Product Details

KetoVie 4:1 Plant Based Protein (Vanilla)

Nutritional Product
1.50 Kcal/mL
Liquid
250-mL Carton

DIN/PIN/NPN

09858245

Manufacturer

Ajinomoto Cambrooke, Inc.

Formulary Listing Date

2023-06-30  

Unit Price

9.2448

Amount MOH Pays

9.2448

Coverage Status

Nutrition Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

Interchangeable Products

NO  

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph