PKU gel Unflavored 1 year and older Powder 30x24g packets B4162
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1 Reimbursement Codes The following information is provided to assist you with obtaining insurance reimbursement for Vitaflo 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 B4162 PKU gel Orange PKU gel Raspberry PKU express15 Unflavored PKU express15 Orange PKU express15 Lemon PKU express15 Tropical PKU express20 Unflavored 3 years and older Powder PKU express20 Orange PKU express20 Lemon PKU express20 Tropical PKU cooler10 Orange 3 years and older RTD 30x87ml pouches PKU cooler10 Purple PKU cooler10 White PKU cooler10 Red
2 PKU cooler15 Orange 3 years and older RTD 30x130ml pouches PKU cooler15 Purple PKU cooler15 White PKU cooler15 Red PKU cooler20 Orange 3 years and older RTD 30x174ml pouches PKU cooler20 Purple PKU cooler20 White PKU cooler20 Red MAPLE SYRUP URINE DISEASE (MSUD) MSUD gel Unflavored 1 year and older Powder 30x24g packets B4162 MSUD express15 Unflavored MSUD express20 Unflavored MSUD cooler15 Orange 3 years and older RTD 30x130ml pouches MSUD cooler15 Red TYROSINEMIA TYR gel Unflavored 1 year and older Powder 30x24g packets B4162 TYR express15 Unflavored TYR express20 Unflavored TYR cooler15 Orange 3 years and older RTD 30x130ml pouches TYR cooler15 Red HOMOCYSTINURIA
3 HCU gel Unflavored 1 year and older Powder 30x24g packets B4162 HCU express15 Unflavored HCU express20 Unflavored HCU cooler15 Orange 3 years and older RTD 30x130ml pouches HCU cooler15 Red METHYLMALONIC ACIDEMIA & PROPIONIC ACIDEMIA MMA/PA gel Unflavored 1 year and older Powder 30x24g packets B4162 MMA/PA express15 Unflavored MMA/PA cooler15 Red 3 years and older RTD 30x130ml pouches GLUTARIC ACIDURIA TYPE 1 GA gel Unflavored 1 year and older Powder 30x24g packets B4162 GA express15 Unflavored UREA CYCLE DISORDERS EAA Supplement 3 years and older Powder g packets UCD trio 1 year and older Powder 400g can DISORDERS OF FAT METABOLISM Lipistart 1 year and older Powder 400g can B4158/B4150 MCT Procal 1 year and older Powder 30x16g packets B4155 DISORDERS OF CARBOHYDRATE METABOLISM Glycosade 5 years and older Powder 30x60g packets B4157/B4162 EMERGENCY REGIMEN
4 S.O.S year and older Powder 30x31g packets B4157/B4162 S.O.S x42g packets S.O.S x52g packets SINGLE DOSE AMINO ACIDS Alanine year and older Powder 30x4g packets B4155 Arginine500 30x4g packets Arginine x4g packets Citrulline200 30x4g packets Citrulline x4g packets Cystine500 30x4g packets Creatine x6g packets Glycine500 30x4g packets Isoleucine50 30x4g packets Isoluecine x4g packets Leucine100 30x4g packets Lysine g packets Methionine100 30x4g packets Phenylalanine50 30x4g packets Tyrosine x4g packets Valine50 30x4g packets Valine x4g packets
5 FLAVOURPACS FlavourPac Lemon 1 year and older Powder 30x4g packets N/A FlavourPac Orange FlavourPac Raspberry FlavourPac Black Currant FlavourPac Tropical KETOGENIC DIETS FruitiVits (Orange Flavor) 4 years and older Powder 30x6g packets B4104 Betaquik 3 years and older Liquid 18 x 250ml cartons B4155 Carbzero 3 years and older Liquid 18 x 250ml cartons B4155
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