Product Details

PMS-Lorazepam

Lorazepam
2 mg
Tablet

DIN/PIN/NPN

00728209

Manufacturer

Pharmascience Inc.

Formulary Listing Date

2002-04-04

Unit Price

0.0699

Amount MOH Pays

0.0699

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N05BA06

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
00637750	Teva-Lorazepam	0.0699	0.0699
00728209	PMS-Lorazepam	0.0699	0.0699
02041448	Ativan	0.0885	0.0699
00655767	Apo-Lorazepam	0.0699	0.0699

LU Clinical Criteria

NO

EAP Criteria

NO

Product Monograph

View Monograph