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Products found: 44

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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
02533251	ABIRATERONE ACETATE	Reddy-Abiraterone (Off-Formulary Interchangeable) 500mg Tab	DRR	52.0625	52.0625	YES	NO	NO
02477114	ABIRATERONE ACETATE	Reddy-Abiraterone (Off-Formulary Interchangeable) 250mg Tab	DRR	26.0313	26.0313	YES	NO	NO
02477440	ALITRETINOIN	Hanzema 30mg Cap	DRR	16.9868	16.9868	YES	YES	YES
02477432	ALITRETINOIN	Hanzema 10mg Cap	DRR	16.9868	16.9868	YES	YES	YES
02417944	ATORVASTATIN CALCIUM	Reddy-Atorvastatin 20mg Tab	DRR	0.2179	0.2179	YES	NO	NO
02417960	ATORVASTATIN CALCIUM	Reddy-Atorvastatin 80mg Tab	DRR	0.2342	0.2342	YES	NO	NO
02417952	ATORVASTATIN CALCIUM	Reddy-Atorvastatin 40mg Tab	DRR	0.2342	0.2342	YES	NO	NO
02417936	ATORVASTATIN CALCIUM	Reddy-Atorvastatin 10mg Tab	DRR	0.1743	0.1743	YES	NO	NO
02519437	CLOBETASOL PROPIONATE	Reddy-Clobetasol Shampoo (Off-Formulary Interchangeable) 0.05% w/w Top Shampoo	DRR	1.0838	N/A	YES	NO	YES
02490463	DAPTOMYCIN	Daptomycin for Injection (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol-Vial Pk	DRR	162.3500	162.3500	YES	NO	NO
02514745	DASATINIB	Reddy-Dasatinib (Off-Formulary Interchangeable) 50mg Tab	DRR	66.1782	66.1782	YES	NO	NO
02514737	DASATINIB	Reddy-Dasatinib (Off-Formulary Interchangeable) 20mg Tab	DRR	32.8823	32.8823	YES	NO	NO
02514753	DASATINIB	Reddy-Dasatinib (Off-Formulary Interchangeable) 70mg Tab	DRR	72.9336	72.9336	YES	NO	NO
02514761	DASATINIB	Reddy-Dasatinib (Off-Formulary Interchangeable) 80mg Tab	DRR	117.3255	N/A	YES	NO	NO
02514788	DASATINIB	Reddy-Dasatinib (Off-Formulary Interchangeable) 100mg Tab	DRR	132.2670	132.2670	YES	NO	NO
02514796	DASATINIB	Reddy-Dasatinib (Off-Formulary Interchangeable) 140mg Tab	DRR	141.8806	N/A	YES	NO	NO
02511150	ERTAPENEM	Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk	DRR	52.2650	52.2650	YES	NO	NO
02406853	FONDAPARINUX SODIUM	Fondaparinux Sodium Injection 2.5mg/0.5mL Inj Sol-Pref Syr 0.5mL Pk (Preservative Free)	DRR	11.1944	11.1944	YES	YES	NO
02406896	FONDAPARINUX SODIUM	Fondaparinux Sodium Injection (Off-Formulary Interchangeable) 7.5mg/0.6mL Inj Sol-Pref Syr 0.6mL Pk (Preservative Free)	DRR	18.1356	18.1356	YES	NO	NO
02483017	LENALIDOMIDE	Reddy-Lenalidomide 5mg Cap	DRR	85.0000	85.0000	YES	YES	NO
02483041	LENALIDOMIDE	Reddy-Lenalidomide 20mg Cap	DRR	100.7500	100.7500	YES	YES	NO
02483033	LENALIDOMIDE	Reddy-Lenalidomide 15mg Cap	DRR	95.5000	95.5000	YES	YES	NO
02483068	LENALIDOMIDE	Reddy-Lenalidomide 25mg Cap	DRR	106.0000	106.0000	YES	YES	NO
02483025	LENALIDOMIDE	Reddy-Lenalidomide 10mg Cap	DRR	90.2500	90.2500	YES	YES	NO
02484714	LENALIDOMIDE	Reddy-Lenalidomide 2.5mg Cap	DRR	82.3750	82.3750	YES	YES	NO
01911929	NITROGLYCERIN	Nitro-Dur 0.6mg/Hr Transdermal Patch	DRR	0.5040	0.5040	YES	NO	NO
01911902	NITROGLYCERIN	Nitro-Dur 0.4mg/Hr Transdermal Patch	DRR	0.5040	0.5040	YES	NO	NO
01911910	NITROGLYCERIN	Nitro-Dur 0.2 (Off-Formulary Interchangeable) 0.2mg/Hr Transdermal Patch	DRR	N/A	N/A	YES	NO	NO
02011271	NITROGLYCERIN	Nitro-Dur 0.8 (Off-Formulary Interchangeable) 0.8mg/Hr Transdermal Patch	DRR	N/A	N/A	YES	NO	NO
02504111	POMALIDOMIDE	Reddy-Pomalidomide (Off-Formulary Interchangeable) 4mg Cap	DRR	425.0000	425.0000	YES	NO	NO
02504081	POMALIDOMIDE	Reddy-Pomalidomide (Off-Formulary Interchangeable) 2mg Cap	DRR	425.0000	425.0000	YES	NO	NO
02504103	POMALIDOMIDE	Reddy-Pomalidomide (Off-Formulary Interchangeable) 3mg Cap	DRR	425.0000	425.0000	YES	NO	NO
02504073	POMALIDOMIDE	Reddy-Pomalidomide (Off-Formulary Interchangeable) 1mg Cap	DRR	425.0000	425.0000	YES	NO	NO
02463113	PROGESTERONE	Reddy-Progesterone (Off-Formulary Interchangeable) 100mg Cap	DRR	1.4358	1.4358	YES	NO	NO
02472414	RIVAROXABAN	Reddy-Rivaroxaban 10mg Tab	DRR	0.7175	0.7175	YES	YES	NO
02472430	RIVAROXABAN	Reddy-Rivaroxaban 15mg Tab	DRR	0.7175	0.7175	YES	YES	NO
02472422	RIVAROXABAN	Reddy-Rivaroxaban 20mg Tab	DRR	0.7175	0.7175	YES	YES	NO
02524503	RIVAROXABAN	Reddy-Rivaroxaban 2.5mg Tab	DRR	0.3550	0.3550	YES	YES	NO
02534533	SAPROPTERIN DIHYDROCHLORIDE	Reddy-Sapropterin (Off-Formulary Interchangeable) 100mg Pd for Sol (Sachet Pk)	DRR	24.7500	N/A	YES	NO	NO
02535610	SAPROPTERIN DIHYDROCHLORIDE	Reddy-Sapropterin (Off-Formulary Interchangeable) 500mg Pd for Sol (Sachet Pk)	DRR	123.7500	N/A	YES	NO	NO
09858315	VIGABATRIN	Vigabatrin for Oral Solution, USP 500mg (Temporary Benefit) 500mg/Sachet Pd for Oral Sol	DRR	5.0000	5.0000	NO	NO	NO
09858318	VIGABATRIN	Vigabatrin Tablets, USP (Temporary Benefit) 500mg Tab	DRR	5.0000	5.0000	NO	NO	NO
02422433	ZOLEDRONIC ACID	Zoledronic Acid Injection 5mg/100mL Inj Sol-100mL Pk (Preservative-Free)	DRR	356.0100	356.0100	YES	YES	NO
02422425	ZOLEDRONIC ACID	Zoledronic Acid for Inj. Concentrate (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free)	DRR	415.5600	415.5600	YES	NO	NO

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