DIN/PIN/NPN Detail |
|
| 52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS | |
| 52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS | LU Criteria Text |
Cosopt Preservative free (DORZOLAMIDE HCL & TIMOLOL MALEATE)2% & 0.5% Oph Sol-0.2mL Pk
DIN/PIN/NPN:02258692
| Interchangeables: | NO |
| Manufacturer: | Elvium Life Sciences |
| Formulary Listing Date: | 2010-04-23 |
| Drug Benefit Price or Unit Price: | 0.8505 |
| Amount MOH Pays: | 0.8505 |
| Coverage Status: |
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