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Products found: 2
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DIN/ PIN/ NPN
Generic Name
Brand Name, Strength & Dosage Form
MFR
Drug Benefit Price or Unit Price
Amount MOH Pays
Inter- change- able
Limited Use
Thera- peutic Notes
02406853
FONDAPARINUX SODIUM
Fondaparinux Sodium Injection 2.5mg/0.5mL Inj Sol-Pref Syr 0.5mL Pk (Preservative Free)
DRR
11.1944
11.1944
YES
YES
NO
02406896
FONDAPARINUX SODIUM
Fondaparinux Sodium Injection (Off-Formulary Interchangeable) 7.5mg/0.6mL Inj Sol-Pref Syr 0.6mL Pk (Preservative Free)
DRR
18.1356
18.1356
YES
NO
NO
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