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Products found: 12
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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
02245828
CLODRONATE DISODIUM
Clasteon 400mg Cap
SUO
1.2083
1.2083
YES
YES
NO
02299909
DAPTOMYCIN
Cubicin (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol-Vial Pk
SUO
N/A
N/A
YES
NO
NO
02426889
ESLICARBAZEPINE ACETATE
Aptiom 600mg Tab
SUO
9.8700
9.8700
NO
YES
NO
02426870
ESLICARBAZEPINE ACETATE
Aptiom 400mg Tab
SUO
9.8700
9.8700
NO
YES
NO
02426862
ESLICARBAZEPINE ACETATE
Aptiom 200mg Tab
SUO
9.8700
9.8700
NO
YES
NO
02426897
ESLICARBAZEPINE ACETATE
Aptiom 800mg Tab
SUO
9.8700
9.8700
NO
YES
NO
02387786
LURASIDONE HYDROCHLORIDE
Latuda 120mg Tab
SUO
4.2500
1.2250
YES
NO
YES
02387778
LURASIDONE HYDROCHLORIDE
Latuda 80mg Tab
SUO
4.5000
1.2250
YES
NO
YES
02413361
LURASIDONE HYDROCHLORIDE
Latuda 60mg Tab
SUO
4.9000
1.2250
YES
NO
YES
02387751
LURASIDONE HYDROCHLORIDE
Latuda 40mg Tab
SUO
4.9000
1.2250
YES
NO
YES
02422050
LURASIDONE HYDROCHLORIDE
Latuda 20mg Tab
SUO
4.2500
1.2250
YES
NO
YES
02275066
TROSPIUM CHLORIDE
Trosec 20mg Tab
SUO
0.8144
0.4072
YES
YES
NO
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