Ordering & Reimbursement Information
|
Product Number
|
Description
|
Packaging
|
Reimbursement Code
|
HCPCS Code
|
|
53206
51639
|
PKU express15 Unflavored
PKU express20 Unflavored
|
30 x 25g packets
30 x 34g packets
|
50600-0532-06
50600-0516-39
|
B4162 & B4157
B4162 & B4157
|
|
53220
51769
|
PKU express15 Orange
PKU express20 Orange
|
30 x 25g packets
30 x 34g packets
|
50600-0532-20
50600-0517-69
|
B4162 & B4157
B4162 & B4157
|
|
53305
51776
|
PKU express15 Lemon
PKU express20 Lemon
|
30 x 25g packets
30 x 34g packets
|
50600-0533-05
50600-0517-76
|
B4162 & B4157
B4162 & B4157
|
|
53336
51783
|
PKU express15 Tropical
PKU express20 Tropical
|
30 x 25g packets
30 x 34g packets
|
50600-0533-36
50600-0517-83
|
B4162 & B4157
B4162 & B4157
|
|
|