DIN/PIN/NPN Detail

56:00 GASTROINTESTINAL DRUGS

56:12:00 CATHARTICS

Fleet Enema Mineral Oil (MINERAL OIL)100% Enema

DIN/PIN/NPN:00107875

Interchangeables:

NO

Manufacturer:

C.B. Fleet Company Inc.

Formulary Listing Date:

1996-10-01

Drug Benefit Price or Unit Price:

0.0452

Amount MOH Pays:

0.0452

Coverage Status:

General Benefit