DIN/NPN/ PIN | Generic Name | Product Name, Strength & Dosage Form | Unit Price, Unit of Issue | Manufacturer | LCA Price | MAC Price | Interchangeable Products | Coverage Status | |
---|---|---|---|---|---|---|---|---|---|
00628131 | AMOXICILLIN TRIHYDRATE | APO-AMOXI 25 MG / ML ORAL SUSPENSION |
0.0247 ML |
APX | 0.0247 | N/A | YES | REGULAR BENEFIT | |
02458586 | AMOXICILLIN TRIHYDRATE | AURO-AMOXICILLIN 25 MG / ML ORAL SUSPENSION |
N/A ML |
AUR | N/A | N/A | YES | UNDER REVIEW | |
02535793 | AMOXICILLIN TRIHYDRATE | JAMP-AMOXICILLIN 25 MG / ML ORAL SUSPENSION |
0.0247 ML |
JPC | 0.0247 | N/A | YES | REGULAR BENEFIT | |
02525348 | AMOXICILLIN TRIHYDRATE | AMOXICILLIN BP 250 MG ORAL CAPSULE |
0.0672 CAP |
SNS | 0.0672 | N/A | YES | REGULAR BENEFIT | |
00628115 | AMOXICILLIN TRIHYDRATE | APO-AMOXI 250 MG ORAL CAPSULE |
0.0672 CAP |
APX | 0.0672 | N/A | YES | REGULAR BENEFIT | |
02388073 | AMOXICILLIN TRIHYDRATE | AURO-AMOXICILLIN 250 MG ORAL CAPSULE |
0.0672 CAP |
AUR | 0.0672 | N/A | YES | REGULAR BENEFIT | |
02433060 | AMOXICILLIN TRIHYDRATE | JAMP-AMOXICILLIN 250 MG ORAL CAPSULE |
0.0672 CAP |
JPC | 0.0672 | N/A | YES | REGULAR BENEFIT | |
00406724 | AMOXICILLIN TRIHYDRATE | NOVAMOXIN 250 MG ORAL CAPSULE |
0.0672 CAP |
TEV | 0.0672 | N/A | YES | REGULAR BENEFIT | |
02036355 | AMOXICILLIN TRIHYDRATE | NOVAMOXIN 250 MG ORAL CHEWABLE TABLET |
0.8282 TAB |
TEV | N/A | N/A | NO | REGULAR BENEFIT | |
02532042 | AMOXICILLIN TRIHYDRATE | PRZ-AMOXICILLIN 250 MG ORAL CAPSULE |
0.0672 CAP |
PCI | 0.0672 | N/A | YES | REGULAR BENEFIT | |
02352753 | AMOXICILLIN TRIHYDRATE | AMOXICILLIN 50 MG / ML ORAL SUSPENSION |
0.0540 ML |
SNS | 0.0540 | N/A | YES | REGULAR BENEFIT | |
02401541 | AMOXICILLIN TRIHYDRATE | AMOXICILLIN 50 MG / ML ORAL SUSPENSION |
0.0540 ML |
SIV | 0.0540 | N/A | YES | REGULAR BENEFIT | |
02352788 | AMOXICILLIN TRIHYDRATE | AMOXICILLIN SUGAR-REDUCED 50 MG / ML ORAL SUSPENSION |
0.0540 ML |
SNS | 0.0540 | N/A | YES | REGULAR BENEFIT | |
00628158 | AMOXICILLIN TRIHYDRATE | APO-AMOXI 50 MG / ML ORAL SUSPENSION |
0.0540 ML |
APX | 0.0540 | N/A | YES | REGULAR BENEFIT | |
02535815 | AMOXICILLIN TRIHYDRATE | JAMP-AMOXICILLIN 50 MG / ML ORAL SUSPENSION |
0.0540 ML |
JPC | 0.0540 | N/A | YES | REGULAR BENEFIT | |
00452130 | AMOXICILLIN TRIHYDRATE | NOVAMOXIN 50 MG / ML ORAL SUSPENSION |
0.0540 ML |
TEV | 0.0540 | N/A | YES | REGULAR BENEFIT | |
01934163 | AMOXICILLIN TRIHYDRATE | NOVAMOXIN SUGAR-REDUCED 50 MG / ML ORAL SUSPENSION |
0.0540 ML |
TEV | 0.0540 | N/A | YES | REGULAR BENEFIT | |
02477726 | AMOXICILLIN TRIHYDRATE | AG-AMOXICILLIN 500 MG ORAL CAPSULE |
0.1308 CAP |
AGP | 0.1308 | N/A | YES | REGULAR BENEFIT | |
02401509 | AMOXICILLIN TRIHYDRATE | AMOXICILLIN 500 MG ORAL CAPSULE |
0.1308 CAP |
SIV | 0.1308 | N/A | YES | REGULAR BENEFIT | |
02525356 | AMOXICILLIN TRIHYDRATE | AMOXICILLIN BP 500 MG ORAL CAPSULE |
0.1308 CAP |
SNS | 0.1308 | N/A | YES | REGULAR BENEFIT | |
00628123 | AMOXICILLIN TRIHYDRATE | APO-AMOXI 500 MG ORAL CAPSULE |
0.1308 CAP |
APX | 0.1308 | N/A | YES | REGULAR BENEFIT | |
02388081 | AMOXICILLIN TRIHYDRATE | AURO-AMOXICILLIN 500 MG ORAL CAPSULE |
0.1308 CAP |
AUR | 0.1308 | N/A | YES | REGULAR BENEFIT | |
02433079 | AMOXICILLIN TRIHYDRATE | JAMP-AMOXICILLIN 500 MG ORAL CAPSULE |
0.1308 CAP |
JPC | 0.1308 | N/A | YES | REGULAR BENEFIT | |
00406716 | AMOXICILLIN TRIHYDRATE | NOVAMOXIN 500 MG ORAL CAPSULE |
0.1308 CAP |
TEV | 0.1308 | N/A | YES | REGULAR BENEFIT | |
02532050 | AMOXICILLIN TRIHYDRATE | PRZ-AMOXICILLIN 500 MG ORAL CAPSULE |
0.1308 CAP |
PCI | 0.1308 | N/A | YES | REGULAR BENEFIT | |
02243350 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | APO-AMOXI CLAV 250 MG * 125 MG ORAL TABLET |
0.2467 TAB |
APX | 0.2467 | N/A | YES | REGULAR BENEFIT | |
02471671 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | AURO-AMOXICLAV 250 MG * 125 MG ORAL TABLET |
0.2467 TAB |
AUR | 0.2467 | N/A | YES | REGULAR BENEFIT | |
02508249 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | JAMP AMOXI CLAV 250 MG * 125 MG ORAL TABLET |
0.2467 TAB |
JPC | 0.2467 | N/A | YES | REGULAR BENEFIT | |
02238831 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | CLAVULIN-200 40 MG / ML * 5.7 MG / ML ORAL SUSPENSION |
