DIN/PIN/NPN Detail |
92:00 UNCLASSIFIED THERAPEUTIC AGENTS | |
LU Criteria Text |
Interchangeables: | YES |
Manufacturer: | Pharmacia & Upjohn |
Formulary Listing Date: | 2008-06-27 |
Drug Benefit Price or Unit Price: | 21.7350 |
Amount MOH Pays: | 12.3941 |
Coverage Status: |
|