PROTHROMBIN COMPLEX-LANS 500UNIT/VIL INJ,LYPHL (32964)    VA PRODUCT (50.68)

Name Value
NAME PROTHROMBIN COMPLEX-LANS 500UNIT/VIL INJ,LYPHL
ACTIVE INGREDIENTS
COPAY TIER
PGX ELIGIBLE NO
PGX SUPPRESSED NO
EFFECTIVE DATE/TIME