DIN/PIN/NPN Detail

92:00 UNCLASSIFIED THERAPEUTIC AGENTS

LU Criteria Text

Protopic (TACROLIMUS)0.1% Oint

DIN/PIN/NPN:02244148

Interchangeables:

NO

Manufacturer:

Leo Pharma Inc.

Formulary Listing Date:

2004-04-06

Drug Benefit Price or Unit Price:

3.5866

Amount MOH Pays:

3.5866

Coverage Status:

Limited Use Product