DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

KetoVie 4:1 Plant Based Protein(Vanilla) (NUTRITIONAL PRODUCT)1.50kcal/mL Liq-250mL Carton

DIN/PIN/NPN:09858245

Interchangeables:

Manufacturer:

Formulary Listing Date:

2023-06-30

Drug Benefit Price or Unit Price:

N/A

Amount MOH Pays:

9.2448

Coverage Status: