DIN/PIN/NPN Detail |
|
| 92:00 UNCLASSIFIED THERAPEUTIC AGENTS | |
| Interchangeables: | NO |
| Manufacturer: | Septa Pharmaceuticals Inc. |
| Formulary Listing Date: | 2025-06-30 |
| Drug Benefit Price or Unit Price: | 5.9696 |
| Amount MOH Pays: | 5.9696 |
| Coverage Status: |
|