DIN/PIN/NPN Detail |
|
| 84:00 SKIN AND MUCOUS MEMBRANE PREPARATIONS | |
| 84:36:00 MISCELLANEOUS SKIN AND MUCOUS MEMBRANE AGENTS | LU Criteria Text |
| Interchangeables: | NO |
| Manufacturer: | AbbVie Corporation |
| Formulary Listing Date: | 2020-01-31 |
| Drug Benefit Price or Unit Price: | 2467.5000 |
| Amount MOH Pays: | 2467.5000 |
| Coverage Status: |
|