Search Results

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Products found: 15

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
02248128	ALMOTRIPTAN	Axert (Off-Formulary Interchangeable) 6.25mg Tab	JNO	N/A	N/A	YES	NO	NO
02248129	ALMOTRIPTAN	Axert (Off-Formulary Interchangeable) 12.5mg Tab	JNO	N/A	N/A	YES	NO	NO
01937413	FENTANYL TRANSDERMAL SYSTEM	Duragesic 100 (Off-Formulary Interchangeable) 100mcg/hr Trans Patch	JNO	N/A	N/A	YES	NO	YES
02280345	FENTANYL TRANSDERMAL SYSTEM	Duragesic 12 (Not a Benefit) 12mcg/hr Trans Patch	JNO	N/A	N/A	YES	NO	YES
09858350	FENTANYL TRANSDERMAL SYSTEM	Duragesic 12 (Not a Benefit) 12mcg/hr Trans Patch	JNO	N/A	N/A	YES	NO	YES
01937383	FENTANYL TRANSDERMAL SYSTEM	Duragesic 25 (Not a Benefit) 25mcg/hr Trans Patch	JNO	N/A	N/A	YES	NO	YES
01937391	FENTANYL TRANSDERMAL SYSTEM	Duragesic 50 (Not a Benefit) 50mcg/hr Trans Patch	JNO	N/A	N/A	YES	NO	YES
01937405	FENTANYL TRANSDERMAL SYSTEM	Duragesic 75 (Off-Formulary Interchangeable) 75mcg/hr Trans Patch	JNO	N/A	N/A	YES	NO	YES
00590665	LITHIUM CARBONATE	Duralith (Off-Formulary Interchangeable) 300mg ER Tab	JNO	N/A	N/A	YES	NO	NO
01924753	OXYBUTYNIN CHLORIDE	Ditropan (Not a Benefit) 1mg/mL O/L	JNO	N/A	N/A	YES	NO	NO
02239907	TOPIRAMATE	Topamax Sprinkle 15mg Sprinkle Cap	JNO	2.1580	2.1580	NO	YES	NO
02239908	TOPIRAMATE	Topamax Sprinkle 25mg Sprinkle Cap	JNO	2.2560	2.2560	NO	YES	NO
02230896	TOPIRAMATE	Topamax 200mg Tab	JNO	6.2770	0.6748	YES	NO	NO
02230893	TOPIRAMATE	Topamax 25mg Tab	JNO	2.2669	0.2433	YES	NO	NO
02230894	TOPIRAMATE	Topamax 100mg Tab	JNO	4.2510	0.4583	YES	NO	NO