DIN/PIN/NPN Detail |
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84:00 SKIN AND MUCOUS MEMBRANE PREPARATIONS | Therapeutic Note(s) |
84:36:00 MISCELLANEOUS SKIN AND MUCOUS MEMBRANE AGENTS |
Interchangeables: | YES |
Manufacturer: | Allergan Inc. |
Formulary Listing Date: | 1996-10-01 |
Drug Benefit Price or Unit Price: | 3.1213 |
Amount MOH Pays: | 1.2965 |
Coverage Status: |
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