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Products found: 62

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DIN/ PIN/ NPN	Generic Name	Brand Name, Strength & Dosage Form	MFR	Drug Benefit Price or Unit Price	Amount MOH Pays	Inter- change- able	Limited Use	Thera- peutic Notes
00264911	CLORAZEPATE DIPOTASSIUM	Tranxene (Not a Benefit) 15mg Cap	ABB	N/A	N/A	YES	NO	NO
00264946	CLORAZEPATE DIPOTASSIUM	Tranxene (Not a Benefit) 7.5mg Cap	ABB	N/A	N/A	YES	NO	NO
00264938	CLORAZEPATE DIPOTASSIUM	Tranxene (Not a Benefit) 3.75mg Cap	ABB	N/A	N/A	YES	NO	NO
80074173	ELECTROLYTE & DEXTROSE	Pedialyte Flavored O/L	ABB	0.0079	0.0079	YES	NO	NO
80072902	ELECTROLYTE & DEXTROSE	Pedialyte Regular O/L	ABB	0.0079	0.0079	YES	NO	NO
00244635	ERYTHROMYCIN BASE	Erythromid (Not a Benefit) 250mg Tab	ABB	N/A	N/A	YES	NO	YES
00000299	ERYTHROMYCIN ETHYLSUCCINATE	EES-200 (Not a Benefit) 40mg/mL O/L	ABB	N/A	N/A	YES	NO	YES
00453617	ERYTHROMYCIN ETHYLSUCCINATE	EES-400 (Not a Benefit) 80mg/mL O/L	ABB	N/A	N/A	YES	NO	YES
09857297	GDH-FAD ENZYME	Freestyle Lite Strip	ABB	N/A	0.7290	NO	NO	NO
09854070	GLUCOSE OXIDASE REAGENT	Precision Xtra Strip	ABB	N/A	0.7290	NO	NO	NO
00884502	LEUPROLIDE ACETATE	Lupron Depot PDS 3.75mg Inj-Kit	ABB	389.1300	389.1300	NO	NO	NO
00836273	LEUPROLIDE ACETATE	Lupron Depot PDS 7.5mg Inj-Kit	ABB	387.9700	387.9700	NO	NO	NO
02239834	LEUPROLIDE ACETATE	Lupron Depot PDS 11.25mg Inj-Kit	ABB	1159.5200	1159.5200	NO	NO	NO
02230248	LEUPROLIDE ACETATE	Lupron Depot PDS 22.5mg Inj-Kit	ABB	1071.0000	1071.0000	NO	NO	NO
02239833	LEUPROLIDE ACETATE	Lupron Depot PDS 30mg Inj-Kit	ABB	1428.0000	1428.0000	NO	NO	NO
02172151	LEVOTHYROXINE (SODIUM)	Synthroid 0.3mg Tab	ABB	0.1449	0.1449	YES	NO	NO
02172143	LEVOTHYROXINE (SODIUM)	Synthroid 0.2mg Tab	ABB	0.1051	0.0533	YES	NO	NO
02172135	LEVOTHYROXINE (SODIUM)	Synthroid 0.175mg Tab	ABB	0.1345	0.1345	NO	NO	NO
02172127	LEVOTHYROXINE (SODIUM)	Synthroid 0.15mg Tab	ABB	0.0990	0.0503	YES	NO	NO
02172119	LEVOTHYROXINE (SODIUM)	Synthroid 0.125mg Tab	ABB	0.1255	0.1255	NO	NO	NO
02171228	LEVOTHYROXINE (SODIUM)	Synthroid 0.112mg Tab	ABB	0.1240	0.1240	NO	NO	NO
02172100	LEVOTHYROXINE (SODIUM)	Synthroid 0.1mg Tab	ABB	0.0920	0.0457	YES	NO	NO
02172097	LEVOTHYROXINE (SODIUM)	Synthroid 0.088mg Tab	ABB	0.1174	0.1174	NO	NO	NO
02172089	LEVOTHYROXINE (SODIUM)	Synthroid 0.075mg Tab	ABB	0.1174	0.1174	NO	NO	NO
02172062	LEVOTHYROXINE (SODIUM)	Synthroid 0.025mg Tab	ABB	0.1086	0.1086	NO	NO	NO
02172070	LEVOTHYROXINE (SODIUM)	Synthroid 0.05mg Tab	ABB	0.0746	0.0371	YES	NO	NO
09857109	NUTRITIONAL PRODUCT	Jevity 1.2 Cal 1.2kcal/mL Liq-1000mL Pk	ABB	N/A	9.1300	NO	NO	NO
09857310	NUTRITIONAL PRODUCT	Jevity 1.5 Cal 1.5kcal/mL Liq-1000mL Pk	ABB	N/A	11.5200	NO	NO	NO
09854479	NUTRITIONAL PRODUCT	Jevity 1 Cal 1.06kcal/mL Liq-1500mL Pk	ABB	N/A	12.2200	NO	NO	NO
09857117	NUTRITIONAL PRODUCT	Jevity 1.2 Cal 1.2kcal/mL Liq-1500mL Pk	ABB	N/A	13.7000	NO	NO	NO
09857312	NUTRITIONAL PRODUCT	Jevity 1.5 Cal 1.5kcal/mL Liq-1500mL Pk	ABB	N/A	17.2800	NO	NO	NO
09854452	NUTRITIONAL PRODUCT	Osmolite 1 Cal 1.06kcal/mL Liq-1500mL Pk	ABB	N/A	8.0100	NO	NO	NO
09857095	NUTRITIONAL PRODUCT	Osmolite 1.2 Cal 1.2kcal/mL Liq-1500mL Pk	ABB	N/A	9.0700	NO	NO	NO
09854392	NUTRITIONAL PRODUCT	Glucerna 1.0 Cal 1kcal/mL Liq-235mL Pk	ABB	N/A	1.8000	NO	NO	NO
97984060	NUTRITIONAL PRODUCT	Jevity 1 Cal 1.06kcal/mL Liq-235mL Pk	ABB	N/A	1.9200	NO	NO	NO
09854096	NUTRITIONAL PRODUCT	Jevity 1.2 Cal 1.2kcal/mL Liq-235mL Pk	ABB	N/A	2.1700	NO	NO	NO
09857344	NUTRITIONAL PRODUCT	Jevity 1.5 Cal 1.5kcal/mL Liq-235mL Pk	ABB	N/A	2.7025	NO	NO	NO
97973165	NUTRITIONAL PRODUCT	Osmolite 1 CAL Liq-235mL Pk	ABB	N/A	1.2600	NO	NO	NO
09854169	NUTRITIONAL PRODUCT	Osmolite 1.2 CAL Liq-235mL Pk	ABB	N/A	1.4400	NO	NO	NO
97984370	NUTRITIONAL PRODUCT	PediaSure Liq-235mL Pk	ABB	N/A	2.4700	NO	NO	NO
09853731	NUTRITIONAL PRODUCT	Suplena Liq-235mL Pk	ABB	N/A	2.0900	NO	NO	NO
97904333	NUTRITIONAL PRODUCT	Ensure Plus Liq-235mL Pk Cans	ABB	N/A	1.7900	NO	NO	NO
09857523	NUTRITIONAL PRODUCT	PediaSure Peptide 1 Cal 1.0kcal/mL Liq-237mL Pk Reclosable Plastic Bottle	ABB	N/A	2.6892	NO	NO	NO
97973084	NUTRITIONAL PRODUCT	RCF Liq-384mL Pk	ABB	N/A	6.2700	NO	NO	NO
97984558	NUTRITIONAL PRODUCT	Alimentum Liq-4x237mL Pk	ABB	N/A	6.1600	NO	NO	NO
09858101	NUTRITIONAL PRODUCT	Vital Peptide 1 Cal 1Kcal/mL Liq-Vanilla Flavour, 220mL Pk bottle	ABB	N/A	5.3721	NO	NO	NO
09858102	NUTRITIONAL PRODUCT	Vital Peptide 1.5 Cal 1.5Kcal/mL Liq-Vanilla Flavour, 220mL Pk bottle	ABB	N/A	7.7472	NO	NO	NO
09858103	NUTRITIONAL PRODUCT	Vital Peptide 1.5 Cal 1.5Kcal/mL Liq-Vanilla Flavour,1000mL Ready to Hang container	ABB	N/A	35.2145	NO	NO	NO
09857124	NUTRITIONAL PRODUCT	Similac Advance NeoSure 5.15kcal/g Pd-363g Pk	ABB	N/A	14.9900	NO	NO	NO
09857564	NUTRITIONAL PRODUCT	Similac Alimentum 5.17Kcal/g Pd-400g Can Pk	ABB	N/A	16.4700	NO	NO	NO
09858158	NUTRITIONAL PRODUCT	Similac Alimentum (Temporary Benefit) 0.677kcal/mL Pd-946mL Bottle	ABB	5.6278	5.6278	NO	NO	NO
00603708	PROPAFENONE HCL	Rythmol 150mg Tab	ABB	1.4380	0.2966	YES	NO	NO
00603716	PROPAFENONE HCL	Rythmol 300mg Tab	ABB	2.5347	0.5227	YES	NO	NO
02357593	RITONAVIR	Norvir 100mg Tab	ABB	1.5660	1.1745	YES	NO	NO
00818674	TERAZOSIN HCL	Hytrin (Not a Benefit) 10mg Tab	ABB	N/A	N/A	YES	NO	NO
00818682	TERAZOSIN HCL	Hytrin (Not a Benefit) 2mg Tab	ABB	N/A	N/A	YES	NO	NO
00818658	TERAZOSIN HCL	Hytrin (Not a Benefit) 1mg Tab	ABB	N/A	N/A	YES	NO	NO
00818666	TERAZOSIN HCL	Hytrin (Not a Benefit) 5mg Tab	ABB	N/A	N/A	YES	NO	NO
00443840	VALPROIC ACID	Depakene (Not a Benefit) 250mg Cap	ABB	N/A	N/A	YES	NO	NO
00507989	VALPROIC ACID	Depakene (Not a Benefit) 500mg Ent Cap	ABB	N/A	N/A	YES	NO	NO
00554324	VERAPAMIL HCL	Isoptin (Not a Benefit) 120mg Tab	ABB	N/A	N/A	YES	NO	NO
00554316	VERAPAMIL HCL	Isoptin (Not a Benefit) 80mg Tab	ABB	N/A	N/A	YES	NO	NO

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