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Products found: 107

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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
02381478	ALENDRONATE	Alendronate Sodium Tablets (Off-Formulary Interchangeable) 5mg Tab	ACH	1.0370	N/A	YES	NO	NO
02381486	ALENDRONATE	Alendronate Sodium Tablets 10mg Tab	ACH	0.4987	0.4987	YES	NO	NO
02381494	ALENDRONATE	Alendronate Sodium Tablets 70mg Tab	ACH	1.7804	1.7804	YES	NO	NO
02419572	AMLODIPINE	Ach-Amlodipine 10mg Tab	ACH	0.1993	0.1993	YES	NO	NO
02419564	AMLODIPINE	Ach-Amlodipine 5mg Tab	ACH	0.1343	0.1343	YES	NO	NO
02351218	ANASTROZOLE	Anastrozole 1mg Tab	ACH	0.9522	0.9522	YES	NO	NO
02487713	APIXABAN	Ach-Apixaban 2.5mg Tab	ACH	0.4084	0.4084	YES	NO	NO
02487721	APIXABAN	Ach-Apixaban 5mg Tab	ACH	0.4084	0.4084	YES	NO	NO
02457741	ATORVASTATIN CALCIUM	Ach-Atorvastatin Calcium 10mg Tab	ACH	0.1743	0.1743	YES	NO	NO
02457784	ATORVASTATIN CALCIUM	Ach-Atorvastatin Calcium 80mg Tab	ACH	0.2342	0.2342	YES	NO	NO
02457776	ATORVASTATIN CALCIUM	Ach-Atorvastatin Calcium 40mg Tab	ACH	0.2342	0.2342	YES	NO	NO
02457768	ATORVASTATIN CALCIUM	Ach-Atorvastatin Calcium 20mg Tab	ACH	0.2179	0.2179	YES	NO	NO
02325985	BICALUTAMIDE	Bicalutamide Tablets 50mg Tab	ACH	1.2690	1.2690	YES	NO	NO
02379260	CANDESARTAN CILEXETIL	Candesartan Cilexetil Tablets 4mg Tab	ACH	0.1700	0.1700	YES	NO	NO
02379279	CANDESARTAN CILEXETIL	Candesartan Cilexetil Tablets 8mg Tab	ACH	0.2281	0.2281	YES	NO	NO
02379287	CANDESARTAN CILEXETIL	Candesartan Cilexetil Tablets 16mg Tab	ACH	0.2281	0.2281	YES	NO	NO
02379295	CANDESARTAN CILEXETIL	Candesartan Cilexetil Tablets 32mg Tab	ACH	0.2281	0.2281	YES	NO	NO
02426757	CAPECITABINE	Ach-Capecitabine 150mg Tab	ACH	0.4575	0.4575	YES	NO	NO
02426765	CAPECITABINE	Ach-Capecitabine 500mg Tab	ACH	1.5250	1.5250	YES	NO	NO
02495341	DIMETHYL FUMARATE	Ach-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap	ACH	9.1933	9.1933	YES	NO	NO
02495368	DIMETHYL FUMARATE	Ach-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap	ACH	18.3867	18.3867	YES	NO	NO
02402645	DONEPEZIL HCL	Ach-Donepezil 5mg Tab	ACH	0.4586	0.4586	YES	YES	NO
02402653	DONEPEZIL HCL	Ach-Donepezil 10mg Tab	ACH	0.4586	0.4586	YES	YES	NO
02434660	ESCITALOPRAM	Ach-Escitalopram 20mg Tab	ACH	0.3310	0.3310	YES	NO	NO
02434652	ESCITALOPRAM	Ach-Escitalopram 10mg Tab	ACH	0.3109	0.3109	YES	NO	NO
02425610	EZETIMIBE	Ach-Ezetimibe 10mg Tab	ACH	0.1811	0.1811	YES	YES	NO
