Product Details
Humalog
Insulin Lispro100 U/mL
Solution for Injection
10-mL Vial Pack
DIN/PIN/NPN
02229704
Manufacturer
Eli Lilly Canada Inc.
Formulary Listing Date
1998-12-31
Unit Price
34.6900
Amount MOH Pays
34.6900
Coverage Status
Limited Use Product Insulin or Oral Hypoglycemic Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A10AB04
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 646 | 1 year | Patient uses an insulin pump that has not been declared compatible with a funded biosimilar version by the insulin pump manufacturer’s product labeling. |