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![]() ![]() severe food allergies that require an elemental formula.inborn errors of metabolism and metabolic disorders.Qualifying medical diagnoses include but are not limited to: Each request is evaluated on an individual basis. Our Oklahoma Formulary can be used for guidance, but it is not all inclusive. *Special formulas for a qualifying medical diagnosis may be requested by completion of the Exception Request for Formula/Food form used for women, infants or children. ![]()
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