Home Health iDBL
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
02207621 ACYCLOVIR APO-ACYCLOVIR 200 MG ORAL TABLET 0.3511
TAB 		APX 0.3511 N/A YES REGULAR BENEFIT Details
02524708 ACYCLOVIR MINT-ACYCLOVIR 200 MG ORAL TABLET 0.3511
TAB 		MPI 0.3511 N/A YES REGULAR BENEFIT Details
02242784 ACYCLOVIR MYLAN-ACYCLOVIR 200 MG ORAL TABLET 0.3511
TAB 		MYP 0.3511 N/A YES REGULAR BENEFIT Details
02285959 ACYCLOVIR TEVA-ACYCLOVIR 200 MG ORAL TABLET 0.3511
TAB 		TEV 0.3511 N/A YES REGULAR BENEFIT Details
00886157 ACYCLOVIR ZOVIRAX 40 MG / ML ORAL SUSPENSION 0.2831
ML 		GSK N/A N/A NO REGULAR BENEFIT Details
02207648 ACYCLOVIR APO-ACYCLOVIR 400 MG ORAL TABLET 0.8890
TAB 		APX 0.8890 N/A YES REGULAR BENEFIT Details
02524716 ACYCLOVIR MINT-ACYCLOVIR 400 MG ORAL TABLET 0.8890
TAB 		MPI 0.8890 N/A YES REGULAR BENEFIT Details
02242463 ACYCLOVIR MYLAN-ACYCLOVIR 400 MG ORAL TABLET 0.8890
TAB 		MYP 0.8890 N/A YES REGULAR BENEFIT Details
02285967 ACYCLOVIR TEVA-ACYCLOVIR 400 MG ORAL TABLET 0.8890
TAB 		TEV 0.8890 N/A YES REGULAR BENEFIT Details
02207656 ACYCLOVIR APO-ACYCLOVIR 800 MG ORAL TABLET 1.2673
TAB 		APX 1.2673 N/A YES REGULAR BENEFIT Details
02524724 ACYCLOVIR MINT-ACYCLOVIR 800 MG ORAL TABLET 1.2673
TAB 		MPI 1.2673 N/A YES REGULAR BENEFIT Details
02242464 ACYCLOVIR MYLAN-ACYCLOVIR 800 MG ORAL TABLET 1.2673
TAB 		MYP 1.2673 N/A YES REGULAR BENEFIT Details
02285975 ACYCLOVIR TEVA-ACYCLOVIR 800 MG ORAL TABLET 1.2673
TAB 		TEV 1.2673 N/A YES REGULAR BENEFIT Details
02420333 ADEFOVIR DIPIVOXIL AA-ADEFOVIR 10 MG ORAL TABLET 18.2518
TAB 		AAP 0.0000 0.0000 NO RESTRICTED BENEFIT Details
02479907 ENTECAVIR ACCEL-ENTECAVIR 0.5 MG ORAL TABLET 4.4000
TAB 		ACP 4.4000 N/A YES RESTRICTED BENEFIT Details
02396955 ENTECAVIR APO-ENTECAVIR 0.5 MG ORAL TABLET 5.5000
TAB 		APX 4.4000 N/A YES RESTRICTED BENEFIT Details
02448777 ENTECAVIR AURO-ENTECAVIR 0.5 MG ORAL TABLET 5.5000
TAB 		AUR 4.4000 N/A YES RESTRICTED BENEFIT Details
02282224 ENTECAVIR BARACLUDE 0.5 MG ORAL TABLET 22.6600
TAB 		BMS 4.4000 N/A YES RESTRICTED BENEFIT Details
02527154 ENTECAVIR ENTECAVIR 0.5 MG ORAL TABLET 5.5000
TAB 		SNS 4.4000 N/A YES RESTRICTED BENEFIT Details
02467232 ENTECAVIR JAMP-ENTECAVIR 0.5 MG ORAL TABLET 5.5000
TAB 		JPC 4.4000 N/A YES RESTRICTED BENEFIT Details
02485907 ENTECAVIR MINT-ENTECAVIR 0.5 MG ORAL TABLET 5.5000
TAB 		MPI 4.4000 N/A YES RESTRICTED BENEFIT Details
02430576 ENTECAVIR PMS-ENTECAVIR 0.5 MG ORAL TABLET 5.5000
TAB 		PMS 4.4000 N/A YES RESTRICTED BENEFIT Details
02292068 FAMCICLOVIR APO-FAMCICLOVIR 500 MG ORAL TABLET N/A
TAB 		APX N/A N/A NO NOT A BENEFIT Details
02278650 FAMCICLOVIR SANDOZ FAMCICLOVIR 500 MG ORAL TABLET N/A
TAB 		SDZ N/A N/A NO NOT A BENEFIT Details
02162695 GANCICLOVIR SODIUM CYTOVENE 500 MG / VIAL INJECTION 48.5996
VIAL 		CAG N/A N/A NO REGULAR BENEFIT Details
02439212 RIBAVIRIN IBAVYR 200 MG ORAL TABLET 12.2399
TAB 		PPH N/A N/A NO SPECIAL AUTHORIZATION Details
02354705 VALACYCLOVIR APO-VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET 1.7218
TAB 		APX 1.7218 N/A YES REGULAR BENEFIT Details
02351560 VALACYCLOVIR MYLAN-VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET 1.7218
TAB 		MYP 1.7218 N/A YES REGULAR BENEFIT Details
02381230 VALACYCLOVIR PMS-VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET 1.7218
TAB 		PMS 1.7218 N/A YES REGULAR BENEFIT Details
02519585 VALACYCLOVIR VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET 1.7218
TAB 		SNS 1.7218 N/A YES REGULAR BENEFIT Details
02295822 VALACYCLOVIR APO-VALACYCLOVIR (CAPLET) 500 MG ORAL TABLET 0.6198
TAB 		APX 0.6198 N/A YES REGULAR BENEFIT Details
02405040 VALACYCLOVIR AURO-VALACYCLOVIR 500 MG ORAL TABLET 0.6198
TAB 		AUR 0.6198 N/A YES REGULAR BENEFIT Details
02440598 VALACYCLOVIR JAMP-VALACYCLOVIR 500 MG ORAL TABLET 0.6198
TAB 		JPC 0.6198 N/A YES REGULAR BENEFIT Details
02441454 VALACYCLOVIR JAMP-VALACYCLOVIR 500 MG ORAL TABLET 0.6198
TAB 		JPC 0.6198 N/A YES REGULAR BENEFIT Details
02351579 VALACYCLOVIR MYLAN-VALACYCLOVIR (CAPLET) 500 MG ORAL TABLET 0.6198
