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Products found: 27New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
02325462ESTRADIOL 17-BVagifem 10 10mcg Vag Tab with ApplicatorNOO4.69334.6933NONONO
02333627GLUCAGON RDNA ORIGINGlucaGen HypoKit 1mg/Vial Inj Pd-Syr PkNOO112.6700112.6700NONONO
02333619GLUCAGON RDNA ORIGINGlucaGen 1mg/Vial Inj Pd-Vial PkNOO108.3300108.3300NONONO
02024217INSULIN (30% NEUTRAL & 70% ISOPHANE) HUMAN BIOSYNTHETICNovolin ge 30/70 1000U/10mL Inj Susp-10mL PkNOO25.810025.8100NONONO
09853812INSULIN (30% NEUTRAL & 70% ISOPHANE) HUMAN BIOSYNTHETICNovolin ge 30/70 Penfill 100U/mL Inj Susp-5x3mL PkNOO48.780048.7800NONONO
02024225INSULIN (ISOPHANE) HUMAN BIOSYNTHETICNovolin ge NPH 1000U/10mL Inj Susp-10mL PkNOO25.670025.6700NONONO
09853782INSULIN (ISOPHANE) HUMAN BIOSYNTHETICNovolin ge NPH Penfill 100U/mL Inj Susp-5x3mL PkNOO50.470050.4700NONONO
02245397INSULIN ASPARTNovoRapid 100U/mL Inj Sol-10mL PkNOO31.210031.2100NOYESNO
02244353INSULIN ASPARTNovoRapid Penfill 100U/mL Inj Sol-5x3mL PkNOO63.310063.3100NOYESNO
02377209INSULIN ASPARTNovoRapid FlexTouch 100U/mL Inj Sol-Prefil 5X3mL Pk Disposable PenNOO65.910065.9100NOYESNO
02265435INSULIN ASPART 30% & INSULIN ASPART PROTAMINE 70%NovoMix 30 Penfill 100U/mL Inj Susp-5x3mL PkNOO58.040058.0400NONONO
02467860INSULIN DEGLUDECTresiba 100U/mL Inj Sol-3X5mL Cart PkNOO111.5000111.5000NONONO
02467887INSULIN DEGLUDECTresiba 200U/mL Inj Sol-Flextouch Pref Pen 3x3mL PkNOO133.8000133.8000NONONO
02467879INSULIN DEGLUDECTresiba 100U/mL Inj Sol-Flextouch Pref Pen 5x3mL PkNOO111.5000111.5000NONONO
02271842INSULIN DETEMIRLevemir Penfill 100U/mL Inj Sol-5x3mL PkNOO114.1600114.1600NONONO
02412829INSULIN DETEMIRLevemir Flextouch 100U/mL Inj Sol-Pref Disp Pen 5X3mL PkNOO115.2900115.2900NONONO
02024233INSULIN HUMAN BIOSYNTHETICNovolin ge Toronto 1000U/10mL Inj Sol-10mL PkNOO25.100025.1000NONONO
09853774INSULIN HUMAN BIOSYNTHETICNovolin ge Toronto Penfill 100U/mL Inj Sol-5x3mL PkNOO49.300049.3000NONONO
02239925REPAGLINIDEGlucoNorm (Off-Formulary Interchangeable) 1mg TabNOON/AN/AYESNONO
02239926REPAGLINIDEGlucoNorm (Off-Formulary Interchangeable) 2mg TabNOON/AN/AYESNONO
02239924REPAGLINIDEGlucoNorm (Off-Formulary Interchangeable) 0.5mg TabNOON/AN/AYESNONO
02540258SEMAGLUTIDEOzempic 0.68mg/mL Inj Sol - Pref Pen 3mL PkNOO218.0300218.0300NOYESNO
02471477SEMAGLUTIDEOzempic 1.34mg/mL Inj Sol-Pref Pen 1.5mL PkNOO218.0300218.0300NOYESNO
02471469SEMAGLUTIDEOzempic 1.34mg/mL Inj Sol-Pref Pen 3mL PkNOO218.0300218.0300NOYESNO
02497603SEMAGLUTIDERybelsus 7mg TabNOO7.20307.2030NOYESNO
02497611SEMAGLUTIDERybelsus 14mg TabNOO7.20307.2030NOYESNO
02497581SEMAGLUTIDERybelsus 3mg TabNOO7.20307.2030NOYESNO