DIN/PIN/NPN Detail |
|
DIN/PIN/NPN Detail |
|
| 84:00 SKIN AND MUCOUS MEMBRANE PREPARATIONS | Therapeutic Note(s) |
| 84:04:08 ANTI-INFECTIVES FUNGICIDES | LU Criteria Text |
| Interchangeables: | YES |
| Manufacturer: | Laboratoire Riva Inc. |
| Formulary Listing Date: | 2024-04-30 |
| Drug Benefit Price or Unit Price: | 3.9424 |
| Amount MOH Pays: | 3.9424 |
| Coverage Status: |
|