Product Details
CellCept
Mycophenolate Mofetil200 mg/mL
Powder for Oral Suspension
175-mL Pack
DIN/PIN/NPN
02242145
Manufacturer
Hoffmann-La Roche Limited
Formulary Listing Date
2005-02-22
Unit Price
342.5800
Amount MOH Pays
244.7025
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
L04AA06
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02242145 | CellCept | 342.5800 | 244.7025 |
| 02522233 | Mar-Mycophenolate Mofetil | 244.7025 | 244.7025 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 556 | Indefinite | For patients who are unable to swallow or tolerate solid oral dosage forms. |