Budgeting For Expendable Medical Materiel In The Operating Force

By LTC Perry C. “Chet” Sosebee, CW2 Stephen W. Iwasko III, and MAJ David S. Coon

July 14, 2026 | Pulse of Army Medicine, 2026 E-Edition

Read Time: < 18 mins

A ‘BOM to Budget’ Calculation:

BOM or Bill of Materials is a list of parts, components, and materials needed for assembly and or function of the end of item. BOMs are used to properly track, label cost of item, and to maintain all components of the end item.

To illustrate our ‘BOM to budget’ calculation, we’ll utilize the notional MES example found in Figure 1. Units must gather the data fields identified within Figure 1 for each MES type, guided by the following steps:

1. Review the Bill of Material (BOM). BOMs contain a plethora of valuable information in one place – it is your best starting point. BOMs are obtained from GCSS-A; the most current version is identified by BOM usage code 4. Take care to match both Line Item Number (LIN) and National Item Identification Number (NIIN) from your property book against the BOM pulled from GCSS-A. Any differences in LIN or NIIN will introduce error. The BOM will list components by Description, Accounting Requirement Codes (ARC), Unit of Issue, and authorized quantity.
2. Determine which expendable items are subject to expiration. An MES is composed of numerous individual items of CL VIII. An expendable item is defined in two ways. Either the item is consumed in use or subject to expiration. This information can be found under the data heading ARC through identifiable codes. ARC codes identify an item’s classification: “X” for expendable items, “D” for durable components, and “N” for nonexpendable equipment. More information regarding ARC Codes is found in AR 710-2, Secondary Item Policy and Retail Level Management, dated 1JUL24.
3. Determine the expendable item’s cost of replacement. This data is available in GCSS-A but is not readily accessible in a single report.
4. Determine the usable shelf-life of each expendable item. Shelf-life (SL) data is available in GCSS-A by searching the transaction code (T-code) of ‘MM03’. Shelf-life data appears under the heading ‘SL’. Information on shelf-life code assignment is found in DoDM 4140.27, Vol. 1, Change 2 (See Figure 2, Shelf-Life Codes). Figure 2 lists Type I and Type II items. Type I items are categorized as non-extendible. CL VIII is typically Type I, non-extendible. Type II items are extendible so long as they have not been issued from a Supply Support Activity (SSA) to an end user. Type II items are part of the Shelf-Life Extension Program. Finally, components with shelf-life codes of “0 (zero)” do not expire, they are only consumed.

Figure 1, Bill of Material (BOM) for a Notional MES

Armed with Figure 1 information, the next step is building a timeline of expenses by item. Because Ibuprofen has a SL Code of ‘H,’ meaning a shelf-life of 12 months, the item must be purchased annually to maintain MES readiness. The Surgical Tape has a SL Code of ‘R’, meaning a shelf-life of 48 months or once every four years. In this manner, Figure 3, Notional MES Costs per Year, can be constructed, inclusive of summated costs per year and a total cost of replenishment for the MES.

Figure 2. Shelf-life codes. Source: DoDM 410.27, Volume 1, Change 2, dated 11 December 2019.

Taking the total cost of replenishment at $33.00, divided by the longest shelf-life at four years, produces an Average Replacement Costs per Year (ARCpY) of $8.25 (See Figure 4, Notional MES Average Replacement Cost per Year (ARCpY)). Surgical Tape has the longest shelf-life of the three items in the MES, therefore four years becomes the default denominator. The denominator will vary for other MES which possess items with a shelf-life beyond four years; most MES have at longest, a shelf-life denominator of ten years. This method eliminates budgetary fluctuation from year to year. When considering total costs of CLVIII replenishment across a unit, an annually consistent figure is preferred for Program Objective Memorandum (POM) requisitions. These calculations produce a dollar figure to maintain a ready MES but does not account for CL VIII consumed in training or on mission; this is discussed further below.

Figure 5. MES Combat Medic (U65480) non-expiring items: Durables and Expendables with SL Code “0”.

