DIN/PIN/NPN Detail |
92:00 UNCLASSIFIED THERAPEUTIC AGENTS | |
LU Criteria Text |
Mar-Mycophenolate Mofetil (MYCOPHENOLATE MOFETIL)200mg/mL Pd for Oral Susp-175mL Pk
DIN/PIN/NPN:02522233
Interchangeables: | YES |
Manufacturer: | Marcan Pharmaceuticals Inc. |
Formulary Listing Date: | 2022-03-31 |
Drug Benefit Price or Unit Price: | 244.7025 |
Amount MOH Pays: | 244.7025 |
Coverage Status: |
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