Product Details
Cefazolin for Injection
Cefazolin Sodium500 mg/Vial
Powder for Injection
Vial (Preservative-Free)
DIN/PIN/NPN
02437104
Manufacturer
SteriMax Inc.
Formulary Listing Date
2022-01-31
Unit Price
4.0000
Amount MOH Pays
4.0000
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
J01DB04
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02108119 | Cefazolin for Injection | NA | NA |
| 02437104 | Cefazolin for Injection | 4.0000 | 4.0000 |
| 02308932 | Cefazolin for Injection USP | 4.0000 | 4.0000 |
LU Clinical Criteria
NOEAP Criteria
| Therapeutic Class | Reimbursement Criteria |
|---|---|
| Anti-Infectives – Telephone Request Service (TRS) Drugs | Cefazolin
For treatment of infections susceptible to cefazolin. Standard Approval Duration: As requested, up to 5 years |