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Products found: 86New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
01914006AMANTADINE HCLSymmetrel (Not a Benefit) 100mg CapBQUN/AN/AYESNOYES
01913999AMANTADINE HCLSymmetrel (Not a Benefit) 10mg/mL O/LBQUN/AN/AYESNOYES
02377233APIXABANEliquis 2.5mg TabBQU1.63360.4084YESYESNO
09857463APIXABANEliquis 2.5mg TabBQU1.63360.4084YESYESNO
02397714APIXABANEliquis 5mg TabBQU1.63360.4084YESYESNO
02294176ATAZANAVIR SULFATEReyataz (Off-Formulary Interchangeable) 300mg CapBQUN/AN/AYESNONO
02248611ATAZANAVIR SULFATEReyataz 200mg CapBQU11.76332.8552YESNONO
02248610ATAZANAVIR SULFATEReyataz 150mg CapBQU11.69502.8386YESNONO
00603821BUSPIRONE HYDROCHLORIDEBuspar (Not a Benefit) 10mg TabBQUN/AN/AYESNONO
02113031BUTORPHANOL TARTRATEStadol NS (Off-Formulary Interchangeable) 10mg/mL Nas Sp-2.5mL PkBQUN/AN/AYESNONO
00695661CAPTOPRILCapoten (Not a Benefit) 12.5mg TabBQUN/AN/AYESNONO
00546283CAPTOPRILCapoten (Not a Benefit) 25mg TabBQUN/AN/AYESNONO
00546291CAPTOPRILCapoten (Not a Benefit) 50mg TabBQUN/AN/AYESNONO
00546305CAPTOPRILCapoten (Not a Benefit) 100mg TabBQUN/AN/AYESNONO
00507245CEFADROXILDuricef (Not a Benefit) 500mg CapBQUN/AN/AYESNONO
02163640CEFEPIMEMaxipime (Off-Formulary Interchangeable) 2g Inj Pd-Vial PkBQUN/AN/AYESNONO
02163632CEFEPIMEMaxipime (Off-Formulary Interchangeable) 1g Inj Pd-Vial PkBQUN/AN/AYESNONO
09857359CEFPROZILCefzil (Not a Benefit) 250mg/5mL Oral Susp-100mL PkBQUN/AN/AYESNONO
09857358CEFPROZILCefzil (Not a Benefit) 125mg/5mL Oral Susp-100mL PkBQUN/AN/AYESNONO
02163683CEFPROZILCefzil (Not a Benefit) 250mg/5mL Oral Susp-75mL PkBQUN/AN/AYESNONO
02163675CEFPROZILCefzil (Not a Benefit) 125mg/5mL Oral Susp-75mL PkBQUN/AN/AYESNONO
02163667CEFPROZILCefzil (Not a Benefit) 500mg TabBQUN/AN/AYESNONO
02163659CEFPROZILCefzil (Not a Benefit) 250mg TabBQUN/AN/AYESNONO
00029165CYANOCOBALAMINRubramin (Not a Benefit) 1mg/mL Inj Sol-10mL PkBQUN/AN/AYESNONO
00344885CYCLOPHOSPHAMIDECytoxan (Not a Benefit) 50mg TabBQUN/AN/AYESNONO
02293137DASATINIBSprycel (Off-Formulary Interchangeable) 50mg TabBQU77.856766.1783YESNONO
02293129DASATINIBSprycel (Off-Formulary Interchangeable) 20mg TabBQU38.685032.8823YESNONO
02293145DASATINIBSprycel (Off-Formulary Interchangeable) 70mg TabBQU85.804272.9337YESNONO
02360829DASATINIBSprycel (Off-Formulary Interchangeable) 140mg TabBQUN/AN/AYESNONO
02320193DASATINIBSprycel (Off-Formulary Interchangeable) 100mg TabBQU155.6083132.2671YESNONO
02360810DASATINIBSprycel (Off-Formulary Interchangeable) 80mg TabBQUN/AN/AYESNONO
02244597DIDANOSINEVidex EC 200mg Enteric Coated CapBQU6.87166.8716NONONO
02244598DIDANOSINEVidex EC 250mg Enteric Coated CapBQU8.51508.5150NONONO
02244599DIDANOSINEVidex EC 400mg Enteric Coated CapBQU13.771713.7717NONONO
02244596DIDANOSINEVidex EC 125mg Enteric Coated CapBQU4.29504.2950NONONO
02246045EFAVIRENZSustiva (Not a Benefit) 600mg TabBQUN/AN/AYESNONO
02300699EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINEAtripla 600mg/300mg/200mg TabBQU45.320011.3300YESNONO
02282224ENTECAVIRBaraclude 0.5mg TabBQU22.66004.4000YESYESNO
00029386FLUPHENAZINE HCLModiten HCL (Not a Benefit) 2mg TabBQUN/AN/AYESNONO
00029378FLUPHENAZINE HCLModiten HCL (Not a Benefit) 1mg TabBQUN/AN/AYESNONO
00029408FLUPHENAZINE HCLModiten HCL (Not a Benefit) 5mg TabBQUN/AN/AYESNONO
01907115FOSINOPRIL SODIUMMonopril (Not a Benefit) 20mg TabBQUN/AN/AYESNONO
01907107FOSINOPRIL SODIUMMonopril (Not a Benefit) 10mg TabBQUN/AN/AYESNONO
01916580HYDROCODONE BITARTRATEHycodan (Not a Benefit) 1mg/mL O/LBQUN/AN/AYESNONO
01910124HYDROCORTISONE VALERATEWestcort (Not a Benefit) 0.2% CrBQUN/AN/AYESNONO
01910132HYDROCORTISONE VALERATEWestcort (Not a Benefit) 0.2% OintBQUN/AN/AYESNONO
00465283HYDROXYUREAHydrea 500mg CapBQU1.14521.0203YESNONO
00360414LOMUSTINE (CCNU)CeeNU 100mg CapBQU22.455022.4550NONONO
00360422LOMUSTINE (CCNU)CeeNU 40mg CapBQU13.602513.6025NONONO
00360430LOMUSTINE (CCNU)CeeNU 10mg CapBQU7.89007.8900NONONO
00731323MEGESTROL ACETATEMegace (Not a Benefit) 160mg TabBQUN/AN/AYESNONO
00386391MEGESTROL ACETATEMegace (Not a Benefit) 40mg TabBQUN/AN/AYESNONO
00463256NADOLOLCorgard (Not a Benefit) 80mg TabBQUN/AN/AYESNONO
00607126NADOLOLCorgard (Not a Benefit) 40mg TabBQUN/AN/AYESNONO
00523372NADOLOLCorgard (Not a Benefit) 160mg TabBQUN/AN/AYESNONO
00029092NYSTATINMycostatin (Not a Benefit) 100000U/g CrBQUN/AN/AYESNOYES
00248169NYSTATINMycostatin (Not a Benefit) 100000U/mL O/LBQUN/AN/AYESNONO
00029556NYSTATINMycostatin (Not a Benefit) 100000U/g OintBQUN/AN/AYESNOYES
00295973NYSTATINMycostatin (Not a Benefit) 25000U/g Vag CrBQUN/AN/AYESNOYES
01916548OXYCODONE HCL & ACETAMINOPHENEndocet 5mg & 325mg TabBQU0.12850.1285YESNOYES
01916475OXYCODONE HCL & ACETAMINOPHENPercocet (Not a Benefit) 5mg & 325mg TabBQUN/AN/AYESNOYES
01916572OXYCODONE HCL & ACETYLSALICYLIC ACIDPercodan (Not a Benefit) 5mg & 325mg TabBQUN/AN/AYESNOYES
02222051PRAVASTATIN SODIUMPravachol 40mg TabBQU1.07500.4143YESNONO
00893749PRAVASTATIN SODIUMPravachol (Not a Benefit) 10mg TabBQUN/AN/AYESNONO
00893757PRAVASTATIN SODIUMPravachol 20mg TabBQU0.89260.3440YESNONO
00483923SOTALOL HCLSotacor (Not a Benefit) 160mg TabBQUN/AN/AYESNONO
00897272SOTALOL HCLSotacor (Not a Benefit) 80mg TabBQUN/AN/AYESNONO
02216116STAVUDINEZerit 40mg CapBQU5.88835.8883NONONO
02216108STAVUDINEZerit 30mg CapBQU5.67915.6791NONONO
02216094STAVUDINEZerit 20mg CapBQU5.44505.4450NONONO
02216086STAVUDINEZerit 15mg CapBQU5.23585.2358NONONO
00579351TRAZODONE HYDROCHLORIDEDesyrel (Not a Benefit) 50mg TabBQUN/AN/AYESNONO
00579378TRAZODONE HYDROCHLORIDEDesyrel (Not a Benefit) 100mg TabBQUN/AN/AYESNONO
00702277TRAZODONE HYDROCHLORIDEDesyrel Dividose (Not a Benefit) 150mg TabBQUN/AN/AYESNONO
00990876TRIAMCINOLONE ACETONIDEKenalog-40 40mg/mL Inj Susp-1mL PkBQU8.96108.9610NONONO
01999761TRIAMCINOLONE ACETONIDEKenalog-10 50mg/5mL Inj Susp-5mL PkBQU19.450019.4500NONONO
01999869TRIAMCINOLONE ACETONIDEKenalog-40 200mg/5mL Inj Susp-5mL PkBQU31.650031.6500NONONO
01999788TRIAMCINOLONE ACETONIDE 0.1% IN ORABASEKenalog-Orabase (Not a Benefit) Oral Top OintBQUN/AN/AYESNONO
02007959WARFARINCoumadin (Not a Benefit) 4mg TabBQUN/AN/AYESNOYES
02240205WARFARINCoumadin (Not a Benefit) 3mg TabBQUN/AN/AYESNOYES
01918362WARFARINCoumadin (Not a Benefit) 10mg TabBQUN/AN/AYESNOYES
01918338WARFARINCoumadin (Not a Benefit) 2mg TabBQUN/AN/AYESNOYES
01918311WARFARINCoumadin (Not a Benefit) 1mg TabBQUN/AN/AYESNOYES
01918354WARFARINCoumadin (Not a Benefit) 5mg TabBQUN/AN/AYESNOYES
02240206WARFARINCoumadin (Not a Benefit) 6mg TabBQUN/AN/AYESNOYES
01918346WARFARINCoumadin (Not a Benefit) 2.5mg TabBQUN/AN/AYESNOYES