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Products found: 10New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
02244266CASPOFUNGINCancidas (Off-Formulary Interchangeable) 70mg/Vial Inj Pd-Vial PkFRSN/AN/AYESNONO
02244265CASPOFUNGIN ACETATECancidas (Off-Formulary Interchangeable) 50mg/Vial Inj-Vial PkFRSN/AN/AYESNONO
00782742CYCLOBENZAPRINE HCLFlexeril (Not a Benefit) 10mg TabFRSN/AN/AYESNOYES
00248843PENICILLIN V (POTASSIUM)PVF-K 500 (Not a Benefit) 300mg TabFRSN/AN/AYESNONO
02240520RIZATRIPTANMaxalt (Off-Formulary Interchangeable) 5mg TabFRSN/AN/AYESNONO
00456888SULINDACClinoril (Not a Benefit) 150mg TabFRSN/AN/AYESNOYES
00432369SULINDACClinoril (Not a Benefit) 200mg TabFRSN/AN/AYESNOYES
00495611TIMOLOL MALEATEBlocadren (Not a Benefit) 20mg TabFRSN/AN/AYESNONO
00353914TIMOLOL MALEATEBlocadren (Not a Benefit) 5mg TabFRSN/AN/AYESNONO
00353922TIMOLOL MALEATEBlocadren (Not a Benefit) 10mg TabFRSN/AN/AYESNONO