AMINO ACID FORMULA WITH FAT, CARBOHYDRATE WITHOUT PHENYLALANINE
amino acid formula with fat, carbohydrate without phenylalanine tablet: modified release,
4 x 110 g
AMINO ACID FORMULA WITH FAT, CARBOHYDRATE WITHOUT PHENYLALANINE (10683G)
10683G
Body System:
Manner of administration:Oral
Restriction
Indication: Phenylketonuria
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 7 | Max qty units: 7 | # of repeats: 5 | DPMQ: $1,761.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| PKU Easy Microtabs | |||||