DIN/PIN/NPN Detail

52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS

52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS

LU Criteria Text

Travatan Z (TRAVOPROST)0.004% Oph Sol-5mL Pk

DIN/PIN/NPN:09857332

Interchangeables:

Manufacturer:

Novartis Pharma Canada Inc.

Formulary Listing Date:

2009-08-18

Drug Benefit Price or Unit Price:

58.9600

Amount MOH Pays:

43.1400

Coverage Status:

Limited Use Product