Product Details
Somatuline Autogel
Lanreotide Acetate120 mg/0.5 mL
ER Solution for Injection
0.5-mL Single-Use Prefilled Syringe
DIN/PIN/NPN
02283417
Manufacturer
Ipsen Limited
Formulary Listing Date
2008-11-04
Unit Price
2422.5832
Amount MOH Pays
1268.9722
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 |
|---|---|---|---|
| 02283417 | Somatuline Autogel | 2422.5832 | 1268.9722 |
| 02555883 | Mytolac | 1268.9722 | 1268.9722 |
LU Clinical Criteria
NORequirements