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Products found: 122

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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
02529394	ALENDRONATE	M-Alendronate 70mg Tab	MAT	1.7804	1.7804	YES	NO	NO
02468018	AMLODIPINE	M-Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab	MAT	0.3328	N/A	YES	NO	NO
02468034	AMLODIPINE	M-Amlodipine 10mg Tab	MAT	0.1993	0.1993	YES	NO	NO
02468026	AMLODIPINE	M-Amlodipine 5mg Tab	MAT	0.1343	0.1343	YES	NO	NO
02542226	AMOXICILLIN & CLAVULANIC ACID	M-Amoxi Clav 50mg & 12.5mg/mL O/L	MAT	0.1216	0.1216	YES	NO	YES
02530694	AMOXICILLIN & CLAVULANIC ACID	M-Amoxi Clav 400mg & 57mg/5mL Susp	MAT	0.1591	0.1591	YES	NO	YES
02529009	APIXABAN	M-Apixaban 2.5mg Tab	MAT	0.4084	0.4084	YES	NO	NO
02529017	APIXABAN	M-Apixaban 5mg Tab	MAT	0.4084	0.4084	YES	NO	NO
02471191	ATORVASTATIN CALCIUM	M-Atorvastatin 80mg Tab	MAT	0.2342	0.2342	YES	NO	NO
02471167	ATORVASTATIN CALCIUM	M-Atorvastatin 10mg Tab	MAT	0.1743	0.1743	YES	NO	NO
02471175	ATORVASTATIN CALCIUM	M-Atorvastatin 20mg Tab	MAT	0.2179	0.2179	YES	NO	NO
02471183	ATORVASTATIN CALCIUM	M-Atorvastatin 40mg Tab	MAT	0.2342	0.2342	YES	NO	NO
02502038	AZITHROMYCIN	M-Azithromycin 250mg Tab	MAT	0.9410	0.9410	YES	NO	YES
02519682	BETAHISTINE DIHYDROCHLORIDE	M-Betahistine (Off-Formulary Interchangeable) 8mg Tab	MAT	0.2259	0.2259	YES	NO	NO
02519690	BETAHISTINE DIHYDROCHLORIDE	M-Betahistine (Off-Formulary Interchangeable) 16mg Tab	MAT	0.3557	0.3557	YES	NO	NO
02519704	BETAHISTINE DIHYDROCHLORIDE	M-Betahistine (Off-Formulary Interchangeable) 24mg Tab	MAT	0.4983	N/A	YES	NO	NO
02548410	BILASTINE	M-Bilastine (Off-Formulary Interchangeable) 20mg Tab	MAT	1.1240	N/A	YES	NO	NO
02495465	CELECOXIB	M-Celecoxib 100mg Cap	MAT	0.1279	0.1279	YES	YES	YES
02495473	CELECOXIB	M-Celecoxib 200mg Cap	MAT	0.2558	0.2558	YES	YES	YES
02512025	CETIRIZINE HYDROCHLORIDE	M-Cetirizine (Off-Formulary Interchangeable) 20mg Tab	MAT	0.7535	N/A	YES	NO	NO
02481995	CINACALCET	M-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab	MAT	18.5900	18.5900	YES	NO	NO
02481987	CINACALCET	M-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab	MAT	10.1947	10.1947	YES	NO	NO
02482002	CINACALCET	M-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab	MAT	27.0517	27.0517	YES	NO	NO
02532123	CITALOPRAM HYDROBROMIDE	M-Citalopram (Off-Formulary Interchangeable) 10mg Tab	MAT	0.4464	N/A	YES	NO	NO
02467844	CITALOPRAM HYDROBROMIDE	M-Citalopram 40mg Tab	MAT	0.1332	0.1332	YES	NO	NO
02467836	CITALOPRAM HYDROBROMIDE	M-Citalopram 20mg Tab	MAT	0.1332	0.1332	YES	NO	NO
02471388	CLARITHROMYCIN	M-Clarithromycin 250mg Tab	MAT	0.4122	0.4122	YES	NO	YES
