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Homepage > SB86055

PKU Lophlex LQ 125 mL Pouch, Juicy Tropical
PKU Lophlex LQ 125 mL Pouch, Juicy Tropical SB86055

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86021
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PKU Lophlex LQ 125 mL Pouch, Mixed Berry Blast
Model#: SB86021
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$15.55
86051
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PKU Lophlex LQ 125 mL Pouch, Juicy Orange
Model#: SB86051
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$15.55
86055
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$15.55


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Description
PKU Lophlex LQ 125 mL Pouch, Juicy Tropical. PKU Lophlex LQ 125 mL pouch, tropical ready to drink, 120 calories. A phenylalanine-free, ready-to-drink medical food containing amino acids, vitamins, trace elements and some minerals; for the dietary management of proven Phenylketonuria (PKU) in individuals 4 years and older including pregnant women and women of child-bearing age.
Model #:
SB86055
HCPCS
B4157
Manufacturer