Blue Cross Blue Shield Oklahoma prior authorization B4161
Blue Cross Blue Shield Oklahoma prior authorization for B4161: Enteral Formula For Pediatrics Hydrolyzed/Amino Acids And Peptide Chain Proteins Includes Fats Carbohydrates Vitamins And Minerals May Include Fiber Administered Through An Enteral Feeding Tube 100 Calories = 1 Unit
- Code
- B4161
- Description
- Enteral Formula For Pediatrics Hydrolyzed/Amino Acids And Peptide Chain Proteins Includes Fats Carbohydrates Vitamins And Minerals May Include Fiber Administered Through An Enteral Feeding Tube 100 Calories = 1 Unit
- Source
- 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 200 Original policy