PROTEIN FORMULA WITH CARBOHYDRATE, FAT, VITAMINS AND MINERALS

protein formula with carbohydrate, fat, vitamins and minerals oral liquid, 12 x 500 mL bottles

PROTEIN FORMULA WITH CARBOHYDRATE, FAT, VITAMINS AND MINERALS (11939J)

protein formula with carbohydrate, fat, vitamins and minerals oral liquid, 12 x 500 mL bottles
11939J
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Dietary management of conditions requiring a source of medium chain triglycerides
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: $1,584.02 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Nutrini Peptisorb Energy