Vitaflo Product Reimbursement & HCPCS 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.

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Find Your Product Code

Choose from the options below to find the reimbursement code you need.

Step 1
Choose Product Category
Step 2
Choose Product
- Renastart
- Renastep
Renastart: 12539-0021-49

HCPCS Code: B4154
Product Description: 1 year and older - Powder - 400g can
Renastep: 12539-0024-84

HCPCS Code: B4154
Product Description: 1 year and older - RTD - 15 x 200 ml can
Choose Product
- PKU air20
- PKU cooler10
- PKU cooler15
- PKU cooler20
- PKU explore5
- PKU explore10
- PKU express plus15
- PKU express plus20
- PKU gel
- PKU sphere15
- PKU sphere20
- PKU sphere20 Liquid
- PKU start
- PKU trio
PKU start
- PKU start (unflavored): 60385-0940-58
HCPCS Code: B4162
PKU air20
- PKU air20 Gold: 12539-0021-69
- PKU air20 Green: 12539-0021-70
- PKU air20 Yellow: 12539-0021-71
HCPCS Code: B4162 & B4157
PKU explore5 Unflavored: 12539-0024-65

HCPCS Code: B4162 & B4157
PKU explore10
- PKU explore10: Orange: 12539-0024-66
- PKU explore10 Raspberry: 12539-0024-67
HCPCS Code: B4162 & B4157
PKU sphere15
- PKU sphere15 Red Berry: 12539-0021-13
- PKU sphere15 Vanilla: 12539-0021-43
HCPCS Code: B4162 & B4157

Product Description: 3 years and older - Powder - 30 x 27g packets
PKU sphere20 Liquid Vanilla: 12539-0024-80

HCPCS Code: B4162 & B4157

Product Description: 3 years and older - RTD - 18x 237ml packets
PKU sphere20
- PKU sphere20 Chocolate: 12539-0022-05
- PKU sphere20 Red Berry: 12539-0021-11
- PKU sphere20 Vanilla: 12539-0021-12
- PKU sphere20 Banana: 12539-0025-82
- PKU sphere20 Lemon: 12539-0025-80
HCPCS Code: B4162 & B4157

Product Description: 3 years and older - Powder - 30 x 35g packets
PKU trio
- PKU trio Unflavored: 50600-0518-06
- PKU trio Vanilla: 50600-0518-13
HCPCS Code: B4162 & B4157
PKU Gel
- PKU gel Unflavored: 50600-0514-48
- PKU gel Orange: 50600-0514-62
- PKU gel Raspberry: 50600-0514-55
HCPCS Code: B4162
Product Description: 1 year and older - Powder - 30x24g packets
PKU express plus15
- PKU express plus15 Unflavored: 12539-0024-87
- PKU express plus15 Orange: 12539-0024-89
- PKU express plus15 Lemon: 12539-0024-88
- PKU express plus15 Tropical: 12539-0024-90
- PKU express plus15 Raspberry: 12539-0025-21
HCPCS Code: B4162/B4157
Product Description: 3 years and older - Powder - 30x25g packets
PKU express plus20
- PKU express plus20 Unflavored: 12539-0024-91
- PKU express plus20 Orange: 12539-0024-93
- PKU express plus20 Lemon: 12539-0024-92
- PKU express plus20 Tropical: 12539-0024-94
- PKU express plus20 Raspberry: 12539-0025-22
HCPCS Code: B4162/B4157
Product Description: 3 years and older - Powder - 30x34g packets
PKU cooler10
- PKU cooler10 Orange: 50600-0548-52
- PKU cooler10 Purple: 50600-0548-76
- PKU cooler10 White: 50600-0549-99
- PKU cooler10 Red: 50600-0513-18
HCPCS Code: B4162/B4157
Product Description: 3 years and older - RTD - 30x87ml pouches
PKU cooler15
- PKU cooler15 Orange: 50600-0545-00
- PKU cooler15 Purple: 50600-0545-62
- PKU cooler15 White: 50600-0549-75
- PKU cooler15 Red: 50600-0519-98
HCPCS Code: B4162/B4157
Product Description: 3 years and older - RTD - 30x130ml pouches
PKU cooler20:
- PKU cooler20 Orange: 50600-0548-14
- PKU cooler20 Purple: 50600-0548-38
- PKU cooler20 White: 50600-0550-19
- PKU cooler20 Red: 50600-0520-01
HCPCS Code: B4162/B4157
Product Description: 3 years and older - RTD - 30x174ml pouches
Choose Product
- MSUD gel Unflavored
- MSUD express plus15 Unflavored
- MSUD express plus20 Unflavored
- MSUD cooler15 Orange
- MSUD cooler15 Red
MSUD gel Unflavored: 50600-0514-93

HCPCS Code: B4162
Product Description: 1 years and older - Powdered - 30x24g packets
MSUD express plus15 Unflavored: 12539-0024-99

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - Powdered - 30x25g packets
MSUD express plus20 Unflavored Reimbursement Code: 12539-0025-00

HCPCS Code: B4162 & B4157
Product Description: 3 year and older - Powdered - 30x34g packets
MSUD cooler15 Orange: 50600-0546-54

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - RTD - 30x130ml pouches
MSUD cooler15 Red: 50600-0509-15

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - RTD - 30x130ml pouches
Choose Product
- TYR gel Unflavored
- TYR express plus15 Unflavored
- TYR express plus20 Unflavored
- TYR cooler15 Orange
- TYR cooler15 Red
- TYR sphere20 Red Berry
- TYR sphere20 Vanilla
TYR gel Unflavored: 50600-0515-09

HCPCS Code: B4162 & B4157
Product Description: 1 year and older - Powder - 30x24g packets
TYR express plus15 Unflavored: 12539-0024-95

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - Powder - 30x25g packets
TYR express plus20 Unflavored: 12539-0024-96

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - Powder - 30x34g packets
TYR cooler15 Orange Reimbursement Code: 50600-0539-92

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - RTD - 30x130ml pouches
TYR cooler15 Red: 50600-0543-26

HCPCS Code: B4162 & B4157
Product description: 3 years and older - RTD - 30x130ml pouches
TYR sphere20 Red Berry: 12539-0022-09

HCPCS Code: B4162 & B4157
Product description: 3 years and older - Powder - 30 x 35g pouches
TYR sphere20 Vanilla: 12539-0021-12

HCPCS Code: B4162 & B4157
Product description: 3 years and older - Powder - 30 x 35g pouches
Choose Product
- HCU gel Unflavored
- HCU express plus15 Unflavored
- HCU express plus20 Unflavored
- HCU cooler15 Orange
- HCU cooler15 Red
HCU gel Unflavored: 50600-0514-86

HCPCS: B4162
Product Description: 1 year and older - Powder - 30x24g packets
HCU express plus15 Unflavored: 12539-0024-97

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - Powder - 30x25g packets
HCU express plus20 Unflavored: 12539-0024-98

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - Powder - 30x34g pouches
HCU cooler15 Orange: 50600-0535-27

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - RTD - 30x130g pouches
HCU cooler15 Red Reimbursement Code: 50600-0504-34

HCPCS Code: B4162 & B4157
Product Description: 3 years and older - RTD - 30x130g pouches
Choose Product
- MMA/PA gel Unflavored
- MMA/PA express15 Unflavored
- MMA/PA cooler15 Red
MMA/PA gel Unflavored: 50600-0515-23

HCPCS Code: B4162
Product Description: 1 year and older - Powder - 30x24g packets
MMA/PA express15 Unflavored: 12539-0020-07

HCPCS Code: B4162/B4157
Product Description: 3 years and older - Powder - 30x25g packets
MMA/PA cooler15 Red Unflavored: 50600-0561-22

HCPCS Code: B4162/B4157
Product Description: 3 years and older - RTD - 30x130ml pouches
Choose Product
- GA gel Unflavored
- GA express15 Unflavored
GA gel Unflavored: 50600-0515-16

HCPCS Code: B4162
Product Description: 1 year and older - Powder - 30x24g packets
GA express15 Unflavored: 50600-0516-22

HCPCS Code: B4162/B4157
Product Description: 3 years and older - Powder - 30x245 packets
Choose Product
- EAA Supplement
- UCD trio
EAA Supplement: 50600-0549-06

HCPCS Code: B4162/B4157
Product Description: 3 years and older - Powder - 50×12.5g packets
UCD trio: 50600-0560-54

HCPCS Code: B4162/B4157
Product Description: 1 year and older - Powder - 400g can
Choose Product
- Lipistart
- MCT Procal (packets)
- K·Quik (previously betaquik)
Lipistart: 12539-0021-47

HCPCS Code: B4158/B4150
Product Description: 1 year and older - Powder - 400g can
MCT Procal (packets): 50600-0502-36

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x16g packets
K·Quik (previously betaquik): 12539-0025-75
HCPCS Code: B4155
Product Description: 3 years and older – 15 x 225 ml bottles
Choose Product
- Glycosade
- Glycosade Lemon
Glycosade: 50600-0514-00

HCPCS Code: B4155
Product Description: 5 years and older - Powder - 30x60g packets
Glycosade Lemon: 12539-0024-76

HCPCS Code: B4155
Product Description: 5 years and older - Powder - 30x60g packets
Choose Product
- S.O.S. 20
- S.O.S. 25
S.O.S. 20 Reimbursement Code: 50600-0522-78

HCPCS Code: B4157/B4162
Product Description: 1 year and older - Powder - 30x42g packets
S.O.S. 25: 50600-0522-85

HCPCS Code: B4157/B4162
Product Description: 1 year and older - Powder - 30x52g packets
Choose Product
- Arginine500
- Arginine2000
- Citrulline200
- Citrulline1000
- Cystine500
- Creatine5000
- Glycine500
- Isoleucine50
- Isoluecine1000
- Leucine100
- Methionine100
- Phenylalanine50
- Tyrosine1000
- Valine50
- Valine1000
Arginine500: 50600-0546-92

