Polycose®

Glucose Polymer Module

Polycose is an easily digested source of carbohydrate calories for use when additional calories are required.
For oral or tube feeding

Availability

Features

Preparation

Nutrition

Ingredients

Supporting Materials

Medicare Rates and HCPCS Codes

Polycose Toolkit

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Polycose®

List Number	Item
00746	Polycose Powder Institutional / 12.3 oz Can / Case of 6

Serving Size: 100 g powder
Amount Per Serving	% DV	% RDI
Nutrient Data
Energy, Cal: 380
Carbohydrate, g: 94
Water, g: 6
Minerals
Sodium, mg^*: 130
Sodium, mEq^*: 5.7
Potassium, mg^*: 10
Potassium, mEq^*: 0.3
Chloride, mg^*: 223
Chloride, mEq^*: 6.3
Calcium, mg: 30
Calcium, mEq: 1.5
Phosphorus, mg^*: 15
^* Does not exceed.

Household Measure (US)	Weight (Metric)	Calories
1 Teaspoon	2 g	8
1 Tablespoon	6 g	23
1/4 Cup	25 g	95
1/3 Cup	33 g	125
1/2 Cup	50 g	190
1 Cup	100 g	380

Polycose®

Unflavored Powder

Unflavored Powder