Product Details
Somatuline Autogel
Lanreotide Acetate90 mg/0.5 mL
ER Solution for Injection
0.5-mL Single-Use Prefilled Syringe
DIN/PIN/NPN
02283409
Manufacturer
Ipsen Limited
Formulary Listing Date
2008-11-04
Unit Price
1935.4291
Amount MOH Pays
1013.7962
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
H01CB03
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02283409 | Somatuline Autogel | 1935.4291 | 1013.7962 |
| 02555875 | Mytolac | 1013.7962 | 1013.7962 |
LU Clinical Criteria
NORequirements