TRIGLYCERIDES MEDIUM CHAIN FORMULA

triglycerides medium chain formula oral liquid, 12 x 500 mL bottles
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: 12 Max qty units: 12 # of repeats: 5 DPMQ: $1,553.40 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Nutrini Peptisorb