DIN/PIN/NPN Detail |
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DIN/PIN/NPN Detail |
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| 92:00 UNCLASSIFIED THERAPEUTIC AGENTS | |
| 92:36:00 DISEASE-MODIFYING ANTIRHEUMATIC AGENTS | LU Criteria Text |
| Interchangeables: | YES |
| Manufacturer: | Pharmascience Inc. |
| Formulary Listing Date: | 2023-01-31 |
| Drug Benefit Price or Unit Price: | 5.9897 |
| Amount MOH Pays: | 5.9897 |
| Coverage Status: |
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