AMINO ACID FORMULA WITHOUT VALINE, LEUCINE AND ISOLEUCINE

amino acid formula without valine, leucine and isoleucine containing 5 g of protein equivalent powder for oral liquid, 30 x 6 g sachets

AMINO ACID FORMULA WITHOUT VALINE, LEUCINE AND ISOLEUCINE (10161T)

amino acid formula without valine, leucine and isoleucine containing 5 g of protein equivalent powder for oral liquid, 30 x 6 g sachets
10161T
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Maple syrup urine disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 12 Max qty units: 12 # of repeats: 5 DPMQ: $2,827.20 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
MSUD amino5