02355043	FINASTERIDE	Finasteride Tablets USP 5mg Tab	ACH	0.3506	0.3506	YES	YES	NO
02475669	FINGOLIMOD	Ach-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap	ACH	73.9100	73.9100	YES	NO	NO
02393441	FLUOXETINE HCL	Ach-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	ACH	1.1773	N/A	YES	NO	YES
02383241	FLUOXETINE HCL	Ach-Fluoxetine 20mg Cap	ACH	0.3311	0.3311	YES	NO	YES
02416840	GABAPENTIN	Gabapentin Capsules USP 100mg Cap	ACH	0.0416	0.0416	YES	NO	NO
02416859	GABAPENTIN	Gabapentin Capsules USP 300mg Cap	ACH	0.1012	0.1012	YES	NO	NO
02416867	GABAPENTIN	Gabapentin Capsules USP 400mg Cap	ACH	0.1206	0.1206	YES	NO	NO
02392526	GABAPENTIN	Gabapentin Tablets USP (Off-Formulary Interchangeable) 600mg Tab	ACH	1.3045	N/A	YES	NO	NO
02392534	GABAPENTIN	Gabapentin Tablets USP (Off-Formulary Interchangeable) 800mg Tab	ACH	1.7393	N/A	YES	NO	NO
02490994	IMATINIB MESYLATE	Ach-Imatinib 400mg Tab	ACH	20.8314	20.8314	YES	NO	YES
02490986	IMATINIB MESYLATE	Ach-Imatinib 100mg Tab	ACH	5.2079	5.2079	YES	NO	YES
02489309	LACOSAMIDE	Ach-Lacosamide 150mg Tab	ACH	1.1763	1.1763	YES	YES	NO
02489317	LACOSAMIDE	Ach-Lacosamide 200mg Tab	ACH	1.4500	1.4500	YES	YES	NO
02489295	LACOSAMIDE	Ach-Lacosamide 100mg Tab	ACH	0.8750	0.8750	YES	YES	NO
02489287	LACOSAMIDE	Ach-Lacosamide 50mg Tab	ACH	0.6313	0.6313	YES	YES	NO
02338459	LETROZOLE	Letrozole Tablets USP 2.5mg Tab	ACH	1.3780	1.3780	YES	NO	NO
02399784	LEVETIRACETAM	Ach-Levetiracetam 500mg Tab	ACH	0.3911	0.3911	YES	YES	NO
02399792	LEVETIRACETAM	Ach-Levetiracetam 750mg Tab	ACH	0.5416	0.5416	YES	YES	NO
02399776	LEVETIRACETAM	Ach-Levetiracetam 250mg Tab	ACH	0.3210	0.3210	YES	YES	NO
02464365	METHOTREXATE	Methotrexate Injection BP 50mg/2mL Inj Sol-2mL Pk	ACH	8.9200	8.9200	YES	NO	NO
02491311	METHOTREXATE	Methotrexate Subcutaneous 15mg/0.3mL Inj Sol-Pref Syr	ACH	16.3800	16.3800	YES	NO	NO
02491362	METHOTREXATE	Methotrexate Subcutaneous 25mg/0.5mL Inj Sol-Pref Syr	ACH	19.5000	19.5000	YES	NO	NO
02491354	METHOTREXATE	Methotrexate Subcutaneous 22.5mg/0.45mL Inj Sol-Pref Syr	ACH	17.5000	17.5000	YES	NO	NO
02491346	METHOTREXATE	Methotrexate Subcutaneous 20mg/0.4mL Inj Sol-Pref Syr	ACH	17.5000	17.5000	YES	NO	NO
02491338	METHOTREXATE	Methotrexate Subcutaneous 17.5mg/0.35mL Inj Sol-Pref Syr	ACH	16.0000	16.0000	YES	NO	NO
02509067	METHOTREXATE	Ach-Methotrexate 2.5mg Tab	ACH	0.2513	0.2513	YES	NO	NO
02379236	MONTELUKAST SODIUM	Ach-Montelukast (Off-Formulary Interchangeable) 10mg Tab	ACH	1.7735	1.7735	YES	NO	NO
