Ventura, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 95 189,198 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4152 = 1 Unit new unit 0.3033857693 69 162,136 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 52 110,835 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 111 16,112 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 5 9,065 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 71 7,779 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 7 2,388 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 13 1,067 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 120 $1.56Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 87 44 $101.13Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 5 9 $35.39Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 74 27 $1,216.05Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 1 3 $35.39Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Palm Bay-Melbourne-Titusville, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, Fats

Philadelphia-Camden-Wilmington, PA-NJ-DE- Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1) MD B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 902 2,345,343 $0.67

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And

Philadelphia-Camden-Wilmington, PA-NJ-DE- Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1) MD B4152 = 1 Unit new unit 0.3033857693 1,116 3,105,519 $0.55

Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates,

Philadelphia-Camden-Wilmington, PA-NJ-DE- Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1) MD B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 759 2,054,883 $1.21Philadelphia-Camden-Wilmington, PA-NJ-DE- Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1) MD B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 1,854 346,099 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptidePhiladelphia-Camden-Wilmington, PA-NJ-DE- Chain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1) MD B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 98 234,220 $1.89Philadelphia-Camden-Wilmington, PA-NJ-DE- Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1) MD B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 625 81,621 $6.06

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine),

Philadelphia-Camden-Wilmington, PA-NJ-DE- Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1) MD B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 155 35,321 $0.94Philadelphia-Camden-Wilmington, PA-NJ-DE- Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1) MD B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 226 28,708 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesPhiladelphia-Camden-Wilmington, PA-NJ-DE- Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1) MD B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 1,605 $1.56Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 1,233 744 $101.13Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 202 469 $35.39Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 1,212 548 $1,216.05Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 18 35 $35.39Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 5 87 $21.44Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Philadelphia-Camden-Wilmington, PA-NJ-DE- Purchase of one (1) MD B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 12 6 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 234 513,906 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4152 = 1 Unit new unit 0.3033857693 228 566,934 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 111 207,865 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 304 40,892 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 21 43,858 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 219 24,429 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 6 1,169 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 29 4,372 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 4,265 $1.56Purchase of one (1)

Phoenix-Mesa-Glendale, AZ E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 231 123 $101.13Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 29 58 $35.39Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 245 92 $1,216.05Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 18 31 $35.39Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Phoenix-Mesa-Glendale, AZ B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 187 468,218 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4152 = 1 Unit new unit 0.3033857693 104 257,812 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 25 57,639 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 157 27,594 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 13 29,952 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 84 10,007 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 27 3,966 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 66 12,442 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 3 8,212 $1.56Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 114 54 $101.13Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 38 75 $35.39Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 96 38 $1,216.05Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 20 27 $35.39Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Portland-Vancouver-Hillsboro, OR-WA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 103 264,086 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4152 = 1 Unit new unit 0.3033857693 110 298,736 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 88 243,247 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 187 35,147 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 14 26,846 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 97 12,188 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 36 7,429 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 12 1,275 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 120 70 $101.13Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 35 63 $35.39Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 120 54 $1,216.05Purchase of one (1)

Poughkeepsie-Newburgh-Middletown, NY B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 5 9 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Poughkeepsie-Newburgh-Middletown, NY B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Poughkeepsie-Newburgh-Middletown, NY B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Poughkeepsie-Newburgh-Middletown, NY B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Poughkeepsie-Newburgh-Middletown, NY B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 327 848,576 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4152 = 1 Unit new unit 0.3033857693 194 593,393 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 104 256,704 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 399 75,552 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 21 48,265 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 185 23,114 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 31 4,094 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 41 6,504 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 229 143 $101.13Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 73 152 $35.39Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 226 98 $1,216.05Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 10 13 $35.39Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Providence-New Bedford-Fall River, RI-MA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Raleigh-Cary, NC B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 155 354,841 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Raleigh-Cary, NC B4152 = 1 Unit new unit 0.3033857693 148 369,354 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Raleigh-Cary, NC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 84 190,069 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Raleigh-Cary, NC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 218 34,327 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Raleigh-Cary, NC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 14 28,059 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Raleigh-Cary, NC B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 134 15,491 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Raleigh-Cary, NC B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 44 7,247 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Raleigh-Cary, NC B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 22 4,360 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Raleigh-Cary, NC B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 4,325 $1.56Purchase of one (1)

