DIN/PIN/NPN Detail |
08:00 ANTI-INFECTIVE AGENTS | |
08:18:00 ANTIVIRALS | LU Criteria Text |
Interchangeables: | YES |
Manufacturer: | Mint Pharmaceuticals Inc. |
Formulary Listing Date: | 2020-03-31 |
Drug Benefit Price or Unit Price: | 5.5000 |
Amount MOH Pays: | 4.4000 |
Coverage Status: |
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