Product Details
Creon 25
Pancrelipase Equivalent To Lipase + Amylase + Protease25000 + 74000 + 62500 USP Units
Capsule with Enteric-Coated Minimicrospheres
DIN/PIN/NPN
01985205
Manufacturer
Solvay Pharma Inc.
Formulary Listing Date
1996-10-01
Unit Price
0.9031
Amount MOH Pays
0.9031
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A09AA02
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 124 | Indefinite | Replacement therapy for pancreatic insufficiency secondary to pancreatic surgery (resection). |
| 125 | Indefinite | Replacement therapy for pancreatic insufficiency due to chronic pancreatitis. |
| 126 | Indefinite | Replacement therapy for pancreatic insufficiency due to carcinoma of the pancreas. |
| 225 | Indefinite | Replacement therapy for pancreatic insufficiency due to cystic fibrosis. |