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Products found: 14
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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
02294222
MICAFUNGIN SODIUM
Mycamine (Off-Formulary Interchangeable) 50mg/Vial Inj Pd-10mL Vial Pk
ASE
N/A
N/A
YES
NO
NO
02311054
MICAFUNGIN SODIUM
Mycamine (Off-Formulary Interchangeable) 100mg/Vial Inj Pd-10mL Vial Pk
ASE
N/A
N/A
YES
NO
NO
02402882
MIRABEGRON
Myrbetriq 50mg ER Tab
ASE
1.4600
1.4600
NO
YES
NO
02402874
MIRABEGRON
Myrbetriq 25mg ER Tab
ASE
1.4600
1.4600
NO
YES
NO
02277263
SOLIFENACIN SUCCINATE
Vesicare 5mg Tab
ASE
1.6892
0.3041
YES
YES
NO
02277271
SOLIFENACIN SUCCINATE
Vesicare 10mg Tab
ASE
1.6892
0.3041
YES
YES
NO
02176009
TACROLIMUS
Prograf 5mg/mL Amp
ASE
128.2350
128.2350
NO
YES
NO
02175983
TACROLIMUS
Prograf 5mg Cap
ASE
12.9986
6.4993
YES
YES
NO
02243144
TACROLIMUS
Prograf 0.5mg Cap
ASE
2.0291
1.0146
YES
YES
NO
02175991
TACROLIMUS
Prograf 1mg Cap
ASE
2.5956
1.2978
YES
YES
NO
02331667
TACROLIMUS
Advagraf 3mg ER Cap
ASE
8.5188
8.5188
NO
YES
NO
02296489
TACROLIMUS
Advagraf 5mg ER Cap
ASE
14.2205
14.2205
NO
YES
NO
02296462
TACROLIMUS
Advagraf 0.5mg ER Cap
ASE
2.2199
2.2199
NO
YES
NO
02296470
TACROLIMUS
Advagraf 1mg ER Cap
ASE
2.8396
2.8396
NO
YES
NO
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