Product Details
Mepron
Atovaquone750 mg/5 mL
Oral Liquid
DIN/PIN/NPN
02217422
Manufacturer
GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care
Formulary Listing Date
1997-04-10
Unit Price
3.8377
Amount MOH Pays
1.5856
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 | 3.8377 | 1.5856 |
| 02528495 | GLN-Atovaquone | 1.5857 | 1.5856 |
| 02556618 | Auro-Atovaquone | 1.5856 | 1.5856 |
LU Clinical Criteria
NORequirements