DIN/PIN/NPN Detail

84:00 SKIN AND MUCOUS MEMBRANE PREPARATIONS

84:04:06 ANTI-INFECTIVES ANTIVIRALS

Apo-Acyclovir Ointment (ACYCLOVIR)5% Top Oint

DIN/PIN/NPN:02477130

Interchangeables:

Manufacturer:

Formulary Listing Date:

2019-05-31

Drug Benefit Price or Unit Price:

12.3114

Amount MOH Pays:

N/A

Coverage Status:

Off-Formulary Interchangeable