DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Althera (Temporary Benefit)(NUTRITIONAL PRODUCT)2024Kcal/400g Pd-400g Can

DIN/PIN/NPN:09858160

Interchangeables:

NO

Manufacturer:

Nestle Health Science

Formulary Listing Date:

2022-07-29

Drug Benefit Price or Unit Price:

18.0700

Amount MOH Pays:

18.0700

Coverage Status:

Temporary Benefit