| Package AWP: | $14.16 |
| Package: | 30 EA |
| J-Code: | |
| Strength: | 40 MG-125 MG-3 |
| Form: | Capsule |
| NDC Number: | 52747071030 52747-0710-30 |
| Generic Name: | 931828 931828 |
| Brand Name: | INTEGRA |
| Mfg. Part No: | 4556742 |
| Std Packaging: | 30/BT |
| Manufacturer: | US Pharma Corp |
| Replacement: | |
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