AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS, TRACE ELEMENTS AND MEDIUM CHAIN TRIGLYCERIDES
amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and
medium chain triglycerides powder for oral liquid, 400 g
Body System:
Manner of administration:Oral
Restriction
Indication: Cows' milk protein enteropathy
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Severe cows' milk protein enteropathy with failure to thrive
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Combined intolerance to cows' milk protein, soy protein and protein hydrolysate formulae
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and
soy protein
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Eosinophilic oesophagitis
Treatment phase: Initial treatment for up to 3 months
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 8 | Max qty units: 8 | # of repeats: 5 | DPMQ: $327.92 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Alfamino Junior | |||||
amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and
medium chain triglycerides powder for oral liquid, 400 g
Body System:
Manner of administration:Oral
Restriction
Indication: Cows' milk protein enteropathy
Treatment phase: Continuing treatment
Restriction
Indication: Severe cows' milk protein enteropathy with failure to thrive
Treatment phase: Continuing treatment
Restriction
Indication: Combined intolerance to cows' milk protein, soy protein and protein hydrolysate formulae
Treatment phase: Continuing treatment
Restriction
Indication: Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and
soy protein
Treatment phase: Continuing treatment
Restriction
Indication: Cows' milk anaphylaxis
Restriction
Indication: Severe intestinal malabsorption including short bowel syndrome
Restriction
Indication: Eosinophilic oesophagitis
Treatment phase: Continuing treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 8 | Max qty units: 8 | # of repeats: 5 | DPMQ: $327.92 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Alfamino Junior | |||||
amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and
medium chain triglycerides powder for oral liquid, 400 g
Body System:
Manner of administration:Oral
Restriction
Indication: Cows' milk protein enteropathy
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Severe cows' milk protein enteropathy with failure to thrive
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Combined intolerance to cows' milk protein, soy protein and protein hydrolysate formulae
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and
soy protein
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Eosinophilic oesophagitis
Treatment phase: Initial treatment for up to 3 months
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 8 | Max qty units: 8 | # of repeats: 5 | DPMQ: $344.72 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Neocate Junior | |||||
amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and
medium chain triglycerides powder for oral liquid, 400 g
Body System:
Manner of administration:Oral
Restriction
Indication: Cows' milk protein enteropathy
Treatment phase: Continuing treatment
Restriction
Indication: Severe cows' milk protein enteropathy with failure to thrive
Treatment phase: Continuing treatment
Restriction
Indication: Combined intolerance to cows' milk protein, soy protein and protein hydrolysate formulae
Treatment phase: Continuing treatment
Restriction
Indication: Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and
soy protein
Treatment phase: Continuing treatment
Restriction
Indication: Cows' milk anaphylaxis
Restriction
Indication: Severe intestinal malabsorption including short bowel syndrome
Restriction
Indication: Eosinophilic oesophagitis
Treatment phase: Continuing treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 8 | Max qty units: 8 | # of repeats: 5 | DPMQ: $344.72 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Neocate Junior | |||||
amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and
medium chain triglycerides powder for oral liquid, 400 g
Body System:
Manner of administration:Oral
Restriction
Indication: Cows' milk protein enteropathy
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Severe cows' milk protein enteropathy with failure to thrive
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and
soy protein
Treatment phase: Initial treatment for up to 6 months
Restriction
Indication: Cows' milk protein enteropathy
Treatment phase: Continuing treatment
Restriction
Indication: Severe cows' milk protein enteropathy with failure to thrive
Treatment phase: Continuing treatment
Restriction
Indication: Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and
soy protein
Treatment phase: Continuing treatment
Restriction
Indication: Cows' milk anaphylaxis
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 8 | Max qty units: 8 | # of repeats: 5 | DPMQ: $374.24 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Essential Care Jr | |||||
amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and
medium chain triglycerides powder for oral liquid, 400 g
Body System:
Manner of administration:Oral
Restriction
Indication: Combined intolerance to cows' milk protein, soy protein and protein hydrolysate formulae
Treatment phase: Continuing treatment
Restriction
Indication: Severe intestinal malabsorption including short bowel syndrome
Restriction
Indication: Eosinophilic oesophagitis
Treatment phase: Continuing treatment
Restriction
Indication: Eosinophilic oesophagitis
Treatment phase: Initial treatment for up to 3 months
Restriction
Indication: Combined intolerance to cows' milk protein, soy protein and protein hydrolysate formulae
Treatment phase: Initial treatment for up to 6 months
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 8 | Max qty units: 8 | # of repeats: 5 | DPMQ: $374.24 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Essential Care Jr | |||||