DIN/PIN/NPN Detail |
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92:00 UNCLASSIFIED THERAPEUTIC AGENTS | |
92:36:00 DISEASE-MODIFYING ANTIRHEUMATIC AGENTS | LU Criteria Text |
Interchangeables: | NO |
Manufacturer: | AbbVie Corporation |
Formulary Listing Date: | 2024-08-30 |
Drug Benefit Price or Unit Price: | 76.9600 |
Amount MOH Pays: | 76.9600 |
Coverage Status: |
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