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 |
0.1042 |
0.0665 |
LU Clinical Criteria
NO
EAP Criteria
NO
Product Monograph
View Monograph