DIN/PIN/NPN Detail
96:00 MISCELLANEOUS
96:01:00 NUTRITION PRODUCTS
Jevity 1.5 Cal
(NUTRITIONAL PRODUCT)
1.5kcal/mL Liq-1000mL Pk
DIN/PIN/NPN:
09857310
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Interchangeables:
NO
Manufacturer:
Abbott Laboratories Limited
Formulary Listing Date:
2008-12-03
Drug Benefit Price or Unit Price:
N/A
Amount MOH Pays:
11.5200
Coverage Status:
Nutrition Product
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