Product Details

Ach-Mycophenolate

Mycophenolate Mofetil
500 mg
Tablet

DIN/PIN/NPN

02378574

Manufacturer

Accord Healthcare Inc.

Formulary Listing Date

2012-06-26

Unit Price

0.7423

Amount MOH Pays

0.7423

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

92:00:00 Unclassified Therapeutic Agents

Therapeutic Note

NO

ATC Code

L04AA06

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02348675	Teva-Mycophenolate	0.7423	0.7423
02313855	Sandoz Mycophenolate Mofetil	0.7423	0.7423
02457377	Mycophenolate Mofetil	0.7423	0.7423
02378574	Ach-Mycophenolate	0.7423	0.7423
02380382	Jamp-Mycophenolate	0.7423	0.7423
02237484	CellCept	4.3692	0.7423
02352567	Apo-Mycophenolate	0.7423	0.7423

LU Clinical Criteria

NO

EAP Criteria

NO

Product Monograph

View Monograph