Product Details
Lolo
Ethinyl Estradiol + Norethindrone Acetate
3-Phase (10 mcg + 1 mg/10 mcg)
Tablet
28's Pack
DIN/PIN/NPN
02417456
Manufacturer
AbbVie Corporation
Formulary Listing Date
2026-06-30
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Not a Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
G03AB04
Interchangeable Products
| DIN/ PIN/ NPN |
Brand name |
Unit Price |
Amount MOH pays |
| 02553481 |
Elfy |
16.1084 |
NA |
| 02417456 |
Lolo |
NA |
NA |
LU Clinical Criteria
NO
Requirements
EAP Criteria
NO
Product Monograph
View Monograph