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: 3
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02375311
Apo-Brimonidine-Timop
23.2900
23.2900
09857298
Combigan
46.5800
23.2900
02531704
Jamp Brimonidine/Timolol
23.2900
23.2900
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