DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Vivonex T.E.N. (NUTRITIONAL PRODUCT) Pd-80.4g Pk

DIN/PIN/NPN:09853618

Interchangeables:

NO

Manufacturer:

Nestle Health Science

Formulary Listing Date:

1996-10-01

Drug Benefit Price or Unit Price:

N/A

Amount MOH Pays:

9.7843

Coverage Status:

Nutrition Product