HCPCS Code: B4155
Product Description; 1 year and older - Powder - 30x4g packets
Arginine2000: 50600-0502-67

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Citrulline200: 50600-0502-81

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Citrulline1000: 50600-0550-95

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Cystine500: 50600-0547-77

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Creatine5000: 50600-0503-04

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x6g packets
Glycine500: 50600-0544-56

HCPCS Code: B4155
Product Decription: 1 year and older - Powder - 30x4g packets
Isoleucine50: 50600-0543-02

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Isoleucine1000: 50600-0551-18

HCPCS Code:B4155
Product Description: 1 year and older - Powder - 30x4g packets
Leucine100: 50600-0549-20

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Methionine100: 50600-0554-40

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Phenylalanine50: 50600-0549-44

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Tyrosine1000: 50600-0547-91

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Valine50: 50600-0543-33

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Valine1000: 50600-0551-32

HCPCS Code: B4155
Product Description: 1 year and older - Powder - 30x4g packets
Choose Product
- FruitiVits (Orange Flavor)
- K·Quik (previously betaquik)
- K·Flo
- MCTprocal
FruitiVits (Orange Flavor): 50600-0513-25

HCPCS Code: B4104
Product Description: 4 years and older - 30x6g packets
K·Quik (previously betaquik): 12539-0025-75
HCPCS Code: B4155
Product Description: 3 years and older – 15 x 225 ml bottles
K·Flo: 12539-0025-77
HCPCS Code: B4154
Product Description: 3 years and older – 24 x 250 ml (8.45 fl oz) bottles
MCTprocal: 50600-0502-36
HCPCS Code: B4155
Product Description: 3 years and older – 30 x 16 g packets
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Reimbursement & HCPCS Codes

Find Your Product Code

Step 1

Step 2

Renastart: 12539-0021-49

HCPCS Code: B4154

Renastep: 12539-0024-84

HCPCS Code: B4154

PKU start

HCPCS Code: B4162

PKU air20

HCPCS Code: B4162 & B4157

PKU explore5 Unflavored: 12539-0024-65

HCPCS Code: B4162 & B4157

PKU explore10

HCPCS Code: B4162 & B4157

PKU sphere15

HCPCS Code: B4162 & B4157

PKU sphere20 Liquid Vanilla: 12539-0024-80

HCPCS Code: B4162 & B4157

PKU sphere20

HCPCS Code: B4162 & B4157

PKU trio

HCPCS Code: B4162 & B4157

PKU Gel

HCPCS Code: B4162

PKU express plus15

HCPCS Code: B4162/B4157

PKU express plus20

HCPCS Code: B4162/B4157

PKU cooler10

HCPCS Code: B4162/B4157

PKU cooler15

HCPCS Code: B4162/B4157

PKU cooler20:

HCPCS Code: B4162/B4157

MSUD gel Unflavored: 50600-0514-93

HCPCS Code: B4162

MSUD express plus15 Unflavored: 12539-0024-99

HCPCS Code: B4162 & B4157

MSUD express plus20 Unflavored Reimbursement Code: 12539-0025-00

HCPCS Code: B4162 & B4157

MSUD cooler15 Orange: 50600-0546-54

HCPCS Code: B4162 & B4157

MSUD cooler15 Red: 50600-0509-15

HCPCS Code: B4162 & B4157

TYR gel Unflavored: 50600-0515-09

HCPCS Code: B4162 & B4157

TYR express plus15 Unflavored: 12539-0024-95

HCPCS Code: B4162 & B4157

TYR express plus20 Unflavored: 12539-0024-96

HCPCS Code: B4162 & B4157

TYR cooler15 Orange Reimbursement Code: 50600-0539-92

HCPCS Code: B4162 & B4157

TYR cooler15 Red: 50600-0543-26

HCPCS Code: B4162 & B4157

TYR sphere20 Red Berry: 12539-0022-09

HCPCS Code: B4162 & B4157

TYR sphere20 Vanilla: 12539-0021-12

HCPCS Code: B4162 & B4157

HCU gel Unflavored: 50600-0514-86

HCPCS: B4162

HCU express plus15 Unflavored: 12539-0024-97

HCPCS Code: B4162 & B4157

HCU express plus20 Unflavored: 12539-0024-98

HCPCS Code: B4162 & B4157

HCU cooler15 Orange: 50600-0535-27

HCPCS Code: B4162 & B4157

HCU cooler15 Red Reimbursement Code: 50600-0504-34

HCPCS Code: B4162 & B4157

MMA/PA gel Unflavored: 50600-0515-23

HCPCS Code: B4162

MMA/PA express15 Unflavored: 12539-0020-07

HCPCS Code: B4162/B4157

MMA/PA cooler15 Red Unflavored: 50600-0561-22

HCPCS Code: B4162/B4157

GA gel Unflavored: 50600-0515-16

HCPCS Code: B4162