Product Details

Tri-Cyclen Lo

Norgestimate + Ethinyl Estradiol
3-Phase
Tablet
21's Pack

DIN/PIN/NPN

02258560

Manufacturer

Janssen Inc.

Formulary Listing Date

2008-02-12

Unit Price

NA

Amount MOH Pays

NA

Coverage Status

Not a Benefit

ODB Formulary Therapeutic Classification

68:32:00 Progestogens and Oral Contraceptives

Therapeutic Note

NO

ATC Code

G03AB11

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02258560	Tri-Cyclen Lo	NA	NA
02401967	Tricira Lo (21 Day)	13.3900	13.3900

LU Clinical Criteria

NO

Requirements

NA

EAP Criteria

NO

Product Monograph

View Monograph