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Products found: 90New 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
02397714APIXABANEliquis 5mg TabBQU1.63361.2252YESYESNO
09857463APIXABANEliquis 2.5mg TabBQU1.63361.2252YESYESNO
02377233APIXABANEliquis 2.5mg TabBQU1.63361.2252YESYESNO
02294176ATAZANAVIR SULFATEReyataz (Off-Formulary Interchangeable) 300mg CapBQUN/AN/AYESNONO
02248611ATAZANAVIR SULFATEReyataz 200mg CapBQU11.76335.7104YESNOYES
02248610ATAZANAVIR SULFATEReyataz 150mg CapBQU11.69505.6771YESNOYES
00603821BUSPIRONE HYDROCHLORIDEBuspar (Not a Benefit) 10mg TabBQUN/AN/AYESNONO
02113031BUTORPHANOL TARTRATEStadol NS (Off-Formulary Interchangeable) 10mg/mL Nas Sp-2.5mL PkBQUN/AN/AYESNONO
00546291CAPTOPRILCapoten (Not a Benefit) 50mg TabBQUN/AN/AYESNONO
00546283CAPTOPRILCapoten (Not a Benefit) 25mg TabBQUN/AN/AYESNONO
00695661CAPTOPRILCapoten (Not a Benefit) 12.5mg TabBQUN/AN/AYESNONO
00546305CAPTOPRILCapoten (Not a Benefit) 100mg TabBQUN/AN/AYESNONO
00507245CEFADROXILDuricef (Not a Benefit) 500mg CapBQUN/AN/AYESNONO
02163632CEFEPIMEMaxipime (Off-Formulary Interchangeable) 1g Inj Pd-Vial PkBQUN/AN/AYESNONO
02163640CEFEPIMEMaxipime (Off-Formulary Interchangeable) 2g 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
00464880CHOLESTYRAMINE RESINQuestran 9g Pk (Not a Benefit) Oral Pd-Pouch PkBQUN/AN/AYESNONO
01918486CHOLESTYRAMINE RESINQuestran Light 4g Pk (Not a Benefit) Oral Pd-Pouch PkBQUN/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
02320193DASATINIBSprycel (Off-Formulary Interchangeable) 100mg TabBQU155.6083132.2671YESNONO
02360829DASATINIBSprycel (Off-Formulary Interchangeable) 140mg TabBQUN/AN/AYESNONO
02360810DASATINIBSprycel (Off-Formulary Interchangeable) 80mg TabBQUN/AN/AYESNONO
02244598DIDANOSINEVidex EC 250mg Enteric Coated CapBQU8.51508.5150NONOYES
02244596DIDANOSINEVidex EC 125mg Enteric Coated CapBQU4.29504.2950NONOYES
02244599DIDANOSINEVidex EC 400mg Enteric Coated CapBQU13.771713.7717NONOYES
02244597DIDANOSINEVidex EC 200mg Enteric Coated CapBQU6.87166.8716NONOYES
02239886EFAVIRENZSustiva 50mg CapBQU1.30501.3050NONOYES
02239888EFAVIRENZSustiva 200mg CapBQU5.22285.2228NONOYES
02246045EFAVIRENZSustiva 600mg TabBQU15.66833.8030YESNOYES
02300699EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINEAtripla 600mg/300mg/200mg TabBQU45.320011.3300YESNOYES
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 CapBQU1.02031.0203YESNONO
00360430LOMUSTINE (CCNU)CeeNU 10mg CapBQU7.89007.8900NONONO
00360422LOMUSTINE (CCNU)CeeNU 40mg CapBQU13.602513.6025NONONO
00360414LOMUSTINE (CCNU)CeeNU 100mg CapBQU22.455022.4550NONONO
00386391MEGESTROL ACETATEMegace (Not a Benefit) 40mg TabBQUN/AN/AYESNONO
00731323MEGESTROL ACETATEMegace (Not a Benefit) 160mg 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
00893749PRAVASTATIN SODIUMPravachol (Not a Benefit) 10mg TabBQUN/AN/AYESNONO
00893757PRAVASTATIN SODIUMPravachol 20mg TabBQU0.89260.3440YESNONO
02222051PRAVASTATIN SODIUMPravachol 40mg TabBQU1.07500.4143YESNONO
00483923SOTALOL HCLSotacor (Not a Benefit) 160mg TabBQUN/AN/AYESNONO
00897272SOTALOL HCLSotacor (Not a Benefit) 80mg TabBQUN/AN/AYESNONO
02216086STAVUDINEZerit 15mg CapBQU5.23585.2358NONOYES
02216108STAVUDINEZerit 30mg CapBQU5.67915.6791NONOYES
02216094STAVUDINEZerit 20mg CapBQU5.44505.4450NONOYES
02216116STAVUDINEZerit 40mg CapBQU5.88835.8883NONOYES
00579378TRAZODONE HYDROCHLORIDEDesyrel (Not a Benefit) 100mg TabBQUN/AN/AYESNONO
00579351TRAZODONE HYDROCHLORIDEDesyrel (Not a Benefit) 50mg 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
01918338WARFARINCoumadin (Not a Benefit) 2mg TabBQUN/AN/AYESNOYES
01918346WARFARINCoumadin (Not a Benefit) 2.5mg TabBQUN/AN/AYESNOYES
02240205WARFARINCoumadin (Not a Benefit) 3mg TabBQUN/AN/AYESNOYES
02007959WARFARINCoumadin (Not a Benefit) 4mg TabBQUN/AN/AYESNOYES
01918354WARFARINCoumadin (Not a Benefit) 5mg TabBQUN/AN/AYESNOYES
02240206WARFARINCoumadin (Not a Benefit) 6mg TabBQUN/AN/AYESNOYES
01918362WARFARINCoumadin (Not a Benefit) 10mg TabBQUN/AN/AYESNOYES
01918311WARFARINCoumadin (Not a Benefit) 1mg TabBQUN/AN/AYESNOYES