DIN/PIN/NPN Detail
96:00 MISCELLANEOUS
96:01:00 NUTRITION PRODUCTS
Nutramigen A+
(NUTRITIONAL PRODUCT)
5kcal/g Pd-454g Pk
DIN/PIN/NPN:
09857345
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Interchangeables:
NO
Manufacturer:
Mead Johnson Nutritionals
Formulary Listing Date:
2010-03-02
Drug Benefit Price or Unit Price:
N/A
Amount MOH Pays:
29.1300
Coverage Status:
Nutrition Product
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