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Products found: 50New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOHLTC PaysInter- change- ableLimited UseThera- peutic Notes
02453916BUPRENORPHINE & NALOXONEAct Buprenorphine/Naloxone 8mg & 2mg SL TabACV2.36502.3650YESNONO
02453908BUPRENORPHINE & NALOXONEAct Buprenorphine/Naloxone 2mg & 0.5mg SL TabACV1.33501.3350YESNONO
02439654BUPROPION HCLAct Bupropion XL 150mg ER TabACV0.14630.1463YESYESNO
02439662BUPROPION HCLAct Bupropion XL 300mg ER TabACV0.29270.2927YESYESNO
02420155CELECOXIBAct Celecoxib 100mg CapACV0.12790.1279YESYESYES
02420163CELECOXIBAct Celecoxib 200mg CapACV0.25580.2558YESYESYES
02403196CLARITHROMYCINAct Clarithromycin XL 500mg ER TabACV1.25721.2572YESNOYES
02420813DESOGESTREL & ETHINYL ESTRADIOLReclipsen 21 (Not a Benefit) 0.15mg & 0.03mg Tab-21 PkACVN/AN/AYESNONO
02417464DESOGESTREL & ETHINYL ESTRADIOLReclipsen 28 (Not a Benefit) 0.15mg & 0.03mg Tab-28 PkACVN/AN/AYESNONO
02448327DEXTROAMPHETAMINE SULFATEAct Dextroamphetamine SR 15mg SR CapACV0.98980.9898YESNOYES
02448319DEXTROAMPHETAMINE SULFATEAct Dextroamphetamine SR 10mg SR CapACV0.80960.8096YESNOYES
02412691DUTASTERIDEAct Dutasteride 0.5mg CapACV0.30270.3027YESYESNO
02454297ESCITALOPRAMAct Escitalopram ODT 10mg Orally Disintegrating TabACV1.31991.3199YESNONO
02454300ESCITALOPRAMAct Escitalopram ODT 20mg Orally Disintegrating TabletACV1.40521.4052YESNONO
02423863ESOMEPRAZOLEAct Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mgACV1.8690N/AYESNONO
02423855ESOMEPRAZOLEAct Esomeprazole (Off-Formulary Interchangeable) 20mg DR TabACV1.8690N/AYESNONO
02414716EZETIMIBEAct Ezetimibe 10mg TabACV0.18110.1811YESYESNO
02281279FLUCONAZOLEACT Fluconazole 100mg TabACV2.28912.2891YESNONO
02281260FLUCONAZOLEACT Fluconazole 50mg TabACV1.29041.2904YESNONO
02429764GLICLAZIDEAct Gliclazide MR 30mg SR TabACV0.09310.0931YESNONO
02436256LATANOPROST & TIMOLOL MALEATEAct Latanoprost/Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL PkACV11.070011.0700YESYESNO
02274205LEVETIRACETAMAct Levetiracetam 750mg TabACV0.54160.5416YESYESNO
02274191LEVETIRACETAMAct Levetiracetam 500mg TabACV0.39110.3911YESYESNO
02274183LEVETIRACETAMAct Levetiracetam 250mg TabACV0.32100.3210YESYESNO
02257726METFORMIN HCLAct Metformin 500mg TabACV0.02470.0247YESNONO
02257734METFORMIN HCLAct Metformin (Off-Formulary Interchangeable) 850mg TabACV0.2090N/AYESNONO
02441969METHYLPHENIDATE HCLAct Methylphenidate ER 54mg SR TabACV0.84790.8479YESNOYES
02441950METHYLPHENIDATE HCLAct Methylphenidate ER 36mg SR TabACV0.68630.6863YESNOYES
02441942METHYLPHENIDATE HCLAct Methylphenidate ER 27mg SR TabACV0.60550.6055YESNOYES
02441934METHYLPHENIDATE HCLAct Methylphenidate ER 18mg SR TabACV0.52460.5246YESNOYES
02439255MIXED SALT AMPHETAMINEAct Amphetamine XR 15mg ER CapACV0.68380.6838YESNOYES
02439247MIXED SALT AMPHETAMINEAct Amphetamine XR 10mg ER CapACV0.61050.6105YESNOYES
02439271MIXED SALT AMPHETAMINEAct Amphetamine XR 25mg ER CapACV0.83050.8305YESNOYES
02439263MIXED SALT AMPHETAMINEAct Amphetamine XR 20mg ER CapACV0.75720.7572YESNOYES
02439239MIXED SALT AMPHETAMINEAct Amphetamine XR 5mg ER CapACV0.53720.5372YESNOYES
02439298MIXED SALT AMPHETAMINEAct Amphetamine XR 30mg ER CapACV0.90380.9038YESNOYES
02404656MOXIFLOXACIN HYDROCHLORIDEAct Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free)ACV11.2700N/AYESNONO
02442191OLMESARTAN MEDOXOMILAct Olmesartan 20mg TabACV0.30190.3019YESNONO
02442205OLMESARTAN MEDOXOMILAct Olmesartan 40mg TabACV0.30190.3019YESNONO
02443120OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEAct Olmesartan HCT 40mg & 12.5mg TabACV0.30190.3019YESNONO
02443112OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEAct Olmesartan HCT 20mg & 12.5mg TabACV0.30190.3019YESNONO
02443139OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEAct Olmesartan HCT 40mg & 25mg TabACV0.30190.3019YESNONO
02404095OLOPATADINE HCLAct Olopatadine 0.2% (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL PkACV26.1300N/AYESNONO
02422247SOLIFENACIN SUCCINATEAct Solifenacin 10mg TabACV0.30410.3041YESYESNO
02422239SOLIFENACIN SUCCINATEAct Solifenacin 5mg TabACV0.30410.3041YESYESNO
02428644TADALAFILAct Tadalafil (Off-Formulary Interchangeable) 10mg TabACV11.9255N/AYESNONO
02428636TADALAFILAct Tadalafil (Off-Formulary Interchangeable) 5mg TabACV3.6471N/AYESNONO
02428628TADALAFILAct Tadalafil (Off-Formulary Interchangeable) 2.5mg TabACV3.6471N/AYESNONO
02428652TADALAFILAct Tadalafil (Off-Formulary Interchangeable) 20mg TabACV12.3569N/AYESNONO
02441160TEMOZOLOMIDEAct Temozolomide 5mg CapACV3.90003.9000YESYESNO