Product Details
Stieva-A
Tretinoin0.05%
Cream
DIN/PIN/NPN
00518182
Manufacturer
Stiefel Canada Inc.
Formulary Listing Date
1996-10-01
Unit Price
0.2144
Amount MOH Pays
0.2144
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
D10AD01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 01926519 | Vitamin A Acid | NA | NA |
| 00518182 | Stieva-A | 0.2144 | 0.2144 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 269 | 1 year | For the treatment of acne vulgaris. |