DIN/PIN/NPN Detail |
|
| 52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS | |
| 52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS | LU Criteria Text |
| Interchangeables: | NO |
| Manufacturer: | Allergan Inc. |
| Formulary Listing Date: | 1996-10-01 |
| Drug Benefit Price or Unit Price: | 7.9000 |
| Amount MOH Pays: | 7.9000 |
| Coverage Status: |
|