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Products found: 8
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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
02404516
PERAMPANEL
Fycompa 2mg Tab
EIS
10.3869
5.7128
YES
YES
NO
02404524
PERAMPANEL
Fycompa 4mg Tab
EIS
10.3869
5.7128
YES
YES
NO
02404532
PERAMPANEL
Fycompa 6mg Tab
EIS
10.3869
5.7128
YES
YES
NO
02404540
PERAMPANEL
Fycompa 8mg Tab
EIS
10.3869
5.7128
YES
YES
NO
02404567
PERAMPANEL
Fycompa 12mg Tab
EIS
10.3869
5.7128
YES
YES
NO
02404559
PERAMPANEL
Fycompa 10mg Tab
EIS
10.3869
5.7128
YES
YES
NO
02369621
RUFINAMIDE
Banzel (Off-Formulary Interchangeable) 200mg Tab
EIS
1.9047
1.0083
YES
NO
NO
02369648
RUFINAMIDE
Banzel (Off-Formulary Interchangeable) 400mg Tab
EIS
4.1503
2.1970
YES
NO
NO
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