02505355 | AFLIBERCEPT | Eylea 40mg/mL Inj Sol-0.05mL Pref Syr (Preservative-Free) | BAH | 1418.0000 | 1418.0000 | NO | YES | NO |
02415992 | AFLIBERCEPT | Eylea 40mg/mL Sol for Intravitreal Inj-0.05mL Vial Pk | BAH | 1418.0000 | 1418.0000 | NO | YES | NO |
02374900 | DIENOGEST | Visanne 2mg Tab | BAH | 2.1136 | 1.0231 | YES | YES | NO |
02261723 | DROSPIRENONE & ETHINYL ESTRADIOL | Yasmin 21 3.0mg & 0.03mg Tab-21 Pk | BAH | 12.4400 | 6.2181 | YES | NO | NO |
02261731 | DROSPIRENONE & ETHINYL ESTRADIOL | Yasmin 28 3.0mg & 0.03mg Tab-28 Pk | BAH | 12.4400 | 6.2188 | YES | NO | NO |
02321157 | DROSPIRENONE & ETHINYL ESTRADIOL | Yaz 3.0mg & 0.02mg Tab-28 Pk | BAH | 16.5200 | 8.2600 | YES | NO | NO |
02155869 | NIFEDIPINE | Adalat (Not a Benefit) 5mg Cap | BAH | N/A | N/A | YES | NO | NO |
02155877 | NIFEDIPINE | Adalat (Not a Benefit) 10mg Cap | BAH | N/A | N/A | YES | NO | YES |
02325926 | NIMODIPINE | Nimotop 30mg Tab | BAH | 10.3006 | 10.3006 | NO | YES | NO |
02378612 | RIVAROXABAN | Xarelto 20mg Tab | BAH | 2.8700 | 2.8700 | NO | YES | NO |
02378604 | RIVAROXABAN | Xarelto 15mg Tab | BAH | 2.8700 | 2.8700 | NO | YES | NO |
02316986 | RIVAROXABAN | Xarelto 10mg Tab | BAH | 2.8700 | 2.8700 | NO | YES | NO |
02480808 | RIVAROXABAN | Xarelto 2.5mg Tab | BAH | 1.4200 | 1.4200 | NO | YES | NO |
02372436 | VARDENAFIL HCL | Staxyn (Off-Formulary Interchangeable) 10mg Orally Disintergrating Tab | BAH | N/A | N/A | YES | NO | NO |