Product Details

PMS-Lorazepam

Lorazepam
0.5 mg
Tablet

DIN/PIN/NPN

00728187

Manufacturer

Pharmascience Inc.

Formulary Listing Date

2002-04-04

Unit Price

0.0359

Amount MOH Pays

0.0359

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
00711101	Teva-Lorazepam	0.0359	0.0359
00728187	PMS-Lorazepam	0.0359	0.0359
02041413	Ativan	0.0479	0.0359
00655740	Apo-Lorazepam	0.0359	0.0359

LU Clinical Criteria

NO

EAP Criteria

NO

Product Monograph

View Monograph