DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Modulen (NUTRITIONAL PRODUCT)1kcal/mL Pd-400g Pk

DIN/PIN/NPN:09857393

Interchangeables:

NO

Manufacturer:

Nestle Health Science

Formulary Listing Date:

2011-09-15

Drug Benefit Price or Unit Price:

N/A

Amount MOH Pays:

29.0000

Coverage Status:

Nutrition Product