0.1652 ML |
GSK | N/A | N/A | NO | REGULAR BENEFIT | |
02539411 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | JAMP AMOXI CLAV 40 MG / ML * 5.7 MG / ML ORAL SUSPENSION |
N/A ML |
JPC | N/A | N/A | NO | UNDER REVIEW | |
02536021 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | AMOXICILLIN/CLAV 500 MG * 125 MG ORAL TABLET |
N/A TAB |
SNS | N/A | N/A | YES | UNDER REVIEW | |
02243351 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | APO-AMOXI CLAV 500 MG * 125 MG ORAL TABLET |
0.3778 TAB |
APX | 0.3778 | N/A | YES | REGULAR BENEFIT | |
02471698 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | AURO-AMOXICLAV 500 MG * 125 MG ORAL TABLET |
0.3778 TAB |
AUR | 0.3778 | N/A | YES | REGULAR BENEFIT | |
02508257 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | JAMP AMOXI CLAV 500 MG * 125 MG ORAL TABLET |
0.3778 TAB |
JPC | 0.3778 | N/A | YES | REGULAR BENEFIT | |
02482576 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | SANDOZ AMOXI-CLAV 500 MG * 125 MG ORAL TABLET |
0.3778 TAB |
SDZ | 0.3778 | N/A | YES | REGULAR BENEFIT | |
02238830 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | CLAVULIN-400 80 MG / ML * 11.4 MG / ML ORAL SUSPENSION |
0.3206 ML |
GSK | 0.2386 | N/A | YES | REGULAR BENEFIT | |
02539446 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | JAMP AMOXI CLAV 80 MG / ML * 11.4 MG / ML ORAL SUSPENSION |
N/A ML |
JPC | N/A | N/A | YES | UNDER REVIEW | |
02530694 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | M-AMOXI CLAV 80 MG / ML * 11.4 MG / ML ORAL SUSPENSION |
0.2386 ML |
MTR | 0.2386 | N/A | YES | REGULAR BENEFIT | |
02536048 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | AMOXICILLIN/CLAV 875 MG * 125 MG ORAL TABLET |
N/A TAB |
SNS | N/A | N/A | YES | UNDER REVIEW | |
02245623 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | APO-AMOXI CLAV 875 MG * 125 MG ORAL TABLET |
0.5551 TAB |
APX | 0.5551 | N/A | YES | REGULAR BENEFIT | |
02471701 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | AURO-AMOXICLAV 875 MG * 125 MG ORAL TABLET |
0.5551 TAB |
AUR | 0.5551 | N/A | YES | REGULAR BENEFIT | |
02508265 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | JAMP AMOXI CLAV 875 MG * 125 MG ORAL TABLET |
0.5551 TAB |
JPC | 0.5551 | N/A | YES | REGULAR BENEFIT | |
02482584 | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM | SANDOZ AMOXI-CLAV 875 MG * 125 MG ORAL TABLET |
0.5551 TAB |
SDZ | 0.5551 | N/A | YES | REGULAR BENEFIT | |
00020877 | AMPICILLIN | NOVO-AMPICILLIN 250 MG ORAL CAPSULE |
0.4656 CAP |
TEV | N/A | N/A | NO | RESTRICTED BENEFIT/ SPECIAL AUTHORIZATION | |
00020885 | AMPICILLIN | NOVO-AMPICILLIN 500 MG ORAL CAPSULE |
0.8826 CAP |
TEV | N/A | N/A | NO | RESTRICTED BENEFIT/ SPECIAL AUTHORIZATION | |
02227002 | AMPICILLIN SODIUM | AMPICILLIN 1 G / VIAL INJECTION |
N/A VIAL |
FKC | N/A | N/A | NO | NOT A BENEFIT | |
01933345 | AMPICILLIN SODIUM | AMPICILLIN SODIUM 1 G / VIAL INJECTION |
5.5886 VIAL |
TEV | 0.0000 | 0.0000 | NO | REGULAR BENEFIT | |
02226995 | AMPICILLIN SODIUM | AMPICILLIN 2 G / VIAL INJECTION |
N/A VIAL |
FKC | N/A | N/A | NO | NOT A BENEFIT | |
01933353 | AMPICILLIN SODIUM | AMPICILLIN SODIUM 2 G / VIAL INJECTION |
11.1781 VIAL |
TEV | 0.0000 | 0.0000 | NO | REGULAR BENEFIT | |
02227029 | AMPICILLIN SODIUM | AMPICILLIN 250 MG / VIAL INJECTION |
N/A VIAL |
FKC | N/A | N/A | NO | NOT A BENEFIT | |
00872644 | AMPICILLIN SODIUM | AMPICILLIN SODIUM 250 MG / VIAL INJECTION |
3.1830 VIAL |
TEV | 0.0000 | 0.0000 | NO | REGULAR BENEFIT | |
02227010 | AMPICILLIN SODIUM | AMPICILLIN 500 MG / VIAL INJECTION |
N/A VIAL |
FKC | N/A | N/A | NO | NOT A BENEFIT | |
00872652 | AMPICILLIN SODIUM | AMPICILLIN SODIUM 500 MG / VIAL INJECTION |
3.3384 VIAL |
TEV | 0.0000 | 0.0000 | NO | REGULAR BENEFIT |
DIN/NPN/ PIN | 00628131 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | APO-AMOXI 25 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0247 |
Manufacturer | APX |
LCA Price | 0.0247 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02458586 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AURO-AMOXICILLIN 25 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | N/A |
