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KetoCal 2.5:1 Liquid, Vanilla |
Product Code |
Reimbursement Code |
HCPCS Code |
Packaging |
Calories Per 8 fl oz Prism |
137246 |
49735-01-7246 |
B4154 |
27 x 237 mL (8fl oz) |
363 |
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|
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KetoCal® 3:1 Powder, Unflavored |
Product Code |
Reimbursement Code |
HCPCS Code |
Packaging |
Calories Per Can |
16672 |
49735-0166-72 |
B4154 |
6 x 300 g (11 oz) |
2097 |
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KetoCal® 4:1 Powder, Vanilla |
Product Code |
Reimbursement Code |
HCPCS Code |
Packaging |
Calories Per Can |
101777 |
49735-0166-70 |
B4154 |
6 x 300 g (11 oz) |
2103 |
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KetoCal® 4:1 Liquid, Unflavored |
Product Code |
Reimbursement Code |
HCPCS Code |
Packaging |
Calories Per 8 fl oz Prism |
80183 |
49735-0130-54 |
|
27 x 237 mL (8 fl oz) |
356 |
|
|
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KetoCal® 4:1 Liquid, Vanilla |
Product Code |
Reimbursement Code |
HCPCS Code |
Packaging |
Calories Per 8 fl oz Prism |
80180 |
49735-0187-96 |
|
27 x 237 mL (8 fl oz) |
356 |
|
|
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Liquigen® |
Product Code |
Reimbursement Code |
HCPCS Code |
Packaging |
Calories Per 8.5 fl oz Bottle |
Case (12 Bottles) |
71957 |
49735-0119-57 |
B4155 |
3 x 4 x 250 mL (8.5 fl oz) |
1125 |
Unit (3 bottles) |
71957-3 |
49735-0195-73 |
B4155 |
4 x 250 mL (8.5 fl oz) |
1125 |
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