Interchangeable Grouping
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68:00 HORMONES AND SUBSTITUTES
68:32:00 PROGESTOGENS AND ORAL CONTRACEPTIVES
ETHINYL ESTRADIOL & LEVONORGESTREL
20mcg & 100mcg Tab-28 Pk
Interchangeables found: 4
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02236975
Alesse 28
15.7700
3.9425
02387883
Alysena 28
3.9425
3.9425
02532182
Audrina 28
3.9425
3.9425
02298546
Aviane 28
3.9425
3.9425
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