Product Details

Pedialyte Flavored

Electrolyte + Dextrose

Oral Liquid

DIN/PIN/NPN

80074173

Manufacturer

Abbott Laboratories Limited

Formulary Listing Date

2018-08-30

Unit Price

0.0079

Amount MOH Pays

0.0079

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

40:12:00 Replacement Agents

Therapeutic Note

NO

ATC Code

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
80072902	Pedialyte Regular	0.0079	0.0079
80074173	Pedialyte Flavored	0.0079	0.0079

LU Clinical Criteria

NO

Requirements

NA

EAP Criteria

NO

Product Monograph

View Monograph