DIN/PIN/NPN Detail |
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| 12:00 AUTONOMIC AGENTS | |
| 12:08:08 PARASYMPATHOLYTIC (CHOLINERGIC BLOCKING) AGENTS ANTIMUSCARINICS/ANTISPASMODICS | LU Criteria Text |
Glycopyrrolate Injection USP (GLYCOPYRROLATE)0.4mg/2mL Inj Sol (Preservative Free)
DIN/PIN/NPN:02513749
| Interchangeables: | YES |
| Manufacturer: | Jamp Pharma Corporation |
| Formulary Listing Date: | 2024-08-30 |
| Drug Benefit Price or Unit Price: | 2.7825 |
| Amount MOH Pays: | 2.7825 |
| Coverage Status: |
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