Product Details
Cefazolin for Injection
Cefazolin Sodium10 g/Vial
Powder for Injection
Vial (Preservative-Free)
DIN/PIN/NPN
02437120
Manufacturer
SteriMax Inc.
Formulary Listing Date
2022-01-31
Unit Price
56.0000
Amount MOH Pays
56.0000
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 |
---|---|---|---|
02297213 | Cefazolin for Injection | 56.0000 | 56.0000 |
02108135 | Cefazolin for Injection | NA | NA |
02437120 | Cefazolin for Injection | 56.0000 | 56.0000 |
02465477 | Cefazolin for Injection USP | 56.0000 | 56.0000 |
02308967 | Cefazolin for Injection USP | 56.0000 | 56.0000 |
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 |