DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Nutramigen A+ with LGG (NUTRITIONAL PRODUCT)5Kcal/g Pd-561g Can Pk

DIN/PIN/NPN:09857565

Interchangeables:

NO

Manufacturer:

Mead Johnson Nutritionals

Formulary Listing Date:

2017-08-30

Drug Benefit Price or Unit Price:

N/A

Amount MOH Pays:

35.9900

Coverage Status:

Nutrition Product