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Products found: 108New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
02381478ALENDRONATEAlendronate Sodium Tablets (Off-Formulary Interchangeable) 5mg TabACH1.0370N/AYESNONO
02381486ALENDRONATEAlendronate Sodium Tablets 10mg TabACH0.49870.4987YESNONO
02381494ALENDRONATEAlendronate Sodium Tablets 70mg TabACH1.78041.7804YESNONO
02419572AMLODIPINEAch-Amlodipine 10mg TabACH0.19930.1993YESNONO
02419564AMLODIPINEAch-Amlodipine 5mg TabACH0.13430.1343YESNONO
02351218ANASTROZOLEAnastrozole 1mg TabACH0.95220.9522YESNONO
02487721APIXABANAch-Apixaban 5mg TabACH0.40840.4084YESYESNO
09858170APIXABANAch-Apixaban 2.5mg TabACH0.40840.4084YESYESNO
02487713APIXABANAch-Apixaban 2.5mg TabACH0.40840.4084YESYESNO
02457768ATORVASTATIN CALCIUMAch-Atorvastatin Calcium 20mg TabACH0.21790.2179YESNONO
02457784ATORVASTATIN CALCIUMAch-Atorvastatin Calcium 80mg TabACH0.23420.2342YESNONO
02457776ATORVASTATIN CALCIUMAch-Atorvastatin Calcium 40mg TabACH0.23420.2342YESNONO
02457741ATORVASTATIN CALCIUMAch-Atorvastatin Calcium 10mg TabACH0.17430.1743YESNONO
02325985BICALUTAMIDEBicalutamide Tablets 50mg TabACH1.26901.2690YESNONO
02379295CANDESARTAN CILEXETILCandesartan Cilexetil Tablets 32mg TabACH0.22810.2281YESNONO
02379287CANDESARTAN CILEXETILCandesartan Cilexetil Tablets 16mg TabACH0.22810.2281YESNONO
02379279CANDESARTAN CILEXETILCandesartan Cilexetil Tablets 8mg TabACH0.22810.2281YESNONO
02379260CANDESARTAN CILEXETILCandesartan Cilexetil Tablets 4mg TabACH0.17000.1700YESNONO
02426757CAPECITABINEAch-Capecitabine 150mg TabACH0.45750.4575YESNONO
02426765CAPECITABINEAch-Capecitabine 500mg TabACH1.52501.5250YESNONO
02495368DIMETHYL FUMARATEAch-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR CapACH18.386718.3867YESNONO
02495341DIMETHYL FUMARATEAch-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR CapACH9.19339.1933YESNONO
02402645DONEPEZIL HCLAch-Donepezil 5mg TabACH0.45860.4586YESYESNO
02402653DONEPEZIL HCLAch-Donepezil 10mg TabACH0.45860.4586YESYESNO
02434660ESCITALOPRAMAch-Escitalopram 20mg TabACH0.33100.3310YESNONO
02434652ESCITALOPRAMAch-Escitalopram 10mg TabACH0.31090.3109YESNONO
02425610EZETIMIBEAch-Ezetimibe 10mg TabACH0.18110.1811YESYESNO
02355043FINASTERIDEFinasteride Tablets USP 5mg TabACH0.35060.3506YESYESNO
02475669FINGOLIMODAch-Fingolimod (Off-Formulary Interchangeable) 0.5mg CapACH73.910073.9100YESNONO
02393441FLUOXETINE HCLAch-Fluoxetine (Off-Formulary Interchangeable) 10mg CapACH1.1773N/AYESNOYES
02383241FLUOXETINE HCLAch-Fluoxetine 20mg CapACH0.33110.3311YESNOYES
02416867GABAPENTINGabapentin Capsules USP 400mg CapACH0.12060.1206YESNONO
02416859GABAPENTINGabapentin Capsules USP 300mg CapACH0.10120.1012YESNONO
02416840GABAPENTINGabapentin Capsules USP 100mg CapACH0.04160.0416YESNONO
02392526GABAPENTINGabapentin Tablets USP (Off-Formulary Interchangeable) 600mg TabACH1.3045N/AYESNONO
02392534GABAPENTINGabapentin Tablets USP (Off-Formulary Interchangeable) 800mg TabACH1.7393N/AYESNONO
02490986IMATINIB MESYLATEAch-Imatinib 100mg TabACH5.20795.2079YESNOYES
02490994IMATINIB MESYLATEAch-Imatinib 400mg TabACH20.831420.8314YESNOYES
02489309LACOSAMIDEAch-Lacosamide 150mg TabACH1.17631.1763YESYESNO
02489287LACOSAMIDEAch-Lacosamide 50mg TabACH0.63130.6313YESYESNO
02489317LACOSAMIDEAch-Lacosamide 200mg TabACH1.45001.4500YESYESNO
02489295LACOSAMIDEAch-Lacosamide 100mg TabACH0.87500.8750YESYESNO
02338459LETROZOLELetrozole Tablets USP 2.5mg TabACH1.37801.3780YESNONO
02399776LEVETIRACETAMAch-Levetiracetam 250mg TabACH0.32100.3210YESYESNO
02399784LEVETIRACETAMAch-Levetiracetam 500mg TabACH0.39110.3911YESYESNO
02399792LEVETIRACETAMAch-Levetiracetam 750mg TabACH0.54160.5416YESYESNO
02464365METHOTREXATEMethotrexate Injection BP 50mg/2mL Inj Sol-2mL PkACH8.92008.9200YESNONO
02491311METHOTREXATEMethotrexate Subcutaneous 15mg/0.3mL Inj Sol-Pref SyrACH16.380016.3800YESNONO
02491338METHOTREXATEMethotrexate Subcutaneous 17.5mg/0.35mL Inj Sol-Pref SyrACH16.000016.0000YESNONO
02491354METHOTREXATEMethotrexate Subcutaneous 22.5mg/0.45mL Inj Sol-Pref SyrACH17.500017.5000YESNONO
02491362METHOTREXATEMethotrexate Subcutaneous 25mg/0.5mL Inj Sol-Pref SyrACH19.500019.5000YESNONO
02491346METHOTREXATEMethotrexate Subcutaneous 20mg/0.4mL Inj Sol-Pref SyrACH17.500017.5000YESNONO
02509067METHOTREXATEAch-Methotrexate 2.5mg TabACH0.25130.2513YESNONO
02379236MONTELUKAST SODIUMAch-Montelukast (Off-Formulary Interchangeable) 10mg TabACH1.77351.7735YESNONO
02383780MYCOPHENOLATE MOFETILMycophenolate Mofetil Capsules 250mg CapACH0.37120.3712YESNONO
02378574MYCOPHENOLATE MOFETILAch-Mycophenolate 500mg TabACH0.74230.7423YESNONO
02456338OLMESARTAN MEDOXOMILAch-Olmesartan 40mg TabACH0.30190.3019YESNONO
02456311OLMESARTAN MEDOXOMILAch-Olmesartan 20mg TabACH0.30190.3019YESNONO
02468956OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEAch-Olmesartan HCTZ 40mg & 12.5mg TabACH0.30190.3019YESNONO
02468948OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEAch-Olmesartan HCTZ 20mg & 12.5mg TabACH0.30190.3019YESNONO
02468964OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEAch-Olmesartan HCTZ 40mg & 25mg TabACH0.30190.3019YESNONO
02416549OMEPRAZOLEOmeprazole Magnesium Delayed Release Tab 20mgACH0.22870.2287YESYESNO
09857500OMEPRAZOLE MAGNESIUMOmeprazole Magnesium Delayed Release Tab 20mgACH0.22870.2287YESYESNO
02391600PIOGLITAZONE HCLPioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 15mg TabACH1.57161.5716YESNONO
02339587PIOGLITAZONE HCLPioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 30mg TabACH2.20172.2017YESNONO
02339595PIOGLITAZONE HCLPioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 45mg TabACH3.31053.3105YESNONO
02440660PRAVASTATIN SODIUMAch-Pravastatin 40mg TabACH0.41430.4143YESNONO
02440652PRAVASTATIN SODIUMAch-Pravastatin 20mg TabACH0.34400.3440YESNONO
02440644PRAVASTATIN SODIUMAch-Pravastatin 10mg TabACH0.29160.2916YESNONO
02449900PREGABALINAch-Pregabalin 300mg CapACH0.41450.4145YESNONO
