DIN/PIN/NPN Detail

68:00 HORMONES AND SUBSTITUTES

68:12:00 CONTRACEPTIVES

Mirena (LEVONORGESTREL)52mg Insert

DIN/PIN/NPN:02243005

Interchangeables:

NO

Manufacturer:

Bayer Inc., Consumer Care Division

Formulary Listing Date:

2001-10-11

Drug Benefit Price or Unit Price:

372.5500

Amount MOH Pays:

372.5500

Coverage Status:

General Benefit