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Products found: 28

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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
01947923	BETHANECHOL CHLORIDE	Duvoid 50mg Tab	PAL	0.9449	0.9449	NO	NO	NO
01947931	BETHANECHOL CHLORIDE	Duvoid 25mg Tab	PAL	0.7175	0.7175	NO	NO	NO
01947958	BETHANECHOL CHLORIDE	Duvoid 10mg Tab	PAL	0.4431	0.4431	NO	NO	NO
02290308	CYPROTERONE ACETATE & ETHINYL ESTRADIOL	Cyestra-35 (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk	PAL	23.3394	N/A	YES	NO	NO
01924559	DEXTROAMPHETAMINE SULFATE	Dexedrine Spansules 10mg SR Cap	PAL	1.1506	0.8096	YES	NO	YES
01924567	DEXTROAMPHETAMINE SULFATE	Dexedrine Spansules 15mg SR Cap	PAL	1.4067	0.9898	YES	NO	YES
01924516	DEXTROAMPHETAMINE SULFATE	Dexedrine 5mg Tab	PAL	0.7792	0.5081	YES	NO	YES
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
02086026	FLUDROCORTISONE ACETATE	Florinef 0.1mg Tab	PAL	0.5213	0.5213	NO	NO	NO
00074454	FLUMETHASONE PIVALATE & IODOCHLORHYDROXYQUIN	Locacorten-Vioform 0.02% & 1% Ot Sol	PAL	2.3836	2.3836	NO	NO	YES
02240335	FOSFOMYCIN TROMETHAMINE	Monurol Sachet-3g Pk	PAL	21.6700	14.0250	YES	NO	YES
02106280	LABETALOL HCL	Trandate 200mg Tab	PAL	0.7148	0.3504	YES	NO	NO
02106272	LABETALOL HCL	Trandate 100mg Tab	PAL	0.4044	0.1983	YES	NO	NO
02244290	METHADONE HCL	Metadol-D 10mg/mL Oral Concentrate	PAL	0.1500	0.1500	NO	NO	YES
02296039	METHIMAZOLE	Tapazole (Off-Formulary Interchangeable) 10mg Tab	PAL	N/A	N/A	YES	NO	NO
00015741	METHIMAZOLE	Tapazole 5mg Tab	PAL	0.3588	0.1531	YES	NO	NO
00591467	MORPHINE SULFATE	Statex 1mg/mL O/L	PAL	0.0200	0.0200	NO	NO	YES
00591475	MORPHINE SULFATE	Statex 5mg/mL O/L	PAL	0.0803	0.0803	NO	NO	YES
00594652	MORPHINE SULFATE	Statex 5mg Tab	PAL	0.1251	0.1251	NO	NO	YES
00594644	MORPHINE SULFATE	Statex 10mg Tab	PAL	0.1934	0.1934	NO	NO	YES
02230733	NITROGLYCERIN	Trinipatch 0.4mg/Hr/14 Sq Cm Patch	PAL	0.8110	0.8110	NO	NO	NO
02230734	NITROGLYCERIN	Trinipatch 0.6mg/Hr/21 Sq Cm Patch	PAL	0.8110	0.8110	NO	NO	NO
00511552	PIZOTYLINE	Sandomigran DS 1mg Tab	PAL	1.1026	1.1026	NO	NO	NO
02280248	TESTOSTERONE	Testim 1% Top Gel-5g Pk	PAL	4.3180	4.3180	NO	YES	NO
02296403	TRAMADOL HCL	Tridural (Off-Formulary Interchangeable) 200mg ER Tab	PAL	N/A	N/A	YES	NO	YES
02296411	TRAMADOL HCL	Tridural (Off-Formulary Interchangeable) 300mg 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

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