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
00029149 AMPHOTERICIN B FUNGIZONE IV 50 MG / VIAL INJECTION 87.3238
VIAL
CAG N/A N/A NO REGULAR BENEFIT Details
02433443 NYSTATIN JAMP-NYSTATIN 100,000 UNIT / ML ORAL SUSPENSION 0.0518
ML
JPC 0.0518 N/A YES REGULAR BENEFIT Details
00792667 NYSTATIN PMS-NYSTATIN 100,000 UNIT / ML ORAL SUSPENSION 0.0518
ML
PMS 0.0518 N/A YES REGULAR BENEFIT Details
02194201 NYSTATIN TEVA-NYSTATIN 100,000 UNIT / ML ORAL SUSPENSION 0.0518
ML
TEV 0.0518 N/A YES REGULAR BENEFIT Details
DIN/NPN/ PIN 00029149
Generic Name AMPHOTERICIN B
Product Name, Strength & Dosage Form FUNGIZONE IV 50 MG / VIAL INJECTION
Unit Price, Unit of Issue 87.3238
Manufacturer CAG
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02433443
Generic Name NYSTATIN
Product Name, Strength & Dosage Form JAMP-NYSTATIN 100,000 UNIT / ML ORAL SUSPENSION
Unit Price, Unit of Issue 0.0518
Manufacturer JPC
LCA Price 0.0518
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00792667
Generic Name NYSTATIN
Product Name, Strength & Dosage Form PMS-NYSTATIN 100,000 UNIT / ML ORAL SUSPENSION
Unit Price, Unit of Issue 0.0518
Manufacturer PMS
LCA Price 0.0518
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02194201
Generic Name NYSTATIN
Product Name, Strength & Dosage Form TEVA-NYSTATIN 100,000 UNIT / ML ORAL SUSPENSION
Unit Price, Unit of Issue 0.0518
Manufacturer TEV
LCA Price 0.0518
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.