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