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Products found: 62New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
00264911CLORAZEPATE DIPOTASSIUMTranxene (Not a Benefit) 15mg CapABBN/AN/AYESNONO
00264946CLORAZEPATE DIPOTASSIUMTranxene (Not a Benefit) 7.5mg CapABBN/AN/AYESNONO
00264938CLORAZEPATE DIPOTASSIUMTranxene (Not a Benefit) 3.75mg CapABBN/AN/AYESNONO
80074173ELECTROLYTE & DEXTROSEPedialyte Flavored O/LABB0.00790.0079YESNONO
80072902ELECTROLYTE & DEXTROSEPedialyte Regular O/LABB0.00790.0079YESNONO
00244635ERYTHROMYCIN BASEErythromid (Not a Benefit) 250mg TabABBN/AN/AYESNOYES
00000299ERYTHROMYCIN ETHYLSUCCINATEEES-200 (Not a Benefit) 40mg/mL O/LABBN/AN/AYESNOYES
00453617ERYTHROMYCIN ETHYLSUCCINATEEES-400 (Not a Benefit) 80mg/mL O/LABBN/AN/AYESNOYES
09857297GDH-FAD ENZYMEFreestyle Lite StripABBN/A0.7290NONONO
09854070GLUCOSE OXIDASE REAGENTPrecision Xtra StripABBN/A0.7290NONONO
00884502LEUPROLIDE ACETATELupron Depot PDS 3.75mg Inj-KitABB389.1300389.1300NONONO
00836273LEUPROLIDE ACETATELupron Depot PDS 7.5mg Inj-KitABB387.9700387.9700NONONO
02239834LEUPROLIDE ACETATELupron Depot PDS 11.25mg Inj-KitABB1159.52001159.5200NONONO
02239833LEUPROLIDE ACETATELupron Depot PDS 30mg Inj-KitABB1428.00001428.0000NONONO
02230248LEUPROLIDE ACETATELupron Depot PDS 22.5mg Inj-KitABB1071.00001071.0000NONONO
02172097LEVOTHYROXINE (SODIUM)Synthroid 0.088mg TabABB0.11740.1174NONONO
02172089LEVOTHYROXINE (SODIUM)Synthroid 0.075mg TabABB0.11740.1174NONONO
02172070LEVOTHYROXINE (SODIUM)Synthroid 0.05mg TabABB0.07460.0390YESNONO
02172062LEVOTHYROXINE (SODIUM)Synthroid 0.025mg TabABB0.10860.1086NONONO
02172100LEVOTHYROXINE (SODIUM)Synthroid 0.1mg TabABB0.09200.0480YESNONO
02172151LEVOTHYROXINE (SODIUM)Synthroid 0.3mg TabABB0.14490.1449YESNONO
02172143LEVOTHYROXINE (SODIUM)Synthroid 0.2mg TabABB0.10510.0560YESNONO
02172135LEVOTHYROXINE (SODIUM)Synthroid 0.175mg TabABB0.13450.1345NONONO
02172127LEVOTHYROXINE (SODIUM)Synthroid 0.15mg TabABB0.09900.0528YESNONO
02172119LEVOTHYROXINE (SODIUM)Synthroid 0.125mg TabABB0.12550.1255NONONO
02171228LEVOTHYROXINE (SODIUM)Synthroid 0.112mg TabABB0.12400.1240NONONO
09857109NUTRITIONAL PRODUCTJevity 1.2 Cal 1.2kcal/mL Liq-1000mL PkABBN/A9.1300NONONO
09857310NUTRITIONAL PRODUCTJevity 1.5 Cal 1.5kcal/mL Liq-1000mL PkABBN/A11.5200NONONO
09854479NUTRITIONAL PRODUCTJevity 1 Cal 1.06kcal/mL Liq-1500mL PkABBN/A12.2200NONONO
09857117NUTRITIONAL PRODUCTJevity 1.2 Cal 1.2kcal/mL Liq-1500mL PkABBN/A13.7000NONONO
09857312NUTRITIONAL PRODUCTJevity 1.5 Cal 1.5kcal/mL Liq-1500mL PkABBN/A17.2800NONONO
