Product Details

Santyl

Collagenase
250 Units/g
Ointment
30-g Tube Pack

DIN/PIN/NPN

09858336

Manufacturer

Smith & Nephew Inc.

Formulary Listing Date

2024-05-31  

Unit Price

87.5000

Amount MOH Pays

87.5000

Coverage Status

Temporary Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

D03BA02

Interchangeable Products

NO  

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph