DIN/PIN/NPN Detail

92:00 UNCLASSIFIED THERAPEUTIC AGENTS

92:36:00 DISEASE-MODIFYING ANTIRHEUMATIC AGENTS

LU Criteria Text

Xeljanz (TOFACITINIB)10mg Tab

DIN/PIN/NPN:02480786

Interchangeables:

Manufacturer:

Pfizer Canada Inc.

Formulary Listing Date:

2020-09-30

Drug Benefit Price or Unit Price:

43.7833

Amount MOH Pays:

21.1718

Coverage Status:

Limited Use Product