Insurance Billing Codes

The following information is provided to assist you with obtaining insurance reimbursement for our products. Individual coverage varies by state and provider. Please contact your provider for more information.

PHENYLKETONURIA (PKU)
PKU gel Unflavored	1 year and older	Powder	30x24g packets		50600-0514-48	B4162
PKU gel Orange					50600-0514-62
PKU gel Raspberry					50600-0514-55
PKU express15 Unflavored	3 years and older	Powder	30x25g packets		50600-0532-06	B4162/B4157
PKU express15 Orange					50600-0532-20
PKU express15 Lemon					50600-0533-05
PKU express15 Tropical					50600-0533-36
PKU cooler10 Orange	3 years and older	RTD	30x87ml pouches		50600-0548-52	B4162/B4157
PKU cooler10 Purple					50600-0548-76
PKU cooler10 White					50600-0549-99
PKU cooler10 Red					50600-0513-18
PKU cooler15 Orange	3 years and older	RTD	30x130ml pouches		50600-0545-00	B4162/B4157
PKU cooler15 Purple					50600-0545-62
PKU cooler15 White					50600-0549-75
PKU cooler15 Red					50600-0519-98
PKU cooler20 Orange	3 years and older	RTD	30x174ml pouches		50600-0548-14	B4162/B4157
PKU cooler20 Purple					50600-0548-38
PKU cooler20 White					50600-0550-19
PKU cooler20 Red					50600-0520-01
MAPLE SYRUP URINE DISEASE (MSUD)
MSUD gel Unflavored	1 year and older	Powder	30x24g packets		50600-0514-93	B4162
MSUD express15 Unflavored	3 years and older	Powder	30x25g packets		50600-0535-34	B4162/B4157
MSUD cooler15 Orange	3 years and older	RTD	30x130ml pouches		50600-0546-54	B4162/B4157
MSUD cooler15 Red					50600-0509-15
TYROSINEMIA
TYR gel Unflavored	1 year and older	Powder	30x24g packets		50600-0515-09	B4162
TYR express15 Unflavored	3 years and older	Powder	30x25g packets		50600-0538-48	B4162/B4157
TYR cooler15 Orange	3 years and older	RTD	30x130ml pouches		50600-0539-92	B4162/B4157
TYR cooler15 Red					50600-0543-26
HOMOCYSTINURIA
HCU gel Unflavored	1 year and older	Powder	30x24g packets		50600-0514-86	B4162
HCU express15 Unflavored	3 years and older	Powder	30x25g packets		50600-0535-58	B4162/B4157
HCU cooler15 Orange	3 years and older	RTD	30x130ml pouches		50600-0535-27	B4162/B4157
HCU cooler15 Red					50600-0504-34
METHYLMALONIC ACIDEMIA & PROPIONIC ACIDEMIA
MMA/PA gel Unflavored	1 year and older	Powder	30x24g packets		50600-0515-23	B4162
MMA/PA express15 Unflavored	3 years and older	Powder	30x25g packets		50600-0543-71	B4162/B4157
GLUTARIC ACIDURIA TYPE 1
GA gel Unflavored	1 year and older	Powder	30x24g packets		50600-0515-16	B4162
GA express15 Unflavored	3 years and older	Powder	30x25g packets		50600-0516-22	B4162/B4157
UREA CYCLE DISORDERS
EAA Supplement	3 years and older	Powder	50x12.5g packets		50600-0549-06	B4155
Solvil	1 year and older	Powder	30x5g packets		50600-0522-85	B4155
DISORDERS OF FAT METABOLISM
Lipistart	1 year and older	Powder	400g can		50600-0502-05	B4158/B4150
MCT Procal (packets)	1 year and older	Powder	30x16g packets		50600-0502-36	B4155
MCT Procal (tub)			480g tub		50600-0507-62
CLINICAL NUTRITION THERAPY
Pro-Cal (packets)	1 year and older	Powder	30x15g packets		50600-0500-76	B4155
Pro-Cal (tub)			510g tub		50600-0500-07
Doc Omega	1 year and older	Powder	30x4g packets		50600-0505-40	B4157/B4162
Key Omega					50600-0555-07
S.O.S. 15	1 year and older	Powder	30x31g packets		50600-0522-61	B4157/B4162
S.O.S. 20			30x42g packets		50600-0522-78
S.O.S. 25			30x52g packets		50600-0522-85
AMINO ACID SUPPLEMENTS
Arginine500	1 year and older	Powder	30x4g packets		50600-0546-92	B4155
Arginine2000			30x4g packets		50600-0502-67
Citrulline200			30x4g packets		50600-0502-81
Citrulline1000			30x4g packets		50600-0550-95
Cystine500			30x4g packets		50600-0547-77
Creatine5000			30x6g packets		50600-0503-04
Glycine500			30x4g packets		50600-0544-56
Isoleucine50			30x4g packets		50600-0543-02
Isoluecine1000			30x4g packets		50600-0551-18
Leucine100			30x4g packets		50600-0549-20
Lysine4000			30x5.6g packets		50600-0544-49
Methionine100			30x4g packets		50600-0554-40
Phenylalanine50			30x4g packets		50600-0549-44
Tyrosine1000			30x4g packets		50600-0547-91
Valine50			30x4g packets		50600-0543-33
Valine1000			30x4g packets		50600-0551-32
FLAVOURPACS
FlavourPac Lemon	1 year and older	Powder	30x4g packets	50600-0540-98		N/A
FlavourPac Orange				50600-0541-11
FlavourPac Raspberry				50600-0541-35
FlavourPac Black Currant				50600-0541-59
FlavourPac Tropical				50600-0541-73

How to Order

How to Order