02383780	MYCOPHENOLATE MOFETIL	Mycophenolate Mofetil Capsules 250mg Cap	ACH	0.3712	0.3712	YES	NO	NO
02378574	MYCOPHENOLATE MOFETIL	Ach-Mycophenolate 500mg Tab	ACH	0.7423	0.7423	YES	NO	NO
02456338	OLMESARTAN MEDOXOMIL	Ach-Olmesartan 40mg Tab	ACH	0.3019	0.3019	YES	NO	NO
02456311	OLMESARTAN MEDOXOMIL	Ach-Olmesartan 20mg Tab	ACH	0.3019	0.3019	YES	NO	NO
02468956	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	Ach-Olmesartan HCTZ 40mg & 12.5mg Tab	ACH	0.3019	0.3019	YES	NO	NO
02468964	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	Ach-Olmesartan HCTZ 40mg & 25mg Tab	ACH	0.3019	0.3019	YES	NO	NO
02468948	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	Ach-Olmesartan HCTZ 20mg & 12.5mg Tab	ACH	0.3019	0.3019	YES	NO	NO
02416549	OMEPRAZOLE	Omeprazole Magnesium Delayed Release Tab 20mg	ACH	0.2287	0.2287	YES	YES	NO
09857500	OMEPRAZOLE MAGNESIUM	Omeprazole Magnesium Delayed Release Tab 20mg	ACH	0.2287	0.2287	YES	YES	NO
02339587	PIOGLITAZONE HCL	Pioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 30mg Tab	ACH	2.2017	2.2017	YES	NO	NO
02391600	PIOGLITAZONE HCL	Pioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 15mg Tab	ACH	1.5716	1.5716	YES	NO	NO
02339595	PIOGLITAZONE HCL	Pioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 45mg Tab	ACH	3.3105	3.3105	YES	NO	NO
02440652	PRAVASTATIN SODIUM	Ach-Pravastatin 20mg Tab	ACH	0.3440	0.3440	YES	NO	NO
02440644	PRAVASTATIN SODIUM	Ach-Pravastatin 10mg Tab	ACH	0.2916	0.2916	YES	NO	NO
02440660	PRAVASTATIN SODIUM	Ach-Pravastatin 40mg Tab	ACH	0.4143	0.4143	YES	NO	NO
02449838	PREGABALIN	Ach-Pregabalin 25mg Cap	ACH	0.1481	0.1481	YES	NO	NO
02449846	PREGABALIN	Ach-Pregabalin 50mg Cap	ACH	0.2324	0.2324	YES	NO	NO
02449854	PREGABALIN	Ach-Pregabalin 75mg Cap	ACH	0.3007	0.3007	YES	NO	NO
02449870	PREGABALIN	Ach-Pregabalin 150mg Cap	ACH	0.4145	0.4145	YES	NO	NO
02449897	PREGABALIN	Ach-Pregabalin (Off-Formulary Interchangeable) 225mg Cap	ACH	1.7270	N/A	YES	NO	NO
02449900	PREGABALIN	Ach-Pregabalin 300mg Cap	ACH	0.4145	0.4145	YES	NO	NO
02450860	QUETIAPINE	Ach-Quetiapine Fumarate XR 50mg ER Tab	ACH	0.2501	0.2501	YES	NO	NO
02450879	QUETIAPINE	Ach-Quetiapine Fumarate XR 150mg ER Tab	ACH	0.4926	0.4926	YES	NO	NO
02450887	QUETIAPINE	Ach-Quetiapine Fumarate XR 200mg ER Tab	ACH	0.6661	0.6661	YES	NO	NO
02450895	QUETIAPINE	Ach-Quetiapine Fumarate XR 300mg ER Tab	ACH	0.9776	0.9776	YES	NO	NO
02450909	QUETIAPINE	Ach-Quetiapine Fumarate XR 400mg ER Tab	ACH	1.3270	1.3270	YES	NO	NO
02387794	QUETIAPINE	Quetiapine Tablets 25mg Tab	ACH	0.0494	0.0494	YES	NO	NO
02387808	QUETIAPINE	Quetiapine Tablets 100mg Tab	ACH	0.1318	0.1318	YES	NO	NO
02387816	QUETIAPINE	Quetiapine Tablets (Off-Formulary Interchangeable) 150mg Tab	ACH	1.3518	N/A	YES	NO	NO
02387824	QUETIAPINE	Quetiapine Tablets 200mg Tab	ACH	0.2647	0.2647	YES	NO	NO
02387832	QUETIAPINE	Quetiapine Tablets 300mg Tab	ACH	0.3863	0.3863	YES	NO	NO
02438917	ROSUVASTATIN CALCIUM	Ach-Rosuvastatin 5mg Tab	ACH	0.1284	0.1284	YES	NO	NO
02438941	ROSUVASTATIN CALCIUM	Ach-Rosuvastatin 40mg Tab	ACH	0.1990	0.1990	YES	NO	NO
02438933	ROSUVASTATIN CALCIUM	Ach-Rosuvastatin 20mg Tab	ACH	0.1692	0.1692	YES	NO	NO
02438925	ROSUVASTATIN CALCIUM	Ach-Rosuvastatin 10mg Tab	ACH	0.1354	0.1354	YES	NO	NO
02512475	SITAGLIPTIN	Ach-Sitagliptin 25mg Tab	ACH	0.8197	0.8197	YES	NO	YES
02512483	SITAGLIPTIN	Ach-Sitagliptin 50mg Tab	ACH	0.8197	0.8197	YES	NO	YES
02512491	SITAGLIPTIN	Ach-Sitagliptin 100mg Tab	ACH	0.8197	0.8197	YES	NO	YES
02439352	SOLIFENACIN SUCCINATE	Ach-Solifenacin Succinate 10mg Tab	ACH	0.3041	0.3041	YES	YES	NO
02439344	SOLIFENACIN SUCCINATE	Ach-Solifenacin Succinate 5mg Tab	ACH	0.3041	0.3041	YES	YES	NO
02456095	TACROLIMUS	Ach-Tacrolimus 1mg Cap	ACH	1.2978	1.2978	YES	YES	NO
02456109	TACROLIMUS	Ach-Tacrolimus 5mg Cap	ACH	6.4993	6.4993	YES	YES	NO
02454068	TACROLIMUS	Ach-Tacrolimus 0.5mg Cap	ACH	1.0146	1.0146	YES	YES	NO
02515989	TADALAFIL	Ach-Tadalafil (Off-Formulary Interchangeable) 5mg Tab	ACH	3.6470	3.6470	YES	NO	NO
02516004	TADALAFIL	Ach-Tadalafil (Off-Formulary Interchangeable) 20mg Tab	ACH	12.3575	12.3575	YES	NO	NO
02515997	TADALAFIL	Ach-Tadalafil (Off-Formulary Interchangeable) 10mg Tab	ACH	11.9250	11.9250	YES	NO	NO
02407485	TELMISARTAN	Ach-Telmisartan 40mg Tab	ACH	0.2161	0.2161	YES	NO	NO
02407493	TELMISARTAN	Ach-Telmisartan 80mg Tab	ACH	0.2161	0.2161	YES	NO	NO
02419122	TELMISARTAN & HYDROCHLOROTHIAZIDE	Telmisartan and Hydrochlorothiazide Tab 80mg & 25mg Tab	ACH	0.2098	0.2098	YES	NO	NO
02419114	TELMISARTAN & HYDROCHLOROTHIAZIDE	Telmisartan and Hydrochlorothiazide Tab 80mg & 12.5mg Tab	ACH	0.2098	0.2098	YES	NO	NO
02502933	TERIFLUNOMIDE	Ach-Teriflunomide 14mg Tab	ACH	14.9300	14.9300	YES	YES	NO
02395738	TOPIRAMATE	Ach-Topiramate 25mg Tab	ACH	0.2433	0.2433	YES	NO	NO
02395746	TOPIRAMATE	Ach-Topiramate 100mg Tab	ACH	0.4583	0.4583	YES	NO	NO
02395754	TOPIRAMATE	Ach-Topiramate 200mg Tab	ACH	0.6748	0.6748	YES	NO	NO

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