DIN/PIN/NPN Detail

88:00 VITAMINS

88:08:00 VITAMIN B

Mint-Leucovorin (LEUCOVORIN CALCIUM)5mg Tab

DIN/PIN/NPN:02496828

Interchangeables:

Manufacturer:

Mint Pharmaceuticals Inc.

Formulary Listing Date:

2021-03-29

Drug Benefit Price or Unit Price:

3.6776

Amount MOH Pays:

3.6776

Coverage Status:

General Benefit