DIN/PIN/NPN Detail |
|
| 84:00 SKIN AND MUCOUS MEMBRANE PREPARATIONS | |
| 84:92:00 MISCELLANEOUS SKIN AND MUCOUS MEMBRANE AGENTS | LU Criteria Text |
| Interchangeables: | NO |
| Manufacturer: | Sun Pharma |
| Formulary Listing Date: | 2022-02-28 |
| Drug Benefit Price or Unit Price: | 4935.0000 |
| Amount MOH Pays: | 4935.0000 |
| Coverage Status: |
|