DIN/PIN/NPN Detail |
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84:00 SKIN AND MUCOUS MEMBRANE PREPARATIONS | |
84:36:00 MISCELLANEOUS SKIN AND MUCOUS MEMBRANE AGENTS | LU Criteria Text |
Interchangeables: | NO |
Manufacturer: | Leo Pharma Inc. |
Formulary Listing Date: | 1997-04-10 |
Drug Benefit Price or Unit Price: | 1.2208 |
Amount MOH Pays: | 1.2208 |
Coverage Status: |
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