Interchangeable Grouping
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52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS
52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS
CHLORHEXIDINE GLUCONATE
0.12% Oral Rinse
Interchangeables found: 3
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02240433
Perichlor
(Off-Formulary Interchangeable)
0.0253
N/A
02493160
Perichlor Without Alcohol
(Off-Formulary Interchangeable)
0.0253
N/A
02237452
Peridex
(Off-Formulary Interchangeable)
N/A
N/A
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