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Products found: 64New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
02027801ACETAMINOPHENPediatrix 80mg/mL O/LRPH0.14360.1436YESNONO
00608238ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINERatio-Tecnal (Off-Formulary Interchangeable) 330mg & 50mg & 40mg CapRPH1.6192N/AYESNOYES
00608181ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATERatio-Tecnal C1/2 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 30mg CapRPH2.1261N/AYESNOYES
00608203ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATERatio-Tecnal C1/4 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 15mg CapRPH1.7363N/AYESNOYES
02259605AMLODIPINERatio-Amlodipine 5mg TabRPH0.13430.1343YESNONO
02259613AMLODIPINERatio-Amlodipine 10mg TabRPH0.19930.1993YESNONO
02350319ATORVASTATIN CALCIUMRatio-Atorvastatin 20mg TabRPH0.21790.2179YESNONO
02350297ATORVASTATIN CALCIUMRatio-Atorvastatin 10mg TabRPH0.17430.1743YESNONO
02350335ATORVASTATIN CALCIUMRatio-Atorvastatin 80mg TabRPH0.23420.2342YESNONO
02350327ATORVASTATIN CALCIUMRatio-Atorvastatin 40mg TabRPH0.23420.2342YESNONO
02236507BACLOFENRatio-Baclofen 10mg TabRPH0.15950.1595YESNOYES
02236508BACLOFENRatio-Baclofen 20mg TabRPH0.31040.3104YESNOYES
00809187BETAMETHASONE DIPROPIONATERatio-Topisone 0.05% LotRPH0.19800.1980YESNONO
00805009BETAMETHASONE DIPROPIONATERatio-Topisone 0.05% OintRPH0.21520.2152YESNONO
00849669BETAMETHASONE DIPROPIONATE IN A BASE CONTAINING PROPYLENE GLYCOLRatio-Topilene 0.05% OintRPH0.51860.5186YESNOYES
00849650BETAMETHASONE DIPROPIONATE IN PROPYLENE GLYCOL BASERatio-Topilene 0.05% CrRPH0.51860.5186YESNOYES
00535427BETAMETHASONE VALERATERatio-Ectosone Mild 0.05% CrRPH0.06110.0596YESNONO
00535435BETAMETHASONE VALERATERatio-Ectosone Regular 0.1% CrRPH0.09110.0889YESNONO
00653209BETAMETHASONE VALERATERatio-Ectosone Mild 0.05% LotRPH0.28470.2847YESNONO
00750050BETAMETHASONE VALERATERatio-Ectosone Regular 0.1% LotRPH0.31250.3125YESNONO
00653217BETAMETHASONE VALERATERatio-Ectosone 0.1% Scalp LotRPH0.08530.0853YESNONO
02252317CARVEDILOLRatio-Carvedilol 6.25mg TabRPH0.20600.2060YESYESNO
02252333CARVEDILOLRatio-Carvedilol 25mg TabRPH0.20600.2060YESYESNO
02252309CARVEDILOLRatio-Carvedilol 3.125mg TabRPH0.20600.2060YESYESNO
02252325CARVEDILOLRatio-Carvedilol 12.5mg TabRPH0.20600.2060YESYESNO
02246825CIPROFLOXACINRatio-Ciprofloxacin 250mg TabRPH0.44540.4454YESNOYES
02246826CIPROFLOXACINRatio-Ciprofloxacin 500mg TabRPH0.50250.5025YESNOYES
02246827CIPROFLOXACINRatio-Ciprofloxacin 750mg TabRPH0.92010.9201YESNOYES
02236506CYCLOBENZAPRINE HCLRatio-Cyclobenzaprine (Not a Benefit) 10mg TabRPHN/AN/AYESNOYES
02300001ENALAPRIL MALEATERatio-Enalapril 10mg TabRPH0.26470.2647YESNOYES
02299992ENALAPRIL MALEATERatio-Enalapril 5mg TabRPH0.22030.2203YESNOYES
