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Products found: 175New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
00545015ACETAZOLAMIDEAcetazolamide 250mg TabAAP0.14140.1414YESNONO
02420333ADEFOVIR DIPIVOXILAA-Adefovir (Off-Formulary Interchangeable) 10mg TabAAP20.9130N/AYESNONO
00479799ALLOPURINOLZyloprim 200mg TabAAP0.13000.1300YESNOYES
00402796ALLOPURINOLZyloprim 300mg TabAAP0.21250.2125YESNOYES
00402818ALLOPURINOLZyloprim 100mg TabAAP0.07800.0780YESNOYES
02249510AMILORIDE HCLMidamor 5mg TabAAP0.32970.3297NONONO
00784400AMILORIDE HCL & HYDROCHLOROTHIAZIDEAA-Amilzide 5mg & 50mg TabAAP0.08810.0881YESNONO
00335088AMITRIPTYLINEElavil 50mg TabAAP0.23470.1540YESNONO
00335053AMITRIPTYLINEElavil 10mg TabAAP0.06640.0435YESNONO
00335061AMITRIPTYLINEElavil 25mg TabAAP0.12110.0829YESNONO
02248764ATENOLOL & CHLORTHALIDONEAA-Atenidone 100 & 25mg TabAAP0.87550.8755YESNONO
02248763ATENOLOL & CHLORTHALIDONEAA-Atenidone 50 & 25mg TabAAP0.53420.5342YESNONO
02290340BENAZEPRILBenazepril 10mg TabAAP0.99380.9938YESNONO
02290332BENAZEPRILBenazepril 5mg TabAAP0.94850.9485YESNONO
02273918BENAZEPRILBenazepril 20mg TabAAP1.28751.2875YESNONO
02301334BRIMONIDINEBrimonidine P 0.15% Oph SolAAP2.03052.0305YESYESNO
02230454BROMOCRIPTINEBromocriptine 5mg CapAAP1.70971.7097YESNONO
02087324BROMOCRIPTINEBromocriptine 2.5mg TabAAP1.08001.0800YESNONO
02242504BUTORPHANOL TARTRATEButorphanol Nasal Spray (Off-Formulary Interchangeable) 10mg/mL Nas Sp-2.5mL PkAAP64.020064.0200YESNONO
00522724CHLORDIAZEPOXIDEChlordiazepoxide 5mg CapAAP0.08250.0825YESNONO
00522996CHLORDIAZEPOXIDEChlordiazepoxide 25mg CapAAP0.20140.2014YESNONO
00522988CHLORDIAZEPOXIDEChlordiazepoxide 10mg CapAAP0.11150.1115YESNONO
00360279CHLORTHALIDONEChlorthalidone 50mg TabAAP0.12770.1277YESNONO
00584215CIMETIDINECimetidine 200mg TabAAP0.35570.3557YESNOYES
00487872CIMETIDINECimetidine 300mg TabAAP0.34230.3423YESNOYES
00600059CIMETIDINECimetidine 400mg TabAAP0.29300.2930YESNOYES
00749494CIMETIDINECimetidine 800mg TabAAP0.25300.2530YESNOYES
00600067CIMETIDINECimetidine 600mg TabAAP0.34050.3405YESNOYES
00860689CLORAZEPATE DIPOTASSIUMClorazepate 3.75mg CapAAP0.16870.1687YESNONO
00860700CLORAZEPATE DIPOTASSIUMClorazepate 7.5mg CapAAP0.22000.2200YESNONO
00860697CLORAZEPATE DIPOTASSIUMClorazepate 15mg CapAAP0.44050.4405YESNONO
02458748CLOZAPINEAA-Clozapine (Off-Formulary Interchangeable) 50mg TabAAP1.3206N/AYESNONO
02458756CLOZAPINEAA-Clozapine (Off-Formulary Interchangeable) 200mg TabAAP5.2892N/AYESNONO
02248035CLOZAPINEAA-Clozapine (Off-Formulary Interchangeable) 100mg TabAAP2.6446N/AYESNONO
02248034CLOZAPINEAA-Clozapine (Off-Formulary Interchangeable) 25mg TabAAP0.6594N/AYESNONO
02245898CYPROTERONE ACETATECyproterone 50mg TabAAP1.40851.4000YESNONO
02216272DESIPRAMINEDesipramine 75mg TabAAP1.01841.0184YESNONO
02216256DESIPRAMINEDesipramine 25mg TabAAP0.43450.4345YESNONO
02216264DESIPRAMINEDesipramine 50mg TabAAP0.76590.7659YESNONO
02242465DESMOPRESSIN ACETATEDesmopressin Spray 10mcg/Metered Dose Nas Sp-2.5mL PkAAP36.110036.1100YESNONO
02443236DEXTROAMPHETAMINE SULFATEDextroamphetamine 5mg TabAAP0.50810.5081YESNOYES
00362158DIAZEPAMDiazepam 5mg TabAAP0.16620.1662YESNONO
00405337DIAZEPAMDiazepam 10mg TabAAP0.12040.1204YESNONO
00405329DIAZEPAMDiazepam 2mg TabAAP0.05320.0532YESNONO
00771376DILTIAZEM HCLAA-Diltiaz 30mg TabAAP0.18660.1866YESNONO
00771384DILTIAZEM HCLAA-Diltiaz 60mg TabAAP0.32730.3273YESNONO
00024325DOXEPIN HCLSinequan 10mg CapAAP0.40750.4075NONONO
00024341DOXEPIN HCLSinequan 50mg CapAAP0.92740.9274NONONO
00024333DOXEPIN HCLSinequan 25mg CapAAP0.50000.5000NONONO
02352923ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDEEnalapril Maleate/HCTZ (Off-Formulary Interchangeable) 5mg & 12.5mg TabAAP0.8762N/AYESNONO
02352931ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDEEnalapril Maleate/HCTZ (Off-Formulary Interchangeable) 10mg & 25mg TabAAP1.2284N/AYESNONO
00682020ERYTHROMYCIN BASEErythro-Base 250mg TabAAP0.18650.1865YESNOYES
02239864FENOFIBRATEAA-Feno-Micro 200mg CapAAP0.92570.9257YESNONO
02243180FENOFIBRATEAA-Feno-Micro (Off-Formulary Interchangeable) 67mg CapAAP0.6025N/AYESNONO
02246859FENOFIBRATEAA-Feno-Super (Off-Formulary Interchangeable) 100mg TabAAP0.9883N/AYESNONO
02246860FENOFIBRATEAA-Feno-Super 160mg TabAAP1.00221.0022YESNONO
00545031FERROUS GLUCONATEFerrous Gluconate 300mg 300mg TabAAP0.03600.0360YESNONO
02246082FLUNARIZINE HCLFlunarizine 5mg CapAAP0.73480.7348YESYESNO
00521701FLURAZEPAMFlurazepam 30mg CapAAP0.13640.1364YESNONO
00521698FLURAZEPAMFlurazepam 15mg CapAAP0.11660.1166YESNONO
01912046FLURBIPROFENFlurbiprofen 50mg TabAAP0.45300.4530YESNOYES
01912038FLURBIPROFENFlurbiprofen 100mg TabAAP0.59300.5930YESNOYES
02238560FLUTAMIDEFlutamide 250mg TabAAP1.82551.8255YESNONO
00426849FOLIC ACIDFolic Acid 5mg TabAAP0.04040.0404YESNONO
00646059HYDROXYZINE HCLHydroxyzine (Not a Benefit) 10mg CapAAPN/AN/AYESNONO
00646016HYDROXYZINE HCLHydroxyzine (Not a Benefit) 50mg CapAAPN/AN/AYESNONO
00646024HYDROXYZINE HCLHydroxyzine (Not a Benefit) 25mg CapAAPN/AN/AYESNONO
00360201IMIPRAMINEImipramine 10mg TabAAP0.13970.1397YESNONO
00326852IMIPRAMINEImipramine 50mg TabAAP0.50210.5021YESNONO
00312797IMIPRAMINEImipramine 25mg TabAAP0.25730.2573YESNONO
02126222IPRATROPIUM BROMIDEAA-Ipravent 250mcg/mL Inh Sol-20mL PkAAP6.31406.3140YESYESNO
02246084IPRATROPIUM BROMIDEIpravent (Off-Formulary Interchangeable) 0.06% Nasal SprayAAP2.9700N/AYESNONO
00670944ISOSORBIDE DINITRATEISDN 5mg SL TabAAP0.06330.0633YESNONO
00441694ISOSORBIDE DINITRATEISDN 30mg TabAAP0.08740.0874YESNONO
00441686ISOSORBIDE DINITRATEISDN 10mg TabAAP0.03720.0372YESNONO
00790427KETOPROFENKetoprofen 50mg CapAAP0.34400.3440YESNOYES
00790435KETOPROFENKetoprofen-E 50mg Ent TabAAP0.33790.3379YESNOYES
00842664KETOPROFENKetoprofen-E 100mg Ent TabAAP0.69590.6959YESNOYES
02172577KETOPROFENKetoprofen SR 200mg LA TabAAP1.39251.3925YESNOYES
02245821KETOROLAC TROMETHAMINEKetorolac 0.5% Oph SolAAP2.59602.5960YESNOYES
02162660KETOROLAC TROMETHAMINEToradol (Off-Formulary Interchangeable) 10mg TabAAPN/AN/AYESNOYES
02470780LANSOPRAZOLE & CLARITHROMYCIN & AMOXICILLINAA-LansoprazoleAmoxicillinClarithromycin 30mg & 500mg & 500mg Tab/Cap PkAAP67.910067.9100YESYESNO
02245211LEVODOPA & CARBIDOPAAA-Levocarb CR 200mg & 50mg CR TabAAP1.42821.4282YESYESNO
02272873LEVODOPA & CARBIDOPAAA-Levocarb CR 100mg & 25mg CR TabAAP0.79740.7974YESYESNO
02266695LITHIUM CARBONATELithmax (Off-Formulary Interchangeable) 300mg ER TabAAP0.28800.2880YESNONO
02410761LORAZEPAMLorazepam Sublingual (Off-Formulary Interchangeable) 2mg SL TabAAP0.2152N/AYESNONO
02410745LORAZEPAMLorazepam Sublingual (Off-Formulary Interchangeable) 0.5mg SL TabAAP0.1099N/AYESNONO
02410753LORAZEPAMLorazepam Sublingual (Off-Formulary Interchangeable) 1mg SL TabAAP0.1385N/AYESNONO
02220172LOVASTATINLovastatin 20mg TabAAP1.08461.0846YESNONO
02220180LOVASTATINLovastatin 40mg TabAAP1.98121.9812YESNONO
02229452MEFENAMIC ACIDMefenamic 250mg CapAAP0.49880.4988YESNOYES
00155225MEFENAMIC ACIDPonstan (Not a Benefit) 250mg CapAAPN/AN/AYESNOYES
02244366MEFLOQUINE HCLMefloquine (Off-Formulary Interchangeable) 250mg TabAAP3.69503.6950YESNONO
02195925MEGESTROL ACETATEMegestrol 160mg TabAAP5.81515.8151YESNONO
02195917MEGESTROL ACETATEMegestrol 40mg TabAAP1.33401.3340YESNONO
02245882METHAZOLAMIDEMethazolamide 50mg TabAAP0.49130.4913YESNONO
02238406METHOTRIMEPRAZINEMethoprazine 50mg TabAAP0.40600.4060YESNONO
02238403METHOTRIMEPRAZINEMethoprazine 2mg TabAAP0.07210.0721YESNONO
02238404METHOTRIMEPRAZINEMethoprazine 5mg TabAAP0.10430.1043YESNONO
02238405METHOTRIMEPRAZINEMethoprazine 25mg TabAAP0.26810.2681YESNONO
00360260METHYLDOPAMethyldopa 250mg TabAAP0.15790.1579YESNONO
