DIN/PIN/NPN Detail |
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| 12:00 AUTONOMIC AGENTS | |
| 12:08:08 PARASYMPATHOLYTIC (CHOLINERGIC BLOCKING) AGENTS ANTIMUSCARINICS/ANTISPASMODICS | LU Criteria Text |
Glycopyrrolate Injection USP (GLYCOPYRROLATE)4mg/20mL Inj Sol (With Preservative)
DIN/PIN/NPN:02473887
| Interchangeables: | YES |
| Manufacturer: | Sterimax Inc. |
| Formulary Listing Date: | 2022-08-31 |
| Drug Benefit Price or Unit Price: | 2.7825 |
| Amount MOH Pays: | 2.7825 |
| Coverage Status: |
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