DIN/PIN/NPN Detail |
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DIN/PIN/NPN Detail |
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| 28:00 CENTRAL NERVOUS SYSTEM DRUGS | |
| 28:12:00 ANTICONVULSANTS | LU Criteria Text |
| Interchangeables: | NO |
| Manufacturer: | Pendopharm, Division of Pharmascience Inc. |
| Formulary Listing Date: | 2022-12-21 |
| Drug Benefit Price or Unit Price: | 0.8142 |
| Amount MOH Pays: | 0.8142 |
| Coverage Status: |
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