02471396	CLARITHROMYCIN	M-Clarithromycin (Off-Formulary Interchangeable) 500mg Tab	MAT	2.2009	N/A	YES	NO	YES
02479923	CLINDAMYCIN HCL	M-Clindamycin 150mg Cap	MAT	0.2217	0.2217	YES	NO	NO
02479931	CLINDAMYCIN HCL	M-Clindamycin 300mg Cap	MAT	0.4434	0.4434	YES	NO	NO
02502283	CLOPIDOGREL BISULFATE	M-Clopidogrel 75mg Tab	MAT	0.2631	0.2631	YES	NO	NO
02535300	DAPAGLIFLOZIN	M-Dapagliflozin 10mg Tab	MAT	0.6825	0.6825	YES	NO	YES
02535297	DAPAGLIFLOZIN	M-Dapagliflozin 5mg Tab	MAT	0.6825	0.6825	YES	NO	YES
02543613	DIENOGEST	M-Dienogest 2mg Tab	MAT	0.5115	0.5115	YES	YES	NO
02546086	DILTIAZEM HCL	M-Diltiazem CD 120mg LA Cap	MAT	0.3634	0.3634	YES	NO	NO
02546094	DILTIAZEM HCL	M-Diltiazem CD 180mg LA Cap	MAT	0.4824	0.4824	YES	NO	NO
02546108	DILTIAZEM HCL	M-Diltiazem CD 240mg LA Cap	MAT	0.6399	0.6399	YES	NO	NO
02546116	DILTIAZEM HCL	M-Diltiazem CD 300mg LA Cap	MAT	0.7999	0.7999	YES	NO	NO
02546434	DILTIAZEM HCL	M-Diltiazem T 120mg SR Cap	MAT	0.2133	0.2133	YES	NO	NO
02546442	DILTIAZEM HCL	M-Diltiazem T 180mg SR Cap	MAT	0.2889	0.2889	YES	NO	NO
02546477	DILTIAZEM HCL	M-Diltiazem T 360mg SR Cap	MAT	0.5778	0.5778	YES	NO	NO
02546469	DILTIAZEM HCL	M-Diltiazem T 300mg SR Cap	MAT	0.4720	0.4720	YES	NO	NO
02546450	DILTIAZEM HCL	M-Diltiazem T 240mg SR Cap	MAT	0.3832	0.3832	YES	NO	NO
02467453	DONEPEZIL HCL	M-Donepezil 5mg Tab	MAT	0.4586	0.4586	YES	YES	NO
02467461	DONEPEZIL HCL	M-Donepezil 10mg Tab	MAT	0.4586	0.4586	YES	YES	NO
02537796	DORZOLAMIDE HCL & TIMOLOL MALEATE	M-Dorzolamide-Timolol 2% & 0.5% Oph Sol	MAT	2.0951	2.0951	YES	YES	NO
02543478	DOXYCYCLINE HYCLATE	M-Doxycycline 100mg Tab	MAT	0.4560	0.4560	YES	NO	NO
02473208	DULOXETINE	M-Duloxetine 30mg DR Cap	MAT	0.4814	0.3611	YES	NO	NO
02473216	DULOXETINE	M-Duloxetine 60mg DR Cap	MAT	0.9769	0.7327	YES	NO	NO
02471418	ESCITALOPRAM	M-Escitalopram 10mg Tab	MAT	0.3109	0.3109	YES	NO	NO
02471426	ESCITALOPRAM	M-Escitalopram 20mg Tab	MAT	0.3310	0.3310	YES	NO	NO
02520117	ESOMEPRAZOLE	M-Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg	MAT	1.8690	N/A	YES	NO	NO
02520109	ESOMEPRAZOLE	M-Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab	MAT	1.8690	N/A	YES	NO	NO
02467437	EZETIMIBE	M-Ezetimibe 10mg Tab	MAT	0.1811	0.1811	YES	YES	NO
02522489	FINASTERIDE	M-Finasteride 5mg Tab	MAT	0.3506	0.3506	YES	YES	NO
02529432	FLUOXETINE HCL	M-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	MAT	1.1773	N/A	YES	NO	YES
02529440	FLUOXETINE HCL	M-Fluoxetine 20mg Cap	MAT	0.3311	0.3311	YES	NO	YES
02524813	IRBESARTAN	M-Irbesartan 75mg Tab	MAT	0.2281	0.2281	YES	NO	NO
02524848	IRBESARTAN	M-Irbesartan 300mg Tab	MAT	0.2281	0.2281	YES	NO	NO
02524821	IRBESARTAN	M-Irbesartan 150mg Tab	MAT	0.2281	0.2281	YES	NO	NO
02513285	LATANOPROST	M-Latanoprost 0.005% Oph Sol-2.5mL Pk	MAT	9.5830	9.5830	YES	YES	NO
02514516	LATANOPROST & TIMOLOL MALEATE	M-Latanoprost-Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk	MAT	11.0670	11.0670	YES	YES	NO
02524570	LEVETIRACETAM	M-Levetiracetam 500mg Tab	MAT	0.3911	0.3911	YES	YES	NO
02524562	LEVETIRACETAM	M-Levetiracetam 250mg Tab	MAT	0.3210	0.3210	YES	YES	NO
02524589	LEVETIRACETAM	M-Levetiracetam 750mg Tab	MAT	0.5416	0.5416	YES	YES	NO
02547775	METFORMIN HCL	M-Metformin (Off-Formulary Interchangeable) 850mg Tab	MAT	0.2090	N/A	YES	NO	NO
02547767	METFORMIN HCL	M-Metformin 500mg Tab	MAT	0.0247	0.0247	YES	NO	NO
02534916	METHOTREXATE	M-Methotrexate 2.5mg Tab	MAT	0.2513	0.2513	YES	NO	NO
02519755	METRONIDAZOLE	M-Metronidazole 500mg Cap	MAT	0.2739	0.2739	YES	NO	NO
02488183	MONTELUKAST SODIUM	M-Montelukast (Off-Formulary Interchangeable) 10mg Tab	MAT	1.7735	1.7735	YES	NO	NO
02472791	MOXIFLOXACIN HYDROCHLORIDE	M-Moxifloxacin 400mg Tab	MAT	1.5230	1.5230	YES	NO	NO
02467372	PANTOPRAZOLE SODIUM	M-Pantoprazole 40mg Ent Tab	MAT	0.2016	0.2016	YES	YES	NO
02467402	PAROXETINE HCL	M-Paroxetine (Off-Formulary Interchangeable) 10mg Tab	MAT	1.0430	N/A	YES	NO	NO
02467410	PAROXETINE HCL	M-Paroxetine 20mg Tab	MAT	0.3250	0.3250	YES	NO	NO
02467429	PAROXETINE HCL	M-Paroxetine 30mg Tab	MAT	0.3453	0.3453	YES	NO	NO
02482924	PERINDOPRIL ERBUMINE	M-Perindopril Erbumine 2mg Tab	MAT	0.1632	0.1632	YES	NO	NO
02482940	PERINDOPRIL ERBUMINE	M-Perindopril Erbumine 8mg Tab	MAT	0.2831	0.2831	YES	NO	NO
02482932	PERINDOPRIL ERBUMINE	M-Perindopril Erbumine 4mg Tab	MAT	0.2042	0.2042	YES	NO	NO
02496119	PILOCARPINE HCL	M-Pilocarpine (Off-Formulary Interchangeable) 5mg Tab	MAT	1.1708	1.1708	YES	NO	NO
02550644	PIRFENIDONE	M-Pirfenidone (Off-Formulary Interchangeable) 267mg Tab	MAT	6.7120	6.7120	YES	NO	NO
02550652	PIRFENIDONE	M-Pirfenidone (Off-Formulary Interchangeable) 801mg Tab	MAT	20.1360	20.1360	YES	NO	NO
02476290	PRAVASTATIN SODIUM	M-Pravastatin 40mg Tab	MAT	0.4143	0.4143	YES	NO	NO
02476282	PRAVASTATIN SODIUM	M-Pravastatin 20mg Tab	MAT	0.3440	0.3440	YES	NO	NO
02476274	PRAVASTATIN SODIUM	M-Pravastatin 10mg Tab	MAT	0.2916	0.2916	YES	NO	NO
02467321	PREGABALIN	M-Pregabalin 150mg Cap	MAT	0.4145	0.4145	YES	NO	NO
02467313	PREGABALIN	M-Pregabalin 75mg Cap	MAT	0.3007	0.3007	YES	NO	NO
02467305	PREGABALIN	M-Pregabalin 50mg Cap	MAT	0.2324	0.2324	YES	NO	NO
02467291	PREGABALIN	M-Pregabalin 25mg Cap	MAT	0.1481	0.1481	YES	NO	NO
02541963	PREGABALIN	M-Pregabalin 300mg Cap	MAT	0.4145	0.4145	YES	NO	NO
02527928	QUETIAPINE	M-Quetiapine Fumarate XR 50mg ER Tab	MAT	0.2501	0.2501	YES	NO	NO
02527936	QUETIAPINE	M-Quetiapine Fumarate XR 150mg ER Tab	MAT	0.4926	0.4926	YES	NO	NO
02527960	QUETIAPINE	M-Quetiapine Fumarate XR 400mg ER Tab	MAT	1.3270	1.3270	YES	NO	NO
02527952	QUETIAPINE	M-Quetiapine Fumarate XR 300mg ER Tab	MAT	0.9776	0.9776	YES	NO	NO
02527944	QUETIAPINE	M-Quetiapine Fumarate XR 200mg ER Tab	MAT	0.6661	0.6661	YES	NO	NO
02551608	RIVAROXABAN	M-Rivaroxaban 2.5mg Tab	MAT	0.3550	0.3550	YES	NO	NO
02551616	RIVAROXABAN	M-Rivaroxaban 10mg Tab	MAT	0.7175	0.7175	YES	NO	NO
02551624	RIVAROXABAN	M-Rivaroxaban 15mg Tab	MAT	0.7175	0.7175	YES	NO	NO
02551632	RIVAROXABAN	M-Rivaroxaban 20mg Tab	MAT	0.7175	0.7175	YES	NO	NO
02496534	ROSUVASTATIN CALCIUM	M-Rosuvastatin 5mg Tab	MAT	0.1284	0.1284	YES	NO	NO
02496542	ROSUVASTATIN CALCIUM	M-Rosuvastatin 10mg Tab	MAT	0.1354	0.1354	YES	NO	NO
02496550	ROSUVASTATIN CALCIUM	M-Rosuvastatin 20mg Tab	MAT	0.1692	0.1692	YES	NO	NO
02496569	ROSUVASTATIN CALCIUM	M-Rosuvastatin 40mg Tab	MAT	0.1990	0.1990	YES	NO	NO
02530937	SERTRALINE HCL	M-Sertraline 25mg Cap	MAT	0.1516	0.1516	YES	NO	YES
02530945	SERTRALINE HCL	M-Sertraline 50mg Cap	MAT	0.3032	0.3032	YES	NO	YES
02530953	SERTRALINE HCL	M-Sertraline 100mg Cap	MAT	0.3303	0.3303	YES	NO	YES
02430037	SILDENAFIL	M-Sildenafil (Off-Formulary Interchangeable) 100mg Tab	MAT	9.2000	9.2000	YES	NO	NO
02529696	SOLIFENACIN SUCCINATE	M-Solifenacin Succinate 5mg Tab	MAT	0.3041	0.3041	YES	YES	NO
02529718	SOLIFENACIN SUCCINATE	M-Solifenacin Succinate 10mg Tab	MAT	0.3041	0.3041	YES	YES	NO
02512114	TADALAFIL	M-Tadalafil (Off-Formulary Interchangeable) 5mg Tab	MAT	3.6470	3.6470	YES	NO	NO
02512130	TADALAFIL	M-Tadalafil (Off-Formulary Interchangeable) 20mg Tab	MAT	12.3575	12.3575	YES	NO	NO
02512122	TADALAFIL	M-Tadalafil (Off-Formulary Interchangeable) 10mg Tab	MAT	11.9250	11.9250	YES	NO	NO
02523833	TERIFLUNOMIDE	M-Teriflunomide 14mg Tab	MAT	14.9300	14.9300	YES	YES	NO
02529769	TICAGRELOR	M-Ticagrelor 90mg Tab	MAT	0.3960	0.3960	YES	YES	NO
02529750	TICAGRELOR	M-Ticagrelor (Off-Formulary Interchangeable) 60mg Tab	MAT	1.2844	N/A	YES	NO	NO
02524511	VALSARTAN	M-Valsartan (Off-Formulary Interchangeable) 40mg Tab	MAT	0.5823	N/A	YES	NO	NO
02524538	VALSARTAN	M-Valsartan 80mg Tab	MAT	0.2159	0.2159	YES	NO	NO
02524546	VALSARTAN	M-Valsartan 160mg Tab	MAT	0.2159	0.2159	YES	NO	NO
02471280	VENLAFAXINE HCL	M-Venlafaxine XR 37.5mg ER Cap	MAT	0.0913	0.0913	YES	NO	NO
02471299	VENLAFAXINE HCL	M-Venlafaxine XR 75mg ER Cap	MAT	0.1825	0.1825	YES	NO	NO
02471302	VENLAFAXINE HCL	M-Venlafaxine XR 150mg ER Cap	MAT	0.1927	0.1927	YES	NO	NO
02467968	ZOPICLONE	M-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab	MAT	0.4685	0.4685	YES	NO	NO
02467941	ZOPICLONE	M-Zopiclone (Off-Formulary Interchangeable) 5mg Tab	MAT	0.2231	0.2231	YES	NO	NO

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