Product Details

Mint-Itraconazole

Itraconazole
100 mg
Capsule


DIN/PIN/NPN

02462559

Manufacturer

Mint Pharmaceuticals Inc.

Formulary Listing Date

2017-07-31  

Unit Price

3.9270

Amount MOH Pays

3.9270

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

J02AC02

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02047454 Sporanox 6.5190 3.9270
02462559 Mint-Itraconazole 3.9270 3.9270
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph