Product Details

Dapsone

Dapsone
100 mg
Tablet


DIN/PIN/NPN

02041510

Manufacturer

Jacobus Pharmaceutical Company Inc.

Formulary Listing Date

1996-10-01  

Unit Price

1.4061

Amount MOH Pays

0.7031

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

J04BA02

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02489058 Riva-Dapsone 0.7031 0.7031
02481227 Mar-Dapsone 0.7031 0.7031
02041510 Dapsone 1.4061 0.7031
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph