DIN/PIN/NPN Detail
08:00 ANTI-INFECTIVE AGENTS
08:18:00 ANTIVIRALS
LU Criteria Text
Paxlovid
(NIRMATRELVIR & RITONAVIR)
150mg & 100mg Tab-30 Pk
DIN/PIN/NPN:
02524031
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Interchangeables:
NO
Manufacturer:
Pfizer Canada Inc.
Formulary Listing Date:
2024-05-17
Drug Benefit Price or Unit Price:
1288.8800
Amount MOH Pays:
1288.8800
Coverage Status:
Limited Use Product
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