| Package AWP: | $5,100.00 |
| Package: | 100 EA |
| J-Code: | |
| Strength: | |
| Form: | Tablet |
| NDC Number: | 59528445601 |
| Generic Name: | Vit C/Biotin/Ca Pantothenate/Vit B12/DSS/Folic Aci |
| Brand Name: | NEPHRON FA |
| Mfg. Part No: | 1923150 |
| Std Packaging: | 100/BT |
| Manufacturer: | NEPHROTECH |
| Replacement: | |