Drugs: Contract Drugs List Part 1 – Prescription Drugs (N ...
1 gm/vial ea. 2 gm/vial ea. 10 gm/vial ea. 1 gm, piggyback ea. 2 gm, piggyback ea * NAFTIFINE HCL * Restricted to claims with dates of service from October 1, 2005, through November 30, 2011, for all dosage forms. Topical Cream 1 % 15 gm gm. 30 gm gm. 60 gm gm. 90 gm gm. Topical Gel 1 % 20 gm gm. 40 gm gm. 60 gm gm. 90 gm gm. NALIDIXIC ACID ... ................
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