02449846PREGABALINAch-Pregabalin 50mg CapACH0.23240.2324YESNONO
02449854PREGABALINAch-Pregabalin 75mg CapACH0.30070.3007YESNONO
02449870PREGABALINAch-Pregabalin 150mg CapACH0.41450.4145YESNONO
02449897PREGABALINAch-Pregabalin (Off-Formulary Interchangeable) 225mg CapACH1.7270N/AYESNONO
02449838PREGABALINAch-Pregabalin 25mg CapACH0.14810.1481YESNONO
02450895QUETIAPINEAch-Quetiapine Fumarate XR 300mg ER TabACH0.97760.9776YESNONO
02450887QUETIAPINEAch-Quetiapine Fumarate XR 200mg ER TabACH0.66610.6661YESNONO
02450909QUETIAPINEAch-Quetiapine Fumarate XR 400mg ER TabACH1.32701.3270YESNONO
02450860QUETIAPINEAch-Quetiapine Fumarate XR 50mg ER TabACH0.25010.2501YESNONO
02450879QUETIAPINEAch-Quetiapine Fumarate XR 150mg ER TabACH0.49260.4926YESNONO
02387824QUETIAPINEQuetiapine Tablets 200mg TabACH0.26470.2647YESNONO
02387832QUETIAPINEQuetiapine Tablets 300mg TabACH0.38630.3863YESNONO
02387816QUETIAPINEQuetiapine Tablets (Off-Formulary Interchangeable) 150mg TabACH1.3518N/AYESNONO
02387808QUETIAPINEQuetiapine Tablets 100mg TabACH0.13180.1318YESNONO
02387794QUETIAPINEQuetiapine Tablets 25mg TabACH0.04940.0494YESNONO
02438917ROSUVASTATIN CALCIUMAch-Rosuvastatin 5mg TabACH0.12840.1284YESNONO
02438925ROSUVASTATIN CALCIUMAch-Rosuvastatin 10mg TabACH0.13540.1354YESNONO
02438933ROSUVASTATIN CALCIUMAch-Rosuvastatin 20mg TabACH0.16920.1692YESNONO
02438941ROSUVASTATIN CALCIUMAch-Rosuvastatin 40mg TabACH0.19900.1990YESNONO
02512483SITAGLIPTINAch-Sitagliptin 50mg TabACH0.81970.8197YESNOYES
02512491SITAGLIPTINAch-Sitagliptin 100mg TabACH0.81970.8197YESNOYES
02512475SITAGLIPTINAch-Sitagliptin 25mg TabACH0.81970.8197YESNOYES
02439344SOLIFENACIN SUCCINATEAch-Solifenacin Succinate 5mg TabACH0.30410.3041YESYESNO
02439352SOLIFENACIN SUCCINATEAch-Solifenacin Succinate 10mg TabACH0.30410.3041YESYESNO
02456109TACROLIMUSAch-Tacrolimus 5mg CapACH6.49936.4993YESYESNO
02454068TACROLIMUSAch-Tacrolimus 0.5mg CapACH1.01461.0146YESYESNO
02456095TACROLIMUSAch-Tacrolimus 1mg CapACH1.29781.2978YESYESNO
02516004TADALAFILAch-Tadalafil (Off-Formulary Interchangeable) 20mg TabACH12.357512.3575YESNONO
02515997TADALAFILAch-Tadalafil (Off-Formulary Interchangeable) 10mg TabACH11.925011.9250YESNONO
02515989TADALAFILAch-Tadalafil (Off-Formulary Interchangeable) 5mg TabACH3.64703.6470YESNONO
02407493TELMISARTANAch-Telmisartan 80mg TabACH0.21610.2161YESNONO
02407485TELMISARTANAch-Telmisartan 40mg TabACH0.21610.2161YESNONO
02419114TELMISARTAN & HYDROCHLOROTHIAZIDETelmisartan and Hydrochlorothiazide Tab 80mg & 12.5mg TabACH0.20980.2098YESNONO
02419122TELMISARTAN & HYDROCHLOROTHIAZIDETelmisartan and Hydrochlorothiazide Tab 80mg & 25mg TabACH0.20980.2098YESNONO
02502933TERIFLUNOMIDEAch-Teriflunomide 14mg TabACH14.930014.9300YESYESNO
02395746TOPIRAMATEAch-Topiramate 100mg TabACH0.45830.4583YESNONO
02395738TOPIRAMATEAch-Topiramate 25mg TabACH0.24330.2433YESNONO
02395754TOPIRAMATEAch-Topiramate 200mg TabACH0.67480.6748YESNONO