DIN/PIN/NPN Detail |
56:00 GASTROINTESTINAL DRUGS | |
56:22:00 ANTIEMETICS AND ANTINAUSEANTS | LU Criteria Text |
Interchangeables: | YES |
Manufacturer: | Jamp Pharma Corporation |
Formulary Listing Date: | 2024-06-28 |
Drug Benefit Price or Unit Price: | 4.9930 |
Amount MOH Pays: | 3.8840 |
Coverage Status: |
|