TAB 		MYP 0.6198 N/A YES REGULAR BENEFIT Details
02298457 VALACYCLOVIR PMS-VALACYCLOVIR (CAPLET) 500 MG ORAL TABLET 0.6198
TAB 		PMS 0.6198 N/A YES REGULAR BENEFIT Details
02347091 VALACYCLOVIR SANDOZ VALACYCLOVIR 500 MG ORAL TABLET 0.6198
TAB 		SDZ 0.6198 N/A YES REGULAR BENEFIT Details
02357534 VALACYCLOVIR TEVA-VALACYCLOVIR 500 MG ORAL TABLET 0.6198
TAB 		TEV 0.6198 N/A YES REGULAR BENEFIT Details
02442000 VALACYCLOVIR VALACYCLOVIR 500 MG ORAL TABLET 0.6198
TAB 		SIV 0.6198 N/A YES REGULAR BENEFIT Details
02454645 VALACYCLOVIR VALACYCLOVIR 500 MG ORAL TABLET 0.6198
TAB 		SNS 0.6198 N/A YES REGULAR BENEFIT Details
02219492 VALACYCLOVIR VALTREX (CAPLET) 500 MG ORAL TABLET 3.8882
TAB 		GSK 0.6198 N/A YES REGULAR BENEFIT Details
02435179 VALGANCICLOVIR HCL AURO-VALGANCICLOVIR 450 MG ORAL TABLET 5.8553
TAB 		AUR 0.0000 0.0000 YES REGULAR BENEFIT Details
02495457 VALGANCICLOVIR HCL MINT-VALGANCICLOVIR 450 MG ORAL TABLET 5.8553
TAB 		MPI 0.0000 0.0000 YES REGULAR BENEFIT Details
02413825 VALGANCICLOVIR HCL TEVA-VALGANCICLOVIR 450 MG ORAL TABLET 5.8553
TAB 		TEV 0.0000 0.0000 YES REGULAR BENEFIT Details
02245777 VALGANCICLOVIR HCL VALCYTE 450 MG ORAL TABLET 26.9559
TAB 		CAG 0.0000 0.0000 YES REGULAR BENEFIT Details
02535483 VALGANCICLOVIR HCL AURO-VALGANCICLOVIR 50 MG / ML ORAL SUSPENSION 2.0589
ML 		AUR 2.0589 N/A YES REGULAR BENEFIT Details
02306085 VALGANCICLOVIR HCL VALCYTE 50 MG / ML ORAL SUSPENSION 2.9949
ML 		CAG 2.0589 N/A YES REGULAR BENEFIT Details
DIN/NPN/ PIN 02207621
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form APO-ACYCLOVIR 200 MG ORAL TABLET
Unit Price, Unit of Issue 0.3511
Manufacturer APX
LCA Price 0.3511
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02524708
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form MINT-ACYCLOVIR 200 MG ORAL TABLET
Unit Price, Unit of Issue 0.3511
Manufacturer MPI
LCA Price 0.3511
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02242784
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form MYLAN-ACYCLOVIR 200 MG ORAL TABLET
Unit Price, Unit of Issue 0.3511
Manufacturer MYP
LCA Price 0.3511
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02285959
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form TEVA-ACYCLOVIR 200 MG ORAL TABLET
Unit Price, Unit of Issue 0.3511
Manufacturer TEV
LCA Price 0.3511
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00886157
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form ZOVIRAX 40 MG / ML ORAL SUSPENSION
Unit Price, Unit of Issue 0.2831
Manufacturer GSK
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02207648
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form APO-ACYCLOVIR 400 MG ORAL TABLET
Unit Price, Unit of Issue 0.8890
Manufacturer APX
LCA Price 0.8890
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02524716
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form MINT-ACYCLOVIR 400 MG ORAL TABLET
Unit Price, Unit of Issue 0.8890
Manufacturer MPI
LCA Price 0.8890
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02242463
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form MYLAN-ACYCLOVIR 400 MG ORAL TABLET
Unit Price, Unit of Issue 0.8890
Manufacturer MYP
LCA Price 0.8890
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02285967
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form TEVA-ACYCLOVIR 400 MG ORAL TABLET
Unit Price, Unit of Issue 0.8890
Manufacturer TEV
LCA Price 0.8890
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02207656
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form APO-ACYCLOVIR 800 MG ORAL TABLET
Unit Price, Unit of Issue 1.2673
Manufacturer APX
LCA Price 1.2673
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02524724
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form MINT-ACYCLOVIR 800 MG ORAL TABLET
Unit Price, Unit of Issue 1.2673
Manufacturer MPI
LCA Price 1.2673
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02242464
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form MYLAN-ACYCLOVIR 800 MG ORAL TABLET
