Search Results

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Products found: 100New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOHLTC PaysInter- change- ableLimited UseThera- peutic Notes
01910159ACEBUTOLOL HCLRhotral (Not a Benefit) 200mg TabSAVN/AN/AYESNONO
01910140ACEBUTOLOL HCLRhotral (Not a Benefit) 100mg TabSAVN/AN/AYESNONO
01910167ACEBUTOLOL HCLRhotral (Not a Benefit) 400mg TabSAVN/AN/AYESNONO
01926543ACEBUTOLOL HCLSectral 100mg TabSAV0.37420.0787YESNONO
01926578ACEBUTOLOL HCLSectral 400mg TabSAV1.06950.2466YESNONO
01926551ACEBUTOLOL HCLSectral 200mg TabSAV0.56150.1177YESNONO
02245565ALFUZOSIN HYDROCHLORIDEXatral 10mg Prolong-Rel TabSAV1.04040.2601YESYESNO
02240749BUSERELIN ACETATESuprefact Depot 9.45mg Implant KitSAV1226.76001226.7600NONONO
02228955BUSERELIN ACETATESuprefact Depot 6.3mg Implant KitSAV827.8500827.8500NONONO
02225166BUSERELIN ACETATESuprefact 1mg/mL Inj Sol-5.5mL PkSAV67.030067.0300NONONO
02225158BUSERELIN ACETATESuprefact 1mg/mL Nas Sp-10mL PkSAV85.530085.5300NONONO
01926691CALCITONIN (SALMON SYNTHETIC)Calcimar 400IU/2mL Inj Sol-2mL PkSAV60.960060.9600NONONO
02238682CLOPIDOGREL BISULFATEPlavix 75mg TabSAV2.71250.2631YESNONO
02330555CLOPIDOGREL BISULFATEPlavix (Off-Formulary Interchangeable) 300mg TabSAVN/AN/AYESNONO
02018160DANAZOLCyclomen 200mg CapSAV2.36762.3676NONONO
02018152DANAZOLCyclomen 100mg CapSAV1.48161.4816NONONO
02018144DANAZOLCyclomen 50mg CapSAV0.99830.9983NONONO
02099136DESIPRAMINENorpramin (Not a Benefit) 50mg TabSAVN/AN/AYESNONO
02099128DESIPRAMINENorpramin (Not a Benefit) 25mg TabSAVN/AN/AYESNONO
02224801DISOPYRAMIDERythmodan 100mg CapSAV0.29500.2950YESNONO
01931563ELECTROLYTE & DEXTROSEGastrolyte Oral Pd-1 Sach PkSAV0.79500.7950NONONO
02236564ENOXAPARINLovenox 100mg/mL Inj Sol-3mLVial PkSAV66.170066.1700NOYESNO
02012472ENOXAPARINLovenox 30mg/0.3mL Pref Syr-0.3mL PkSAV6.61706.6170NOYESNO
02236883ENOXAPARINLovenox 40mg/0.4mL Pref Syr-0.4mL PkSAV8.82208.8220NOYESNO
02378426ENOXAPARINLovenox 60mg/0.6mL Pref Syr-0.6mL PkSAV13.233013.2330NOYESNO
02378434ENOXAPARINLovenox 80mg/0.8mL Pref Syr-0.8mL PkSAV17.645017.6450NOYESNO
02242692ENOXAPARINLovenox HP 120mg/0.8mL Pref Syr-0.8mL PkSAV26.467026.4670NOYESNO
02378442ENOXAPARINLovenox 100mg/mL Pref Syr-1mL PkSAV22.056022.0560NOYESNO
02378469ENOXAPARINLovenox HP 150mg/mL Pref Syr-1mL PkSAV33.085033.0850NOYESNO
02017598ERGOCALCIFEROLDrisdol (Not a Benefit) 8288IU/mL O/LSAVN/AN/AYESNONO
02222000FELODIPINERenedil (Not a Benefit) 10mg SR TabSAVN/AN/AYESNOYES
02221993FELODIPINERenedil (Not a Benefit) 5mg SR TabSAVN/AN/AYESNOYES
02224623FRAMYCETIN SULFATE & GRAMICIDIN & DEXAMETHASONESofracort 5mg & 50mcg & 0.5mg/mL Oph/Ot SolSAV2.05752.0575NONOYES
02224720FUROSEMIDELasix 10mg/mL O/LSAV0.32290.3229NONONO
02224690FUROSEMIDELasix (Not a Benefit) 20mg TabSAVN/AN/AYESNONO
02224704FUROSEMIDELasix (Not a Benefit) 40mg TabSAVN/AN/AYESNONO
02224755FUROSEMIDELasix Special 500mg TabSAV3.32703.3270NOYESNO
02245274GLIMEPIRIDEAmaryl (Off-Formulary Interchangeable) 4mg TabSAVN/AN/AYESNONO
02245273GLIMEPIRIDEAmaryl (Off-Formulary Interchangeable) 2mg TabSAVN/AN/AYESNONO
02245272GLIMEPIRIDEAmaryl (Off-Formulary Interchangeable) 1mg TabSAVN/AN/AYESNONO
02224569GLYBURIDEDiabeta 5mg TabSAV0.26370.0574YESNONO
02224550GLYBURIDEDiabeta 2.5mg TabSAV0.14670.0321YESNONO
02017709HYDROXYCHLOROQUINE SULFATEPlaquenil 200mg TabSAV0.63020.1576YESNONO
02245689INSULIN GLARGINELantus-(Vial) 100U/mL Inj Sol-10mL Vial PkSAV61.690061.6900NONONO
02294338INSULIN GLARGINELantus Solostar 100U/mL Inj Sol-5x3mL PkSAV92.850092.8500NONONO
02251930INSULIN GLARGINELantus-(Cartridge) 100U/mL Inj Sol-5x3mL PkSAV92.850092.8500NONONO
02279479INSULIN GLULISINE (DNA ORIGIN)Apidra 100U/mL Inj 5x3mL Cart ClickStar PenSAV52.650052.6500NONOYES
02279460INSULIN GLULISINE (DNA ORIGIN)Apidra 100U/mL Inj Sol-10mL VialSAV26.580026.5800NONOYES
02294346INSULIN GLULISINE (DNA ORIGIN)Apidra 100U/mL Inj Sol-5x3mL SoloSTAR Pref PenSAV53.150053.1500NONOYES
02237925IRBESARTANAvapro 300mg TabSAV1.26710.2281YESNONO
02237923IRBESARTANAvapro 75mg TabSAV1.26710.2281YESNONO
02237924IRBESARTANAvapro 150mg TabSAV1.26710.2281YESNONO
02241819IRBESARTAN & HYDROCHLOROTHIAZIDEAvalide 300mg & 12.5mg TabSAV1.26710.2281YESNONO
02280213IRBESARTAN & HYDROCHLOROTHIAZIDEAvalide (Not a Benefit) 300mg & 25mg TabSAVN/AN/AYESNONO
02241818IRBESARTAN & HYDROCHLOROTHIAZIDEAvalide 150mg & 12.5mg TabSAV1.26710.2281YESNONO
00761680KETOPROFENRhodis-EC (Not a Benefit) 100mg Ent TabSAVN/AN/AYESNOYES
02241889LEFLUNOMIDEArava 20mg TabSAV11.06802.6433YESNONO
02241888LEFLUNOMIDEArava 10mg TabSAV11.06772.6433YESNONO
02248240LEUPROLIDE ACETATEEligard 22.5mg Pd Susp Inj-Pref Syr KitSAV891.0000891.0000NONONO
02248999LEUPROLIDE ACETATEEligard 30mg Pd Susp Inj-Pref Syr KitSAV1285.20001285.2000NONONO
02248239LEUPROLIDE ACETATEEligard 7.5mg Pd Susp Inj-Pref Syr KitSAV310.7200310.7200NONONO
02268892LEUPROLIDE ACETATEEligard 45mg Pd Susp Inj-Pref Syr KitSAV1500.00001500.0000NONONO
02099233METFORMIN HCLGlucophage 500mg TabSAV0.27160.0247YESNONO
02162849METFORMIN HCLGlucophage (Off-Formulary Interchangeable) 850mg TabSAVN/AN/AYESNONO
01927698METHOTRIMEPRAZINENozinan 25mg/mL Inj Sol-1mL PkSAV3.68103.6810NONONO
01927655METHOTRIMEPRAZINENozinan (Not a Benefit) 5mg TabSAVN/AN/AYESNONO
01927671METHOTRIMEPRAZINENozinan (Not a Benefit) 50mg TabSAVN/AN/AYESNONO
