Interchangeable Grouping
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68:00 HORMONES AND SUBSTITUTES
68:08:00 ANDROGENS
LU Criteria Text
TESTOSTERONE CYPIONATE
100mg/mL Oily Inj Sol-10mL Pk
Interchangeables found: 2
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
00030783
Depo-Testosterone
(Not a Benefit)
N/A
N/A
02496003
Taro-Testosterone Cypionate Injection
34.8780
34.8780
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