Unit Price, Unit of Issue 1.2673
Manufacturer MYP
LCA Price 1.2673
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02285975
Generic Name ACYCLOVIR
Product Name, Strength & Dosage Form TEVA-ACYCLOVIR 800 MG ORAL TABLET
Unit Price, Unit of Issue 1.2673
Manufacturer TEV
LCA Price 1.2673
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02420333
Generic Name ADEFOVIR DIPIVOXIL
Product Name, Strength & Dosage Form AA-ADEFOVIR 10 MG ORAL TABLET
Unit Price, Unit of Issue 18.2518
Manufacturer AAP
LCA Price 0.0000
MAC Price 0.0000
Interchangeable Products NO
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02479907
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form ACCEL-ENTECAVIR 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 4.4000
Manufacturer ACP
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02396955
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form APO-ENTECAVIR 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 5.5000
Manufacturer APX
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02448777
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form AURO-ENTECAVIR 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 5.5000
Manufacturer AUR
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02282224
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form BARACLUDE 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 22.6600
Manufacturer BMS
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02527154
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form ENTECAVIR 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 5.5000
Manufacturer SNS
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02467232
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form JAMP-ENTECAVIR 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 5.5000
Manufacturer JPC
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02485907
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form MINT-ENTECAVIR 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 5.5000
Manufacturer MPI
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02430576
Generic Name ENTECAVIR
Product Name, Strength & Dosage Form PMS-ENTECAVIR 0.5 MG ORAL TABLET
Unit Price, Unit of Issue 5.5000
Manufacturer PMS
LCA Price 4.4000
MAC Price N/A
Interchangeable Products YES
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 02292068
Generic Name FAMCICLOVIR
Product Name, Strength & Dosage Form APO-FAMCICLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer APX
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 02278650
Generic Name FAMCICLOVIR
Product Name, Strength & Dosage Form SANDOZ FAMCICLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer SDZ
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 02162695
Generic Name GANCICLOVIR SODIUM
Product Name, Strength & Dosage Form CYTOVENE 500 MG / VIAL INJECTION
Unit Price, Unit of Issue 48.5996
Manufacturer CAG
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02439212
Generic Name RIBAVIRIN
Product Name, Strength & Dosage Form IBAVYR 200 MG ORAL TABLET
Unit Price, Unit of Issue 12.2399
Manufacturer PPH
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status SPECIAL AUTHORIZATION
Details
DIN/NPN/ PIN 02354705
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form APO-VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET
Unit Price, Unit of Issue 1.7218
Manufacturer APX
LCA Price 1.7218
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02351560
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form MYLAN-VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET
Unit Price, Unit of Issue 1.7218
Manufacturer MYP
LCA Price 1.7218
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02381230
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form PMS-VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET
Unit Price, Unit of Issue 1.7218
Manufacturer PMS
LCA Price 1.7218
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02519585
