Interchangeable Grouping
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52:00 EYE, EAR, NOSE AND THROAT PREPARATIONS
52:36:00 OTHER EYE, EAR, NOSE AND THROAT AGENTS
LU Criteria Text
BRIMONIDINE TARTRATE & TIMOLOL MALEATE
0.2% & 0.5% Oph Sol-10mL Pk
Interchangeables found: 2
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02375311
Apo-Brimonidine-Timop
34.9350
34.9350
09857298
Combigan
46.5800
34.9350
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