DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Similac Alimentum (Temporary Benefit)(NUTRITIONAL PRODUCT)0.677kcal/mL Pd-946mL Bottle

DIN/PIN/NPN:09858158

Interchangeables:

Manufacturer:

Formulary Listing Date:

2022-06-30

Drug Benefit Price or Unit Price:

5.6278

Amount MOH Pays:

5.6278

Coverage Status: