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Products found: 142

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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
02523116	ALENDRONATE	NRA-Alendronate 70mg Tab	NRA	1.7804	1.7804	YES	NO	NO
02476479	AMLODIPINE	NRA-Amlodipine 10mg Tab	NRA	0.1993	0.1993	YES	NO	NO
02476460	AMLODIPINE	NRA-Amlodipine 5mg Tab	NRA	0.1343	0.1343	YES	NO	NO
02526069	APIXABAN	NRA-Apixaban 5mg Tab	NRA	0.4084	0.4084	YES	NO	NO
02526050	APIXABAN	NRA-Apixaban 2.5mg Tab	NRA	0.4084	0.4084	YES	NO	NO
02546884	APIXABAN	NRA-Apixaban Tablets 2.5mg Tab	NRA	0.4084	0.4084	YES	NO	NO
02546892	APIXABAN	NRA-Apixaban Tablets 5mg Tab	NRA	0.4084	0.4084	YES	NO	NO
02472228	ARIPIPRAZOLE	NRA-Aripiprazole 5mg Tab	NRA	0.9046	0.9046	YES	NO	YES
02472252	ARIPIPRAZOLE	NRA-Aripiprazole 15mg Tab	NRA	1.2692	1.2692	YES	NO	YES
02472201	ARIPIPRAZOLE	NRA-Aripiprazole 2mg Tab	NRA	0.8092	0.8092	YES	NO	YES
02472244	ARIPIPRAZOLE	NRA-Aripiprazole 10mg Tab	NRA	1.0754	1.0754	YES	NO	YES
02472279	ARIPIPRAZOLE	NRA-Aripiprazole 30mg Tab	NRA	1.0017	1.0017	YES	NO	YES
02472260	ARIPIPRAZOLE	NRA-Aripiprazole 20mg Tab	NRA	1.0017	1.0017	YES	NO	YES
02476517	ATORVASTATIN CALCIUM	NRA-Atorvastatin 10mg Tab	NRA	0.1743	0.1743	YES	NO	NO
02476541	ATORVASTATIN CALCIUM	NRA-Atorvastatin 80mg Tab	NRA	0.2342	0.2342	YES	NO	NO
02476533	ATORVASTATIN CALCIUM	NRA-Atorvastatin 40mg Tab	NRA	0.2342	0.2342	YES	NO	NO
02476525	ATORVASTATIN CALCIUM	NRA-Atorvastatin 20mg Tab	NRA	0.2179	0.2179	YES	NO	NO
02479680	AZITHROMYCIN	NRA-Azithromycin 250mg Tab	NRA	0.9410	0.9410	YES	NO	YES
02544946	BETAHISTINE DIHYDROCHLORIDE	NRA-Betahistine (Off-Formulary Interchangeable) 24mg Tab	NRA	0.4983	N/A	YES	NO	NO
02544911	BETAHISTINE DIHYDROCHLORIDE	NRA-Betahistine (Off-Formulary Interchangeable) 8mg Tab	NRA	0.2259	0.2259	YES	NO	NO
02544938	BETAHISTINE DIHYDROCHLORIDE	NRA-Betahistine (Off-Formulary Interchangeable) 16mg Tab	NRA	0.3557	0.3557	YES	NO	NO
02551934	BILASTINE	NRA-Bilastine (Off-Formulary Interchangeable) 20mg Tab	NRA	1.1243	N/A	YES	NO	NO
02527030	CANDESARTAN CILEXETIL	NRA-Candesartan 32mg Tab	NRA	0.2281	0.2281	YES	NO	NO
02527022	CANDESARTAN CILEXETIL	NRA-Candesartan 16mg Tab	NRA	0.2281	0.2281	YES	NO	NO
02527014	CANDESARTAN CILEXETIL	NRA-Candesartan 8mg Tab	NRA	0.2281	0.2281	YES	NO	NO
02527006	CANDESARTAN CILEXETIL	NRA-Candesartan 4mg Tab	NRA	0.1700	0.1700	YES	NO	NO
02531240	CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE	NRA-Candesartan HCTZ 16mg & 12.5mg Tab	NRA	0.2156	0.2156	YES	NO	NO
02531267	CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE	NRA-Candesartan HCTZ 32mg & 25mg Tab	NRA	0.3008	0.3008	YES	NO	NO
02531259	CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE	NRA-Candesartan HCTZ 32mg & 12.5mg Tab	NRA	0.2156	0.2156	YES	NO	NO
02479737	CELECOXIB	NRA-Celecoxib 100mg Cap	NRA	0.1279	0.1279	YES	YES	YES
02479745	CELECOXIB	NRA-Celecoxib 200mg Cap	NRA	0.2558	0.2558	YES	YES	YES
02521806	CETIRIZINE HYDROCHLORIDE	NRA-Cetirizine (Off-Formulary Interchangeable) 20mg Tab	NRA	0.7535	N/A	YES	NO	NO
02530236	CETIRIZINE HYDROCHLORIDE	NRA-Cetirizine Tablets (Off-Formulary Interchangeable) 20mg Tab	NRA	0.7535	N/A	YES	NO	NO
02492008	CIPROFLOXACIN	NRA-Ciprofloxacin 500mg Tab	NRA	0.5025	0.5025	YES	NO	YES
02477645	CITALOPRAM HYDROBROMIDE	NRA-Citalopram 20mg Tab	NRA	0.1332	0.1332	YES	NO	NO
02477653	CITALOPRAM HYDROBROMIDE	NRA-Citalopram 40mg Tab	NRA	0.1332	0.1332	YES	NO	NO
02493748	CLINDAMYCIN HCL	NRA-Clindamycin 150mg Cap	NRA	0.2217	0.2217	YES	NO	NO
02493756	CLINDAMYCIN HCL	NRA-Clindamycin 300mg Cap	NRA	0.4434	0.4434	YES	NO	NO
02482037	CLOPIDOGREL BISULFATE	NRA-Clopidogrel 75mg Tab	NRA	0.2631	0.2631	YES	NO	NO
02538334	DAPAGLIFLOZIN	NRA-Dapagliflozin 5mg Tab	NRA	0.6825	0.6825	YES	NO	YES
02538342	DAPAGLIFLOZIN	NRA-Dapagliflozin 10mg Tab	NRA	0.6825	0.6825	YES	NO	YES
02535394	DONEPEZIL HCL	NRA-Donepezil 10mg Tab	NRA	0.4586	0.4586	YES	YES	NO
02535386	DONEPEZIL HCL	NRA-Donepezil 5mg Tab	NRA	0.4586	0.4586	YES	YES	NO
02482126	DULOXETINE	NRA-Duloxetine 30mg DR Cap	NRA	0.4814	0.3611	YES	NO	NO
02482134	DULOXETINE	NRA-Duloxetine 60mg DR Cap	NRA	0.9769	0.7327	YES	NO	NO
02476851	ESCITALOPRAM	NRA-Escitalopram 10mg Tab	NRA	0.3109	0.3109	YES	NO	NO
02476878	ESCITALOPRAM	NRA-Escitalopram 20mg Tab	NRA	0.3310	0.3310	YES	NO	NO
02481669	EZETIMIBE	NRA-Ezetimibe 10mg Tab	NRA	0.1811	0.1811	YES	YES	NO
02536420	EZETIMIBE	NRA-Ezetimibe Tablets 10mg Tab	NRA	0.1811	0.1811	YES	YES	NO
02530074	FLECAINIDE ACETATE	NRA-Flecainide 100mg Tab	NRA	0.2779	0.2779	YES	NO	NO
02530066	FLECAINIDE ACETATE	NRA-Flecainide 50mg Tab	NRA	0.1389	0.1389	YES	NO	NO
02503875	FLUOXETINE HCL	NRA-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	NRA	1.1773	N/A	YES	NO	YES
02503883	FLUOXETINE HCL	NRA-Fluoxetine 20mg Cap	NRA	0.3311	0.3311	YES	NO	YES
02511886	HYDROXYCHLOROQUINE SULFATE	NRA-Hydroxychloroquine 200mg Tab	NRA	0.1576	0.1576	YES	NO	NO
02499568	LACOSAMIDE	NRA-Lacosamide 50mg Tab	NRA	0.6313	0.6313	YES	YES	NO
02499584	LACOSAMIDE	NRA-Lacosamide 150mg Tab	NRA	1.1763	1.1763	YES	YES	NO
02499592	LACOSAMIDE	NRA-Lacosamide 200mg Tab	NRA	1.4500	1.4500	YES	YES	NO
