AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINE
amino acid formula with vitamins and minerals without methionine oral liquid, 30 x
125 mL pouches
AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINE (1548L)
1548L
Body System:
Manner of administration:Oral
Restriction
Indication: Pyridoxine non-responsive homocystinuria
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 3 | # of repeats: 5 | DPMQ: $2,560.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| HCU Lophlex LQ 20 | |||||