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Products found: 55

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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
02245329	ALENDRONATE	Fosamax 70mg Tab	OCI	12.6250	1.7804	YES	NO	NO
02276429	ALENDRONATE & CHOLECALCIFEROL	Fosavance 70mg & 70mcg Tab	OCI	5.5335	2.4348	YES	NO	YES
02314940	ALENDRONATE & CHOLECALCIFEROL	Fosavance 70mg & 140mcg Tab	OCI	5.4250	2.4348	YES	NO	NO
02374803	ASENAPINE	Saphris 5mg SL Tab	OCI	1.5910	1.5910	NO	NO	YES
02374811	ASENAPINE	Saphris 10mg SL Tab	OCI	1.5910	1.5910	NO	NO	YES
00323071	BETAMETHASONE DIPROPIONATE	Diprosone 0.05% Cr	OCI	0.2174	0.2048	YES	NO	NO
00417246	BETAMETHASONE DIPROPIONATE	Diprosone 0.05% Lot	OCI	0.2100	0.1980	YES	NO	NO
00344923	BETAMETHASONE DIPROPIONATE	Diprosone 0.05% Oint	OCI	0.2284	0.2152	YES	NO	NO
00629367	BETAMETHASONE DIPROPIONATE IN A BASE CONTAINING PROPYLENE GLYCOL	Diprolene 0.05% Oint	OCI	0.5186	0.5186	YES	NO	NO
00670901	ENALAPRIL MALEATE	Vasotec 10mg Tab	OCI	1.4638	0.2647	YES	NO	YES
00708879	ENALAPRIL MALEATE	Vasotec 5mg Tab	OCI	1.2182	0.2203	YES	NO	YES
00670928	ENALAPRIL MALEATE	Vasotec 20mg Tab	OCI	1.7665	0.3195	YES	NO	YES
00657298	ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDE	Vaseretic (Off-Formulary Interchangeable) 10mg & 25mg Tab	OCI	N/A	N/A	YES	NO	NO
02253186	ETHINYL ESTRADIOL & ETONOGESTREL	Nuvaring (Off-Formulary Interchangeable) 0.120mg & 0.015mg/24 hr Slow Release Vag Ring	OCI	N/A	N/A	YES	NO	NO
02499509	ETONOGESTREL	Nexplanon 68mg/Implant ER Subdermal Implant	OCI	299.2500	299.2500	NO	NO	NO
02247521	EZETIMIBE	Ezetrol 10mg Tab	OCI	2.0415	0.1811	YES	YES	NO
02238213	FINASTERIDE	Propecia (Off-Formulary Interchangeable) 1mg Tab	OCI	N/A	N/A	YES	NO	NO
02010909	FINASTERIDE	Proscar 5mg Tab	OCI	2.4390	0.3506	YES	YES	NO
00328219	LEVODOPA & CARBIDOPA	Sinemet (Not a Benefit) 250mg & 25mg Tab	OCI	N/A	N/A	YES	NO	NO
00513997	LEVODOPA & CARBIDOPA	Sinemet (Not a Benefit) 100mg & 25mg Tab	OCI	N/A	N/A	YES	NO	NO
02182815	LOSARTAN POTASSIUM	Cozaar 25mg Tab	OCI	1.9924	0.3147	YES	NO	NO
02182882	LOSARTAN POTASSIUM	Cozaar 100mg Tab	OCI	1.9924	0.3147	YES	NO	NO
02182874	LOSARTAN POTASSIUM	Cozaar 50mg Tab	OCI	1.9924	0.3147	YES	NO	NO
02297841	LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE	Hyzaar 100mg & 12.5mg Tab	OCI	1.9508	0.3082	YES	NO	NO
02230047	LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE	Hyzaar 50mg & 12.5mg Tab	OCI	1.9924	0.3147	YES	NO	NO
02241007	LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE	Hyzaar DS 100mg & 25mg Tab	OCI	1.9924	0.3147	YES	NO	NO
02248544	MIRTAZAPINE	Remeron RD 45mg Orally Disintegrating Tab	OCI	1.6580	1.2132	YES	NO	NO
02248542	MIRTAZAPINE	Remeron RD 15mg Orally Disintegrating Tab	OCI	0.5529	0.4046	YES	NO	NO
02248543	MIRTAZAPINE	Remeron RD 30mg Orally Disintegrating Tab	OCI	1.1052	0.8087	YES	NO	NO
02243910	MIRTAZAPINE	Remeron 30mg Tab	OCI	1.8987	0.3100	YES	NO	NO
00851744	MOMETASONE FUROATE	Elocom 0.1% Cr	OCI	0.7393	0.5542	YES	NO	NO
00871095	MOMETASONE FUROATE	Elocom 0.1% Lot	OCI	0.5255	0.3627	YES	NO	NO
02238465	MOMETASONE FUROATE	Nasonex (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose Pk	OCI	N/A	N/A	YES	NO	YES
00851736	MOMETASONE FUROATE	Elocom 0.1% Oint	OCI	0.7342	0.2252	YES	NO	NO
02243596	MOMETASONE FUROATE	Asmanex Twisthaler 400mcg/Metered Dose Pd Inh-30 Dose Pk	OCI	40.4100	40.4100	NO	NO	YES
02243595	MOMETASONE FUROATE	Asmanex Twisthaler 200mcg/Metered Dose Pd Inh-60 Dose Pk	OCI	40.4100	40.4100	NO	NO	YES
09857431	MOMETASONE FUROATE	Asmanex Twisthaler 400mcg/Metered Dose Pd Inh-60 Dose Pk	OCI	80.7900	80.7900	NO	NO	YES
02361752	MOMETASONE FUROATE & FORMOTEROL FUMARATE DIHYDRATE	Zenhale 100mcg & 5mcg Metered Dose Inh-120 Dose Pk	OCI	114.6360	114.6360	NO	YES	NO
02361760	MOMETASONE FUROATE & FORMOTEROL FUMARATE DIHYDRATE	Zenhale 200mcg & 5mcg Metered Dose Inh-120 Dose Pk	OCI	138.9120	138.9120	NO	YES	NO
02238216	MONTELUKAST SODIUM	Singulair (Off-Formulary Interchangeable) 5mg Chew Tab	OCI	N/A	N/A	YES	NO	NO
02243602	MONTELUKAST SODIUM	Singulair 4mg Chew Tab	OCI	1.6783	0.2758	YES	YES	NO
02247997	MONTELUKAST SODIUM	Singulair (Off-Formulary Interchangeable) 4mg Gran Pk	OCI	N/A	N/A	YES	NO	NO
02238217	MONTELUKAST SODIUM	Singulair (Off-Formulary Interchangeable) 10mg Tab	OCI	N/A	N/A	YES	NO	NO
02318679	OLMESARTAN MEDOXOMIL	Olmetec 40mg Tab	OCI	1.3327	0.3019	YES	NO	NO
02318660	OLMESARTAN MEDOXOMIL	Olmetec 20mg Tab	OCI	1.3327	0.3019	YES	NO	NO
02319632	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	Olmetec Plus 40mg & 25mg Tab	OCI	1.3327	0.3019	YES	NO	NO
02319616	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	Olmetec Plus 20mg & 12.5mg Tab	OCI	1.3327	0.3019	YES	NO	NO
02319624	OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE	Olmetec Plus 40mg & 12.5mg Tab	OCI	1.3327	0.3019	YES	NO	NO
02166704	PROGESTERONE	Prometrium (Off-Formulary Interchangeable) 100mg Cap	OCI	N/A	N/A	YES	NO	NO
02240519	RIZATRIPTAN	Maxalt RPD (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab	OCI	21.4865	11.1650	YES	NO	NO
02240518	RIZATRIPTAN	Maxalt RPD (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab	OCI	21.4865	11.1650	YES	NO	NO
02240521	RIZATRIPTAN	Maxalt (Off-Formulary Interchangeable) 10mg Tab	OCI	21.4865	11.1150	YES	NO	NO
00884332	SIMVASTATIN	Zocor 10mg Tab	OCI	2.6848	0.2023	YES	NO	NO
00884340	SIMVASTATIN	Zocor 20mg Tab	OCI	3.3182	0.2501	YES	NO	NO
00884359	SIMVASTATIN	Zocor 40mg Tab	OCI	3.3182	0.2501	YES	NO	NO

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