GLYCOMACROPEPTIDE AND ESSENTIAL AMINO ACID FORMULA WITH VITAMINS, MINERALS, AND LOW IN TYROSINE AND PHENYLALANINE
glycomacropeptide and essential amino acid formula with vitamins, minerals, and low
in tyrosine and phenylalanine powder for oral liquid, 30 x 35 g sachets
Body System:
Manner of administration:Oral
Restriction
Indication: Tyrosinaemia
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: $3,902.16 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| TYR Sphere20 | |||||
glycomacropeptide and essential amino acid formula with vitamins, minerals, and low
in tyrosine and phenylalanine powder for oral liquid, 30 x 31 g sachets
Body System:
Manner of administration:Oral
Restriction
Indication: Tyrosinaemia
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: $3,200.12 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Tylactin Build 20 | |||||