DIN/PIN/NPN Detail

12:00 AUTONOMIC AGENTS

12:04:00 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS

LU Criteria Text

PMS-Donepezil (DONEPEZIL HCL)5mg Tab

DIN/PIN/NPN:02322331

Interchangeables:

Manufacturer:

Pharmascience Inc.

Formulary Listing Date:

2014-02-27

Drug Benefit Price or Unit Price:

0.4586

Amount MOH Pays:

0.4586

Coverage Status:

Limited Use Product