MES Combat Medic:

According to FMSWEB, for FY26, there are 10,050 authorized MES Combat Medic in the U.S. Army force structure, making MES Combat Medic the Army’s most abundant MES (See Appendix A, BOM for MES Combat Medic). Within LIN: U65480 / NIIN: 016092699, there are 59 total components listed within the BOM as of 3 February 2026. 26 of the 59 components are ARC ‘D’ (qty: 4) or ARC ‘X’ with a SL of ‘0’ (qty: 22), meaning these components do not expire. If not consumed during the year, these 26 components will remain ready for use.

The remaining 33 expendable items possess various Type I SL codes ranging between two and eight years per Figure 2. The MES Combat Medic (U65480) cost of readiness for expiring items can be constructed using the same process found in Figure 3, calculating costs per year and total cost of replenishment for the MES. With a total cost of replacement for expiring CL VIII calculated at $19,500.52, and the lifespan of the set being eight years, the annual budget to maintain a single MES Combat Medic at 100% readiness is $2,437.56 per year.

Recommended Annual Budgets for Common MES Types:

Using the ‘BOM to budget’ calculation described above, the cost of maintaining full medical readiness for the Army Medical Department’s (AMEDD) most common MES types is listed in Figure 8.

Figure 7. MES Combat Medic (U65480) expiring items: expendable with a shelf-life between two and eight years. Blank data fields represent $0.00. Data as of 6 February 2026.

Figure 8. The cost of maintaining medical readiness to 100% fill among common AMEDD MES. Current as of 9 February 2026.

A QUESTION & ANSWER DISCUSSION:

My unit does not have the budget to maintain all MES sets at 100% fill. What should I do?

Determine with unit leadership an appropriate goal for CL VIII readiness. This goal may be: (1) a standard percentage fill by MES, (2) a total unit spending goal, or (3) a shelf-life threshold by MES based on Figure 2. In addition to budgetary considerations, unit training calendars must be consulted. Known deployments and major training events, such as live-fire exercises or airborne operations, require full medical preparedness. Note that most potency and dated (P&D) items contain a shorter shelf-life, expiring annually or less than annually, though are critical to the provision of lifesaving care.

CL VIII readiness goals may vary by MES type. For example, MES Combat Medic (LIN: U65480) may have a higher priority for CL VIII fill than MES Chemical Agent Patient (LIN: M23673) based on the unit mission or training requirements. Alternatively, Commanders may choose to prioritize maintaining some sets at 100 percent readiness while accepting reduced fill rates for lower-priority or redundant sets. For example, the Commander directs two of six MES Tactical Combat Medical Care (TCMC) are maintained at 100% fill to ‘fight tonight,’ while accepting the risk of maintaining remaining MES TCMC sets at 50% fill. The unit goal for CL VIII readiness should be deliberately and thoughtfully discussed (consider preparing a decision brief for the unit command team). By deliberately filling shelf-life groups with the longest lifespan first, you will buy your unit years of readiness.

With what CL VIII am I supposed to train my medics?

First, expiring CL VIII is your friend – use it! By following the methodologies above, the unit has already budgeted for replacement CL VIII, therefore, there should be a flow of expired items towards training use. Second, a proven technique is to plan for and maintain training stock separately from your MES fills. For example, ADMINISTRATION SET, INTRAVENOUS FLUIDS (IV) has a shelf-life of ‘Q’ or three years yet training IV fluid administration is likely a skill your medics will train annually, if not more. By placing requisition orders to support unit training events separately from your MES inventory, accurate go-to-war inventories are more easily maintained. There is a time and place for MES inventories to be used, but likely not for every range coverage or field training exercise. Release of MES inventory to support training or operations should be a commander’s decision. Note that GCSS-A requires constant user maintenance; if CL VIII is used or expired, the component inventory must be updated as consumed in GCSS-A and then reordered. GCSS-A actions are not yet automatic; these actions of ordering, receiving, inventorying, and consuming CL VIII reflects the medical command supply discipline of a unit.

Are AR 220-1, Army Unit Status Reporting (USR) and Force Registration-Consolidated Polices (dated 16 August 2022), standards enough to keep commanders informed?

