Caloric Agents

Showing all 5 results

NAME	ALSO KNOW AS	DRUG CATEGORY	FORMULARY CATEGORY	WHAT WE COVER	COST SHARE
Dextrose Soln 10%(Generic)	Dextrose Soln 10 % (Brand)	Caloric Agents	MA	Administered in Medical Office	N/A
Dextrose Soln 5%(Generic)	Dextrose Soln 5 % (Brand)	Caloric Agents	MA	Administered in Medical Office	N/A
Fat Emulsion Plant Based Emul 20Gm/100Ml (Generic)	Intralipid Emul 20 % (Brand)	Caloric Agents	MA	Administered in Medical Office	N/A
Fat Emulsion Plant Based Emul 20Gm/100Ml (Generic)	Nutrilipid Emul 20 % (Brand)	Caloric Agents	MA	Administered in Medical Office	N/A
Fat Emulsion Plant Based Emul 30Gm/100Ml (Generic)	Intralipid Emul 30 % (Brand)	Caloric Agents	MA	Administered in Medical Office	N/A