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form VALACYCLOVIR (CAPLET) 1,000 MG ORAL TABLET
Unit Price, Unit of Issue 1.7218
Manufacturer SNS
LCA Price 1.7218
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02295822
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form APO-VALACYCLOVIR (CAPLET) 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer APX
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02405040
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form AURO-VALACYCLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer AUR
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02440598
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form JAMP-VALACYCLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer JPC
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02441454
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form JAMP-VALACYCLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer JPC
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02351579
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form MYLAN-VALACYCLOVIR (CAPLET) 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer MYP
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02298457
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form PMS-VALACYCLOVIR (CAPLET) 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer PMS
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02347091
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form SANDOZ VALACYCLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer SDZ
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02357534
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form TEVA-VALACYCLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer TEV
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02442000
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form VALACYCLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer SIV
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02454645
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form VALACYCLOVIR 500 MG ORAL TABLET
Unit Price, Unit of Issue 0.6198
Manufacturer SNS
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02219492
Generic Name VALACYCLOVIR
Product Name, Strength & Dosage Form VALTREX (CAPLET) 500 MG ORAL TABLET
Unit Price, Unit of Issue 3.8882
Manufacturer GSK
LCA Price 0.6198
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02435179
Generic Name VALGANCICLOVIR HCL
Product Name, Strength & Dosage Form AURO-VALGANCICLOVIR 450 MG ORAL TABLET
Unit Price, Unit of Issue 5.8553
Manufacturer AUR
LCA Price 0.0000
MAC Price 0.0000
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02495457
Generic Name VALGANCICLOVIR HCL
Product Name, Strength & Dosage Form MINT-VALGANCICLOVIR 450 MG ORAL TABLET
Unit Price, Unit of Issue 5.8553
Manufacturer MPI
LCA Price 0.0000
MAC Price 0.0000
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02413825
Generic Name VALGANCICLOVIR HCL
Product Name, Strength & Dosage Form TEVA-VALGANCICLOVIR 450 MG ORAL TABLET
Unit Price, Unit of Issue 5.8553
Manufacturer TEV
LCA Price 0.0000
MAC Price 0.0000
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02245777
Generic Name VALGANCICLOVIR HCL
Product Name, Strength & Dosage Form VALCYTE 450 MG ORAL TABLET
Unit Price, Unit of Issue 26.9559
Manufacturer CAG
LCA Price 0.0000
MAC Price 0.0000
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02535483
Generic Name VALGANCICLOVIR HCL
Product Name, Strength & Dosage Form AURO-VALGANCICLOVIR 50 MG / ML ORAL SUSPENSION
Unit Price, Unit of Issue 2.0589
Manufacturer AUR
LCA Price 2.0589
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02306085
Generic Name VALGANCICLOVIR HCL
Product Name, Strength & Dosage Form VALCYTE 50 MG / ML ORAL SUSPENSION
Unit Price, Unit of Issue 2.9949
Manufacturer CAG
LCA Price 2.0589
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
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NOTICE:
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.