The status of MES are reported monthly in the USR, with specific emphasis upon common medical pacing items such as MES TCMC (LIN: M30499). Maintenance issues are addressed by R-level (Equipment Readiness/serviceability), whereas supply levels including CL VIII, are reflected by S-level (Supply/equipment on hand). Section 5-4.l of AR 220-1 describes evaluating component-part availability, which states:

“Do not count the set as on hand (available), if more than 10 percent of the nonexpendable, durable, or expendable components with a shelf-life of 60 months or greater are unserviceable, expired, missing, depleted, or require supply action…COMPO 1, echelons above brigade (EAB) medical units, such as medical units with a standard requirement code (SRC) series of 08, will exclude from readiness calculations all expendable items with a shelf-life less than 60 months that are part of sets covered in an Army centralized contingency program.”

As a result, units routinely report high levels of MES readiness based on this AR 220-1 regulation. In today’s operating environment, where the requirement to ‘fight tonight’ is an ever-increasing reality, the regulatory reporting guidance of AR 220-1 can be misleading. A unit commander reviewing USR could erroneously believe a subordinate unit possesses a high state of medical equipment readiness, when in fact, large percentages of CL VIII are absent. To alleviate the possibility of confusion, we recommend annotating the true percentage fill of CL VIII for MES pacing items within USR commander comments for S-level. It is the unit commander’s responsibility to maintain full understanding of their MES status. True ‘fight tonight’ readiness and USR reported equipment readiness is a gap GCSS-A could close in the future.

My unit does not have a 68J, Medical Logistics Specialist, assigned. What are GCSS-A tips and tricks for CL VIII?

GCSS- A is only as good as the unit discipline used to keep it accurate. Time must be deliberately set aside on the unit training calendar to conduct MES inventories. Once inventoried, updating GCSS-A becomes a full-time job. Ideally the identified Soldier, regardless of MOS, attends the forty-hour ‘Medical Logistics Course’ with ATRRS Course Number ‘CATC-LOG 74A’ to gain the skills and understanding necessary to navigate GCSS-A for CL VIII. Like a unit supply sergeant, your unit’s CL VIII manager will also require roles within GCSS-A to update unit sets. Coordinate with your Brigade’s Property Book Officer (PBO) for GCSS-A access. As of February 2026, the Army is currently in Wave 3 of MiC implementation, with the goal of reaching full operational capability by FY2028.

What is the definitive source for MES inventories?

The BOM. HQDA EXORD 138-21, published in June 2021, directs all medical devices and sets are placed and accounted for in GCSS-A. Annex D identifies that all sets will be loaded into GCSS-A and have the appropriate Set, Kits and outfits (SKOs) aligned to them. SKOs are the precursors to BOMs. Appendix 1 of Annex D states to use Medical Materiel Information Portal (MMIP) for SKOs when no BOM is available, however, by 2026 nearly all BOMs are built in GCSS-A. All LINs listed in Figure 8 all have associated BOMs as of the writing of this paper.

Where should we go from here?

While the calculations discussed above are simple, the data collection and aggregation required to produce an MES budget estimate is cumbersome; the burden should not be placed at the unit level. Ideally, an easily accessible web-based tool could be created, where units could view the costs of MES maintenance by selecting a shelf-life benchmark. Conceptually, selecting ‘M’ would display the cost of maintaining the set for all MES CL VIII with a shelf-life of 24-month and greater. With review of ‘M’ threshold amounts, based on budget realities, a unit may elect to reduce MES fill goals to ‘Q’ for 36-months. Such a user interface tool would greatly assist units to wisely spend CL VIII budgets by risk-informed discussion, rather than over-purchasing CL VIII with a shorter shelf-life. Integration of this information within an accessible web-based platform, such as Vantage (https://vantage.army.mil/), is an ideal approach. This integrated tool could further refine unit budgetary calculations by referencing Unit Identification Code (UIC)-data, such as the unit’s Modified Table of Organization and Equipment (MTOE) found on FMSWEB (Force Management System Web). In the meantime, the authors are willing and able to share data which is housed on the 421st Multifunctional Medical Battalion’s (MMB) MS Teams site.

MEDLOG in Campaigning (MiC) is an exciting endeavour for the AMEDD which has brought forth new computing capabilities within GCSS-A. As a result, units are better able to make data-driven decisions regarding MES inventories and requisitions. Shelf-life data paired with component item costs in GCSS-A creates the opportunity to produce improved unit CL VIII budgets. In an era of balancing ‘fight tonight’ requirements with budgetary constraints, the tools provided by MiC will set medical units on a path towards improved medical preparedness.

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