Low Profile Gastrostomy Tube Kit Mic-Key® 16 Fr. 2.5 cm Tube Silicone Sterile Kits and Trays Manufacturer # 0124-24 Country of

Manufacturer # 0124-24 Country of Origin Mexico Application Bolus Enteral Feeding Extension Tube Set FSA Eligible - Primary UOM Yes For Use With For For use with MIC-Key Low-Profile Gastrostomy

HCPCS A4351 (Disclaimer) Is_Active_Vendor Y Is_DSCSA N Is_Discontinued N Is_Medical_Device Y Length 13 Inch Lot_Tracking_Flag N Material Hydrophilic Coated Polyurethane On_Allocation N Securing Method Without Balloon Sterility Sterile Style Straight Tip Supplier_ID 488040 UNSPSC Code 42142702

(1) Bolus Extension Set

Manufacturer # 2202 Country of Origin United States Application Xeroform Petrolatum Impregnated Dressing Color Tan Dimensions 2 X 2 Inch HCPCS A6222 (Disclaimer) Impregnated Ingredients Bismuth Tribromophenate (Xeroform) Is_Active_Vendor Y Is_DSCSA N Is_Discontinued N Is_ECAT N Is_GSA N Is_Medical_Device Y Is_VA Y Length Up to 4 Inch Length Lot_Tracking_Flag N Material Gauze On_Allocation N Shape Square Sterility Sterile Strength 3% Strength Supplier_ID 4459528 UNSPSC Code 42311524 Width 2 Inch Width

(1) Tool Module with (1) Penlight

Low Profile Gastrostomy Tube Kit Mic-Key® 16 Fr. 2.5 cm Tube Silicone Sterile Kits and Trays Manufacturer # 0124-24 Country ofManufacturer # 8140 16 2. 5 Country of Origin Mexico Application Low Profile Gastrostomy Tube Kit Contents 1 MIC KEY Low Profile Gastrostomy Feeding Tube with ENFit Connectors, Insertion Stylet, Water soluble Lubricant, Continuous Feed Extension Set with ENFit Connector, 12 inch, Bolus Feed Extension Set with ENFit Connector, 12 inch, 6 mL Luer Slip Syringe, 35 mL ENFit Enteral Feeding Syringe, Gauze Pad HCPCS B4088 (Disclaimer) Is_Active_Vendor Y