DIN/PIN/NPN Detail |
|
| 56:00 GASTROINTESTINAL DRUGS | |
| 56:40:00 MISCELLANEOUS G.I. DRUGS | LU Criteria Text |
| Interchangeables: | YES |
| Manufacturer: | Accord Healthcare Inc. |
| Formulary Listing Date: | 2014-08-28 |
| Drug Benefit Price or Unit Price: | 0.2287 |
| Amount MOH Pays: | 0.2287 |
| Coverage Status: |
|