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

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  

EAP Criteria

NO

Product Monograph

View Monograph