DIN/PIN/NPN Detail
92:00 UNCLASSIFIED THERAPEUTIC AGENTS
LU Criteria Text
Jamp-Montelukast
(MONTELUKAST SODIUM)
4mg Chew Tab
DIN/PIN/NPN:
02442353
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Interchangeables:
YES
Manufacturer:
Jamp Pharma Corporation
Formulary Listing Date:
2018-12-21
Drug Benefit Price or Unit Price:
0.2758
Amount MOH Pays:
0.2758
Coverage Status:
Limited Use Product
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