09854452NUTRITIONAL PRODUCTOsmolite 1 Cal 1.06kcal/mL Liq-1500mL PkABBN/A8.0100NONONO
09857095NUTRITIONAL PRODUCTOsmolite 1.2 Cal 1.2kcal/mL Liq-1500mL PkABBN/A9.0700NONONO
09854392NUTRITIONAL PRODUCTGlucerna 1.0 Cal 1kcal/mL Liq-235mL PkABBN/A1.8000NONONO
97984060NUTRITIONAL PRODUCTJevity 1 Cal 1.06kcal/mL Liq-235mL PkABBN/A1.9200NONONO
09854096NUTRITIONAL PRODUCTJevity 1.2 Cal 1.2kcal/mL Liq-235mL PkABBN/A2.1700NONONO
09857344NUTRITIONAL PRODUCTJevity 1.5 Cal 1.5kcal/mL Liq-235mL PkABBN/A2.7025NONONO
97973165NUTRITIONAL PRODUCTOsmolite 1 CAL Liq-235mL PkABBN/A1.2600NONONO
09854169NUTRITIONAL PRODUCTOsmolite 1.2 CAL Liq-235mL PkABBN/A1.4400NONONO
97984370NUTRITIONAL PRODUCTPediaSure Liq-235mL PkABBN/A2.4700NONONO
09853731NUTRITIONAL PRODUCTSuplena Liq-235mL PkABBN/A2.0900NONONO
97904333NUTRITIONAL PRODUCTEnsure Plus Liq-235mL Pk CansABBN/A1.7900NONONO
09857523NUTRITIONAL PRODUCTPediaSure Peptide 1 Cal 1.0kcal/mL Liq-237mL Pk Reclosable Plastic BottleABBN/A2.6892NONONO
97973084NUTRITIONAL PRODUCTRCF Liq-384mL PkABBN/A6.2700NONONO
97984558NUTRITIONAL PRODUCTAlimentum Liq-4x237mL PkABBN/A6.1600NONONO
09858101NUTRITIONAL PRODUCTVital Peptide 1 Cal 1Kcal/mL Liq-Vanilla Flavour, 220mL Pk bottleABBN/A5.3721NONONO
09858102NUTRITIONAL PRODUCTVital Peptide 1.5 Cal 1.5Kcal/mL Liq-Vanilla Flavour, 220mL Pk bottleABBN/A7.7472NONONO
09858103NUTRITIONAL PRODUCTVital Peptide 1.5 Cal 1.5Kcal/mL Liq-Vanilla Flavour,1000mL Ready to Hang containerABBN/A35.2145NONONO
09857124NUTRITIONAL PRODUCTSimilac Advance NeoSure 5.15kcal/g Pd-363g PkABBN/A14.9900NONONO
09857564NUTRITIONAL PRODUCTSimilac Alimentum 5.17Kcal/g Pd-400g Can PkABBN/A16.4700NONONO
09858158NUTRITIONAL PRODUCTSimilac Alimentum (Temporary Benefit) 0.677kcal/mL Pd-946mL BottleABB5.62785.6278NONONO
00603708PROPAFENONE HCLRythmol 150mg TabABB1.43800.2966YESNONO
00603716PROPAFENONE HCLRythmol 300mg TabABB2.53470.5227YESNONO
02357593RITONAVIRNorvir 100mg TabABB1.56601.1745YESNONO
00818674TERAZOSIN HCLHytrin (Not a Benefit) 10mg TabABBN/AN/AYESNONO
00818658TERAZOSIN HCLHytrin (Not a Benefit) 1mg TabABBN/AN/AYESNONO
00818682TERAZOSIN HCLHytrin (Not a Benefit) 2mg TabABBN/AN/AYESNONO
00818666TERAZOSIN HCLHytrin (Not a Benefit) 5mg TabABBN/AN/AYESNONO
00443840VALPROIC ACIDDepakene (Not a Benefit) 250mg CapABBN/AN/AYESNONO
00507989VALPROIC ACIDDepakene (Not a Benefit) 500mg Ent CapABBN/AN/AYESNONO
00554316VERAPAMIL HCLIsoptin (Not a Benefit) 80mg TabABBN/AN/AYESNONO
00554324VERAPAMIL HCLIsoptin (Not a Benefit) 120mg TabABBN/AN/AYESNONO