Ordering & Reimbursement Information
|
Product
|
Packaging
|
Product Number
|
Reimbursement Code
|
HCPCS Code
|
|
PKU air20 Gold
|
30 x 174ml
|
21698
|
50600-0216-98
|
B4162
|
|
PKU air20 Green
|
30 x 174ml
|
21704
|
50600-0217-04
|
B4162
|
|
PKU air20 Yellow
|
30 x 174ml
|
21711
|
50600-0217-11
|
B4162
|