DIN/PIN/NPN Detail

52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS

52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS

Xalacom (LATANOPROST & TIMOLOL MALEATE)50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk

DIN/PIN/NPN:02246619

Interchangeables:

Manufacturer:

Formulary Listing Date:

2004-11-04

Drug Benefit Price or Unit Price:

38.6660

Amount MOH Pays:

11.0670

Coverage Status: