Product Details

Lisinopril/HCTZ (Type Z)

Lisinopril + Hydrochlorothiazide
20 mg + 12.5 mg
Tablet


DIN/PIN/NPN

02362953

Manufacturer

Sanis Health Inc.

Formulary Listing Date

2011-10-25  

Unit Price

0.2504

Amount MOH Pays

0.2504

Coverage Status

General Benefit Chronic-Use Medication

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

C09BA03

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02045737 Zestoretic 1.1159 0.2504
02301776 Teva-Lisinopril/HCTZ (Type Z) 0.2504 0.2504
02302373 Sandoz Lisinopril HCT 0.2504 0.2504
02362953 Lisinopril/HCTZ (Type Z) 0.2504 0.2504
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph