B4162

Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Short Description: Ef ped specmetabolic inherit

Coverage Code: Special coverage instructions apply

Action Code: No maintenance for this code

Date Added: January 1, 2005

Effective Date: January 1, 2005

Termination Date:

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