Manufacturer | AUR |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | UNDER REVIEW |
Details |
DIN/NPN/ PIN | 02535793 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | JAMP-AMOXICILLIN 25 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0247 |
Manufacturer | JPC |
LCA Price | 0.0247 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02525348 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AMOXICILLIN BP 250 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.0672 |
Manufacturer | SNS |
LCA Price | 0.0672 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 00628115 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | APO-AMOXI 250 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.0672 |
Manufacturer | APX |
LCA Price | 0.0672 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02388073 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AURO-AMOXICILLIN 250 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.0672 |
Manufacturer | AUR |
LCA Price | 0.0672 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02433060 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | JAMP-AMOXICILLIN 250 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.0672 |
Manufacturer | JPC |
LCA Price | 0.0672 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 00406724 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | NOVAMOXIN 250 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.0672 |
Manufacturer | TEV |
LCA Price | 0.0672 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02036355 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | NOVAMOXIN 250 MG ORAL CHEWABLE TABLET |
Unit Price, Unit of Issue | 0.8282 |
Manufacturer | TEV |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02532042 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | PRZ-AMOXICILLIN 250 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.0672 |
Manufacturer | PCI |
LCA Price | 0.0672 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02352753 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AMOXICILLIN 50 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0540 |
Manufacturer | SNS |
LCA Price | 0.0540 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02401541 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AMOXICILLIN 50 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0540 |
Manufacturer | SIV |
LCA Price | 0.0540 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02352788 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AMOXICILLIN SUGAR-REDUCED 50 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0540 |
Manufacturer | SNS |
LCA Price | 0.0540 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 00628158 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | APO-AMOXI 50 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0540 |
Manufacturer | APX |
LCA Price | 0.0540 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02535815 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | JAMP-AMOXICILLIN 50 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0540 |
Manufacturer | JPC |
LCA Price | 0.0540 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 00452130 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | NOVAMOXIN 50 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0540 |
Manufacturer | TEV |
LCA Price | 0.0540 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 01934163 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | NOVAMOXIN SUGAR-REDUCED 50 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.0540 |
Manufacturer | TEV |
