Source	General Schedule
Body System	VARIOUS > GENERAL NUTRIENTS > OTHER NUTRIENTS

Restricted Benefit

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
3443FMPNP	AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINE, THREONINE AND VALINE AND LOW IN ISOLEUCINE amino acid formula with vitamins and minerals without methionine, threonine and valine and low in isoleucine powder for oral liquid, 30 x 25 g sachets (PI, CMI)	4	4	5	$2560.72	$31.60	$31.60
	Available brands
	MMA/PA express 15

Source	General Schedule
Body System	VARIOUS > GENERAL NUTRIENTS > OTHER NUTRIENTS

Restricted Benefit

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
8591EMPNP	AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE amino acid formula with vitamins and minerals without phenylalanine powder for oral liquid, 30 x 25 g sachets (PI, CMI)	4	4	5	$1271.12	$31.60	$31.60
	Available brands
	PKU express 15

Source	General Schedule
Body System	VARIOUS > GENERAL NUTRIENTS > OTHER NUTRIENTS

Restricted Benefit

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
8632HMPNP	AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINE amino acid formula with vitamins and minerals without valine, leucine and isoleucine powder for oral liquid, 30 x 25 g sachets (PI, CMI)	4	4	5	$2560.72	$31.60	$31.60
	Available brands
	MSUD express 15

Source	General Schedule
Body System	VARIOUS > GENERAL NUTRIENTS > OTHER NUTRIENTS

Restricted Benefit

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
8744FMPNP	AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINE amino acid formula with vitamins and minerals without methionine powder for oral liquid, 30 x 25 g sachets (PI, CMI)	4	4	5	$2560.72	$31.60	$31.60
	Available brands
	HCU express 15