Raleigh-Cary, NC E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 126 63 $101.13Purchase of one (1)

Raleigh-Cary, NC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 20 54 $35.39Purchase of one (1)

Raleigh-Cary, NC B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 149 63 $1,216.05Purchase of one (1)

Raleigh-Cary, NC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 6 10 $35.39Purchase of one (1)

Raleigh-Cary, NC B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Raleigh-Cary, NC B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Raleigh-Cary, NC B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Raleigh-Cary, NC B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Richmond, VA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 205 491,241 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Richmond, VA B4152 = 1 Unit new unit 0.3033857693 233 707,891 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Richmond, VA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 177 386,345 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Richmond, VA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 345 63,493 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Richmond, VA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 21 37,994 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Richmond, VA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 227 28,819 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Richmond, VA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 61 15,593 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Richmond, VA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 38 5,971 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Richmond, VA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 4 9,802 $1.56Purchase of one (1)

Richmond, VA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 261 167 $101.13Purchase of one (1)

Richmond, VA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 52 197 $35.39Purchase of one (1)

Richmond, VA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 214 89 $1,216.05Purchase of one (1)

Richmond, VA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 4 $35.39Purchase of one (1)

Richmond, VA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Richmond, VA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Richmond, VA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Richmond, VA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Rochester, NY B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 229 672,399 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Rochester, NY B4152 = 1 Unit new unit 0.3033857693 89 278,788 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Rochester, NY B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 66 183,767 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Rochester, NY B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 226 49,669 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Rochester, NY B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 10 16,406 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Rochester, NY B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 71 11,066 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Rochester, NY B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 13 1,410 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Rochester, NY B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 86 16,212 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Rochester, NY B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 1,113 $1.56Purchase of one (1)

Rochester, NY E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 138 91 $101.13Purchase of one (1)

Rochester, NY B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 70 118 $35.39Purchase of one (1)

Rochester, NY B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 106 51 $1,216.05Purchase of one (1)

Rochester, NY B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 12 23 $35.39Purchase of one (1)

Rochester, NY B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Rochester, NY B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 7 $21.44Purchase of one (1)

Rochester, NY B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Rochester, NY B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 4 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 308 838,230 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4152 = 1 Unit new unit 0.3033857693 106 328,314 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 129 336,589 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 294 52,982 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 7 19,154 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 195 32,499 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 28 4,783 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 67 10,778 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 260 152 $101.13Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 86 145 $35.39Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 178 73 $1,216.05Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 36 61 $35.39Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 2 7 $15.94Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Sacramento--Arden-Arcade--Roseville, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Salt Lake City, UT B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 72 117,098 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Salt Lake City, UT B4152 = 1 Unit new unit 0.3033857693 39 108,116 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Salt Lake City, UT B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 21 31,566 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Salt Lake City, UT B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 94 12,360 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Salt Lake City, UT B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 10 20,439 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Salt Lake City, UT B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 33 2,727 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Salt Lake City, UT B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 4 448 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Salt Lake City, UT B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 2 345 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Salt Lake City, UT B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 7,233 $1.56Purchase of one (1)

Salt Lake City, UT E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 63 39 $101.13Purchase of one (1)

Salt Lake City, UT B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 4 9 $35.39Purchase of one (1)

Salt Lake City, UT B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 72 23 $1,216.05Purchase of one (1)

Salt Lake City, UT B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 2 $35.39Purchase of one (1)

