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Products found: 20

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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
02298813	APREPITANT	Emend Tri-Pack 125mg & 80mg Cap	MEK	106.9839	106.9839	NO	YES	NO
00611174	CLOTRIMAZOLE & BETAMETHASONE DIPROPIONATE	Lotriderm Cream (Off-Formulary Interchangeable) 1% w/w & 0.05% w/w Top Cr	MEK	N/A	N/A	YES	NO	YES
02481545	DORAVIRINE	Pifeltro 100mg Tab	MEK	16.6500	16.6500	NO	NO	NO
02482592	DORAVIRINE/LAMIVUDINE/TENOFOVIR DISOPROXIL FUMARATE	Delstrigo 100mg & 300mg & 300mg Tab	MEK	28.7900	28.7900	NO	NO	NO
02451131	ELBASVIR & GRAZOPREVIR	Zepatier 50mg & 100mg Tab	MEK	666.9400	666.9400	NO	YES	NO
02240351	EPTIFIBATIDE	Integrilin (Off-Formulary Interchangeable) 0.75mg/mL 100mL Vial Pk	MEK	N/A	N/A	YES	NO	NO
02240352	EPTIFIBATIDE	Integrilin (Off-Formulary Interchangeable) 2mg/mL 10mL Vial Pk	MEK	N/A	N/A	YES	NO	NO
02424622	POSACONAZOLE	Posanol (Off-Formulary Interchangeable) 100mg DR Tab	MEK	53.7642	42.6030	YES	NO	NO
02465337	RALTEGRAVIR POTASSIUM	Isentress HD 600mg Tab	MEK	14.0301	14.0301	NO	NO	NO
02416794	SITAGLIPTIN & METFORMIN	Janumet XR 50mg & 1000mg ER Tab	MEK	1.7785	0.8893	YES	NO	YES
02416786	SITAGLIPTIN & METFORMIN	Janumet XR 50mg & 500mg ER Tab	MEK	1.7785	0.8893	YES	NO	YES
02416808	SITAGLIPTIN & METFORMIN	Janumet XR 100mg & 1000mg ER Tab	MEK	3.5568	1.7784	YES	NO	YES
02333864	SITAGLIPTIN & METFORMIN	Janumet 50mg & 850mg Tab	MEK	1.7785	0.8893	YES	NO	YES
02333856	SITAGLIPTIN & METFORMIN	Janumet 50mg & 500mg Tab	MEK	1.7785	0.8893	YES	NO	YES
02333872	SITAGLIPTIN & METFORMIN	Janumet 50mg & 1000mg Tab	MEK	1.7785	0.8893	YES	NO	YES
02241096	TEMOZOLOMIDE	Temodal 250mg Cap	MEK	401.7041	97.5010	YES	NO	NO
02312794	TEMOZOLOMIDE	Temodal 140mg Cap	MEK	224.9623	54.6025	YES	NO	NO
02241095	TEMOZOLOMIDE	Temodal 100mg Cap	MEK	160.6862	39.0015	YES	NO	NO
02241093	TEMOZOLOMIDE	Temodal 5mg Cap	MEK	8.0340	1.9500	YES	NO	NO
02241094	TEMOZOLOMIDE	Temodal 20mg Cap	MEK	32.1360	7.8000	YES	NO	NO

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