02499576	LACOSAMIDE	NRA-Lacosamide 100mg Tab	NRA	0.8750	0.8750	YES	YES	NO
02520486	LETROZOLE	NRA-Letrozole 2.5mg Tab	NRA	1.3780	1.3780	YES	NO	NO
02499193	LEVETIRACETAM	NRA-Levetiracetam 250mg Tab	NRA	0.3210	0.3210	YES	YES	NO
02499207	LEVETIRACETAM	NRA-Levetiracetam 500mg Tab	NRA	0.3911	0.3911	YES	YES	NO
02499215	LEVETIRACETAM	NRA-Levetiracetam 750mg Tab	NRA	0.5416	0.5416	YES	YES	NO
02522314	LURASIDONE HYDROCHLORIDE	NRA-Lurasidone 20mg Tab	NRA	1.2250	1.2250	YES	NO	YES
02522349	LURASIDONE HYDROCHLORIDE	NRA-Lurasidone 80mg Tab	NRA	1.2250	1.2250	YES	NO	YES
02522330	LURASIDONE HYDROCHLORIDE	NRA-Lurasidone 60mg Tab	NRA	1.2250	1.2250	YES	NO	YES
02522322	LURASIDONE HYDROCHLORIDE	NRA-Lurasidone 40mg Tab	NRA	1.2250	1.2250	YES	NO	YES
02536439	METFORMIN HCL	NRA-Metformin 500mg Tab	NRA	0.0247	0.0247	YES	NO	NO
02536447	METFORMIN HCL	NRA-Metformin (Off-Formulary Interchangeable) 850mg Tab	NRA	0.2090	N/A	YES	NO	NO
02534932	MIRTAZAPINE	NRA-Mirtazapine 30mg Tab	NRA	0.3100	0.3100	YES	NO	NO
02489821	MONTELUKAST SODIUM	NRA-Montelukast (Off-Formulary Interchangeable) 10mg Tab	NRA	1.7735	1.7735	YES	NO	NO
02536226	OLANZAPINE	NRA-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab	NRA	7.5977	N/A	YES	NO	NO
02536218	OLANZAPINE	NRA-Olanzapine ODT 15mg Rapid Dissolve Tab	NRA	1.0711	1.0711	YES	NO	NO
02536196	OLANZAPINE	NRA-Olanzapine ODT 10mg Rapid Dissolve Tab	NRA	0.7143	0.7143	YES	NO	NO
02536188	OLANZAPINE	NRA-Olanzapine ODT 5mg Rapid Dissolve Tab	NRA	0.3574	0.3574	YES	NO	NO
02545616	OLANZAPINE	NRA-Olanzapine 10mg Tab	NRA	0.7088	0.7088	YES	NO	NO
02545624	OLANZAPINE	NRA-Olanzapine 15mg Tab	NRA	1.0631	1.0631	YES	NO	NO
02545632	OLANZAPINE	NRA-Olanzapine (Off-Formulary Interchangeable) 20mg Tab	NRA	10.3093	N/A	YES	NO	NO
02545608	OLANZAPINE	NRA-Olanzapine 7.5mg Tab	NRA	0.5316	0.5316	YES	NO	NO
02545594	OLANZAPINE	NRA-Olanzapine 5mg Tab	NRA	0.3544	0.3544	YES	NO	NO
02545586	OLANZAPINE	NRA-Olanzapine 2.5mg Tab	NRA	0.1772	0.1772	YES	NO	NO
02499258	OLMESARTAN MEDOXOMIL	NRA-Olmesartan 20mg Tab	NRA	0.3019	0.3019	YES	NO	NO
02499266	OLMESARTAN MEDOXOMIL	NRA-Olmesartan 40mg Tab	NRA	0.3019	0.3019	YES	NO	NO
02508273	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	NRA-Olmesartan HCTZ 20mg & 12.5mg Tab	NRA	0.3019	0.3019	YES	NO	NO
02508281	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	NRA-Olmesartan HCTZ 40mg & 12.5mg Tab	NRA	0.3019	0.3019	YES	NO	NO
02508303	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	NRA-Olmesartan HCTZ 40mg & 25mg Tab	NRA	0.3019	0.3019	YES	NO	NO
02471825	PANTOPRAZOLE SODIUM	NRA-Pantoprazole 40mg Ent Tab	NRA	0.2016	0.2016	YES	YES	NO
02479788	PAROXETINE HCL	NRA-Paroxetine 30mg Tab	NRA	0.3453	0.3453	YES	NO	NO
02479761	PAROXETINE HCL	NRA-Paroxetine 20mg Tab	NRA	0.3250	0.3250	YES	NO	NO
02479753	PAROXETINE HCL	NRA-Paroxetine (Off-Formulary Interchangeable) 10mg Tab	NRA	1.0430	N/A	YES	NO	NO
02489015	PERINDOPRIL ERBUMINE	NRA-Perindopril 2mg Tab	NRA	0.1632	0.1632	YES	NO	NO
02489023	PERINDOPRIL ERBUMINE	NRA-Perindopril 4mg Tab	NRA	0.2042	0.2042	YES	NO	NO
02489031	PERINDOPRIL ERBUMINE	NRA-Perindopril 8mg Tab	NRA	0.2831	0.2831	YES	NO	NO
02479192	PREGABALIN	NRA-Pregabalin 300mg Cap	NRA	0.4145	0.4145	YES	NO	NO
02479133	PREGABALIN	NRA-Pregabalin 75mg Cap	NRA	0.3007	0.3007	YES	NO	NO
02479125	PREGABALIN	NRA-Pregabalin 50mg Cap	NRA	0.2324	0.2324	YES	NO	NO
02479117	PREGABALIN	NRA-Pregabalin 25mg Cap	NRA	0.1481	0.1481	YES	NO	NO
02479168	PREGABALIN	NRA-Pregabalin 150mg Cap	NRA	0.4145	0.4145	YES	NO	NO
02550377	PRUCALOPRIDE	NRA-Prucalopride (Off-Formulary Interchangeable) 1mg Tab	NRA	2.0145	N/A	YES	NO	NO
02550385	PRUCALOPRIDE	NRA-Prucalopride (Off-Formulary Interchangeable) 2mg Tab	NRA	3.1025	N/A	YES	NO	NO
02510677	QUETIAPINE	NRA-Quetiapine XR 50mg ER Tab	NRA	0.2501	0.2501	YES	NO	NO
02510685	QUETIAPINE	NRA-Quetiapine XR 150mg ER Tab	NRA	0.4926	0.4926	YES	NO	NO
02510693	QUETIAPINE	NRA-Quetiapine XR 200mg ER Tab	NRA	0.6661	0.6661	YES	NO	NO
02510707	QUETIAPINE	NRA-Quetiapine XR 300mg ER Tab	NRA	0.9776	0.9776	YES	NO	NO
02510715	QUETIAPINE	NRA-Quetiapine XR 400mg ER Tab	NRA	1.3270	1.3270	YES	NO	NO
02486237	QUETIAPINE	NRA-Quetiapine 25mg Tab	NRA	0.0494	0.0494	YES	NO	NO
02486199	RAMIPRIL	NRA-Ramipril Cap 10mg	NRA	0.1034	0.1034	YES	NO	NO
02486180	RAMIPRIL	NRA-Ramipril Cap 5mg	NRA	0.0817	0.0817	YES	NO	NO
02486172	RAMIPRIL	NRA-Ramipril Cap 2.5mg	NRA	0.0817	0.0817	YES	NO	NO
02489384	RIZATRIPTAN	NRA-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab	NRA	11.1150	11.1150	YES	NO	NO
02477483	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin 5mg Tab	NRA	0.1284	0.1284	YES	NO	NO
02477505	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin 20mg Tab	NRA	0.1692	0.1692	YES	NO	NO
02477513	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin 40mg Tab	NRA	0.1990	0.1990	YES	NO	NO
02477491	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin 10mg Tab	NRA	0.1354	0.1354	YES	NO	NO
02536633	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin Tablets 40mg Tab	NRA	0.1990	0.1990	YES	NO	NO
02536609	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin Tablets 10mg Tab	NRA	0.1354	0.1354	YES	NO	NO
02536595	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin Tablets 5mg Tab	NRA	0.1284	0.1284	YES	NO	NO
02536625	ROSUVASTATIN CALCIUM	NRA-Rosuvastatin Tablets 20mg Tab	NRA	0.1692	0.1692	YES	NO	NO
02488434	SERTRALINE HCL	NRA-Sertraline 25mg Cap	NRA	0.1516	0.1516	YES	NO	YES
02488442	SERTRALINE HCL	NRA-Sertraline 50mg Cap	NRA	0.3032	0.3032	YES	NO	YES
02488450	SERTRALINE HCL	NRA-Sertraline 100mg Cap	NRA	0.3303	0.3303	YES	NO	YES
02476819	SILDENAFIL	NRA-Sildenafil (Off-Formulary Interchangeable) 100mg Tab	NRA	9.2006	9.2006	YES	NO	NO
02520966	TADALAFIL	NRA-Tadalafil (Off-Formulary Interchangeable) 20mg Tab	NRA	12.3575	12.3575	YES	NO	NO
02520931	TADALAFIL	NRA-Tadalafil (Off-Formulary Interchangeable) 5mg Tab	NRA	3.6471	3.6471	YES	NO	NO
02452499	TADALAFIL	Priva-Tadalafil (Off-Formulary Interchangeable) 10mg Tab	NRA	11.9250	11.9250	YES	NO	NO
02452502	TADALAFIL	Priva-Tadalafil (Off-Formulary Interchangeable) 20mg Tab	NRA	12.3575	12.3575	YES	NO	NO
02452480	TADALAFIL	Priva-Tadalafil (Off-Formulary Interchangeable) 5mg Tab	NRA	3.6471	3.6471	YES	NO	NO
02503808	TELMISARTAN	NRA-Telmisartan 80mg Tab	NRA	0.2161	0.2161	YES	NO	NO
02503794	TELMISARTAN	NRA-Telmisartan 40mg Tab	NRA	0.2161	0.2161	YES	NO	NO
02504138	TELMISARTAN & HYDROCHLOROTHIAZIDE	NRA-Telmisartan HCTZ 80mg & 25mg Tab	NRA	0.2098	0.2098	YES	NO	NO
02504146	TELMISARTAN & HYDROCHLOROTHIAZIDE	NRA-Telmisartan HCTZ 80mg & 12.5mg Tab	NRA	0.2098	0.2098	YES	NO	NO
02538474	TOPIRAMATE	NRA-Topiramate 200mg Tab	NRA	0.6748	0.6748	YES	NO	NO
02538458	TOPIRAMATE	NRA-Topiramate 100mg Tab	NRA	0.4583	0.4583	YES	NO	NO
02538466	TOPIRAMATE	NRA-Topiramate 25mg Tab	NRA	0.2433	0.2433	YES	NO	NO
02469650	TRAMADOL HCL & ACETAMINOPHEN	NRA-Tramadol/ACET (Off-Formulary Interchangeable) 37.5mg & 325mg Tab	NRA	0.6264	N/A	YES	NO	YES
02544024	URSODIOL	NRA-Ursodiol 500mg Tab	NRA	0.7242	0.7242	YES	YES	NO
02544032	URSODIOL	NRA-Ursodiol 250mg Tab	NRA	0.3818	0.3818	YES	YES	NO
02542951	VARENICLINE TARTRATE	NRA-Varenicline 0.5mg Tab	NRA	0.4618	0.4618	YES	YES	NO
02542978	VARENICLINE TARTRATE	NRA-Varenicline 1.0mg Tab	NRA	0.4618	0.4618	YES	YES	NO
02542986	VARENICLINE TARTRATE	NRA-Varenicline 0.5mg & 1.0mg Tab (Starter Pack-53 Tabs)	NRA	24.3853	24.3853	YES	YES	NO
02489392	ZOLMITRIPTAN	NRA-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab	NRA	6.8600	6.8600	YES	NO	NO
02477378	ZOPICLONE	NRA-Zopiclone (Off-Formulary Interchangeable) 5mg Tab	NRA	0.2231	0.2231	YES	NO	NO
02477386	ZOPICLONE	NRA-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab	NRA	0.4685	0.4685	YES	NO	NO

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