DIN/PIN/NPN Detail

08:00 ANTI-INFECTIVE AGENTS

08:18:00 ANTIVIRALS

LU Criteria Text

Apo-Entecavir (ENTECAVIR)0.5mg Tab

DIN/PIN/NPN:02396955

Interchangeables:

Manufacturer:

Formulary Listing Date:

2013-01-29

Drug Benefit Price or Unit Price:

5.5000

Amount MOH Pays:

4.4000

Coverage Status:

Limited Use Product