DIN/PIN/NPN Detail

56:00 GASTROINTESTINAL DRUGS

56:40:00 MISCELLANEOUS G.I. DRUGS

Pentasa (5-AMINOSALICYLIC ACID)4g/100mL Enema

DIN/PIN/NPN:02153556

Interchangeables:

NO

Manufacturer:

Formulary Listing Date:

1996-12-19

Drug Benefit Price or Unit Price:

9.1942

Amount MOH Pays:

9.1942

Coverage Status:

General Benefit