Product Details
Odan Bupropion SR
Bupropion HCl150 mg
Tablet
DIN/PIN/NPN
02275082
Manufacturer
Odan Laboratories Ltd.
Formulary Listing Date
2006-08-24
Unit Price
0.9169
Amount MOH Pays
0.9169
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N06AX12
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02237825 | Wellbutrin SR | NA | NA |
| 02275082 | Odan Bupropion SR | 0.9169 | 0.9169 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 315 | Indefinite | For the treatment of depression. |