DIN/PIN/NPN Detail

92:00 UNCLASSIFIED THERAPEUTIC AGENTS

LU Criteria Text

AG-Ursodiol (URSODIOL)250mg Tab

DIN/PIN/NPN:02505363

Interchangeables:

Manufacturer:

Angita Pharma Inc.

Formulary Listing Date:

2021-06-30

Drug Benefit Price or Unit Price:

0.3818

Amount MOH Pays:

0.3818

Coverage Status:

Limited Use Product