DIN/PIN/NPN Detail

56:00 GASTROINTESTINAL DRUGS

56:22:00 ANTIEMETICS AND ANTINAUSEANTS

LU Criteria Text

Mar-Ondansetron ODT Tablet (ONDANSETRON HYDROCHLORIDE)4mg

DIN/PIN/NPN:02514966

Interchangeables:

Manufacturer:

Marcan Pharmaceuticals Inc.

Formulary Listing Date:

2022-05-31

Drug Benefit Price or Unit Price:

3.2720

Amount MOH Pays:

2.5450

Coverage Status:

Limited Use Product