Oral Supplement KetoVie® 3:1 Unflavored Liquid 8.5 oz. Carton Bags and Meter Bags made possible by exclusive LevaFiber

made possible by exclusive LevaFiber Technology

(1) 36 X 30 Inch Burn Wrap Dimensions 15

(1)12 X 16 Inch Face Burn Dressing

Manufacturer # 4986 Brand OpSite Manufacturer Smith & Nephew Country of Origin Unknown Application Transparent Film Dressing Delivery Method 2 Tab Delivery Dimensions 6 X 11 Inch FSA Eligible - Sell UOM Yes HCPCS A6259 Label Without Label Length 5 to 12 Inch Length Material Adhesive / Film Shape Rectangle Shape Range Rectangle / Sqaure Sterility Sterile UNSPSC Code 42311527 Width 5 to 6 Inch Width

HCPCS Code- E0167

Oral Supplement KetoVie® 3:1 Unflavored Liquid 8.5 oz. Carton Bags and Meter Bags made possible by exclusive LevaFiberKetoVie 3: 1 is indicated for the dietary management of intractable epilepsy and other disorders for individuals 1+ years that require a ketogenic diet for both oral and tube feeding KetoVie 3: 1 also contains supplemental DHA and ARA to help support brain and eye development plus fructooligosaccherides (FOS) and galactooligosaccherides (GOS), prebiotic fibers which help support digestive health and immunity The formula has a mild milk taste without