Product Details

Ativan

Lorazepam
0.5 mg
Tablet


DIN/PIN/NPN

02041413

Manufacturer

Pfizer Canada Inc.

Formulary Listing Date

1996-10-01  

Unit Price

0.0479

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