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Products found: 2
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DIN/ PIN/ NPN
Generic Name
Brand Name, Strength & Dosage Form
MFR
Drug Benefit Price or Unit Price
Amount MOH Pays
Interchangeable
Limited Use
Therapeutic Notes
02420201
DIMETHYL FUMARATE
Tecfidera (Off-Formulary Interchangeable) 240mg DR Cap
BIG
36.7734
18.3867
YES
NO
NO
02404508
DIMETHYL FUMARATE
Tecfidera (Off-Formulary Interchangeable) 120mg DR Cap
BIG
18.3866
9.1933
YES
NO
NO
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