Product Details
Octreotide Acetate Omega
Octreotide200 mcg/mL
Solution for Injection
5-mL Multi-Dose Vial Pack
DIN/PIN/NPN
02248642
Manufacturer
Omega Laboratories Ltd.
Formulary Listing Date
2008-03-25
Unit Price
72.7725
Amount MOH Pays
72.7725
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
H01CB02
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02049392 | Sandostatin | 97.0300 | 72.7725 |
| 02248642 | Octreotide Acetate Omega | 72.7725 | 72.7725 |
LU Clinical Criteria
NORequirements
NA