Product Details

Phenytoin Sodium

Phenytoin (Diphenylhydantoin) Sodium
100 mg
Capsule


DIN/PIN/NPN

02460912

Manufacturer

A A Pharma Inc.

Formulary Listing Date

2017-09-28  

Unit Price

0.0665

Amount MOH Pays

0.0665

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N03AB02

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02460912 Phenytoin Sodium 0.0665 0.0665
00022780 Dilantin 0.1083 0.0665
 

LU Clinical Criteria

NO  

Requirements

NA

EAP Criteria

  NO

Product Monograph

View Monograph