00360252METHYLDOPAMethyldopa 125mg TabAAP0.10090.1009YESNONO
00426830METHYLDOPAMethyldopa 500mg TabAAP0.25880.2588YESNONO
02285169METOPROLOL TARTRATEAA-Metoprolol SR 100mg LA TabAAP0.14150.1415YESNONO
02285177METOPROLOL TARTRATEAA-Metoprolol SR 200mg LA TabAAP0.25680.2568YESNONO
00545066METRONIDAZOLEMetronidazole 250mg TabAAP0.06350.0635YESNONO
02084104MINOCYCLINE HCLMinocycline 100mg CapAAP1.08361.0836YESNONO
02084090MINOCYCLINE HCLMinocycline 50mg CapAAP0.56160.5616YESNONO
02244022MISOPROSTOLMisoprostol 100mcg TabAAP0.26360.2636YESNONO
02244023MISOPROSTOLMisoprostol 200mcg TabAAP0.43890.4389YESNONO
02240456MOCLOBEMIDEMoclobemide 300mg TabAAP1.03991.0399YESNONO
02232150MOCLOBEMIDEMoclobemide 150mg TabAAP0.52950.5295YESNONO
02232148MOCLOBEMIDEMoclobemide 100mg TabAAP0.34000.3400YESNONO
02238639NABUMETONENabumetone (Off-Formulary Interchangeable) 500mg TabAAP0.7363N/AYESNOYES
00755907NIFEDIPINENifedipine 10mg CapAAP0.48770.4877YESNOYES
00725110NIFEDIPINENifedipine 5mg CapAAP0.36790.3679YESNONO
00511528NITRAZEPAMMogadon 5mg TabAAP0.18260.1826NONONO
00511536NITRAZEPAMMogadon 10mg TabAAP0.27320.2732NONONO
00319511NITROFURANTOINNitrofurantoin 50mg TabAAP0.17030.1703YESNOYES
00312738NITROFURANTOINNitrofurantoin 100mg TabAAP0.22720.2272YESNOYES
02229524NORFLOXACINNorfloxacin 400mg TabAAP1.85861.8586YESNONO
00015229NORTRIPTYLINEAventyl 10mg CapAAP0.29950.2995NONONO
00015237NORTRIPTYLINEAventyl 25mg CapAAP0.60540.6054NONONO
02236783ORCIPRENALINE SULFATEOrciprenaline 2mg/mL O/LAAP0.05740.0574YESNONO
00642215PENICILLIN V (POTASSIUM)PEN V-K 300mg TabAAP0.18730.1873YESNONO
02230090PENTOXIFYLLINEPentoxifylline SR 400mg SR TabAAP0.80420.8042YESYESNO
00335118PERPHENAZINEPerphenazine 8mg TabAAP0.08880.0888YESNONO
00335126PERPHENAZINEPerphenazine 4mg TabAAP0.08080.0808YESNONO
00335096PERPHENAZINEPerphenazine 16mg TabAAP0.13590.1359YESNONO
00335134PERPHENAZINEPerphenazine 2mg TabAAP0.06680.0668YESNONO
02460912PHENYTOIN (DIPHENYLHYDANTOIN) SODIUMPhenytoin Sodium 100mg CapAAP0.06650.0665YESNONO
00313823PIMOZIDEOrap 4mg TabAAP0.41360.4136YESNONO
00313815PIMOZIDEOrap 2mg TabAAP0.22790.2279YESNONO
02245432PIMOZIDEPimozide 2mg TabAAP0.30930.2279YESNONO
02245433PIMOZIDEPimozide 4mg TabAAP0.41360.4136YESNONO
02469677PINAVERIUM BROMIDEPinaverium (Off-Formulary Interchangeable) 50mg TabAAP0.31000.3100YESNONO
02469685PINAVERIUM BROMIDEPinaverium (Off-Formulary Interchangeable) 100mg TabAAP0.54050.5405YESNONO
00271373PREDNISONEWinpred 1mg TabAAP0.12760.1276NONONO
00396761PRIMIDONEPrimidone 250mg TabAAP0.08870.0887YESNONO
00399310PRIMIDONEPrimidone 125mg TabAAP0.05640.0564YESNONO
00886432PROCHLORPERAZINEProchlorazine 10mg TabAAP0.20250.2025YESNONO
00886440PROCHLORPERAZINEProchlorazine 5mg TabAAP0.16590.1659YESNONO
02493268RISEDRONATE SODIUMAA-Risedronate DR 35mg DR TabAAP2.96632.9663YESNONO
02403374ROSIGLITAZONERosiglitazone (Off-Formulary Interchangeable) 4mg TabAAP1.91971.9197YESNONO
02403382ROSIGLITAZONERosiglitazone (Off-Formulary Interchangeable) 8mg TabAAP2.74522.7452YESNONO
02403366ROSIGLITAZONERosiglitazone (Off-Formulary Interchangeable) 2mg TabAAP1.22341.2234YESNONO
02230641SELEGILINE HCLSelegiline 5mg TabAAP0.50210.5021YESNONO
00445274SULFAMETHOXAZOLE & TRIMETHOPRIMSulfatrim 400mg & 80mg TabAAP0.10770.1077YESNOYES
00445282SULFAMETHOXAZOLE & TRIMETHOPRIMSulfatrim-DS 800mg & 160mg TabAAP0.20740.2074YESNOYES
00604453TEMAZEPAMRestoril 15mg CapAAP0.24610.2461NONONO
00604461TEMAZEPAMRestoril 30mg CapAAP0.29800.2980NONONO
00580929TETRACYCLINETetracycline 250mg CapAAP0.06700.0670YESNOYES
02360128THEOPHYLLINE ANHYDROUSTheo ER 600mg SR TabAAP0.45240.4524YESNONO
02360101THEOPHYLLINE ANHYDROUSTheo ER 400mg SR TabAAP0.37350.3734YESNONO
02237701TICLOPIDINE HCLTiclopidine 250mg TabAAP1.06791.0679YESYESNO
00755869TIMOLOL MALEATETimolol 20mg TabAAP0.63040.6304YESNONO
00755850TIMOLOL MALEATETimolol 10mg TabAAP0.32390.3239YESNONO
00755842TIMOLOL MALEATETimolol 5mg TabAAP0.20770.2077YESNONO
00808563TRIAZOLAMTriazolam 0.125mg TabAAP0.14960.1496YESNONO
00808571TRIAZOLAMTriazolam 0.25mg TabAAP0.25510.2551YESNONO
00345539TRIFLUOPERAZINETrifluoperazine 1mg TabAAP0.13400.1340YESNONO
00326836TRIFLUOPERAZINETrifluoperazine 10mg TabAAP0.28460.2846YESNONO
00312746TRIFLUOPERAZINETrifluoperazine 5mg TabAAP0.23750.2375YESNONO
00312754TRIFLUOPERAZINETrifluoperazine 2mg TabAAP0.17930.1793YESNONO
00545058TRIHEXYPHENIDYL HCLTrihexyphenidyl 2mg TabAAP0.03760.0376YESNONO
00545074TRIHEXYPHENIDYL HCLTrihexyphenidyl 5mg TabAAP0.06810.0681YESNONO
02245663TRIMEBUTINE MALEATETrimebutine (Off-Formulary Interchangeable) 100mg TabAAP0.32650.3265YESNONO
02245664TRIMEBUTINE MALEATETrimebutine (Off-Formulary Interchangeable) 200mg TabAAP0.76770.7677YESNONO
02243116TRIMETHOPRIMTrimethoprim 100mg TabAAP0.26170.2617YESNONO
02243117TRIMETHOPRIMTrimethoprim 200mg TabAAP0.53780.5378YESNONO
02070987TRIMIPRAMINETrimipramine 75mg CapAAP0.78000.7800YESNONO
00740810TRIMIPRAMINETrimipramine 50mg TabAAP0.57950.5795YESNONO
00740799TRIMIPRAMINETrimipramine 12.5mg TabAAP0.21560.2156YESNONO
00740802TRIMIPRAMINETrimipramine 25mg TabAAP0.29600.2960YESNONO
00740829TRIMIPRAMINETrimipramine 100mg TabAAP0.98890.9889YESNONO