AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE

Source General Schedule
Body System VARIOUS > GENERAL NUTRIENTS > OTHER NUTRIENTS
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
9397NMPNP AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE
amino acid formula with vitamins and minerals without phenylalanine oral liquid, 60 x 62.5 mL cans (PI, CMI)
2 2 5 $856.93 $39.50 $39.50
Available brands
PKU Lophlex LQ 10
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