AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE
amino acid formula with vitamins and minerals without phenylalanine oral semi-solid,
36 x 109 g tubs
AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE (2806Q)
2806Q
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: 3 | Max qty units: 3 | # of repeats: 5 | DPMQ: $1,520.97 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| PKU Lophlex Sensation 20 | |||||