Salt Lake City, UT B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Salt Lake City, UT B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 2 2 $21.44Purchase of one (1)

Salt Lake City, UT B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Salt Lake City, UT B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

San Antonio-New Braunfels, TX B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 413 1,070,182 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

San Antonio-New Braunfels, TX B4152 = 1 Unit new unit 0.3033857693 276 807,989 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

San Antonio-New Braunfels, TX B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 377 845,056 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Antonio-New Braunfels, TX B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 677 120,485 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

San Antonio-New Braunfels, TX B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 35 86,494 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Antonio-New Braunfels, TX B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 317 43,173 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

San Antonio-New Braunfels, TX B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 112 24,186 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Antonio-New Braunfels, TX B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 41 5,714 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

San Antonio-New Braunfels, TX B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 2,679 $1.56Purchase of one (1)

San Antonio-New Braunfels, TX E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 440 256 $101.13Purchase of one (1)

San Antonio-New Braunfels, TX B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 36 81 $35.39Purchase of one (1)

San Antonio-New Braunfels, TX B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 433 183 $1,216.05Purchase of one (1)

San Antonio-New Braunfels, TX B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 13 27 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) San Antonio-New Braunfels, TX B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) San Antonio-New Braunfels, TX B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) San Antonio-New Braunfels, TX B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) San Antonio-New Braunfels, TX B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 603 1,582,465 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4152 = 1 Unit new unit 0.3033857693 295 775,051 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 372 777,618 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 909 166,029 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 18 45,384 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 260 36,626 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 160 22,911 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 55 8,184 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 3 4,842 $1.56Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 761 455 $101.13Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 52 88 $35.39Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 655 293 $1,216.05Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 17 36 $35.39Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 11 $2.45Purchase of one (1)

San Diego-Carlsbad-San Marcos, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 683 1,855,916 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4152 = 1 Unit new unit 0.3033857693 280 862,635 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 537 1,433,586 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 974 191,781 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 44 80,032 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 348 55,044 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 142 24,029 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 140 21,741 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 8 26,853 $1.56Purchase of one (1)

San Francisco-Oakland-Fremont, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 756 501 $101.13Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 46 70 $35.39Purchase of one (1)

San Francisco-Oakland-Fremont, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 591 282 $1,216.05Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 21 57 $35.39Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

San Francisco-Oakland-Fremont, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

San Francisco-Oakland-Fremont, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 266 782,158 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4152 = 1 Unit new unit 0.3033857693 95 249,757 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 214 526,586 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 368 74,317 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 15 27,913 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 147 23,344 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 45 7,260 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 42 6,719 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 2 4,987 $1.56Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 282 173 $101.13Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 36 77 $35.39Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 237 113 $1,216.05Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 9 17 $35.39Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

San Jose-Sunnyvale-Santa Clara, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Scranton--Wilkes-Barre, PA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 122 304,507 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Scranton--Wilkes-Barre, PA B4152 = 1 Unit new unit 0.3033857693 88 233,221 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Scranton--Wilkes-Barre, PA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 49 137,375 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Scranton--Wilkes-Barre, PA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 166 29,564 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Scranton--Wilkes-Barre, PA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 15 39,503 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Scranton--Wilkes-Barre, PA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 66 8,290 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Scranton--Wilkes-Barre, PA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 6 1,215 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Scranton--Wilkes-Barre, PA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 34 3,391 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Scranton--Wilkes-Barre, PA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Scranton--Wilkes-Barre, PA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 68 37 $101.13Purchase of one (1)

Scranton--Wilkes-Barre, PA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 53 114 $35.39Purchase of one (1)

Scranton--Wilkes-Barre, PA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 105 45 $1,216.05Purchase of one (1)

Scranton--Wilkes-Barre, PA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 4 $35.39Purchase of one (1)

