DIN/PIN/NPN Detail |
![]() |
96:00 MISCELLANEOUS | |
96:01:00 NUTRITION PRODUCTS |
Interchangeables: | NO |
Manufacturer: | Vitaflo USA, LLC |
Formulary Listing Date: | 2021-11-30 |
Drug Benefit Price or Unit Price: | N/A |
Amount MOH Pays: | 42.2750 |
Coverage Status: |
|
DIN/PIN/NPN Detail |
![]() |
96:00 MISCELLANEOUS | |
96:01:00 NUTRITION PRODUCTS |
Interchangeables: | NO |
Manufacturer: | Vitaflo USA, LLC |
Formulary Listing Date: | 2021-11-30 |
Drug Benefit Price or Unit Price: | N/A |
Amount MOH Pays: | 42.2750 |
Coverage Status: |
|