Product Details
Ativan
Lorazepam0.5 mg
Tablet
DIN/PIN/NPN
02041413
Manufacturer
Pfizer Canada Inc.
Formulary Listing Date
1996-10-01
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Not a Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N05BA06
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 00711101 | Teva-Lorazepam | 0.0359 | 0.0359 |
| 00728187 | PMS-Lorazepam | 0.0359 | 0.0359 |
| 02041413 | Ativan | NA | NA |
| 00655740 | Apo-Lorazepam | 0.0359 | 0.0359 |
LU Clinical Criteria
NORequirements