DIN/PIN/NPN Detail

88:00 VITAMINS

88:16:00 VITAMIN D

One-Alpha (ALFACALCIDOL)0.25mcg Cap

DIN/PIN/NPN:00474517

Interchangeables:

Manufacturer:

Leo Pharma Inc.

Formulary Listing Date:

1996-10-01

Drug Benefit Price or Unit Price:

0.6142

Amount MOH Pays:

0.4313

Coverage Status:

General Benefit
Designated Pharaceutical Product