02299984ENALAPRIL MALEATERatio-Enalapril 2.5mg TabRPH0.18630.1863YESNOYES
02300028ENALAPRIL MALEATERatio-Enalapril 20mg TabRPH0.31950.3195YESNOYES
02306905FINASTERIDERatio-Finasteride 5mg TabRPH0.35060.3506YESYESNO
02296071FLUTICASONE PROPIONATERatio-Fluticasone (Off-Formulary Interchangeable) 50mcg/Actuation Nas Sp-120 Dose PkRPH21.9700N/AYESNOYES
02260905GABAPENTINRatio-Gabapentin 400mg CapRPH0.12060.1206YESNONO
02097168IPRATROPIUM BROMIDERatio-Ipratropium UDV 250mcg/mL Inh Sol-2mL UDV PkRPH1.31801.3180YESYESNO
00854409LACTULOSERatio-Lactulose 667mg/mL O/LRPH0.01450.0145YESNONO
02243352LAMOTRIGINERatio-Lamotrigine 25mg TabRPH0.06980.0698YESNONO
02320908MEMANTINE HCLRatio-Memantine (Off-Formulary Interchangeable) 10mg TabRPH1.6357N/AYESNONO
02242974METFORMIN HCLRatio-Metformin 500mg TabRPH0.02470.0247YESNONO
02242931METFORMIN HCLRatio-Metformin (Off-Formulary Interchangeable) 850mg TabRPH0.2090N/AYESNONO
02248130MOMETASONE FUROATERatio-Mometasone 0.1% OintRPH0.22520.2252YESNONO
02194201NYSTATINRatio-Nystatin 100000U/mL O/LRPH0.05180.0518YESNONO
02194228NYSTATINRatio-Nystatin 100000U/g OintRPH0.12770.1277YESNOYES
02194163NYSTATINRatio-Nystatin 100000U/g Vag CrRPH0.31910.3191NONOYES
02260867OMEPRAZOLERatio-Omeprazole DR Tab 20mgRPH0.22870.2287YESYESNO
09857267OMEPRAZOLE MAGNESIUMRatio-Omeprazole DR Tab 20mgRPH0.22870.2287YESYESNO
00608157OXYCODONE HCL & ACETYLSALICYLIC ACIDRatio-Oxycodan 5mg & 325mg TabRPH0.45990.4599YESNOYES
02246932PRAVASTATIN SODIUMRatio-Pravastatin 40mg TabRPH0.41430.4143YESNONO
02246931PRAVASTATIN SODIUMRatio-Pravastatin 20mg TabRPH0.34400.3440YESNONO
02246930PRAVASTATIN SODIUMRatio-Pravastatin 10mg TabRPH0.29160.2916YESNONO
00700401PREDNISOLONE ACETATERatio-Prednisolone 1% Oph SuspRPH1.94001.9400YESNOYES
02287706RAMIPRILRatio-Ramipril Cap 2.5mgRPH0.08170.0817YESNONO
02319861RISEDRONATE SODIUMRatio-Risedronate 35mg TabRPH1.67641.6764YESNONO
00851841SALBUTAMOLRatio-Salbutamol Inhaler (Not a Benefit) 100mcg/Metered Dose Inh-200 dose PkRPHN/AN/AYESNONO
02084236SOTALOL HCLRatio-Sotalol 160mg TabRPH0.16230.1623YESNONO
02271583SUMATRIPTAN SUCCINATERatio-Sumatriptan (Off-Formulary Interchangeable) 50mg TabRPH9.06509.0650YESNONO
02271591SUMATRIPTAN SUCCINATERatio-Sumatriptan (Off-Formulary Interchangeable) 100mg TabRPH9.98679.9867YESNONO
02240334TRYPTOPHANRatio-Tryptophan (Off-Formulary Interchangeable) 500mg CapRPH0.4987N/AYESNONO
02237250TRYPTOPHANRatio-Tryptophan (Off-Formulary Interchangeable) 1g TabRPH0.8978N/AYESNONO
02240333TRYPTOPHANRatio-Tryptophan (Off-Formulary Interchangeable) 500mg TabRPH0.4987N/AYESNONO
02242481ZOPICLONERatio-Zopiclone (Off-Formulary Interchangeable) 7.5mg TabRPH0.46850.4685YESNONO
02246534ZOPICLONERatio-Zopiclone (Off-Formulary Interchangeable) 5mg TabRPH0.22310.2231YESNONO