Product Details
Hydralazine Hydrochloride Injection, USP
Hydralazine HCl20 mg/mL
Solution for Injection
1-mL Clear Glass Vial
DIN/PIN/NPN
02516160
Manufacturer
Auro Pharma Inc.
Formulary Listing Date
2023-09-28
Unit Price
8.7375
Amount MOH Pays
8.7375
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
C02DB02
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 00723754 | Apresoline | 11.6500 | 8.7375 |
| 02516160 | Hydralazine Hydrochloride Injection, USP | 8.7375 | 8.7375 |
LU Clinical Criteria
NORequirements
NA