Product Details

Nutramigen Liquid Concentrate

Nutritional Product
68 Kcal/100 mL
Liquid
384-mL Can

DIN/PIN/NPN

09858157

Manufacturer

Mead Johnson & Company LLC

Formulary Listing Date

2022-06-30  

Unit Price

8.3200

Amount MOH Pays

8.3200

Coverage Status

Temporary Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

Interchangeable Products

NO  

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph