02490773 | ERTAPENEM | Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | JUN | 52.2650 | 52.2650 | YES | NO | NO |
02511150 | ERTAPENEM | Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | DRR | 52.2650 | 52.2650 | YES | NO | NO |
02492148 | ERTAPENEM | Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | AUR | 52.2650 | 52.2650 | YES | NO | NO |