DIN/PIN/NPN Detail |
|
| 40:00 ELECTROLYTIC, CALORIC AND WATER BALANCE | |
| 40:20:00 CALORIC AGENTS | LU Criteria Text |
| Interchangeables: | NO |
| Manufacturer: | Baxter Corporation |
| Formulary Listing Date: | 2020-06-30 |
| Drug Benefit Price or Unit Price: | 30.0000 |
| Amount MOH Pays: | 30.0000 |
| Coverage Status: |
|