Scranton--Wilkes-Barre, PA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Scranton--Wilkes-Barre, PA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Scranton--Wilkes-Barre, PA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Scranton--Wilkes-Barre, PA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 2 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 506 1,351,963 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4152 = 1 Unit new unit 0.3033857693 274 775,757 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 138 362,445 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 556 109,945 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 46 109,413 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 258 34,437 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 57 11,341 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 143 19,517 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 7 18,655 $1.56Purchase of one (1)

Seattle-Tacoma-Bellevue, WA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 315 163 $101.13Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 78 208 $35.39Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 278 121 $1,216.05Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 62 136 $35.39Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 6 $15.94Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 28 $21.44Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Seattle-Tacoma-Bellevue, WA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

South-West-Chicago-Metro CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 242 615,739 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

South-West-Chicago-Metro CBA B4152 = 1 Unit new unit 0.3033857693 161 475,524 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

South-West-Chicago-Metro CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 114 254,384 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

South-West-Chicago-Metro CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 287 47,778 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

South-West-Chicago-Metro CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 18 38,531 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

South-West-Chicago-Metro CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 145 17,372 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

South-West-Chicago-Metro CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 25 4,903 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

South-West-Chicago-Metro CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 68 10,412 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

South-West-Chicago-Metro CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

South-West-Chicago-Metro CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 246 139 $101.13Purchase of one (1)

South-West-Chicago-Metro CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 18 50 $35.39Purchase of one (1)

South-West-Chicago-Metro CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 223 98 $1,216.05Purchase of one (1)

South-West-Chicago-Metro CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 11 33 $35.39Purchase of one (1)

South-West-Chicago-Metro CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

South-West-Chicago-Metro CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

South-West-Chicago-Metro CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

South-West-Chicago-Metro CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Southern NY Metro CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 574 1,425,772 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Southern NY Metro CBA B4152 = 1 Unit new unit 0.3033857693 522 1,417,984 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Southern NY Metro CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 397 946,107 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Southern NY Metro CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 919 167,509 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Southern NY Metro CBA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 90 228,678 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Southern NY Metro CBA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 450 60,998 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Southern NY Metro CBA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 119 28,788 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Southern NY Metro CBA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 73 9,945 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Southern NY Metro CBA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 6 13,931 $1.56Purchase of one (1)

Southern NY Metro CBA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 766 484 $101.13Purchase of one (1)

Southern NY Metro CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 153 380 $35.39Purchase of one (1)

Southern NY Metro CBA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 638 287 $1,216.05Purchase of one (1)

Southern NY Metro CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 9 18 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Southern NY Metro CBA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Southern NY Metro CBA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Southern NY Metro CBA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 30 $2.45

Purchase of one (1) Southern NY Metro CBA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 4 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Springfield, MA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 125 350,456 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Springfield, MA B4152 = 1 Unit new unit 0.3033857693 76 214,592 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Springfield, MA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 49 143,141 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Springfield, MA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 150 31,135 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Springfield, MA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 12 25,001 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Springfield, MA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 95 13,903 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Springfield, MA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 25 5,486 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Springfield, MA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 14 2,739 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Springfield, MA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 4,739 $1.56Purchase of one (1)

Springfield, MA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 53 36 $101.13Purchase of one (1)

Springfield, MA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 45 67 $35.39Purchase of one (1)

Springfield, MA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 93 43 $1,216.05Purchase of one (1)

Springfield, MA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 8 14 $35.39Purchase of one (1)

Springfield, MA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Springfield, MA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Springfield, MA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Springfield, MA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

St. Louis, MO-IL B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 464 1,249,680 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

St. Louis, MO-IL B4152 = 1 Unit new unit 0.3033857693 541 1,620,556 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

St. Louis, MO-IL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 279 659,877 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

St. Louis, MO-IL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 730 133,035 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

St. Louis, MO-IL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 39 78,890 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

St. Louis, MO-IL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 345 42,557 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

St. Louis, MO-IL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 27 4,203 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

