| Package AWP: | $123,121.00 |
| Package: | 0.5 ML |
| J-Code: | J1645 |
| Strength: | 12500 IU/0.5 ML |
| Form: | Solution |
| NDC Number: | 00069022002 |
| Generic Name: | Dalteparin Sodium |
| Brand Name: | FRAGMIN |
| Mfg. Part No: | 00069022002 |
| Std Packaging: | 10/BX 12BX/CS |
| Manufacturer: | PFIZER |
| Replacement: | |
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