GLYCOMACROPEPTIDE FORMULA WITH AMINO ACIDS, VITAMINS, MINERALS, TRACE ELEMENTS, CARBOHYDRATE, FAT AND LOW PHENYLALANINE
glycomacropeptide formula with amino acids, vitamins, minerals, trace elements, carbohydrate,
fat and low phenylalanine powder for oral liquid, 30 x 33.4 g sachets
GLYCOMACROPEPTIDE FORMULA WITH AMINO ACIDS, VITAMINS, MINERALS, TRACE ELEMENTS, CARBOHYDRATE, FAT AND LOW PHENYLALANINE (14644R)
14644R
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: 4 | Max qty units: 4 | # of repeats: 5 | DPMQ: $2,085.72 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| PKU GMPro ULTRA | |||||