DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Peptamen 1.5 with Prebio (NUTRITIONAL PRODUCT)1.5kcal/mL Liq - 250mL Tetra Pk

DIN/PIN/NPN:09858355

Interchangeables:

NO

Manufacturer:

Nestle Health Science

Formulary Listing Date:

2025-05-30

Drug Benefit Price or Unit Price:

N/A

Amount MOH Pays:

13.2225

Coverage Status:

Nutrition Product