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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
Interchangeable
Limited Use
Therapeutic Notes
02469383
LETERMOVIR
Prevymis (Off-Formulary Interchangeable) 480mg Tab
MEK
238.7160
179.0370
YES
NO
NO
02469375
LETERMOVIR
Prevymis (Off-Formulary Interchangeable) 240mg Tab
MEK
238.7160
179.0370
YES
NO
NO
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