DIN/PIN/NPN Detail
92:00 UNCLASSIFIED THERAPEUTIC AGENTS
LU Criteria Text
Ragwitek
(STANDARDIZED SHORT RAGWEED POLLEN ALLERGENIC EXTRACT)
12U SL Tab
DIN/PIN/NPN:
02423723
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Interchangeables:
NO
Manufacturer:
ALK-Abello A/S
Formulary Listing Date:
2015-04-30
Drug Benefit Price or Unit Price:
4.6533
Amount MOH Pays:
4.6533
Coverage Status:
Limited Use Product
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