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
BIMATOPROST
0.01% Oph Sol-7.5mL Pk
Interchangeables found: 3
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
09858395
Bimatoprost RC
45.1418
45.1418
09858396
Jamp Bimatoprost Solution RC
45.1418
45.1418
09857398
Lumigan RC
90.2838
45.1418
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