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
00628131 AMOXICILLIN TRIHYDRATE APO-AMOXI 25 MG / ML ORAL SUSPENSION 0.0352
ML
APX N/A N/A NO REGULAR BENEFIT Details
02352710 AMOXICILLIN TRIHYDRATE AMOXICILLIN 250 MG ORAL CAPSULE 0.0672
CAP
SNS 0.0672 N/A YES REGULAR BENEFIT Details
00628115 AMOXICILLIN TRIHYDRATE APO-AMOXI 250 MG ORAL CAPSULE 0.0672
CAP
APX 0.0672 N/A YES REGULAR BENEFIT Details
02388073 AMOXICILLIN TRIHYDRATE AURO-AMOXICILLIN 250 MG ORAL CAPSULE 0.0672
CAP
AUR 0.0672 N/A YES REGULAR BENEFIT Details
02433060 AMOXICILLIN TRIHYDRATE JAMP-AMOXICILLIN 250 MG ORAL CAPSULE 0.0672
CAP
JPC 0.0672 N/A YES REGULAR BENEFIT Details
00406724 AMOXICILLIN TRIHYDRATE NOVAMOXIN 250 MG ORAL CAPSULE 0.0672
CAP
TEV 0.0672 N/A YES REGULAR BENEFIT Details
02036355 AMOXICILLIN TRIHYDRATE NOVAMOXIN 250 MG ORAL CHEWABLE TABLET 0.7512
TAB
TEV N/A N/A NO REGULAR BENEFIT Details
02352753 AMOXICILLIN TRIHYDRATE AMOXICILLIN 50 MG / ML ORAL SUSPENSION 0.0540
ML
SNS 0.0540 N/A YES REGULAR BENEFIT Details
02401541 AMOXICILLIN TRIHYDRATE AMOXICILLIN 50 MG / ML ORAL SUSPENSION 0.0540
ML
SIV 0.0540 N/A YES REGULAR BENEFIT Details
02352788 AMOXICILLIN TRIHYDRATE AMOXICILLIN SUGAR-REDUCED 50 MG / ML ORAL SUSPENSION 0.0540
ML
SNS 0.0540 N/A YES REGULAR BENEFIT Details
00628158 AMOXICILLIN TRIHYDRATE APO-AMOXI 50 MG / ML ORAL SUSPENSION 0.0540
ML
APX 0.0540 N/A YES REGULAR BENEFIT Details
00452130 AMOXICILLIN TRIHYDRATE NOVAMOXIN 50 MG / ML ORAL SUSPENSION 0.0540
ML
TEV 0.0540 N/A YES REGULAR BENEFIT Details
01934163 AMOXICILLIN TRIHYDRATE NOVAMOXIN SUGAR-REDUCED 50 MG / ML ORAL SUSPENSION 0.0540
ML
TEV 0.0540 N/A YES REGULAR BENEFIT Details
02352729 AMOXICILLIN TRIHYDRATE AMOXICILLIN 500 MG ORAL CAPSULE 0.1308
CAP
SNS 0.1308 N/A YES REGULAR BENEFIT Details
02401509 AMOXICILLIN TRIHYDRATE AMOXICILLIN 500 MG ORAL CAPSULE 0.1308
CAP
SIV 0.1308 N/A YES REGULAR BENEFIT Details
00628123 AMOXICILLIN TRIHYDRATE APO-AMOXI 500 MG ORAL CAPSULE 0.1308
CAP
APX 0.1308 N/A YES REGULAR BENEFIT Details
02388081 AMOXICILLIN TRIHYDRATE AURO-AMOXICILLIN 500 MG ORAL CAPSULE 0.1308
CAP
AUR 0.1308 N/A YES REGULAR BENEFIT Details
02433079 AMOXICILLIN TRIHYDRATE JAMP-AMOXICILLIN 500 MG ORAL CAPSULE 0.1308
CAP
JPC 0.1308 N/A YES REGULAR BENEFIT Details
00406716 AMOXICILLIN TRIHYDRATE NOVAMOXIN 500 MG ORAL CAPSULE 0.1308
CAP
TEV 0.1308 N/A YES REGULAR BENEFIT Details
01916882 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM CLAVULIN-125F 25 MG / ML * 6.25 MG / ML ORAL SUSPENSION 0.0969
ML
GSK N/A N/A NO REGULAR BENEFIT Details
02243350 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM APO-AMOXI CLAV 250 MG * 125 MG ORAL TABLET 0.9375
TAB
APX N/A N/A NO REGULAR BENEFIT Details
02238831 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM CLAVULIN-200 40 MG / ML * 5.7 MG / ML ORAL SUSPENSION 0.1498
ML
GSK N/A N/A NO REGULAR BENEFIT Details
01916874 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM CLAVULIN-250F 50 MG / ML * 12.5 MG / ML ORAL SUSPENSION 0.2039
ML
GSK N/A N/A NO REGULAR BENEFIT Details
02243351 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM APO-AMOXI CLAV 500 MG * 125 MG ORAL TABLET 0.7555
TAB
APX 0.7555 N/A YES REGULAR BENEFIT Details
01916858 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM CLAVULIN-500F 500 MG * 125 MG ORAL TABLET 1.5420
TAB
GSK 0.7555 N/A YES REGULAR BENEFIT Details
02482576 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM SANDOZ AMOXI-CLAV 500 MG * 125 MG ORAL TABLET 0.7555
TAB
SDZ 0.7555 N/A YES REGULAR BENEFIT Details
02238830 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM CLAVULIN-400 80 MG / ML * 11.4 MG / ML ORAL SUSPENSION 0.2869
ML
GSK N/A N/A NO REGULAR BENEFIT Details
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 Details
02238829 AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM CLAVULIN-875 875 MG * 125 MG ORAL TABLET 2.2735
TAB
GSK 0.5551 N/A YES REGULAR BENEFIT Details
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 Details
00020877 AMPICILLIN NOVO-AMPICILLIN 250 MG ORAL CAPSULE 0.4223
CAP
TEV N/A N/A NO RESTRICTED BENEFIT/ SPECIAL AUTHORIZATION Details
00020885 AMPICILLIN NOVO-AMPICILLIN 500 MG ORAL CAPSULE 0.8006
CAP
TEV N/A N/A NO RESTRICTED BENEFIT/ SPECIAL AUTHORIZATION Details
02227002 AMPICILLIN SODIUM AMPICILLIN 1 G / VIAL INJECTION N/A
VIAL
FKC N/A N/A NO NOT A BENEFIT Details
01933345 AMPICILLIN SODIUM AMPICILLIN SODIUM 1 G / VIAL INJECTION 5.5886
VIAL
TEV N/A N/A NO REGULAR BENEFIT Details
02226995 AMPICILLIN SODIUM AMPICILLIN 2 G / VIAL INJECTION N/A
VIAL
FKC N/A N/A NO NOT A BENEFIT Details
01933353 AMPICILLIN SODIUM AMPICILLIN SODIUM 2 G / VIAL INJECTION 11.1781
VIAL
TEV N/A N/A NO REGULAR BENEFIT Details
02227029 AMPICILLIN SODIUM AMPICILLIN 250 MG / VIAL INJECTION N/A
VIAL
FKC N/A N/A NO NOT A BENEFIT Details
00872644 AMPICILLIN SODIUM AMPICILLIN SODIUM 250 MG / VIAL INJECTION 3.1830
VIAL
TEV N/A N/A NO REGULAR BENEFIT Details
02227010 AMPICILLIN SODIUM AMPICILLIN 500 MG / VIAL INJECTION N/A
VIAL
FKC N/A N/A NO NOT A BENEFIT Details
00872652 AMPICILLIN SODIUM AMPICILLIN SODIUM 500 MG / VIAL INJECTION 3.3384
VIAL
TEV N/A N/A NO REGULAR BENEFIT Details
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 0.0352
Manufacturer APX
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02352710
Generic Name AMOXICILLIN TRIHYDRATE
Product Name, Strength & Dosage Form AMOXICILLIN 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 0.7512
Manufacturer TEV
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
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 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 02352729
Generic Name AMOXICILLIN TRIHYDRATE
Product Name, Strength & Dosage Form AMOXICILLIN 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 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 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 01916882
Generic Name AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM
Product Name, Strength & Dosage Form CLAVULIN-125F 25 MG / ML * 6.25 MG / ML ORAL SUSPENSION
Unit Price, Unit of Issue 0.0969
Manufacturer GSK
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
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 0.9375
Manufacturer APX
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
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 0.1498
Manufacturer GSK
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 01916874
Generic Name AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM
Product Name, Strength & Dosage Form CLAVULIN-250F 50 MG / ML * 12.5 MG / ML ORAL SUSPENSION
Unit Price, Unit of Issue 0.2039
Manufacturer GSK
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
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 0.7555
Manufacturer APX
LCA Price 0.7555
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 01916858
Generic Name AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM
Product Name, Strength & Dosage Form CLAVULIN-500F 500 MG * 125 MG ORAL TABLET
Unit Price, Unit of Issue 1.5420
Manufacturer GSK
LCA Price 0.7555
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 0.7555
Manufacturer SDZ
LCA Price 0.7555
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 0.2869
Manufacturer GSK
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
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 02238829
Generic Name AMOXICILLIN TRIHYDRATE/ CLAVULANATE POTASSIUM
Product Name, Strength & Dosage Form CLAVULIN-875 875 MG * 125 MG ORAL TABLET
Unit Price, Unit of Issue 2.2735
Manufacturer GSK
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 0.4223
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 0.8006
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 N/A
MAC Price N/A
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 N/A
MAC Price N/A
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 N/A
MAC Price N/A
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 N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
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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.