St. Louis, MO-IL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 171 26,887 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

St. Louis, MO-IL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 3 8,850 $1.56Purchase of one (1)

St. Louis, MO-IL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 568 332 $101.13Purchase of one (1)

St. Louis, MO-IL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 88 207 $35.39Purchase of one (1)

St. Louis, MO-IL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 477 212 $1,216.05Purchase of one (1)

St. Louis, MO-IL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 29 67 $35.39Purchase of one (1)

St. Louis, MO-IL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 6 $15.94Purchase of one (1)

St. Louis, MO-IL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

St. Louis, MO-IL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

St. Louis, MO-IL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 2 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Stockton, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 110 278,043 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Stockton, CA B4152 = 1 Unit new unit 0.3033857693 81 175,929 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Stockton, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 105 285,955 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Stockton, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 125 21,139 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Stockton, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 4 2,160 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Stockton, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 145 18,544 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Stockton, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 7 2,180 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Stockton, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 20 3,251 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Stockton, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Stockton, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 80 42 $101.13Purchase of one (1)

Stockton, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 7 15 $35.39Purchase of one (1)

Stockton, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 78 29 $1,216.05Purchase of one (1)

Stockton, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 3 7 $35.39Purchase of one (1)

Stockton, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 4 $15.94Purchase of one (1)

Stockton, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Stockton, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Stockton, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Suffolk County CBA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 269 672,392 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Suffolk County CBA B4152 = 1 Unit new unit 0.3033857693 225 599,569 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Suffolk County CBA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 248 635,461 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Suffolk County CBA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 555 106,099 $11.56

CBA Name HCPCSCode HCPCS Code Description Definition of

a Bidding Unit

Weight (The relative market

importance of the item in the product

category based on utilization)

2010Beneficiary

Count(Number of

unique Medicarebeneficiaries in theCBA that receivedthe product in CY

2010)

2010 AllowedUnits

(Number of unitsfor the CBA and

HCPCS code paidby Medicare in CY

2010)

Bid Limit(2012 Fee

Schedule: Bidamount must

be at or belowthis amount)

Your Cost to Purchase One (1) Unit

(Should be less than your bid

amount)

Your BidAmount

(To provide one [1] unit as described in

Definition of a Bidding Unit;

should include cost to buy unit,

overhead and profit)

Your EstimatedCapacity(Number of

units you can furnish in the

CBA for one [1]year)

Suffolk County CBA B4153

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0287722516 78 194,023 $1.89

Suffolk County CBA B4034Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0142260653 152 19,963 $6.06

Suffolk County CBA B4155

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0071919069 134 38,145 $0.94

Suffolk County CBA B4036Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0037422180 30 3,188 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, Includes

Suffolk County CBA B4149Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0030239542 1 1 $1.56

Suffolk County CBA E0776BA IV Pole: Item w PEN ServicesPurchase of one (1)

new unit 0.0000913782 396 260 $101.13

Suffolk County CBA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000644495 163 364 $35.39

Suffolk County CBA B9002 Enteral Nutrition Infusion Pump - With AlarmPurchase of one (1)

new unit 0.0000584484 380 175 $1,216.05

Suffolk County CBA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000188874 5 9 $35.39

Suffolk County CBA B4082 Nasogastric Tubing Without StyletPurchase of one (1)

new unit 0.0000011992 1 1 $15.94

Suffolk County CBA B4081 Nasogastric Tubing With StyletPurchase of one (1)

new unit 0.0000010696 1 1 $21.44

Suffolk County CBA B4083 Stomach Tube - Levine TypePurchase of one (1)

new unit 0.0000003049 1 1 $2.45

Suffolk County CBA B9000 Enteral Nutrition Infusion Pump - Without AlarmPurchase of one (1)

new unit 0.0000001702 1 1 $1,216.05

Syracuse, NY B4150

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3587957658 92 266,498 $0.67

Syracuse, NY B4152

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3033857693 87 242,005 $0.55

Syracuse, NY B4154

Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.2432066971 44 114,850 $1.21

