DIN/PIN/NPN Detail |
12:00 AUTONOMIC AGENTS | |
12:08:08 PARASYMPATHOLYTIC (CHOLINERGIC BLOCKING) AGENTS ANTIMUSCARINICS/ANTISPASMODICS | LU Criteria Text |
Glycopyrrolate Injection USP (GLYCOPYRROLATE)4mg/20mL Inj Sol (With Preservative)
DIN/PIN/NPN:02532379
Interchangeables: | YES |
Manufacturer: | Jamp Pharma Corporation |
Formulary Listing Date: | 2024-03-28 |
Drug Benefit Price or Unit Price: | 2.7825 |
Amount MOH Pays: | 2.7825 |
Coverage Status: |
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