DIN/PIN/NPN Detail

92:00 UNCLASSIFIED THERAPEUTIC AGENTS

92:92:00 OTHER MISCELLANEOUS THERAPEUTIC AGENTS

PMS-Fampridine (FAMPRIDINE)10mg ER Tab

DIN/PIN/NPN:02496216

Interchangeables:

Manufacturer:

Pharmascience Inc.

Formulary Listing Date:

2021-04-30

Drug Benefit Price or Unit Price:

8.4730

Amount MOH Pays:

N/A

Coverage Status:

Off-Formulary Interchangeable