Syracuse, NY B4035Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0374194643 132 23,458 $11.56

Syracuse, NY B4153

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0287722516 7 28,183 $1.89

Syracuse, NY B4034Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0142260653 70 7,454 $6.06

Syracuse, NY B4155

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0071919069 16 3,427 $0.94

Syracuse, NY B4036Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape

Purchase of one (1) new unit 0.0037422180 30 5,542 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, Includes

Syracuse, NY B4149Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.0030239542 1 4,363 $1.56

Syracuse, NY E0776BA IV Pole: Item w PEN ServicesPurchase of one (1)

new unit 0.0000913782 104 54 $101.13

Syracuse, NY B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000644495 22 39 $35.39

Syracuse, NY B9002 Enteral Nutrition Infusion Pump - With AlarmPurchase of one (1)

new unit 0.0000584484 89 34 $1,216.05

Syracuse, NY B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, EachPurchase of one (1)

new unit 0.0000188874 2 5 $35.39

Syracuse, NY B4082 Nasogastric Tubing Without StyletPurchase of one (1)

new unit 0.0000011992 1 1 $15.94

Syracuse, NY B4081 Nasogastric Tubing With StyletPurchase of one (1)

new unit 0.0000010696 1 1 $21.44

Syracuse, NY B4083 Stomach Tube - Levine TypePurchase of one (1)

new unit 0.0000003049 1 1 $2.45

Syracuse, NY B9000 Enteral Nutrition Infusion Pump - Without AlarmPurchase of one (1)

new unit 0.0000001702 1 1 $1,216.05

Tampa-St. Petersburg-Clearwater, FL B4150

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit

Purchase of one (1) new unit 0.3587957658 492 1,103,909 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4152 = 1 Unit new unit 0.3033857693 421 1,202,300 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 322 753,529 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 712 110,458 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 26 40,565 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 407 50,929 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 72 17,338 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 68 8,986 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 485 $1.56Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 612 313 $101.13Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 26 40 $35.39Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 519 204 $1,216.05Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 14 31 $35.39Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Tampa-St. Petersburg-Clearwater, FL B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Toledo, OH B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 111 312,824 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Toledo, OH B4152 = 1 Unit new unit 0.3033857693 123 322,441 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Toledo, OH B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 55 129,798 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Toledo, OH B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 190 35,553 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Toledo, OH B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 19 40,877 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Toledo, OH B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 93 9,267 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Toledo, OH B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 15 2,532 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Toledo, OH B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 11 449 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Toledo, OH B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 398 $1.56Purchase of one (1)

Toledo, OH E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 104 58 $101.13Purchase of one (1)

Toledo, OH B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 53 177 $35.39Purchase of one (1)

Toledo, OH B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 112 50 $1,216.05Purchase of one (1)

Toledo, OH B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 7 20 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Toledo, OH B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Toledo, OH B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Toledo, OH B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Toledo, OH B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Tucson, AZ B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 77 155,043 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Tucson, AZ B4152 = 1 Unit new unit 0.3033857693 47 106,005 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Tucson, AZ B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 23 43,477 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tucson, AZ B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 51 6,194 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Tucson, AZ B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 5 6,897 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tucson, AZ B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 80 8,219 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Tucson, AZ B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 5 803 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tucson, AZ B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 7 1,056 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Tucson, AZ B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Tucson, AZ E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 42 18 $101.13Purchase of one (1)

Tucson, AZ B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 3 5 $35.39Purchase of one (1)

Tucson, AZ B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 34 11 $1,216.05Purchase of one (1)

Tucson, AZ B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 9 15 $35.39Purchase of one (1)

