Product Details

Octreotide Injection

Octreotide
500 mcg/mL
Solution for Injection
1-mL Single-Dose Ampoule Pack

DIN/PIN/NPN

02560291

Manufacturer

SteriMax Inc.

Formulary Listing Date

2026-02-27  

Unit Price

23.7070

Amount MOH Pays

23.7070

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

H01CB02

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
00839213 Sandostatin NA NA
02248641 Octreotide Acetate Omega 23.7070 23.7070
02560291 Octreotide Injection 23.7070 23.7070
 

LU Clinical Criteria

NO  

Requirements


EAP Criteria

  NO

Product Monograph

View Monograph