DIN/PIN/NPN Detail |
56:00 GASTROINTESTINAL DRUGS | |
56:22:00 ANTIEMETICS AND ANTINAUSEANTS | LU Criteria Text |
Interchangeables: | YES |
Manufacturer: | Septa Pharmaceuticals Inc. |
Formulary Listing Date: | 2012-03-26 |
Drug Benefit Price or Unit Price: | 3.3495 |
Amount MOH Pays: | 2.5450 |
Coverage Status: |
|