Tucson, AZ B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Tucson, AZ B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Tucson, AZ B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Tucson, AZ B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Tulsa, OK B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 116 264,616 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Tulsa, OK B4152 = 1 Unit new unit 0.3033857693 97 253,430 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Tulsa, OK B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 62 183,231 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tulsa, OK B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 134 18,186 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Tulsa, OK B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 18 30,813 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tulsa, OK B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 122 15,186 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Tulsa, OK B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 19 3,975 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Tulsa, OK B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 14 2,978 $7.94

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Tulsa, OK B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 3 11,192 $1.56Purchase of one (1)

Tulsa, OK E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 88 46 $101.13Purchase of one (1)

Tulsa, OK B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 7 23 $35.39Purchase of one (1)

Tulsa, OK B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 94 39 $1,216.05Purchase of one (1)

Tulsa, OK B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 15 33 $35.39Purchase of one (1)

Tulsa, OK B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Tulsa, OK B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Tulsa, OK B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Tulsa, OK B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 327 787,837 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4152 = 1 Unit new unit 0.3033857693 274 755,206 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 184 436,504 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 438 71,121 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 25 32,575 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 281 33,969 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 66 15,048 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 62 8,859 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 5 13,922 $1.56Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 270 133 $101.13Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 33 87 $35.39Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 259 108 $1,216.05Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 2 6 $35.39Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Virginia Beach-Norfolk-Newport News, VA-NC B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Visalia-Porterville, CA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 100 247,219 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Visalia-Porterville, CA B4152 = 1 Unit new unit 0.3033857693 28 71,967 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Visalia-Porterville, CA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 45 117,631 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Visalia-Porterville, CA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 123 24,775 $11.56

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Visalia-Porterville, CA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 11 25,301 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Visalia-Porterville, CA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 52 8,973 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Visalia-Porterville, CA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 40 15,524 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Visalia-Porterville, CA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 9 452 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Visalia-Porterville, CA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Visalia-Porterville, CA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 103 64 $101.13Purchase of one (1)

Visalia-Porterville, CA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 51 78 $35.39Purchase of one (1)

Visalia-Porterville, CA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 58 24 $1,216.05Purchase of one (1)

Visalia-Porterville, CA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 17 19 $35.39Purchase of one (1)

Visalia-Porterville, CA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Visalia-Porterville, CA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Visalia-Porterville, CA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Visalia-Porterville, CA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, Fats

Washington-Arlington-Alexandria, DC-VA-MD- Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1) WV B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 562 1,310,850 $0.67

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And

Washington-Arlington-Alexandria, DC-VA-MD- Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1) WV B4152 = 1 Unit new unit 0.3033857693 764 1,947,276 $0.55

Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates,

Washington-Arlington-Alexandria, DC-VA-MD- Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1) WV B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 493 1,148,892 $1.21Washington-Arlington-Alexandria, DC-VA-MD- Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1) WV B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 1,001 169,616 $11.56

Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideWashington-Arlington-Alexandria, DC-VA-MD- Chain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1) WV B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 28 48,268 $1.89Washington-Arlington-Alexandria, DC-VA-MD- Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1) WV B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 645 88,460 $6.06

Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine),

Washington-Arlington-Alexandria, DC-VA-MD- Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1) WV B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 241 57,268 $0.94Washington-Arlington-Alexandria, DC-VA-MD- Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1) WV B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 139 17,888 $7.94

Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesWashington-Arlington-Alexandria, DC-VA-MD- Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1) WV B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 5 16,674 $1.56Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 511 310 $101.13Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 106 255 $35.39Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 635 264 $1,216.05Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 27 53 $35.39Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Washington-Arlington-Alexandria, DC-VA-MD- Purchase of one (1) WV B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Wichita, KS B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 65 160,107 $0.67

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Wichita, KS B4152 = 1 Unit new unit 0.3033857693 72 194,751 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Wichita, KS B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 29 62,970 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Wichita, KS B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 87 13,929 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Wichita, KS B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 5 13,778 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Wichita, KS B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 64 7,315 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Wichita, KS B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 8 1,712 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Wichita, KS B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 5 473 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Wichita, KS B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Wichita, KS E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 44 21 $101.13Purchase of one (1)

