DIN/PIN/NPN Detail

96:00 MISCELLANEOUS

96:01:00 NUTRITION PRODUCTS

Peptamen 1.5 with Prebio (NUTRITIONAL PRODUCT)1.5kcal/mL Liq-1500mL Ready-to-Hang

DIN/PIN/NPN:09858356

Interchangeables:

Manufacturer:

Formulary Listing Date:

2025-05-30

Drug Benefit Price or Unit Price:

N/A

Amount MOH Pays:

79.3351

Coverage Status: