Product Details

Aviane 21

Ethinyl Estradiol + Levonorgestrel
20 mcg + 100 mcg
Tablet
21's Pack

DIN/PIN/NPN

02298538

Manufacturer

Teva Canada Limited

Formulary Listing Date

2008-01-15  

Unit Price

3.9425

Amount MOH Pays

3.9425

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

G03AA07

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02298538 Aviane 21 3.9425 3.9425
02387875 Alysena 21 3.9425 3.9425
02236974 Alesse 21 15.7700 3.9425
02532174 Audrina 21 3.9425 3.9425
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph