Product Details
Odan Bupropion SR
Bupropion HCl100 mg
Tablet
DIN/PIN/NPN
02275074
Manufacturer
Odan Laboratories Ltd.
Formulary Listing Date
2006-08-24
Unit Price
0.5260
Amount MOH Pays
0.5260
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 |
|---|---|---|---|
| 02237824 | Wellbutrin SR | NA | NA |
| 02275074 | Odan Bupropion SR | 0.5260 | 0.5260 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 315 | Indefinite | For the treatment of depression. |