LCA Price | 0.0540 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02477726 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AG-AMOXICILLIN 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | AGP |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02401509 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AMOXICILLIN 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | SIV |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02525356 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AMOXICILLIN BP 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | SNS |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 00628123 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | APO-AMOXI 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | APX |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02388081 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | AURO-AMOXICILLIN 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | AUR |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02433079 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | JAMP-AMOXICILLIN 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | JPC |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 00406716 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | NOVAMOXIN 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | TEV |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02532050 |
Generic Name | AMOXICILLIN TRIHYDRATE |
Product Name, Strength & Dosage Form | PRZ-AMOXICILLIN 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.1308 |
Manufacturer | PCI |
LCA Price | 0.1308 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02243350 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | APO-AMOXI CLAV 250 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.2467 |
Manufacturer | APX |
LCA Price | 0.2467 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02471671 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | AURO-AMOXICLAV 250 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.2467 |
Manufacturer | AUR |
LCA Price | 0.2467 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02508249 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | JAMP AMOXI CLAV 250 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.2467 |
Manufacturer | JPC |
LCA Price | 0.2467 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02238831 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | CLAVULIN-200 40 MG / ML * 5.7 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.1652 |
Manufacturer | GSK |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02539411 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | JAMP AMOXI CLAV 40 MG / ML * 5.7 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | N/A |
Manufacturer | JPC |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | UNDER REVIEW |
Details |
DIN/NPN/ PIN | 02536021 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | AMOXICILLIN/CLAV 500 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | N/A |
Manufacturer | SNS |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | UNDER REVIEW |
Details |
DIN/NPN/ PIN | 02243351 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | APO-AMOXI CLAV 500 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.3778 |
Manufacturer | APX |
LCA Price | 0.3778 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02471698 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | AURO-AMOXICLAV 500 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.3778 |
Manufacturer | AUR |
LCA Price | 0.3778 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02508257 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | JAMP AMOXI CLAV 500 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.3778 |
Manufacturer | JPC |
LCA Price | 0.3778 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02482576 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | SANDOZ AMOXI-CLAV 500 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.3778 |
Manufacturer | SDZ |
LCA Price | 0.3778 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02238830 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | CLAVULIN-400 80 MG / ML * 11.4 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.3206 |
Manufacturer | GSK |
LCA Price | 0.2386 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02539446 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | JAMP AMOXI CLAV 80 MG / ML * 11.4 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | N/A |
Manufacturer | JPC |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | UNDER REVIEW |
Details |
DIN/NPN/ PIN | 02530694 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | M-AMOXI CLAV 80 MG / ML * 11.4 MG / ML ORAL SUSPENSION |
Unit Price, Unit of Issue | 0.2386 |
