DIN/PIN/NPN Detail |
52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS | |
52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS | LU Criteria Text |
Interchangeables: | YES |
Manufacturer: | Pharmascience Inc. |
Formulary Listing Date: | 2016-10-27 |
Drug Benefit Price or Unit Price: | 2.0951 |
Amount MOH Pays: | 2.0951 |
Coverage Status: |
|