Product Details

Portagen

Nutritional Product
1.02 Kcal/mL
Powder
454-g Pack

DIN/PIN/NPN

09854401

Manufacturer

Mead Johnson Nutritionals

Formulary Listing Date

2003-01-30  

Unit Price

NA

Amount MOH Pays

22.2300

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

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