TRIGLYCERIDES MEDIUM CHAIN AND LONG CHAIN WITH GLUCOSE POLYMER

triglycerides medium chain and long chain with glucose polymer powder for oral liquid, 400 g
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Proven inborn errors of protein metabolism
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: $240.08 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Duocal