SOY PROTEIN AND FAT FORMULA WITH VITAMINS AND MINERALS CARBOHYDRATE FREE
soy protein and fat formula with vitamins and minerals carbohydrate free oral liquid,
384 mL can
SOY PROTEIN AND FAT FORMULA WITH VITAMINS AND MINERALS CARBOHYDRATE FREE (8577K)
8577K
Body System:
Manner of administration:Oral
Restriction
Indication: Ketogenic diet
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 120 | Max qty units: 120 | # of repeats: 5 | DPMQ: $553.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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| RCF | |||||