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Supplies Needed Peptide Vials (10 mg blend each): 8 weeks: 4 vials 12 weeks: 6 vials 16 weeks: 8 vials Insulin Syringes (U-100): Daily injections → 7 syringes/week 8 weeks: 56 syringes 12 weeks: 84 syringes 16 weeks: 112 syringes Bacteriostatic Water (10 mL bottles): 3 mL per vial for reconstitution 8 weeks: 12 mL → 2 × 10 mL bottles 12 weeks: 18 mL → 2 × 10 mL bottles 16 weeks: 24 mL → 3 × 10 mL bottles Alcohol Swabs: One for vial, one for injection site daily

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The commenter, therefore, recommended that patients classified as New York Heart Association (NYHA) stage D be systematically excluded by CMS from all proposed quality measures