DIN/PIN/NPN Detail |
56:00 GASTROINTESTINAL DRUGS | |
56:40:00 MISCELLANEOUS G.I. DRUGS | LU Criteria Text |
Interchangeables: | YES |
Manufacturer: | Accord Healthcare Inc. |
Formulary Listing Date: | 2014-08-28 |
Drug Benefit Price or Unit Price: | 0.2287 |
Amount MOH Pays: | 0.2287 |
Coverage Status: |
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