DIN/PIN/NPN Detail |
|
DIN/PIN/NPN Detail |
|
| 92:00 UNCLASSIFIED THERAPEUTIC AGENTS | |
| LU Criteria Text |
| Interchangeables: | YES |
| Manufacturer: | Jamp Pharma Corporation |
| Formulary Listing Date: | 2020-01-31 |
| Drug Benefit Price or Unit Price: | 0.2565 |
| Amount MOH Pays: | 0.2565 |
| Coverage Status: |
|