Wichita, KS B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 7 15 $35.39Purchase of one (1)

Wichita, KS B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 53 17 $1,216.05Purchase of one (1)

Wichita, KS B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 8 14 $35.39Purchase of one (1)

Wichita, KS B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Wichita, KS B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Wichita, KS B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Wichita, KS B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Worcester, MA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 135 401,591 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Worcester, MA B4152 = 1 Unit new unit 0.3033857693 73 246,279 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Worcester, MA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 26 75,565 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Worcester, MA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 156 33,442 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Worcester, MA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 10 22,915 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Worcester, MA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 64 10,552 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Worcester, MA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 26 8,049 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Worcester, MA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 10 906 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Worcester, MA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 1 $1.56Purchase of one (1)

Worcester, MA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 75 45 $101.13Purchase of one (1)

Worcester, MA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 31 71 $35.39Purchase of one (1)

Worcester, MA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 91 37 $1,216.05Purchase of one (1)

Worcester, MA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 4 8 $35.39

2010 Your BidYour

Beneficiary 2010 Allowed Your Cost AmountWeight Bid Limit (To provide one [1] Estimated

(The relative market Count Units (2012 Fee to Purchase unit as described in HCPCS Definition of Capacity(Number of (Number of unitsCBA Name HCPCS Code Description importance of the item in Schedule: Bid One (1) Unit Definition of a (Number ofCode a Bidding Unit the product unique Medicare for the CBA and amount must (Should be less Bidding Unit; units you can

category based on beneficiaries in the HCPCS code paid be at or below than your bid should include cost furnish in the utilization) CBA that received by Medicare in CY this amount) amount) to buy unit, CBA for one [1]the product in CY 2010) overhead and year)2010) profit)

Purchase of one (1) Worcester, MA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94

Purchase of one (1) Worcester, MA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44

Purchase of one (1) Worcester, MA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45

Purchase of one (1) Worcester, MA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05

Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, FatsCarbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4150 Feeding Tube, 100 Calories = 1 Unit new unit 0.3587957658 158 415,226 $0.67Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4152 = 1 Unit new unit 0.3033857693 167 400,224 $0.55Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins, Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4154 Tube, 100 Calories = 1 Unit new unit 0.2432066971 126 326,029 $1.21Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4035 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0374194643 284 50,727 $11.56Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And PeptideChain), Includes Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4153 Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0287722516 17 36,702 $1.89Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4034 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0142260653 133 16,173 $6.06Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific NutrientsCarbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G. Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4155 Feeding Tube, 100 Calories = 1 Unit new unit 0.0071919069 19 4,403 $0.94Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4036 Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape new unit 0.0037422180 19 2,315 $7.94Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, IncludesProteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4149 Through An Enteral Feeding Tube, 100 Calories = 1 Unit new unit 0.0030239542 1 4,258 $1.56Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA E0776BA IV Pole: Item w PEN Services new unit 0.0000913782 181 115 $101.13Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4087 Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each new unit 0.0000644495 46 125 $35.39Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B9002 Enteral Nutrition Infusion Pump - With Alarm new unit 0.0000584484 174 74 $1,216.05Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4088 Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each new unit 0.0000188874 1 3 $35.39Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4082 Nasogastric Tubing Without Stylet new unit 0.0000011992 1 1 $15.94Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4081 Nasogastric Tubing With Stylet new unit 0.0000010696 1 1 $21.44Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B4083 Stomach Tube - Levine Type new unit 0.0000003049 1 1 $2.45Purchase of one (1)

Youngstown-Warren-Boardman, OH-PA B9000 Enteral Nutrition Infusion Pump - Without Alarm new unit 0.0000001702 1 1 $1,216.05