CY2021 Standard MAPD 5T_21333_353_441

lamotrigine starter kit-orange oral kit 42 x 25 mg & 7 x 100 mg. 2. GC. levetiracetam er oral tablet extended release 24 hour 500 mg, 750 mg. 2. GC. ... XCOPRI ORAL TABLET THERAPY PACK 14 X 12.5 MG & 14 X 25 MG, 14 X 150 MG & 14 X200 MG, 14 X 50 MG & 14 X100 MG. 4. ST2; QL (28 EA per 28 days) Calcium Channel Modifying Agents. CELONTIN ORAL ... ................
................