DIN/PIN/NPN Detail |
|
DIN/PIN/NPN Detail |
|
| 96:00 MISCELLANEOUS | |
| 96:01:00 NUTRITION PRODUCTS |
| Interchangeables: | NO |
| Manufacturer: | Nutricia North America |
| Formulary Listing Date: | 2019-01-31 |
| Drug Benefit Price or Unit Price: | N/A |
| Amount MOH Pays: | 7.0561 |
| Coverage Status: |
|