DIN/PIN/NPN Detail
96:00 MISCELLANEOUS
96:01:00 NUTRITION PRODUCTS
Jevity 1.2 Cal
(NUTRITIONAL PRODUCT)
1.2kcal/mL Liq-1500mL Pk
DIN/PIN/NPN:
09857117
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Interchangeables:
NO
Manufacturer:
Abbott Laboratories Limited
Formulary Listing Date:
2003-04-16
Drug Benefit Price or Unit Price:
N/A
Amount MOH Pays:
13.7000
Coverage Status:
Nutrition Product
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