DIN/PIN/NPN Detail

92:00 UNCLASSIFIED THERAPEUTIC AGENTS

92:44:00 IMMUNOSUPPRESSIVE AGENTS

LU Criteria Text

Olumiant (BARICITINIB)2mg Tab

DIN/PIN/NPN:02480018

Interchangeables:

NO

Manufacturer:

Eli Lilly Canada Inc.

Formulary Listing Date:

2021-08-31

Drug Benefit Price or Unit Price:

59.4367

Amount MOH Pays:

59.4367

Coverage Status:

Limited Use Product