Product Details
Tri-Cyclen
Norgestimate + Ethinyl Estradiol3-Phase
Tablet
21's Pack
DIN/PIN/NPN
02028700
Manufacturer
Janssen Inc.
Formulary Listing Date
1996-10-01
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Not a Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
G03AB11
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02486296 | Tri-Jordyna 21 | 14.3900 | 14.3900 |
| 02028700 | Tri-Cyclen | NA | NA |
| 02508087 | Tri-Cira 21 | 14.3900 | 14.3900 |