Search Results

You can sort your results in ascending / descending order by clicking on the column headings, with the exception of Therapeutic Notes.

Products found: 10

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
02290308	CYPROTERONE ACETATE & ETHINYL ESTRADIOL	Cyestra-35 (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk	PAL	23.3394	N/A	YES	NO	NO
02247265	DICLOFENAC SODIUM	Pennsaid (Off-Formulary Interchangeable) 1.5% W/W Top Sol	PAL	N/A	N/A	YES	NO	NO
00728179	FLAVOXATE HCL	Urispas (Not a Benefit) 200mg Tab	PAL	N/A	N/A	YES	NO	NO
02240335	FOSFOMYCIN TROMETHAMINE	Monurol Sachet-3g Pk	PAL	21.6700	14.0250	YES	NO	YES
02244290	METHADONE HCL	Metadol-D 10mg/mL Oral Concentrate	PAL	0.1553	0.1553	NO	NO	YES
00015741	METHIMAZOLE	Tapazole 5mg Tab	PAL	0.3696	0.1531	YES	NO	NO
02296039	METHIMAZOLE	Tapazole (Off-Formulary Interchangeable) 10mg Tab	PAL	N/A	N/A	YES	NO	NO
02296411	TRAMADOL HCL	Tridural (Off-Formulary Interchangeable) 300mg ER Tab	PAL	N/A	N/A	YES	NO	YES
02296403	TRAMADOL HCL	Tridural (Off-Formulary Interchangeable) 200mg ER Tab	PAL	N/A	N/A	YES	NO	YES
02296381	TRAMADOL HCL	Tridural (Off-Formulary Interchangeable) 100mg ER Tab	PAL	N/A	N/A	YES	NO	YES