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Products found: 23New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
02518910APREMILASTGLN-Apremilast (Off-Formulary Interchangeable) 30mg TabGLP18.7238N/AYESNONO
02528495ATOVAQUONEGLN-Atovaquone 750mg/5mL O/LGLP2.37852.3785YESNONO
02466783ATOVAQUONE & PROGUANIL HCLAtovaquone and Proguanil Hydrochloride (Off-Formulary Interchangeable) 250mg & 100mg TabGLP4.13084.1308YESNONO
02519860DAPAGLIFLOZINGLN-Dapagliflozin 10mg TabGLP0.68250.6825YESNOYES
02519852DAPAGLIFLOZINGLN-Dapagliflozin 5mg TabGLP0.68250.6825YESNOYES
02494809DIMETHYL FUMARATEGLN-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR CapGLP9.19339.1933YESNONO
02494817DIMETHYL FUMARATEGLN-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR CapGLP18.386718.3867YESNONO
02421437DROSPIRENONE & ETHINYL ESTRADIOLDrospirenone&Ethinyl Estradiol USP 21 3.0mg & 0.03mg Tab-21 PkGLP6.21816.2181YESNONO
02462060DROSPIRENONE & ETHINYL ESTRADIOLDrospirenone&Ethinyl Estradiol USP 3.0mg & 0.02mg Tab-28 PkGLP8.26008.2600YESNONO
02421445DROSPIRENONE & ETHINYL ESTRADIOLDrospirenone&Ethinyl Estradiol USP 28 3.0mg & 0.03mg Tab-28 PkGLP6.21886.2188YESNONO
02460750EZETIMIBEGLN-Ezetimibe 10mg TabGLP0.18110.1811YESYESNO
02411008GABAPENTINGLN-Gabapentin (Off-Formulary Interchangeable) 800mg TabGLP1.7393N/AYESNONO
02410990GABAPENTINGLN-Gabapentin (Off-Formulary Interchangeable) 600mg TabGLP1.3045N/AYESNONO
02483459MUPIROCIN CALCIUMStramucin 2% w/w CrGLP1.60001.6000NONONO
02486296NORGESTIMATE & ETHINYL ESTRADIOLTri-Jordyna 21 3 Phase Tab-21 PkGLP14.390014.3900YESNONO
02486318NORGESTIMATE & ETHINYL ESTRADIOLTri-Jordyna 28 3 Phase Tab-28 PkGLP14.390014.3900YESNONO
02469812OLMESARTAN MEDOXOMILGLN-Olmesartan 20mg TabGLP0.30190.3019YESNONO
02469820OLMESARTAN MEDOXOMILGLN-Olmesartan 40mg TabGLP0.30190.3019YESNONO
02475715OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEGLN-Olmesartan HCTZ 40mg & 12.5mg TabGLP0.30190.3019YESNONO
02475723OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEGLN-Olmesartan HCTZ 40mg & 25mg TabGLP0.30190.3019YESNONO
02475707OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEGLN-Olmesartan HCTZ 20mg & 12.5mg TabGLP0.30190.3019YESNONO
02426900URSODIOLGLN-Ursodiol 250mg TabGLP0.38180.3818YESYESNO
02426919URSODIOLGLN-Ursodiol 500mg TabGLP0.72420.7242YESYESNO