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
TRAVOPROST
0.004% Oph Sol-5mL Pk
Interchangeables found: 2
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02413167
Sandoz Travoprost
43.1400
43.1400
09857332
Travatan Z
58.9600
43.1400
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