01927663METHOTRIMEPRAZINENozinan (Not a Benefit) 25mg TabSAVN/AN/AYESNONO
00888400METOLAZONEZaroxolyn 2.5mg TabSAV0.21360.2136NONONO
01926861METRONIDAZOLEFlagyl 10% Vag Cr-AppSAV0.25580.2558NONONO
01926845METRONIDAZOLE & NYSTATINFlagystatin 500mg & 100000U/g Vag Cr-AppSAV0.60760.6076NONONO
01926829METRONIDAZOLE & NYSTATINFlagystatin 500mg & 100000U Vag SupSAV3.44403.4440NONONO
02221861NILUTAMIDEAnandron 50mg TabSAV2.41002.4100NONONO
02231441NITROGLYCERINNitrolingual Pump Spray 0.4mg/Metered Dose Spray-200 Dose PkSAV15.24008.4200YESNONO
02221977PENTOXIFYLLINETrental (Not a Benefit) 400mg SR TabSAVN/AN/AYESNONO
02026961POLYSTYRENE SODIUM SULFONATEKayexalate 1mEq/g Oral Pd-454g PkSAV42.020042.0200YESNONO
02230619PREDNISOLONE SODIUM PHOSPHATEPediapred Oral Liquid 6.7mg/5mL O/LSAV0.13990.0900YESNONO
02221853RAMIPRILAltace Cap 10mgSAV1.18500.1034YESNONO
02221829RAMIPRILAltace Cap 1.25mgSAV0.79900.0708YESNONO
02221837RAMIPRILAltace Cap 2.5mgSAV0.89900.0817YESNONO
02221845RAMIPRILAltace Cap 5mgSAV0.92230.0817YESNONO
02281112RAMIPRILAltace (Off-Formulary Interchangeable) 15mg CapSAVN/AN/AYESNONO
02283131RAMIPRIL & HYDROCHLOROTHIAZIDEAltace HCT 2.5mg & 12.5mg TabSAV0.32320.1495YESNONO
02283158RAMIPRIL & HYDROCHLOROTHIAZIDEAltace HCT 5mg & 12.5mg TabSAV0.41430.2011YESNONO
02283174RAMIPRIL & HYDROCHLOROTHIAZIDEAltace HCT 5mg & 25mg TabSAV0.41430.1915YESNONO
02283166RAMIPRIL & HYDROCHLOROTHIAZIDEAltace HCT 10mg & 12.5mg TabSAV0.54250.1317YESNONO
02283182RAMIPRIL & HYDROCHLOROTHIAZIDEAltace HCT 10mg & 25mg TabSAV0.54250.1317YESNONO
02091887RIFAMPINRifadin 150mg CapSAV0.67650.6765YESNOYES
02092808RIFAMPINRifadin 300mg CapSAV1.06491.0649YESNOYES
02354586SEVELAMER CARBONATERenvela (Off-Formulary Interchangeable) 800mg TabSAVN/AN/AYESNONO
01927604SODIUM AUROTHIOMALATEMyochrysine 50mg/mL Inj Sol-1mL PkSAV24.780024.7800NONONO
01927620SODIUM AUROTHIOMALATEMyochrysine 10mg/mL Inj Sol-1mL PkSAV13.100013.1000NONONO
01927612SODIUM AUROTHIOMALATEMyochrysine 25mg/mL Inj Sol-1mL PkSAV15.930015.9300NONONO
01926632TAMOXIFEN CITRATETamofen (Not a Benefit) 20mg TabSAVN/AN/AYESNONO
01926624TAMOXIFEN CITRATETamofen (Not a Benefit) 10mg TabSAVN/AN/AYESNONO
02221950TIAPROFENIC ACIDSurgam (Not a Benefit) 300mg TabSAVN/AN/AYESNOYES
01926519TRETINOINVitamin A Acid (Not a Benefit) 0.05% CrSAVN/AN/AYESNONO
02213834TRIAMCINOLONE ACETONIDENasacort AQ (Off-Formulary Interchangeable) 55mcg/Metered Dose Nas Sp-120 Dose Pk (with Preservative)SAVN/AN/AYESNOYES
02216167ZOPICLONEImovane (Off-Formulary Interchangeable) 5mg TabSAVN/AN/AYESNONO
01926799ZOPICLONEImovane (Off-Formulary Interchangeable) 7.5mg TabSAVN/AN/AYESNONO