DIN/PIN/NPN Detail

28:00 CENTRAL NERVOUS SYSTEM DRUGS

28:16:04 PSYCHOTHERAPEUTIC AGENTS ANTIDEPRESSANTS

LU Criteria Text

Act Bupropion XL (BUPROPION HCL)150mg ER Tab

DIN/PIN/NPN:02439654

Interchangeables:

Manufacturer:

Actavis Pharma Company

Formulary Listing Date:

2016-07-28

Drug Benefit Price or Unit Price:

0.2926

Amount MOH Pays:

0.2926

Coverage Status:

Limited Use Product