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Products found: 15

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
01981501	BOTULINUM TOXIN TYPE A	Botox 100U/Vial Pd Inj-100U Vial Pk	ABV	374.8500	374.8500	NO	YES	NO
02531585	BOTULINUM TOXIN TYPE A	Botox 200U/Vial Pd Inj-200U Vial Pk	ABV	749.7000	749.7000	NO	YES	NO
09857387	BOTULINUM TOXIN TYPE A	Botox 200U/Vial Pd Inj-200U Vial Pk	ABV	749.7000	749.7000	NO	YES	NO
02531577	BOTULINUM TOXIN TYPE A	Botox 50U/Vial Pd Inj-50U Vial Pk	ABV	187.4300	187.4300	NO	YES	NO
09857386	BOTULINUM TOXIN TYPE A	Botox 50U/Vial Pd Inj-50U Vial Pk	ABV	187.4300	187.4300	NO	YES	NO
00891738	CALCITRIOL	Calcijex (Off-Formulary Interchangeable) 1mcg/mL Inj Sol Amp-1mL Pk	ABV	N/A	N/A	YES	NO	NO
02467550	GLECAPREVIR & PIBRENTASVIR	Maviret 100mg & 40mg Tab	ABV	238.0952	238.0952	NO	YES	NO
02369362	KETOROLAC TROMETHAMINE	Acuvail 0.45% w/v Oph Sol-0.4mL Vial Pk (Preservative-Free)	ABV	0.2593	0.2593	NO	NO	YES
02243644	LOPINAVIR & RITONAVIR	Kaletra 80mg/mL & 20mg/mL O/L	ABV	2.3688	2.3688	NO	NO	NO
02312301	LOPINAVIR & RITONAVIR	Kaletra 100mg & 25mg Tab	ABV	2.9317	2.9317	NO	NO	NO
02285533	LOPINAVIR & RITONAVIR	Kaletra 200mg & 50mg Tab	ABV	5.8633	5.8633	NO	NO	NO
02487454	RISANKIZUMAB	Skyrizi 75mg/0.83mL Inj Sol-0.83mL Pref Syr (Preservative-Free)	ABV	2467.5000	2467.5000	NO	YES	NO
02519291	RISANKIZUMAB	Skyrizi 150mg/mL Inj Sol-Pref Pen (Preservative-Free)	ABV	4935.0000	4935.0000	NO	YES	NO
02519283	RISANKIZUMAB	Skyrizi 150mg/mL Inj Sol-Pref Syr (Preservative-Free)	ABV	4935.0000	4935.0000	NO	YES	NO
02495155	UPADACITINIB	Rinvoq 15mg ER Tab	ABV	51.6810	51.6810	NO	YES	NO