| Package AWP: | $0.00 |
| Package: | |
| J-Code: | |
| Strength: | |
| Form: | |
| NDC Number: | 6404164004 64041-6400-4 |
| Generic Name: | |
| Brand Name: | |
| Mfg. Part No: | 15104 |
| Std Packaging: | 24EA/CS |
| Manufacturer: | ALCAVIS |
| Replacement: | |
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