HCPCS Code B4103

Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
Short DescriptionEf ped fluid and electrolyte
Year2026
Coverage CodeD = Special coverage instructions apply
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2005
Code Added DateJanuary 01, 2005
Pricing Indicator46 = Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap - filled amounts)
Type of ServiceE = Enteral/parenteral nutrients/supplies (eff 04/95)