AMINO ACID SYNTHETIC FORMULA
|
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 |
| 1180DMPNP |
AMINO ACID SYNTHETIC FORMULA amino acid synthetic formula powder for oral liquid, 400 g
(PI,
CMI)
|
8 |
8 |
5 |
$296.00 |
$31.60 |
$31.60 |
| Available brands |
| Neocate Junior Vanilla |
space
AMINO ACID SYNTHETIC FORMULA
|
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 |
| 1192RMPNP |
AMINO ACID SYNTHETIC FORMULA amino acid synthetic formula powder for oral liquid, 400 g
(PI,
CMI)
|
8 |
8 |
5 |
$296.00 |
$31.60 |
$31.60 |
| Available brands |
| Neocate Junior Vanilla |
space
AMINO ACID SYNTHETIC FORMULA
|
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 |
| 1521CMPNP |
AMINO ACID SYNTHETIC FORMULA amino acid synthetic formula powder for oral liquid, 400 g
(PI,
CMI)
|
12 |
12 |
5 |
$439.56 |
$31.60 |
$31.60 |
| Available brands |
| Neocate Junior Vanilla |
space
AMINO ACID SYNTHETIC FORMULA
|
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 |
| 2250KMPNP |
AMINO ACID SYNTHETIC FORMULA amino acid synthetic formula powder for oral liquid, 400 g
(PI,
CMI)
|
12 |
12 |
5 |
$439.56 |
$31.60 |
$31.60 |
| Available brands |
| EleCare |
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AMINO ACID SYNTHETIC FORMULA
|
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 |
| 8574GMPNP |
AMINO ACID SYNTHETIC FORMULA amino acid synthetic formula powder for oral liquid, 400 g
(PI,
CMI)
|
8 |
8 |
5 |
$296.00 |
$31.60 |
$31.60 |
| Available brands |
| EleCare |
space
AMINO ACID SYNTHETIC FORMULA
|
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 |
| 8575HMPNP |
AMINO ACID SYNTHETIC FORMULA amino acid synthetic formula powder for oral liquid, 400 g
(PI,
CMI)
|
8 |
8 |
5 |
$296.00 |
$31.60 |
$31.60 |
| Available brands |
| EleCare |
space
- Legend
- MPMedical Practitioner
- NPNurse Practitioner