DIN/PIN/NPN Detail

52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS

52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS

Lacri-Lube (PETROLATUM/MINERAL OIL)55% & 42.5% Oph Oint-3.5g Pk

DIN/PIN/NPN:00210889

Interchangeables:

Manufacturer:

Formulary Listing Date:

1996-10-01

Drug Benefit Price or Unit Price:

7.1900

Amount MOH Pays:

7.1900

Coverage Status: