Product Details

Pantoprazole Magnesium

Pantoprazole Magnesium
40 mg
Enteric Coated Tablet


DIN/PIN/NPN

02441853

Manufacturer

Altius Healthcare Inc.

Formulary Listing Date

2015-11-26  

Unit Price

0.1875

Amount MOH Pays

0.1875

Coverage Status

General Benefit Chronic-Use Medication

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

A02BC02

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02440628 Teva-Pantoprazole Magnesium 0.1875 0.1875
02267233 Tecta 0.8260 0.1875
02466147 Pantoprazole T 0.1875 0.1875
02441853 Pantoprazole Magnesium 0.1875 0.1875
02408570 Mylan-Pantoprazole T 0.1875 0.1875
02519534 Pantoprazole T 0.1875 0.1875
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph