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Products found: 32New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
02163780CODEINE SULFATE TRIHYDRATE & MONOHYDRATECodeine Contin 150mg CR TabPFP1.46901.4690NOYESYES
02163748CODEINE SULFATE TRIHYDRATE & MONOHYDRATECodeine Contin 100mg CR TabPFP0.97900.9790NOYESYES
02230302CODEINE SULFATE TRIHYDRATE & MONOHYDRATECodeine Contin 50mg CR TabPFP0.48900.4890NOYESYES
02163799CODEINE SULFATE TRIHYDRATE & MONOHYDRATECodeine Contin 200mg CR TabPFP1.95801.9580NOYESYES
02125323HYDROMORPHONE HCLHydromorph Contin 3mg CR CapPFP0.76900.7690NONOYES
02359510HYDROMORPHONE HCLHydromorph Contin 9mg CR CapPFP1.51601.5160NONOYES
02359502HYDROMORPHONE HCLHydromorph Contin 4.5mg CR CapPFP0.92800.9280NONOYES
02125331HYDROMORPHONE HCLHydromorph Contin 6mg CR CapPFP1.14901.1490NONOYES
02125390HYDROMORPHONE HCLHydromorph Contin (Off-Formulary Interchangeable) 30mg CR CapPFP5.01005.0100NONOYES
02125382HYDROMORPHONE HCLHydromorph Contin (Off-Formulary Interchangeable) 24mg CR CapPFP4.18104.1810NONOYES
02125366HYDROMORPHONE HCLHydromorph Contin 12mg CR CapPFP1.99801.9980NONOYES
02243562HYDROMORPHONE HCLHydromorph Contin 18mg CR CapPFP2.88252.8825NONOYES
00627100HYDROMORPHONE HCLDilaudid (Not a Benefit) 2mg/mL Inj Sol-1mL PkPFPN/AN/AYESNOYES
00622133HYDROMORPHONE HCLDilaudid-HP (Not a Benefit) 10mg/mL Inj Sol-1mL PkPFPN/AN/AYESNOYES
00786535HYDROMORPHONE HCLDilaudid (Not a Benefit) 1mg/mL Oral SolPFPN/AN/AYESNOYES
00705438HYDROMORPHONE HCLDilaudid 1mg TabPFP0.10100.0959YESNOYES
00786543HYDROMORPHONE HCLDilaudid 8mg TabPFP0.37050.3528YESNOYES
00125121HYDROMORPHONE HCLDilaudid 4mg TabPFP0.23500.2240YESNOYES
00125083HYDROMORPHONE HCLDilaudid 2mg TabPFP0.14900.1417YESNOYES
02015439MORPHINE SULFATEMS Contin 15mg SR TabPFP0.96000.4145YESNOYES
02014297MORPHINE SULFATEMS Contin 30mg SR TabPFP1.45100.6580YESNOYES
02014300MORPHINE SULFATEMS Contin 60mg SR TabPFP2.55801.2180YESNOYES
02014319MORPHINE SULFATEMS Contin 100mg SR TabPFP3.89401.5395YESNOYES
02014327MORPHINE SULFATEMS Contin (Off-Formulary Interchangeable) 200mg SR TabPFP7.26004.5738YESNOYES
02014238MORPHINE SULFATEMS-IR 20mg TabPFP0.44750.4475NONOYES
02014254MORPHINE SULFATEMS-IR 30mg TabPFP0.57450.5745NONOYES
02231934OXYCODONE HCLOxy.IR (Off-Formulary Interchangeable) 5mg TabPFPN/AN/AYESNOYES
02240131OXYCODONE HCLOxy.IR (Off-Formulary Interchangeable) 10mg TabPFPN/AN/AYESNOYES
02240132OXYCODONE HCLOxy.IR (Off-Formulary Interchangeable) 20mg TabPFPN/AN/AYESNOYES
00158348POVIDONE - IODINEBetadine (Not a Benefit) 10% Top SolPFPN/AN/AYESNONO
00026158SENNOSIDES A & BSenokot 8.6mg TabPFP0.04640.0464YESNONO
02171880TIMOLOL MALEATETimoptic-XE (Not a Benefit) 0.25% Oph Gellan SolPFPN/AN/AYESNOYES