DIN/PIN/NPN Detail

40:00 ELECTROLYTIC, CALORIC AND WATER BALANCE

40:28:00 DIURETICS

LU Criteria Text

Jamp Midodrine (MIDODRINE HCL)5mg Tab

DIN/PIN/NPN:02517728

Interchangeables:

Manufacturer:

Jamp Pharma Corporation

Formulary Listing Date:

2022-04-29

Drug Benefit Price or Unit Price:

0.1921

Amount MOH Pays:

0.1921

Coverage Status:

Limited Use Product