DIN/PIN/NPN Detail

28:00 CENTRAL NERVOUS SYSTEM DRUGS

28:10:00 OPIATE ANTAGONISTS

LU Criteria Text

Apo-Naltrexone (NALTREXONE HCL)50mg Tab

DIN/PIN/NPN:02444275

Interchangeables:

Manufacturer:

Formulary Listing Date:

2015-11-26

Drug Benefit Price or Unit Price:

2.8075

Amount MOH Pays:

2.8075

Coverage Status:

Limited Use Product