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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
02258560
NORGESTIMATE & ETHINYL ESTRADIOL
Tri-Cyclen Lo (Not a Benefit) 3 Phase Tab-21 Pk
JAN
N/A
N/A
YES
NO
NO
02258587
NORGESTIMATE & ETHINYL ESTRADIOL
Tri-Cyclen Lo (Not a Benefit) 3 Phase Tab-28 Pk
JAN
N/A
N/A
YES
NO
NO
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