DIN/PIN/NPN Detail

92:00 UNCLASSIFIED THERAPEUTIC AGENTS

LU Criteria Text

Apo-Montelukast (MONTELUKAST SODIUM)4mg Chew Tab

DIN/PIN/NPN:02377608

Interchangeables:

Manufacturer:

Formulary Listing Date:

2012-02-29

Drug Benefit Price or Unit Price:

0.2758

Amount MOH Pays:

0.2758

Coverage Status:

Limited Use Product