Manufacturer | MTR |
LCA Price | 0.2386 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02536048 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | AMOXICILLIN/CLAV 875 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | N/A |
Manufacturer | SNS |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | UNDER REVIEW |
Details |
DIN/NPN/ PIN | 02245623 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | APO-AMOXI CLAV 875 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.5551 |
Manufacturer | APX |
LCA Price | 0.5551 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02471701 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | AURO-AMOXICLAV 875 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.5551 |
Manufacturer | AUR |
LCA Price | 0.5551 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02508265 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | JAMP AMOXI CLAV 875 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.5551 |
Manufacturer | JPC |
LCA Price | 0.5551 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02482584 |
Generic Name | AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM |
Product Name, Strength & Dosage Form | SANDOZ AMOXI-CLAV 875 MG * 125 MG ORAL TABLET |
Unit Price, Unit of Issue | 0.5551 |
Manufacturer | SDZ |
LCA Price | 0.5551 |
MAC Price | N/A |
Interchangeable Products | YES |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 00020877 |
Generic Name | AMPICILLIN |
Product Name, Strength & Dosage Form | NOVO-AMPICILLIN 250 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.4656 |
Manufacturer | TEV |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | RESTRICTED BENEFIT/ SPECIAL AUTHORIZATION |
Details |
DIN/NPN/ PIN | 00020885 |
Generic Name | AMPICILLIN |
Product Name, Strength & Dosage Form | NOVO-AMPICILLIN 500 MG ORAL CAPSULE |
Unit Price, Unit of Issue | 0.8826 |
Manufacturer | TEV |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | RESTRICTED BENEFIT/ SPECIAL AUTHORIZATION |
Details |
DIN/NPN/ PIN | 02227002 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN 1 G / VIAL INJECTION |
Unit Price, Unit of Issue | N/A |
Manufacturer | FKC |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | NOT A BENEFIT |
Details |
DIN/NPN/ PIN | 01933345 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN SODIUM 1 G / VIAL INJECTION |
Unit Price, Unit of Issue | 5.5886 |
Manufacturer | TEV |
LCA Price | 0.0000 |
MAC Price | 0.0000 |
Interchangeable Products | NO |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02226995 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN 2 G / VIAL INJECTION |
Unit Price, Unit of Issue | N/A |
Manufacturer | FKC |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | NOT A BENEFIT |
Details |
DIN/NPN/ PIN | 01933353 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN SODIUM 2 G / VIAL INJECTION |
Unit Price, Unit of Issue | 11.1781 |
Manufacturer | TEV |
LCA Price | 0.0000 |
MAC Price | 0.0000 |
Interchangeable Products | NO |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02227029 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN 250 MG / VIAL INJECTION |
Unit Price, Unit of Issue | N/A |
Manufacturer | FKC |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | NOT A BENEFIT |
Details |
DIN/NPN/ PIN | 00872644 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN SODIUM 250 MG / VIAL INJECTION |
Unit Price, Unit of Issue | 3.1830 |
Manufacturer | TEV |
LCA Price | 0.0000 |
MAC Price | 0.0000 |
Interchangeable Products | NO |
Coverage Status | REGULAR BENEFIT |
Details |
DIN/NPN/ PIN | 02227010 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN 500 MG / VIAL INJECTION |
Unit Price, Unit of Issue | N/A |
Manufacturer | FKC |
LCA Price | N/A |
MAC Price | N/A |
Interchangeable Products | NO |
Coverage Status | NOT A BENEFIT |
Details |
DIN/NPN/ PIN | 00872652 |
Generic Name | AMPICILLIN SODIUM |
Product Name, Strength & Dosage Form | AMPICILLIN SODIUM 500 MG / VIAL INJECTION |
Unit Price, Unit of Issue | 3.3384 |
Manufacturer | TEV |
LCA Price | 0.0000 |
MAC Price | 0.0000 |
Interchangeable Products | NO |
Coverage Status | REGULAR BENEFIT |
Details |