Interactive Drug Benefit List
DIN/NPN/ PIN
Generic Name
Product Name, Strength & Dosage Form
Unit Price, Unit of Issue
Manufacturer
LCA Price
MAC Price
Interchangeable Products
Coverage Status
00545015
ACETAZOLAMIDE
ACETAZOLAMIDE 250 MG ORAL TABLET
0.1580 TAB
AAP
N/A
N/A
NO
REGULAR BENEFIT
Details
02238873
BRINZOLAMIDE
AZOPT 1 % OPHTHALMIC SUSPENSION
3.5460 ML
NOV
N/A
N/A
NO
REGULAR BENEFIT
Details
02522373
DORZOLAMIDE HCL
DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
1.4757 ML
JPC
1.4757
N/A
YES
REGULAR BENEFIT
Details
02453347
DORZOLAMIDE HCL
JAMP-DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
1.4757 ML
JPC
1.4757
N/A
YES
REGULAR BENEFIT
Details
02457210
DORZOLAMIDE HCL
MED-DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
1.4757 ML
GMP
1.4757
N/A
YES
REGULAR BENEFIT
Details
02316307
DORZOLAMIDE HCL
SANDOZ DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
1.4757 ML
SDZ
1.4757
N/A
YES
REGULAR BENEFIT
Details
02269090
DORZOLAMIDE HCL
TRUSOPT (PRESERVATIVE-FREE) 2 % OPHTHALMIC SOLUTION
4.7293 ML
ELV
1.4757
N/A
NO
REGULAR BENEFIT
Details
02216205
DORZOLAMIDE HCL
TRUSOPT 2 % OPHTHALMIC SOLUTION
4.7238 ML
ELV
1.4757
N/A
YES
REGULAR BENEFIT
Details
02245882
METHAZOLAMIDE
METHAZOLAMIDE 50 MG ORAL TABLET
0.6145 TAB
AAP
N/A
N/A
NO
REGULAR BENEFIT
Details
DIN/NPN/ PIN
00545015
Generic Name
ACETAZOLAMIDE
Product Name, Strength & Dosage Form
ACETAZOLAMIDE 250 MG ORAL TABLET
Unit Price, Unit of Issue
0.1580
Manufacturer
AAP
LCA Price
N/A
MAC Price
N/A
Interchangeable Products
NO
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02238873
Generic Name
BRINZOLAMIDE
Product Name, Strength & Dosage Form
AZOPT 1 % OPHTHALMIC SUSPENSION
Unit Price, Unit of Issue
3.5460
Manufacturer
NOV
LCA Price
N/A
MAC Price
N/A
Interchangeable Products
NO
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02522373
Generic Name
DORZOLAMIDE HCL
Product Name, Strength & Dosage Form
DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
Unit Price, Unit of Issue
1.4757
Manufacturer
JPC
LCA Price
1.4757
MAC Price
N/A
Interchangeable Products
YES
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02453347
Generic Name
DORZOLAMIDE HCL
Product Name, Strength & Dosage Form
JAMP-DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
Unit Price, Unit of Issue
1.4757
Manufacturer
JPC
LCA Price
1.4757
MAC Price
N/A
Interchangeable Products
YES
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02457210
Generic Name
DORZOLAMIDE HCL
Product Name, Strength & Dosage Form
MED-DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
Unit Price, Unit of Issue
1.4757
Manufacturer
GMP
LCA Price
1.4757
MAC Price
N/A
Interchangeable Products
YES
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02316307
Generic Name
DORZOLAMIDE HCL
Product Name, Strength & Dosage Form
SANDOZ DORZOLAMIDE 2 % OPHTHALMIC SOLUTION
Unit Price, Unit of Issue
1.4757
Manufacturer
SDZ
LCA Price
1.4757
MAC Price
N/A
Interchangeable Products
YES
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02269090
Generic Name
DORZOLAMIDE HCL
Product Name, Strength & Dosage Form
TRUSOPT (PRESERVATIVE-FREE) 2 % OPHTHALMIC SOLUTION
Unit Price, Unit of Issue
4.7293
Manufacturer
ELV
LCA Price
1.4757
MAC Price
N/A
Interchangeable Products
NO
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02216205
Generic Name
DORZOLAMIDE HCL
Product Name, Strength & Dosage Form
TRUSOPT 2 % OPHTHALMIC SOLUTION
Unit Price, Unit of Issue
4.7238
Manufacturer
ELV
LCA Price
1.4757
MAC Price
N/A
Interchangeable Products
YES
Coverage Status
REGULAR BENEFIT
Details
DIN/NPN/ PIN
02245882
Generic Name
METHAZOLAMIDE
Product Name, Strength & Dosage Form
METHAZOLAMIDE 50 MG ORAL TABLET
Unit Price, Unit of Issue
0.6145
Manufacturer
AAP
LCA Price
N/A
MAC Price
N/A
Interchangeable Products
NO
Coverage Status
REGULAR BENEFIT
Details
GLOSSARY
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The DBL, DBS and related publications require knowledgeable interpretation and are intended primarily for professional health care practitioners, pharmacies, hospitals and organizations associated with the manufacture, distribution and use of pharmaceutical preparations.
Electronic versions of all DBL and DBS related publications are unofficial versions and are provided for convenience and private use only. Official paper versions can be obtained from Alberta Blue Cross who publishes them on behalf of Alberta Health and Alberta Human Services.
Alberta Health reserves the right to make changes, without notice, to the List through the Interactive DBL(iDBL) , and any such changes to the Interactive DBL(iDBL) are effective the date of the change (unless otherwise stated) and regardless of the date of publication in the paper version or updates.