DIN/PIN/NPN Detail

56:00 GASTROINTESTINAL DRUGS

56:22:00 ANTIEMETICS AND ANTINAUSEANTS

LU Criteria Text

CCP-Ondansetron (ONDANSETRON HYDROCHLORIDE)4mg Tab

DIN/PIN/NPN:02458810

Interchangeables:

Manufacturer:

CellChem Pharmaceuticals Inc.

Formulary Listing Date:

2017-11-30

Drug Benefit Price or Unit Price:

3.3495

Amount MOH Pays:

2.5450

Coverage Status:

Limited Use Product