Document ID: chunk:federal_register_of_legislation:F2023N00094:reg:5:p1
Version: federal_register_of_legislation:F2023N00094
Segment Type: reg
Provision Reference: reg 5 (pt 1/9)
Character Range: 2929–10323

5  Particular ready‑prepared pharmaceutical benefits
  Each pharmaceutical benefit mentioned in the following table is specified.

Ready‑prepared pharmaceutical benefits
Column 1                                                                                                                                                                   Column 2                                                                                                                                                       Column 3                         Column 4
Listed drug                                                                                                                                                                Form                                                                                                                                                           Manner of administration         Brand
Acetic Acid                                                                                                                                                                Gel containing acetic acid 0.94% + oxyquinoline sulfate 0.025% + ricinoleic acid 0.75% 100 g                                                                   Topical                          Aci-Jel Vaginal Balance Gel
Amino acid formula supplemented with prebiotics, probiotics and long chain polyunsaturated fatty acids                                                                     Oral powder 400 g (Neocate Syneo)                                                                                                                              Oral                             Neocate Syneo
Amino acid formula with carbohydrate, vitamins, minerals and trace elements without phenylalanine                                                                          Sachets containing oral powder 20 g, 30 (PKU Go)                                                                                                               Oral                             PKU Go
Amino acid formula with carbohydrate without phenylalanine                                                                                                                 Tablets containing 0.92 g protein, 462 (PKU Easy Tablet)                                                                                                       Oral                             PKU Easy Tablet
Amino acid formula with fat, carbohydrate, vitamins, minerals and long chain polyunsaturated fatty acids without phenylalanine and supplemented with docosahexaenoic acid  Oral liquid 500 mL, 20 (PKU Baby)                                                                                                                              Oral                             PKU Baby
Amino acid formula with fat, carbohydrate, vitamins, minerals, and trace elements, without methionine and supplemented with docosahexanoic acid                            Oral liquid 125 mL, 36 (HCU Anamix junior LQ)                                                                                                                  Oral                             HCU Anamix junior LQ
Amino acid formula with fat, carbohydrate, vitamins, minerals and trace elements without phenylalanine                                                                     Bottles containing oral powder 34 g, 30 (PKU Easy Shake & Go)                                                                                                  Oral                             PKU Easy Shake & Go
Amino acid formula with fat, carbohydrate, vitamins, minerals and trace elements without phenylalanine and Tyrosine                                                        Bottles containing oral powder 34g, 30 (TYR Easy Shake & Go)                                                                                                   Oral                             TYR Easy Shake & Go
Amino acid formula with fat, carbohydrate, vitamins, minerals and trace elements without phenylalanine and tyrosine, and supplemented with docosahexanoic acid             Oral liquid 125 mL, 36 (TYR Anamix junior LQ)                                                                                                                  Oral                             TYR Anamix junior LQ
Amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides                                                               Oral powder 400 g (Alfamino Junior)                                                                                                                            Oral                             Alfamino Junior
Oral powder 400 g (Neocate Junior)                                                                                                                                         Oral                                                                                                                                                           Neocate Junior
Amino acid formula with fat, carbohydrate without methionine                                                                                                               Tablets containing 0.91 g protein, 462 (HCU Easy Tablet)                                                                                                       Oral                             HCU Easy Tablet
Amino acid formula with fat, carbohydrate without phenylalanine                                                                                                            Tablets (modified release), 70.8 g protein per 100 g, 110 g, 4 (PKU Easy Microtabs)                                                                            Oral                             PKU Easy Microtabs
Amino acid formula with fat, carbohydrate without phenylalanine and tyrosine                                                                                               Tablets containing 0.91 g protein, 462 (TYR Easy Tablet)                                                                                                       Oral                             TYR Easy Tablet
Amino acid formula with fat, carbohydrate without valine, leucine and isoleucine                                                                                           Tablets containing 0.91 g protein, 462 (MSUD Easy Tablet)                                                                                                      Oral                             MSUD Easy Tablet
Amino acid formula without phenylalanine                                                                                                                                   Tablets 1 g, 75 (Phlexy‑10)                                                                                                                                    Oral                             Phlexy‑10
Amino acid formula without valine, leucine and isoleucine                                                                                                                  Sachets containing oral powder 6 g, 30 (MSUD amino5)                                                                                                           Oral                             MSUD amino5
Amino acid formula with vitamins and minerals, low phenylalanine and