DIN/PIN/NPN Detail |
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92:00 UNCLASSIFIED THERAPEUTIC AGENTS | |
LU Criteria Text |
Glatiramer Acetate Injection (GLATIRAMER ACETATE)20mg/mL Inj Sol Pref Syr-1mL Pk
DIN/PIN/NPN:02541440
Interchangeables: | YES |
Manufacturer: | Mylan Pharmaceuticals ULC |
Formulary Listing Date: | 2024-05-31 |
Drug Benefit Price or Unit Price: | 27.8587 |
Amount MOH Pays: | 27.8587 |
Coverage Status: |
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