DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Peptamen with Prebio (NUTRITIONAL PRODUCT)1kcal/mL Liq-1500mL Pk

DIN/PIN/NPN:09857102

Interchangeables:

NO

Manufacturer:

Nestle Health Science

Formulary Listing Date:

2004-07-20

Drug Benefit Price or Unit Price:

N/A

Amount MOH Pays:

52.8900

Coverage Status:

Nutrition Product