DIN/PIN/NPN Detail

28:00 CENTRAL NERVOUS SYSTEM DRUGS

28:12:00 ANTICONVULSANTS

LU Criteria Text

Topamax Sprinkle (TOPIRAMATE)15mg Sprinkle Cap

DIN/PIN/NPN:02239907

Interchangeables:

NO

Manufacturer:

Janssen-Ortho Inc.

Formulary Listing Date:

2000-11-30

Drug Benefit Price or Unit Price:

2.1580

Amount MOH Pays:

2.1580

Coverage Status:

Limited Use Product