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Products found: 36New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
022975585-AMINOSALICYLIC ACIDMezavant 1.2g Delayed & ER TabTAK1.92701.9270NONONO
02236859ANAGRELIDE HCLAgrylin 0.5mg CapTAK6.26624.6997YESYESNO
02354950DEXLANSOPRAZOLEDexilant (Off-Formulary Interchangeable) 30mg DR CapTAKN/AN/AYESNONO
02354969DEXLANSOPRAZOLEDexilant (Off-Formulary Interchangeable) 60mg DR CapTAKN/AN/AYESNONO
02357380FEBUXOSTATUloric (Off-Formulary Interchangeable) 80mg TabTAKN/AN/AYESNONO
02409100GUANFACINEIntuniv XR 1mg ER TabTAK3.07501.5375YESYESNO
02409135GUANFACINEIntuniv XR 4mg ER TabTAK5.07382.5369YESYESNO
02409127GUANFACINEIntuniv XR 3mg ER TabTAK4.40752.2038YESYESNO
02409119GUANFACINEIntuniv XR 2mg ER TabTAK3.74131.8707YESYESNO
02287161LANTHANUMFosrenol (Off-Formulary Interchangeable) 750mg Chew TabTAK3.62193.0786YESNONO
02287145LANTHANUMFosrenol (Not a Benefit) 250mg Chew TabTAKN/AN/AYESNONO
02287153LANTHANUMFosrenol (Off-Formulary Interchangeable) 500mg Chew TabTAK2.40682.0459YESNONO
02287188LANTHANUMFosrenol (Off-Formulary Interchangeable) 1000mg Chew TabTAK4.80184.0815YESNONO
02347172LISDEXAMFETAMINE DIMESYLATEVyvanse 60mg CapTAK5.05355.0535NONOYES
02322978LISDEXAMFETAMINE DIMESYLATEVyvanse 50mg CapTAK4.49824.4982NONOYES
02322951LISDEXAMFETAMINE DIMESYLATEVyvanse 30mg CapTAK3.38753.3875NONOYES
02347156LISDEXAMFETAMINE DIMESYLATEVyvanse 20mg CapTAK2.83222.8322NONOYES
02439603LISDEXAMFETAMINE DIMESYLATEVyvanse 10mg CapTAK2.27692.2769NONOYES
02347164LISDEXAMFETAMINE DIMESYLATEVyvanse 40mg CapTAK3.94293.9429NONOYES
02490269LISDEXAMFETAMINE DIMESYLATEVyvanse 50mg Chew TabTAK4.49824.4982NONOYES
02490250LISDEXAMFETAMINE DIMESYLATEVyvanse 40mg Chew TabTAK3.94293.9429NONOYES
02490242LISDEXAMFETAMINE DIMESYLATEVyvanse 30mg Chew TabTAK3.38753.3875NONOYES
02490226LISDEXAMFETAMINE DIMESYLATEVyvanse 10mg Chew TabTAK2.27692.2769NONOYES
02490277LISDEXAMFETAMINE DIMESYLATEVyvanse 60mg Chew TabTAK5.05355.0535NONOYES
02490234LISDEXAMFETAMINE DIMESYLATEVyvanse 20mg Chew TabTAK2.83222.8322NONOYES
02248813MIXED SALT AMPHETAMINEAdderall XR 30mg ER CapTAK3.98940.9038YESNOYES
02248812MIXED SALT AMPHETAMINEAdderall XR 25mg ER CapTAK3.66570.8305YESNOYES
02248810MIXED SALT AMPHETAMINEAdderall XR 15mg ER CapTAK3.01850.6838YESNOYES
02248809MIXED SALT AMPHETAMINEAdderall XR 10mg ER CapTAK2.69490.6105YESNOYES
02248808MIXED SALT AMPHETAMINEAdderall XR 5mg ER CapTAK2.37130.5372YESNOYES
02248811MIXED SALT AMPHETAMINEAdderall XR 20mg ER CapTAK3.34210.7572YESNOYES
02389983ONDANSETRON HYDROCHLORIDEOndissolve ODF (Film) 4mgTAK3.27202.5450YESYESNO
02389991ONDANSETRON HYDROCHLORIDEOndissolve ODF (Film) 8mgTAK4.99303.8840YESYESNO
02242572PIOGLITAZONE HCLActos (Off-Formulary Interchangeable) 15mg TabTAK2.50701.5716YESNONO
02242573PIOGLITAZONE HCLActos (Off-Formulary Interchangeable) 30mg TabTAK3.51242.2017YESNONO
02242574PIOGLITAZONE HCLActos (Off-Formulary Interchangeable) 45mg TabTAK5.27105.2710YESNONO