Product Details

Mepron

Atovaquone
750 mg/5 mL
Oral Liquid


DIN/PIN/NPN

02217422

Manufacturer

GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care

Formulary Listing Date

1997-04-10  

Unit Price

3.5596

Amount MOH Pays

2.3785

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

P01AX06

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02217422 Mepron 3.5596 2.3785
02528495 GLN-Atovaquone 2.3785 2.3785
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph