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 · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand,...

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Effective January 2018 2018 Drug Formulary HIOS ISSUER ID: 25768 and 80473 For members with individual and family plans or covered through small employer groups (1–50 employees) Core Access PPO
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Page 1:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

Effective January 2018

2018 Drug Formulary

HIOS ISSUER ID: 25768 and 80473

For members with individual and family plans

or covered through small employer groups (1–50 employees)

Core

Access PPO

Page 2:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

Drug Formulary INTRODUCTION

What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the best overall value, considering effectiveness, safety, and cost.

How is the drug formulary developed? The formulary is developed by the Kaiser Permanente Pharmacy and Therapeutics (P&T) Committee. The P&T Committee is composed of physicians from various medical specialties, pharmacists, and a consumer member. The P&T Committee reviews and selects the most appropriate drugs in each class for the formulary based on safety, effectiveness, and cost. The P&T Committee meets quarterly to review new and existing drugs to ensure that the formulary remains responsive to the needs of members and providers.

How do I search the formulary? Drugs on the formulary are listed by therapeutic class. An alphabetical index is included at the end of this document to assist in locating specific drugs. Drugs are listed by generic name if a generic is available. If there is no generic available, drugs are listed by the brand name. Drugs are organized by class and drug formulary tier. Drugs administered in a provider’s office or in a clinic (e.g., drugs given intravenously) may not be listed on the formulary. For coverage of these drugs, refer to your Benefit Booklet.

How do I use the formulary to understand my drug coverage? Drug coverage is based on an individual’s contracted benefit. Coverage for a specific drug is subject to each member’s medical coverage agreement. Please consult your Benefit Booklet or call Member Service if you have questions about your drug coverage. Kaiser Permanente will only cover FDA-approved drugs used for non-experimental therapies. Most plans exclude experimental and investigational drugs, over-the-counter drugs, drugs used in the treatment of sexual dysfunction disorders, drugs for anticipated illnesses while traveling, or drugs used for cosmetic purposes. Please consult your Benefit Booklet for limitations and exclusions.

Medications not listed in this document are not on the formulary at the time of publication. The most current information is online at www.kp.org/wa/formulary. Non-formulary drugs are not covered unless approved by the health plan as a coverage exception. The prescriber must contact Kaiser Permanente to determine the medical necessity of the non-formulary medication. An alternative formulary medication will be recommended when clinically appropriate. If a coverage exception is not approved, the patient is responsible for the full price of the drug.

Generic drugs are substituted when available and allowed by your prescriber. When a generic is available, the brand-name drug is generally considered non-formulary and subject to a higher cost share.

Page 3:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

The drug formulary is updated periodically and is subject to change. If a drug will be removed from the formulary, members who filled the drug in the prior three months will be notified by letter of the upcoming change. A formulary change notice will also be posted on the member website at least 45 days prior to the effective date.

Drug Formulary Tiers

Tier Description Tier P Preventative drugs and preferred contraceptives:

The Affordable Care Act (ACA) requires that preventative drugs recommended by the U.S. Preventative Services Task Force (USPSTF) are covered in full.

Tier 1 Preferred generic: Generic drugs are copies of brand name drugs in safety, effectiveness, and quality. They contain the same exact quantities of the same active ingredients and are more affordable than the brand name drug.

Tier 2 Preferred brand: Preferred brand drugs do not have a generic alternative, but were determined by the P&T Committee to have high value in their therapeutic class.

Tier 3 Non-preferred: Non-preferred drugs were determined by the P&T Committee to have higher value alternatives in preferred tiers.

Tier 4 Specialty: Specialty drugs are high-cost drugs prescribed by a physician for the treatment of complex conditions. Some specialty products are dispensed from a preferred specialty pharmacy vendor.

Tier C Oral chemotherapy: Washington State law requires that cancer drugs be covered at a comparable level when received at a doctor’s office or picked up from the pharmacy. This tier was created to ensure comparable coverage of preferred anti-cancer drugs regardless where the drug was received.

Tier M Medical benefit: These drugs are usually given at the provider’s office and are covered under the medical benefit.

What are the methods that Kaiser Permanente uses to ensure appropriate and safe use of formulary drugs?

Prior Authorization (PA) The P&T Committee determines that certain drugs should require prior authorization before they will be covered. These drugs most often have alternatives on the formulary, safety concerns, or a high potential for inappropriate use. To request coverage for prior authorization drugs, you or your prescriber must contact Kaiser Permanente. Drugs requiring prior authorization are indicated with a “PA” superscript next to the drug name.

Step Therapy (ST)

Page 4:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

Step therapy requires you to try certain preferred drugs before receiving coverage for the drug you were prescribed. Step therapy is added by the P&T Committee. Step therapy automatically looks at your prescription history when you fill the drug you were prescribed. If you have tried the preferred drugs required by step therapy, the drug you were prescribed will automatically be covered. To request step therapy exceptions, you or your prescriber must contact Kaiser Permanente. Drugs requiring step therapy are indicated with a “ST” superscript next to the drug name.

Quantity Limit (QL) A quantity limit defines how much of a particular drug you can get during a specific time period or the maximum days supply that you can get at once. The P&T Committee determines if a drug should have a quantity limit. To request exceptions to quantity limits, your prescriber must contact Kaiser Permanente. Drugs with quantity limits are indicated with “QL” superscript next to the drug name.

Drugs Limited to Select Pharmacies Some drugs are required to be dispensed from a preferred specialty pharmacy vendor. Members with an out-of-network benefit may use other pharmacies; however, they may pay a higher cost share. Please consult your Benefit Booklet for limitations and exclusions. Drugs limited to select pharmacies are listed on the www.kp.org/wa/formulary webpage.

Covered Diabetic Supplies Some diabetic supplies may be covered at a Tier 1 cost share if they are filled as a prescription. These items are:

• Preferred blood glucose strips: o One Touch Verio o One Touch Ultra o Prodigy – prior authorization required o Contour Next – prior authorization required o Freestyle – prior authorization required

• Disposable insulin syringes and needles • Lancing devices and lancets

Preferred blood glucose meters are covered only when filled through mail order pharmacy.

Mail Order Pharmacy Service Mail order is convenient and efficiently utilizes Kaiser Permanente’s resources. This service works best for drugs that must be taken on regular basis, such as birth control pills and drugs for high blood pressure, high cholesterol, or other chronic conditions. To begin using mail order, ask your prescriber to send your prescription directly to the Mail Order Pharmacy. To transfer an existing prescription from a retail pharmacy, contact the Mail Order Pharmacy.

Address: Kaiser Permanente Mail Order Pharmacy PO Box 34383 Seattle, WA 98124-1383

Page 5:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

Phone: 800-245-RXRX (1-800-245-7979)

Fax: 206-630-7950, or toll-free 1-800-350-1683

Preventative Medications and Preferred Contraceptives In accordance with the Affordable Care Act (ACA) requirements for preventive services, most plans cover preventative care medicines and contraceptives in full. If your plan offers ACA benefits, all prescribed FDA approved contraceptive methods from the Kaiser Permanente formulary list will be covered in full when obtained in-network. For plans with out-of-network (OON) benefits, contraceptives will be subject to the OON cost-share. The list of the preventative medications covered in full is available on the www.kp.org/wa/formulary webpage.

Please consult your Benefit Booklet under “Preventive Services” or call Member Service if you have questions about your coverage for these drugs.

If you request coverage for a non-preferred contraceptive, we will contact your provider to recommend a preferred generic or therapeutically equivalent product. If you and your provider determine that the preferred contraceptive(s) would be medically inappropriate, your provider must request a contraceptive waiver. If waiver is completed, the requested non-preferred contraceptive will be covered in full.

Excluded Prescription Products for Medications that have Over-The-Counter (OTC) Alternatives There are certain prescription products that have the same or similar products available over-the- counter (OTC) without a prescription. In certain cases, Kaiser Permanente will not cover the prescription product. The following prescription drug products are excluded from coverage: esomeprazole magnesium (Nexium) and omeprazole/sodium bicarbonate (Zegerid). Medical Benefit Injectable Drugs Some drugs are given in a non-hospital setting such as home infusion, a medical office, a physician's office, or an infusion suite. These drugs are covered under the medical benefit but may require prior authorization or a non-hospital setting. The list of medical benefit injectable drugs is available on the www.kp.org/wa/formulary webpage.

How do I get additional information? Please contact Member Service at 1-888-630-4636 with any questions or concerns regarding the information contained in this document.

The most current drug formulary is available at www.kp.org/wa/formulary.

Page 6:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

Table of Contents

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

SULFONAMIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANTINEOPLASTICS, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTIBODIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANTINEOPLASTIC COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Page 7:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

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BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

PROGESTERONE ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

HEMATOLOGICAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

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ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

OPIOID ANTAGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

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RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

MEDICAL DEVICES - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

MISCELLANEOUS AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Page 11:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

cefazolin inj 1gm

cephalexin sus 125/5ML

cephalexin sus 250/5ML

cephalexin CAP 250MG

January 2018

cephalexin CAP 500MG

TIER 03 NON PREFERRED

ANTI-INFECTIVES

cephalexin CAP 750MG

Cephalexin TAB 250MG

PENICILLINS

Cephalexin TAB 500MG

TIER 01 GENERIC

Daxbia CAP 333MG

amox/k clav sus 200/5ML

Keflex CAP 250MG

amox/k clav sus 250/5ML

Keflex CAP 500MG

amox/k clav sus 400/5ML

Keflex CAP 750MG

amox/k clav sus 600/5ML

SECOND GENERATION

amox/k clav TAB 250-125

TIER 01 GENERIC

amox/k clav TAB 500-125

cefprozil sus 125/5ML

amox/k clav TAB 875-125

cefprozil sus 250/5ML

amoxicillin sus 125/5ML

cefprozil TAB 250MG

amoxicillin sus 200/5ML

cefprozil TAB 500MG

amoxicillin sus 250/5ML

cefuroxime TAB 250MG

amoxicillin sus 250MG/5m

cefuroxime TAB 500MG

amoxicillin sus 400/5ML

TIER 02 PREFERRED

amoxicillin CAP 250MG

Ceftin Sus 125/5ML

amoxicillin CAP 500MG

Ceftin Sus 250/5ML

amoxicillin TAB 500MG

TIER 03 NON PREFERRED

amoxicillin TAB 875MG

cefaclor CAP 250MG

ampicillin inj 1gm

cefaclor CAP 500MG

ampicillin inj 250MG

Cefaclor ER TAB 500MG

ampicillin inj 500MG

Cefaclor Sus 125/5ML

ampicillin CAP 250MG

Cefaclor Sus 250/5ML

ampicillin CAP 500MG

Cefaclor Sus 375/5ML

dicloxacill CAP 250MG

Ceftin TAB 250MG

dicloxacill CAP 500MG

Ceftin TAB 500MG

penicilln vk sol 125/5ML

THIRD GENERATION

penicilln vk sol 250/5ML

TIER 01 GENERIC

penicilln vk TAB 250MG

cefdinir sus 125/5ML

penicilln vk TAB 500MG

cefdinir sus 250/5ML

Amox/K Clav Chw 200MG

cefdinir CAP 300MG

Amox/K Clav Chw 400MG

cefixime sus 100/5ML

Amoxicillin Chw 125MG

cefixime sus 200/5ML

Amoxicillin Chw 250MG

ceftazidime inj 1gm

Ampicillin CAP 500MG

ceftriaxone inj 1gm

Ampicillin Inj 125MG

ceftriaxone inj 2gm

Ampicillin Sus 125/5ML

ceftriaxone inj 250MG

Ampicillin Sus 250/5ML

ceftriaxone inj 500MG

Penicilln Vk Sol 125/5ML

tazicef inj 1gm

Penicilln Vk Sol 250/5ML

TIER 02 PREFERRED

TIER 02 PREFERRED

Suprax CAP 400MG

Bicillin L-a Inj 1200000

Suprax Sus 500/5ML

Bicillin L-a Inj 2400000

TIER 03 NON PREFERRED

Bicillin L-a Inj 600000

cefpodo prox sus 100/5ML

TIER 03 NON PREFERRED

cefpodo prox sus 50MG/5ML

amox-pot cla TAB ER

cefpodoxime TAB 100MG

Amoxicillin TAB 775MG

cefpodoxime TAB 200MG

Augmentin Sus ES-600

Cedax CAP 400MG

Augmentin Sus 125/5ML

Cedax Sus 180/5ML

Augmentin Sus 250/5ML

Cefditoren TAB 200MG

Augmentin TAB 500MG

Cefditoren TAB 400MG

Augmentin TAB 875MG

Ceftibuten CAP 400MG

Augmentin XR TAB 12HR

Ceftibuten Sus 180/5ML

Moxatag TAB 775MG

Fortaz Inj 1gm

Spectracef TAB 400MG

CEPHALOSPORIN

Suprax Chw 100MG

FIRST GENERATION

Suprax Chw 200MG

TIER 01 GENERIC

Suprax Sus 100/5ML

cefadroxil sus 250/5ML

Suprax Sus 200/5ML

cefadroxil sus 500/5ML

FOURTH GENERATION

cefadroxil CAP 500MG

TIER 03 NON PREFERRED

cefadroxil TAB 1gm

cefepime inj 1gm

Maxipime Inj 1gm

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 1

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doxycycl HYC TAB 100MG

MACROLIDES

doxycycl HYC TAB 100MG DR

doxycycl HYC TAB 150MG DR

TIER 01 GENERIC

doxycycl HYC TAB 200MG DR

azithromycin sus 100/5ML

doxycycl HYC TAB 50MG DR

azithromycin sus 200/5ML

doxycycl HYC TAB 75MG DR

azithromycin TAB 250MG

doxycycline sus 25MG/5ML

azithromycin TAB 500MG

doxycycline TAB 150MG

azithromycin TAB 600MG

doxycycline TAB 75MG

clarithromyc sus 125/5ML

minocycline TAB 100MG

clarithromyc sus 250/5ML

minocycline TAB 135MG ERPA

clarithromyc TAB 250MG

minocycline TAB 45MG ERPA

clarithromyc TAB 500MG

minocycline TAB 50MG

Azithromycin Pow 1gm PAK

minocycline TAB 75MG

Clarithromyc Sus 125/5ML

minocycline TAB 90MG ERPA

Clarithromyc Sus 250/5ML

morgidox CAP 1X100MG

TIER 04 SPECIALTY

morgidox CAP 1X50MG

Dificid TAB 200MGQL,PA

morgidox CAP 2X100MG

TIER 03 NON PREFERRED

tetracycline CAP 250MG

clarithromyc TAB 500MG ER

tetracycline CAP 500MG

erythrom ETH sus 200/5ML

Acticlate TAB 150MG

erythromycin CAP 250MG EC

Acticlate TAB 75MG

Biaxin Sus 250/5ML

Adoxa CAP 150MG

Biaxin TAB 250MG

Adoxa PAK 1/ TAB 100MG

Biaxin TAB 500MG

Adoxa PAK 1/ TAB 150MG

E.e.s. Gran Sus 200/5ML

Adoxa PAK 2/ TAB 100MG

E.e.s. 400 TAB 400MG

Adoxa TAB 100MG

Ery-TAB Tab 250MG EC

Adoxa TAB 50MG

Ery-TAB Tab 333MG EC

Adoxa TAB 75MG

Ery-TAB Tab 500MG EC

Doryx Mpc TAB 120MG

Eryped Sus 200/5ML

Doryx TAB 200MG

Eryped Sus 400/5ML

Doryx TAB 50MG

Erythrocin TAB 250MG

Minocin CAP 100MG

Erythrom ETH TAB 400MG

Minocin CAP 50MG

Erythromycin TAB 250MG Bs

Minocin CAP 75MG

Erythromycin TAB 500MG Bs

Minocycline TAB 45MG ERPA

PCE TAB 333MG EC

Monodox CAP 100MG

PCE TAB 500MG EC

Monodox CAP 75MG

Zithromax Pow 1gm PAK

Solodyn TAB 105MGPA

Zithromax Sus 100/5ML

Solodyn TAB 115MGPA

Zithromax Sus 200/5ML

Solodyn TAB 55MGPA

Zithromax TAB Tri-PAK

Solodyn TAB 65MGPA

Zithromax TAB Z-PAK

Solodyn TAB 80MGPA

Zithromax TAB 250MG

Targadox TAB 50MG

Zithromax TAB 500MG

Tetracycline CAP 250MG

Zithromax TAB 600MG

Tetracycline CAP 500MG

Zmax Sus 2gm

Vibramycin CAP 100MG

Vibramycin Sus 25MG/5ML

TETRACYCLINES

Vibramycin Syp 50MG/5ML

TIER 01 GENERIC

avidoxy TAB 100MG

QUINOLONES

doxycyc mono CAP 100MG

TIER 01 GENERIC

doxycyc mono CAP 150MG

ciprofloxacn sus 250MG/5

doxycyc mono CAP 50MG

ciprofloxacn sus 500MG/5

doxycyc mono CAP 75MG

ciprofloxacn TAB 250MG

doxycyc mono TAB 100MG

ciprofloxacn TAB 500MG

doxycyc mono TAB 150MG

ciprofloxacn TAB 750MG

doxycyc mono TAB 50MG

levofloxacin sol 25MG/ML

doxycyc mono TAB 75MG

levofloxacin TAB 250MG

minocycline CAP 100MG

levofloxacin TAB 500MG

minocycline CAP 50MG

levofloxacin TAB 750MG

minocycline CAP 75MG

moxifloxacin TAB 400MG

mondoxyne nl CAP 100MG

Ciprofloxacn TAB 100MG

mondoxyne nl CAP 50MG

Levofloxacin Sol 25MG/ML

mondoxyne nl CAP 75MG

TIER 04 SPECIALTY

TIER 03 NON PREFERRED

Baxdela TAB 450MGQL,PA

demeclocycl TAB 150MG

TIER 03 NON PREFERRED

demeclocycl TAB 300MG

ciprofloxacn TAB 1000MG

doxycycl HYC CAP 100MG

ciprofloxacn TAB 500MG ER

doxycycl HYC CAP 50MG

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 2

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ofloxacin TAB 400MG

griseofulvin sus 125/5ML

Avelox Abc TAB 400MG

griseofulvin TAB micr 500

Avelox TAB 400MG

griseofulvin TAB ultr 125

Cipro (10%) Sus 500MG/5

griseofulvin TAB ultr 250

Cipro (5%) Sus 250MG/5

itraconazole CAP 100MGPA

Cipro TAB 250MG

ketoconazole TAB 200MG

Cipro TAB 500MG

nystatin TAB 500000

Cipro XR TAB 1000MG

terbinafine TAB 250MG

Cipro XR TAB 500MG

voriconazole sus 40MG/MLQL,PA

Factive TAB 320MG

voriconazole TAB 200MGQL,PA

Levaquin TAB 250MG

voriconazole TAB 50MGQL,PA

Levaquin TAB 500MG

Amphotericin Inj 50MG

Levaquin TAB 750MG

TIER 02 PREFERRED

Ofloxacin TAB 300MG

Sporanox Sol 10MG/MLPA

TIER 04 SPECIALTY

AMINOGLYCOSIDES

flucytosine CAP 250MGQL

flucytosine CAP 500MGQL

TIER 01 GENERIC

Ancobon CAP 250MGQL,PA

gentamicin inj 40MG/ML

Ancobon CAP 500MGQL,PA

neomycin TAB 500MG

Cresemba CAP 186 MGQL,PA

TIER 04 SPECIALTY

Noxafil Sus 40MG/MLQL,PA

tobramycin neb 300/5MLQL,PA

Noxafil TAB 100MGQL,PA

Bethkis Neb 300/4MLQL,PA

Vfend Sus 40MG/MLQL,PA

Kitabis PAK Neb 300/5MLQL,PA

Vfend TAB 200MGQL,PA

Tobi Neb 300/5MLQL,PA

Vfend TAB 50MGQL,PA

Tobi Podhalr CAP 28MGQL,PA

TIER 03 NON PREFERRED

Tobramycin Neb 300/5MLQL,PA

bio-statin pow

TIER 03 NON PREFERRED

nystatin pow

paromomycin CAP 250MG

Bio-statin CAP 1000000

Streptomycin Inj 1gm

Bio-statin CAP 500000

Diflucan Sus 10MG/ML

SULFONAMIDES

Diflucan Sus 40MG/ML

TIER 03 NON PREFERRED

Diflucan TAB 100MG

Sulfadiazine TAB 500MG

Diflucan TAB 150MG

Diflucan TAB 200MG

ANTIMYCOBACTERIAL AGENTS

Diflucan TAB 50MG

TIER 01 GENERIC

Grifulvin V TAB 500MG

ethambutol TAB 100MG

Gris-peg TAB 125MG

ethambutol TAB 400MG

Gris-peg TAB 250MG

isoniazid TAB 100MG

Lamisil Gra 125MG

isoniazid TAB 300MG

Lamisil Gra 187.5MG

pyrazinamide TAB 500MG

Lamisil TAB 250MG

rifabutin CAP 150MG

Onmel TAB 200MGPA

rifampin CAP 150MG

Sporanox CAP PulsepakPA

rifampin CAP 300MG

Sporanox CAP 100MGPA

Isoniazid Syp 50MG/5ML

TIER 02 PREFERRED

ANTIVIRALS

Priftin TAB 150MGPA

TIER 01 GENERIC

TIER 04 SPECIALTY

abacavir sol 20MG/ML

Sirturo TAB 100MGQL,PA

abacavir TAB 300MG

TIER 03 NON PREFERRED

acyclovir sus 200/5ML

Cycloserine CAP 250MG

acyclovir CAP 200MG

Myambutol TAB 100MG

acyclovir TAB 400MG

Myambutol TAB 400MG

acyclovir TAB 800MG

Mycobutin CAP 150MG

didanosine CAP 125MG

Paser Gra 4gm

didanosine CAP 200MG

Rifadin CAP 150MG

didanosine CAP 250MG

Rifadin CAP 300MG

didanosine CAP 400MG

Rifamate CAP

entecavir TAB 0.5MGQL

Rifater TAB

entecavir TAB 1MGQL

Trecator TAB 250MG

lamivud/zido TAB 150-300

lamivudine sol 10MG/ML

ANTIFUNGALS

lamivudine TAB 100MG

TIER 01 GENERIC

lamivudine TAB 150MG

fluconazole sus 10MG/ML

lamivudine TAB 300MG

fluconazole sus 40MG/ML

lopin/riton sol 80-20/ML

fluconazole TAB 100MG

moderiba TAB 200MGQL

fluconazole TAB 150MG

nevirapine TAB 100MG

fluconazole TAB 200MG

nevirapine TAB 200MG

fluconazole TAB 50MG

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 3

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nevirapine TAB 400MG ER

abacav/lamiv TAB /zidovudQL

oseltamivir CAP 30MG

adefov dipiv TAB 10MGQL

oseltamivir CAP 45MG

fosamprenavi TAB 700MGQL

oseltamivir CAP 75MG

valganciclov sol 50MG/MLQL,PA

ribasphere CAP 200MGQL

valganciclov TAB 450MGQL

ribasphere TAB 200MGQL

Aptivus CAP 250MGQL

ribavirin CAP 200MGQL

Aptivus SolQL,PA

ribavirin TAB 200MGQL

Atripla TABQL

rimantadine TAB 100MG

Baraclude Sol .05MG/MLQL

stavudine sol 1MG/ML

Baraclude TAB 0.5MGQL,PA

stavudine CAP 15MG

Baraclude TAB 1MGQL,PA

stavudine CAP 20MG

Complera TABQL,ST

stavudine CAP 30MG

Daklinza TAB 30MGQL,PA

stavudine CAP 40MG

Daklinza TAB 60MGQL,PA

valacyclovir TAB 1gm

Daklinza TAB 90MGQL,PA

valacyclovir TAB 500MG

Descovy TAB 200/25QL

zidovudine syp 50MG/5ML

Epclusa TAB 400-100QL,PA

zidovudine CAP 100MG

Epzicom TAB 600-300QL,PA

zidovudine TAB 300MG

Evotaz TAB 300-150QL

Nevirapine Sus 50MG/5ML

Fuzeon Inj 90MGQL,PA

TIER 02 PREFERRED

Genvoya TABQL

Crixivan CAP 200MG

Harvoni TAB 90-400MGQL,PA

Crixivan CAP 400MG

Hepsera TAB 10MGQL,PA

Edurant TAB 25MG

Lexiva Sus 50MG/MLQL

Emtriva CAP 200MG

Lexiva TAB 700MGQL

Emtriva Sol 10MG/ML

Mavyret TAB 100-40MGQL,PA

Epivir HBV Sol 5MG/MLQL

Odefsey TABQL

Intelence TAB 100MG

Olysio CAP 150MGQL,PA

Intelence TAB 200MG

Peg-intron Kit 120 RpQL

Intelence TAB 25MG

Peg-intron Kit 120mcgQL

Invirase CAP 200MG

Peg-intron Kit 150 RpQL

Invirase TAB 500MG

Peg-intron Kit 150mcgQL

Isentress Chw 100MG

Peg-intron Kit 50mcgQL

Isentress Chw 25MG

Peg-intron Kit 50mcg RpQL

Isentress HD TAB 600MG

Peg-intron Kit 80mcg RpQL

Isentress TAB 400MG

Pegasys InjQL

Kaletra TAB 100-25MG

Pegasys Inj ProclickQL

Kaletra TAB 200-50MG

Pegasys Inj 180mcg/MQL

Norvir CAP 100MG

Pegintron Kit 120mcgQL

Norvir Sol 80MG/ML

Pegintron Kit 150mcgQL

Norvir TAB 100MG

Pegintron Kit 50mcgQL

Prezista Sus 100MG/ML

Pegintron Kit 80mcgQL

Prezista TAB 150MG

Prezcobix TAB 800-150QL,PA

Prezista TAB 600MG

Reyataz CAP 150MGQL

Prezista TAB 75MG

Reyataz CAP 200MGQL

Prezista TAB 800MG

Reyataz CAP 300MGQL

Rebetol Sol 40MG/MLQL

Selzentry Sol 20MG/MLQL

Relenza Mis Diskhale

Selzentry TAB 150MGQL

Rescriptor TAB 100 MG

Selzentry TAB 25MGQL

Rescriptor TAB 200MG

Selzentry TAB 300MGQL

Sustiva CAP 200MG

Selzentry TAB 75MGQL

Sustiva CAP 50MG

Sovaldi TAB 400MGQL,PA

Sustiva TAB 600MG

Stribild TABQL,ST

Tamiflu Sus 6MG/ML

Technivie TABQL,PA

Tivicay TAB 10MG

Triumeq TABQL

Tivicay TAB 25MG

Trizivir TABQL,PA

Tivicay TAB 50MG

Truvada TAB 100-150QL

Tybost TAB 150MGPA

Truvada TAB 133-200QL

Videx Sol 2gm

Truvada TAB 167-250QL

Videx Sol 4gm

Truvada TAB 200-300QL

Viracept TAB 250MG

Tyzeka TAB 600MGQL,PA

Viracept TAB 625MG

Valcyte Sol 50MG/MLQL,PA

Viread Pow 40MG/GmQL

Valcyte TAB 450MGQL,PA

Viread TAB 150MGQL

Vemlidy TAB 25MGQL,PA

Viread TAB 200MGQL

Victrelis CAP 200MGQL,PA

Viread TAB 250MGQL

Viekira PAK TABQL,PA

Viread TAB 300MGQL

Viekira XR TABQL,PA

Ziagen Sol 20MG/ML

Vitekta TAB 150MGQL,PA

TIER 04 SPECIALTY

Vitekta TAB 85MGQL,PA

abaca/lamivu TAB 600-300QL

Vosevi TABQL,PA

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 4

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Zepatier TAB 50-100MGQL,PA

SPECIALTY

TIER 03 NON PREFERRED

Daraprim TAB 25MGQL

famciclovir TAB 125MG

TIER 03 NON PREFERRED

famciclovir TAB 250MG

atovaq/progu TAB 250-100PA

famciclovir TAB 500MG

atovaq/progu TAB 62.5-25PA

ribavirin inh 6gm

mefloquine TAB 250MGPA

Combivir TAB 150-300

quinine sulf CAP 324MG

Copegus TAB 200MGQL

Coartem TAB 20-120MG

Epivir HBV TAB 100MG

Malarone TAB 250-100PA

Epivir Sol 10MG/ML

Malarone TAB 62.5-25PA

Epivir TAB 150MG

Plaquenil TAB 200MG

Epivir TAB 300MG

Qualaquin CAP 324MG

Famvir TAB 125MG

Famvir TAB 250MG

ANTHELMINTICS

Famvir TAB 500MG

TIER 02 PREFERRED

Flumadine TAB 100MG

Biltricide TAB 600MG

Isentress Pow 100MG

TIER 04 SPECIALTY

Kaletra Sol

Albenza TAB 200MGQL

Moderiba PAK 1200/Day

TIER 03 NON PREFERRED

Moderiba PAK 800/Day

ivermectin TAB 3MG

Moderiba TAB 1000/Day

Emverm Chw 100MG

Moderiba TAB 600/Day

Stromectol TAB 3MG

Rebetol CAP 200MGQL

Retrovir CAP 100MG

MISC. ANTI-INFECTIVES

Retrovir Syp 50MG/5ML

TIER 01 GENERIC

Reyataz Pow 50MG

clindamycin inj 150MG/ML

Ribapak PAK 1200/Day

clindamycin inj 300/2ML

Ribapak PAK 800/Day

clindamycin inj 300MG

Ribapak TAB 1000/Day

clindamycin sol 75MG/5ML

Ribapak TAB 600/Day

clindamycin CAP 150MG

Ribasphere TAB 400MG

clindamycin CAP 300MG

Ribasphere TAB 600MG

clindamycin CAP 75MG

Ribatab TAB 1000/Day

colistimeth inj 150MG

Ribatab TAB 1200/Day

dapsone TAB 100MG

Ribatab TAB 800/Day

dapsone TAB 25MG

Sitavig TAB 50MG

linezolid sus 100/5MLQL

Tamiflu CAP 30MG

linezolid TAB 600MGQL

Tamiflu CAP 45MG

metronidazol TAB 250MG

Tamiflu CAP 75MG

metronidazol TAB 500MG

Valtrex TAB 1gm

smz-tmp sus 200-40/5

Valtrex TAB 500MG

smz-tmp DS TAB 800-160

Videx EC CAP 125MG

smz-tmp TAB 400-80MG

Videx EC CAP 200MG

smz/tmp DS TAB 800-160

Videx EC CAP 250MG

sulfatrim PD sus 200-40/5

Videx EC CAP 400MG

trimethoprim TAB 100MG

Viramune Sus 50MG/5ML

vancomycin 250/5ML

Viramune TAB 200MG

TIER 02 PREFERRED

Viramune XR TAB 100MG

Alinia Sus 100/5ML

Viramune XR TAB 400MG

Alinia TAB 500MG

Virazole Inh 6gm

Primsol Sol 50MG/5ML

Zerit CAP 15MG

Trimpex Sol 50MG/5ML

Zerit CAP 20MG

TIER 04 SPECIALTY

Zerit CAP 30MG

atovaquone sus 750/5MLQL

Zerit CAP 40MG

vancomycin CAP 125MGQL

Zerit Sol 1MG/ML

vancomycin CAP 250MGQL

Ziagen TAB 300MG

Cayston Inh 75MGQL,PA

Zovirax CAP 200MG

Impavido CAP 50MGQL,PA

Zovirax Sus 200/5ML

Mepron SusQL,PA

Zovirax TAB 400MG

Sivextro TAB 200MGQL

Zovirax TAB 800MG

Vancocin HCL CAP 125MGQL,PA

Vancocin HCL CAP 250MGQL,PA

ANTIMALARIALS

Xifaxan TAB 200MGQL,PA

TIER 01 GENERIC

Xifaxan TAB 550MGQL,PA

chloroquine TAB 250MG

Zyvox Sus 100MG/5mQL,PA

chloroquine TAB 500MG

Zyvox TAB 600MGQL,PA

hydroxychlor TAB 200MG

TIER M MEDICAL COPAY

Chloroquine TAB 250MG

Invanz Inj 1gmPA

Primaquine TAB 26.3MG

TIER 03 NON PREFERRED

TIER 04

lincomycin inj 300MG/ML

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 5

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metronidazol CAP 375MG

methotrexate inj 250/10ML

tinidazole TAB 250MG

methotrexate inj 50MG/2ML

tinidazole TAB 500MG

methotrexate TAB 2.5MG

Bactrim DS TAB 800-160

Carac CRE 0.5%QL

Bactrim TAB 400-80MG

Efudex CRE 5%QL,PA

Cleocin CAP 150MG

Fluoroplex CRE 1%QL

Cleocin CAP 300MG

Fluorouracil CRE 0.5%QL

Cleocin CAP 75MG

Fluorouracil Sol 2%QL

Cleocin Phos Inj 300MG

Fluorouracil Sol 5%QL

Cleocin PED Sol 75MG/5ML

Methotrexate Inj 25MG/ML

Coly-mycin M Inj 150MG

Purixan Sus 20MG/MLPA

Flagyl CAP 375MG

Tabloid TAB 40MG

Flagyl TAB 250MG

Tolak CRE 4%QL,PA

Flagyl TAB 500MG

Trexall TAB 10MGPA

Ketek TAB 300MG

Trexall TAB 15MGPA

Ketek TAB 400MG

Trexall TAB 5MGPA

Lincocin Inj 300MG/ML

Trexall TAB 7.5MGPA

Nebupent Inh 300MG

Xatmep Sol 2.5MG/MLQL,PA

Pentam 300 Inj 300MG

Xeloda TAB 150MGQL,PA

Tindamax TAB 250MG

Xeloda TAB 500MGQL,PA

Tindamax TAB 500MG

Vancomycn 25 Sol 25MG/ML

ANTIBODIES

Vancomycn 50 Sol 50MG/ML

TIER M MEDICAL COPAY

Rituxan Inj 100MGPA

ANTINEOPLASTICS, ETC.

Rituxan Inj 500MGPA

ALKYLATING AGENTS

HORMONAL AGENTS

TIER C ORAL CHEMO

TIER 01 GENERIC

melphalan TAB 2MGQL

megestrol ac sus 40MG/ML

temozolomide CAP 100MGQL

megestrol ac sus 400MG/10

temozolomide CAP 140MGQL

TIER P PREVENTIVE

temozolomide CAP 180MGQL

tamoxifen TAB 10MG

temozolomide CAP 20MGQL

tamoxifen TAB 20MG

temozolomide CAP 250MGQL

TIER C ORAL CHEMO

temozolomide CAP 5MGQL

anastrozole TAB 1MG

Alkeran TAB 2MGQL

bicalutamide TAB 50MG

Cyclophosph CAP 25MG

exemestane TAB 25MGPA

Cyclophosph CAP 50MG

flutamide CAP 125MG

Gleostine CAP 10MG

letrozole TAB 2.5MG

Gleostine CAP 100MG

leuprolide inj 1MG/0.2

Gleostine CAP 40MG

megestrol ac TAB 20MG

Gleostine CAP 5MG

megestrol ac TAB 40MG

Hexalen CAP 50MGQL,PA

nilutamide TAB 150MGPA

Leukeran TAB 2MG

Arimidex TAB 1MGPA

Lomustine CAP 10MG

Aromasin TAB 25MGPA

Lomustine CAP 100MG

Casodex TAB 50MGPA

Lomustine CAP 40MG

Eligard Inj 22.5MGPA

Myleran TAB 2MG

Eligard Inj 30MGPA

Temodar CAP 100MGQL,PA

Eligard Inj 45MGPA

Temodar CAP 140MGQL,PA

Eligard Inj 7.5MGPA

Temodar CAP 180MGQL,PA

Emcyt CAP 140MGQL,PA

Temodar CAP 20MGQL,PA

Fareston TAB 60MGPA

Temodar CAP 250MGQL,PA

Femara TAB 2.5MGPA

Temodar CAP 5MGQL,PA

Lupron Depot Inj 11.25MG

TIER 04 SPECIALTY

Lupron Depot Inj 22.5MG

Valchlor Gel 0.016%QL,PA

Lupron Depot Inj 3.75MG

Lupron Depot Inj 30MG

ANTIMETABOLITES

Lupron Depot Inj 45MG

TIER C ORAL CHEMO

Lupron Depot Inj 7.5MG

capecitabine TAB 150MGQL,PA

Lysodren TAB 500MGPA

capecitabine TAB 500MGQL,PA

Nilandron TAB 150MGPA

fluorouracil dro 2%QL

Soltamox Sol 10MG/5MLPA

fluorouracil dro 5%QL

Xtandi CAP 40MGQL,PA

fluorouracil CRE 5%QL

Zytiga TAB 250MGQL,PA

mercaptopur TAB 50MG

Zytiga TAB 500MGQL,PA

methotrexate inj 1gm

TIER M MEDICAL COPAY

methotrexate inj 1gm/40ML

Firmagon Inj 120MGPA

methotrexate inj 100/4ML

Firmagon Inj 80MGPA

methotrexate inj 200/8ML

TIER 03

methotrexate inj 25MG/ML

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 6

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NON PREFERRED

Prograf CAP 5MG

Depo-provera Inj 400/MLQL

Rapamune TAB 0.5MG

Megace Oral Sus 40MG/ML

Rapamune TAB 1MG

Rapamune TAB 2MG

IMMUNOMODULATORS

Sandimmune CAP 100MG

Sandimmune CAP 25MG

TIER 01 GENERIC

Sandimmune Sol 100MG/ML

azathioprine TAB 50MG

cyclosporine sol modified

MITOTIC INHIBITORS

cyclosporine CAP 100MG

cyclosporine CAP 100MG MD

TIER C ORAL CHEMO

cyclosporine CAP 25MG

Etoposide CAP 50MG

cyclosporine CAP 25MG mod

gengraf sol 100MG/ML

ENZYME INHIBITORS

gengraf CAP 100MG

TIER C ORAL CHEMO

gengraf CAP 25MG

imatinib mes TAB 100MGQL,PA

gengraf CAP 50MG

imatinib mes TAB 400MGQL,PA

mycophenolat sus 200MG/ML

Afinitor Dis TAB 2MGQL,PA

mycophenolat CAP 250MG

Afinitor Dis TAB 3MGQL,PA

mycophenolat TAB 500MG

Afinitor Dis TAB 5MGQL,PA

mycophenolic TAB 180MG DR

Afinitor TAB 10MGQL,PA

mycophenolic TAB 360MG DR

Afinitor TAB 2.5MGQL,PA

sirolimus TAB 0.5MG

Afinitor TAB 5MGQL,PA

sirolimus TAB 1MG

Afinitor TAB 7.5MGQL,PA

sirolimus TAB 2MG

Alecensa CAP 150MGQL,PA

tacrolimus CAP 0.5MG

Alunbrig TAB 30MGQL,PA

tacrolimus CAP 1MG

Bosulif TAB 100MGQL,PA

tacrolimus CAP 5MG

Bosulif TAB 500MGQL,PA

Cyclosporine CAP 50MG Mod

Cabometyx TAB 20MGPA

TIER 02 PREFERRED

Cabometyx TAB 40MGPA

Rapamune Sol 1MG/ML

Cabometyx TAB 60MGPA

TIER C ORAL CHEMO

Caprelsa TAB 100MGQL,PA

Pomalyst CAP 1MGQL,PA

Caprelsa TAB 300MGQL,PA

Pomalyst CAP 2MGQL,PA

Cometriq Kit 100MGQL,PA

Pomalyst CAP 3MGQL,PA

Cometriq Kit 140MGQL,PA

Pomalyst CAP 4MGQL,PA

Cometriq Kit 60MGQL,PA

Revlimid CAP 10MGQL,PA

Cotellic TAB 20MGQL,PA

Revlimid CAP 15MGQL,PA

Farydak CAP 10MGQL,PA

Revlimid CAP 2.5MGQL,PA

Farydak CAP 15MGQL,PA

Revlimid CAP 20MGQL,PA

Farydak CAP 20MGQL,PA

Revlimid CAP 25MGQL,PA

Gilotrif TAB 20MGQL,PA

Revlimid CAP 5MGQL,PA

Gilotrif TAB 30MGQL,PA

Thalomid CAP 100MGQL,PA

Gilotrif TAB 40MGQL,PA

Thalomid CAP 150MGQL,PA

Gleevec TAB 100MGQL,PA

Thalomid CAP 200MGQL,PA

Gleevec TAB 400MGQL,PA

Thalomid CAP 50MGQL,PA

Ibrance CAP 100MGQL,PA

TIER 04 SPECIALTY

Ibrance CAP 125MGQL,PA

Zortress TAB 0.25MGQL,PA

Ibrance CAP 75MGQL,PA

Zortress TAB 0.5MGQL,PA

Iclusig TAB 15MGQL,PA

Zortress TAB 0.75MGQL,PA

Iclusig TAB 45MGQL,PA

TIER 03 NON PREFERRED

Idhifa TAB 100MGQL,PA

Astagraf XL CAP 0.5MG

Idhifa TAB 50MGQL,PA

Astagraf XL CAP 1MG

Imbruvica CAP 140MGQL,PA

Astagraf XL CAP 5MG

Inlyta TAB 1MGPA

Azasan TAB 100MG

Inlyta TAB 5MGPA

Azasan TAB 75 MG

Iressa TAB 250MGQL,PA

Cellcept CAP 250MG

Jakafi TAB 10MGQL,PA

Cellcept Sus 200MG/ML

Jakafi TAB 15MGQL,PA

Cellcept TAB 500MG

Jakafi TAB 20MGQL,PA

Envarsus XR TAB 0.75MG

Jakafi TAB 25MGQL,PA

Envarsus XR TAB 1MG

Jakafi TAB 5MGQL,PA

Envarsus XR TAB 4MG

Kisqali TAB 200doseQL,PA

Imuran TAB 50MG

Kisqali TAB 400doseQL,PA

Myfortic TAB 180MG

Kisqali TAB 600doseQL,PA

Myfortic TAB 360MG

Lenvima CAP 10 MGQL,PA

Neoral CAP 100MG

Lenvima CAP 14 MGQL,PA

Neoral CAP 25MG

Lenvima CAP 18 MGQL,PA

Neoral Sol 100MG/ML

Lenvima CAP 20 MGQL,PA

Prograf CAP 0.5MG

Lenvima CAP 24 MGQL,PA

Prograf CAP 1MG

Lenvima CAP 8 MGQL,PA

Effective January 1, 2018

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Lynparza CAP 50MGQL,PA

TIER 03 NON PREFERRED

Lynparza TAB 100MGQL,PA

Alferon N Inj 5mu/ML

Lynparza TAB 150MGQL,PA

Mekinist TAB 0.5MGQL,PA

CHEMOTHERAPY RESCUE

Mekinist TAB 2MGQL,PA

TIER 01 GENERIC

Nerlynx TAB 40MGQL,PA

mesna inj 1gm

Nexavar TAB 200MGQL,PA

TIER C ORAL CHEMO

Ninlaro CAP 2.3MGQL,PA

leucovor CA TAB 25MG

Ninlaro CAP 3MGQL,PA

leucovor CA TAB 5MG

Ninlaro CAP 4MGQL,PA

Leucovor CA TAB 10MG

Rubraca TAB 200MGQL,PA

Leucovor CA TAB 15MG

Rubraca TAB 250MGQL,PA

Mesnex TAB 400MG

Rubraca TAB 300MGQL,PA

Rydapt CAP 25MGQL,PA

ANTINEOPLASTIC COMBO

Sprycel TAB 100MGQL,PA

TIER C ORAL CHEMO

Sprycel TAB 140MGQL,PA

Kisqali 200 PAK FemaraQL,PA

Sprycel TAB 20MGQL,PA

Kisqali 400 PAK FemaraQL,PA

Sprycel TAB 50MGQL,PA

Kisqali 600 PAK FemaraQL,PA

Sprycel TAB 70MGQL,PA

Lonsurf TAB 15-6.14QL,PA

Sprycel TAB 80MGQL,PA

Lonsurf TAB 20-8.19QL,PA

Stivarga TAB 40MGQL,PA

Sutent CAP 12.5MGQL,PA

CARDIOVASCULAR DRUGS

Sutent CAP 25MGQL,PA

CARDIAC GLYCOSIDES

Sutent CAP 37.5MGQL,PA

TIER 01 GENERIC

Sutent CAP 50MGQL,PA

digitek TAB 0.125MG

Tafinlar CAP 50MGQL,PA

digitek TAB 0.25MG

Tafinlar CAP 75MGQL,PA

digox TAB 0.125MG

Tagrisso TAB 40MGQL,PA

digox TAB 0.25MG

Tagrisso TAB 80MGQL,PA

digoxin inj 0.25MG/1

Tarceva TAB 100MGQL,PA

digoxin TAB 0.125MG

Tarceva TAB 150MGQL,PA

digoxin TAB 0.25MG

Tarceva TAB 25MGQL,PA

Digoxin Sol 50mcg/ML

Tasigna CAP 150MGQL,PA

TIER 03 NON PREFERRED

Tasigna CAP 200MGQL,PA

Lanoxin Inj 0.25MG/1

Tykerb TAB 250MGQL,PA

Lanoxin PED Inj 0.1MG/ML

Votrient TAB 200MGQL,PA

Lanoxin TAB 0.0625MG

Xalkori CAP 200MGQL,PA

Lanoxin TAB 0.125MG

Xalkori CAP 250MGQL,PA

Lanoxin TAB 0.1875MG

Zejula CAP 100MGQL,PA

Lanoxin TAB 0.25MG

Zelboraf TAB 240MGQL,PA

Zolinza CAP 100MGQL,PA

ANTIANGINAL AGENTS

Zydelig TAB 100MGQL,PA

TIER 01 GENERIC

Zydelig TAB 150MGQL,PA

isosorb din TAB 10MG

Zykadia CAP 150MGQL,PA

isosorb din TAB 20MG

isosorb din TAB 30MG

TOPOISOMERASE I INHIBITOR

isosorb din TAB 5MG

TIER C ORAL CHEMO

isosorb mono TAB 10MG

Hycamtin CAP 0.25MGQL,PA

isosorb mono TAB 120MG ER

Hycamtin CAP 1MGQL,PA

isosorb mono TAB 20MG

isosorb mono TAB 30MG ER

ANTINEOPLASTICS MISC.

isosorb mono TAB 60MG ER

TIER C ORAL CHEMO

minitran dis 0.1MG/HR

bexarotene CAP 75MGQL,PA

minitran dis 0.2MG/HR

hydroxyurea CAP 500MG

minitran dis 0.4MG/HR

tretinoin CAP 10MGQL

minitran dis 0.6MG/HR

Hydrea CAP 500MGPA

nitro-time CAP 9MG CR

Intron A Inj 10muQL

nitroglycer dis 0.1MG/HR

Intron A Inj 18muQL

nitroglycer dis 0.2MG/HR

Intron A Inj 25muQL

nitroglycer dis 0.4MG/HR

Intron A Inj 50muQL

nitroglycer dis 0.6MG/HR

Matulane CAP 50MGQL

nitroglycer CAP 9MG ER

Picato Gel 0.015%QL

TIER 02 PREFERRED

Picato Gel 0.05%QL

Isordil TAB 40MG

Sylatron Kit 200mcgQL,PA

Nitro-bid Oin 2%

Sylatron Kit 300mcgQL,PA

Nitro-dur Dis 0.3MG/HR

Sylatron Kit 600mcgQL,PA

Nitro-dur Dis 0.8MG/HR

Targretin CAP 75MGQL,PA

TIER 03 NON PREFERRED

TIER 04 SPECIALTY

nitroglycrn spr 0.4MG

Actimmune Inj 2mu/0.5QL,PA

Dilatrate SR CAP 40MG

Effective January 1, 2018

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Gonitro Pow 400mcg

Metoprolol TAB 75MG

Isordil TAB 5MG

Propranolol Sol 20MG/5ML

Isosorb Din TAB 40MG ER

Propranolol Sol 40MG/5ML

Nitro-dur Dis 0.1MG/HR

Timolol Mal TAB 10MG

Nitro-dur Dis 0.2MG/HR

Timolol Mal TAB 20MG

Nitro-dur Dis 0.4MG/HR

Timolol Mal TAB 5MG

Nitro-dur Dis 0.6MG/HR

TIER C ORAL CHEMO

Nitroglycer Aer 400mcg

Hemangeol Sol 4.28/MLPA

Nitrolingual Spr Pumpspra

TIER 03 NON PREFERRED

Nitromist Aer 400mcg

Betapace AF TAB 120MG

Nitrostat Sub 0.3MG

Betapace AF TAB 160MG

Ranexa TAB 1000MGPA

Betapace AF TAB 80MG

Ranexa TAB 500MGPA

Betapace TAB 120MG

Betapace TAB 160MG

BETA BLOCKERS

Betapace TAB 80MG

Bystolic TAB 10MG

TIER 01 GENERIC

Bystolic TAB 2.5MG

acebutolol CAP 200MG

Bystolic TAB 20MG

acebutolol CAP 400MG

Bystolic TAB 5MG

atenolol TAB 100MG

Coreg CR CAP 10MG

atenolol TAB 25MG

Coreg CR CAP 20MG

atenolol TAB 50MG

Coreg CR CAP 40MG

betaxolol TAB 10MG

Coreg CR CAP 80MG

betaxolol TAB 20MG

Coreg TAB 12.5MG

bisoprol fum TAB 10MG

Coreg TAB 25MG

bisoprol fum TAB 5MG

Coreg TAB 3.125MG

carvedilol TAB 12.5MG

Coreg TAB 6.25MG

carvedilol TAB 25MG

Corgard TAB 20MG

carvedilol TAB 3.125MG

Corgard TAB 40MG

carvedilol TAB 6.25MG

Corgard TAB 80MG

labetalol TAB 100MG

Inderal LA CAP 120MG

labetalol TAB 200MG

Inderal LA CAP 160MG

labetalol TAB 300MG

Inderal LA CAP 60MG

metoprol suc TAB 100MG ER

Inderal LA CAP 80MG

metoprol suc TAB 200MG ER

Inderal XL CAP 120MG

metoprol suc TAB 25MG ER

Inderal XL CAP 80MG

metoprol suc TAB 50MG ER

Innopran XL CAP 120MG

metoprol TAR TAB 100MG

Innopran XL CAP 80MG

metoprol TAR TAB 25MG

Lopressor TAB 100MG

metoprol TAR TAB 50MG

Lopressor TAB 50MG

metoprolol TAB 100MG ER

Sectral CAP 200MG

metoprolol TAB 200MG ER

Sectral CAP 400MG

metoprolol TAB 25MG ER

Sotylize Sol 5MG/ML

metoprolol TAB 50MG ER

Tenormin TAB 100MG

nadolol TAB 20MG

Tenormin TAB 25MG

nadolol TAB 40MG

Tenormin TAB 50MG

nadolol TAB 80MG

Toprol XL TAB 100MG

pindolol TAB 10MG

Toprol XL TAB 200MG

pindolol TAB 5MG

Toprol XL TAB 25MG

propranolol CAP 120MG ER

Toprol XL TAB 50MG

propranolol CAP 160MG ER

Zebeta TAB 10MG

propranolol CAP 60MG ER

Zebeta TAB 5MG

propranolol CAP 80MG ER

propranolol TAB 10MG

CALCIUM CHANNEL BLOCKERS

propranolol TAB 20MG

propranolol TAB 40MG

TIER 01 GENERIC

propranolol TAB 60MG

afeditab TAB 30MG CR

propranolol TAB 80MG

afeditab TAB 60MG CR

sorine TAB 120MG

amlodipine TAB 10MG

sorine TAB 160MG

amlodipine TAB 2.5MG

sorine TAB 240MG

amlodipine TAB 5MG

sorine TAB 80MG

cartia XT CAP 120/24HR

sotalol AF TAB 120MG

cartia XT CAP 180/24HR

sotalol AF TAB 160MG

cartia XT CAP 240/24HR

sotalol AF TAB 80MG

cartia XT CAP 300/24HR

sotalol HCL TAB 120MG

dilt-XR CAP 120MG

sotalol HCL TAB 160MG

dilt-XR CAP 180MG

sotalol HCL TAB 240MG

dilt-XR CAP 240MG

sotalol HCL TAB 80MG

diltiazem CAP 120MG CD

Metoprolol TAB 37.5MG

diltiazem CAP 120MG ER

Effective January 1, 2018

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diltiazem CAP 180MG CD

verapamil CAP 100MG ER

diltiazem CAP 180MG ER

verapamil CAP 200MG ER

diltiazem CAP 240MG CD

verapamil CAP 300MG ER

diltiazem CAP 240MG ER

Adalat CC TAB 30MG ER

diltiazem CAP 300MG CD

Adalat CC TAB 60MG ER

diltiazem CAP 300MG ER

Adalat CC TAB 90MG ER

diltiazem CAP 360MG CD

Calan SR TAB 120MG

diltiazem CAP 360MG ER

Calan SR TAB 180MG

diltiazem CAP 60MG ER

Calan SR TAB 240MG

diltiazem CAP 90MG ER

Calan TAB 120MG

diltiazem TAB 120MG

Calan TAB 80MG

diltiazem TAB 30MG

Cardizem CD CAP 120MG/24

diltiazem TAB 60MG

Cardizem CD CAP 180MG/24

diltiazem TAB 90MG

Cardizem CD CAP 240MG/24

felodipine TAB 10MG ER

Cardizem CD CAP 300MG/24

felodipine TAB 2.5MG ER

Cardizem CD CAP 360MG/24

felodipine TAB 5MG ER

Cardizem LA TAB 120MG

isradipine CAP 2.5MG

Cardizem LA TAB 180MG

isradipine CAP 5MG

Cardizem LA TAB 240MG

nicardipine CAP 20MG

Cardizem LA TAB 300MG/24

nicardipine CAP 30MG

Cardizem LA TAB 360MG

nifedical XL TAB 30MG

Cardizem LA TAB 420MG/24

nifedical XL TAB 60MG

Cardizem TAB 120MG

nifedipine CAP 10MG

Cardizem TAB 30MG

nifedipine CAP 20MG

Cardizem TAB 60MG

nifedipine TAB 30MG ER

Nisoldipine TAB 20MG ER

nifedipine TAB 60MG ER

Nisoldipine TAB 25.5MG

nifedipine TAB 90MG ER

Nisoldipine TAB 30MG ER

nimodipine CAP 30MG

Nisoldipine TAB 40MG ER

verapamil CAP 120MG ER

Norvasc TAB 10MG

verapamil CAP 120MG SR

Norvasc TAB 2.5MG

verapamil CAP 180MG ER

Norvasc TAB 5MG

verapamil CAP 180MG SR

Procardia CAP 10MG

verapamil CAP 240MG ER

Procardia XL TAB 30MG CR

verapamil CAP 240MG SR

Procardia XL TAB 60MG CR

verapamil CAP 360MG SR

Procardia XL TAB 90MG CR

verapamil TAB 120MG

Sular TAB 17MG

verapamil TAB 120MG ER

Sular TAB 34MG

verapamil TAB 180MG ER

Sular TAB 8.5MG

verapamil TAB 240MG ER

Tiazac CAP 120MG/24

verapamil TAB 40MG

Tiazac CAP 180MG/24

verapamil TAB 80MG

Tiazac CAP 240MG/24

TIER 04 SPECIALTY

Tiazac CAP 300MG/24

Nymalize Sol 30/10MLQL,PA

Tiazac CAP 360MG/24

Nymalize Sol 60/20MLQL,PA

Tiazac CAP 420MG/24

TIER 03 NON PREFERRED

Verelan CAP 120MG SR

diltiazem CAP 120MG/24

Verelan CAP 180MG SR

diltiazem CAP 180MG/24

Verelan CAP 240MG SR

diltiazem CAP 240MG/24

Verelan CAP 360MG SR

diltiazem CAP 300MG/24

Verelan PM CAP 100MG ER

diltiazem CAP 360MG/24

Verelan PM CAP 200MG ER

diltiazem CAP 420MG/24

Verelan PM CAP 300MG ER

diltiazem ER TAB 180MG

diltiazem ER TAB 240MG

ANTIARRHYTHMICS

diltiazem ER TAB 300MG

TIER 01 GENERIC

diltiazem ER TAB 360MG

amiodarone TAB 200MG

diltiazem ER TAB 420MG

disopyramide CAP 100MG

matzim LA TAB 180MG/24

disopyramide CAP 150MG

matzim LA TAB 240MG/24

flecainide TAB 100MG

matzim LA TAB 300MG/24

flecainide TAB 150MG

matzim LA TAB 360MG/24

flecainide TAB 50MG

matzim LA TAB 420MG/24

mexiletine CAP 150MG

nisoldipine TAB 17MG ER

mexiletine CAP 200MG

nisoldipine TAB 34MG ER

mexiletine CAP 250MG

nisoldipine TAB 8.5MG ER

pacerone TAB 200MG

taztia XT CAP 120MG/24

propafenone TAB 150MG

taztia XT CAP 180MG/24

propafenone TAB 225MG

taztia XT CAP 240MG/24

propafenone TAB 300MG

taztia XT CAP 300MG/24

quinidine gl TAB 324MG CR

taztia XT CAP 360MG/24

Effective January 1, 2018

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quinidine gl TAB 324MG ER

ramipril CAP 2.5MG

quinidine SU TAB 300MG

ramipril CAP 5MG

Procainamide Inj 100MG/ML

trandolapril TAB 1MG

Procainamide Inj 500MG/ML

trandolapril TAB 2MG

Quinidine Gl Inj 80MG/ML

trandolapril TAB 4MG

Quinidine SU TAB 200MG

TIER 03 NON PREFERRED

Quinidine SU TAB 300MG

Accupril TAB 10MG

Quinidine SU TAB 300MG ER

Accupril TAB 20MG

TIER 02 PREFERRED

Accupril TAB 40MG

Norpace CAP 100MG CR

Accupril TAB 5MG

Norpace CAP 150MG CR

Aceon TAB 4MG

TIER 03 NON PREFERRED

Aceon TAB 8MG

amiodarone TAB 100MG

Altace CAP 1.25MG

amiodarone TAB 400MG

Altace CAP 10MG

dofetilide CAP 125mcgPA

Altace CAP 2.5MG

dofetilide CAP 250mcgPA

Altace CAP 5MG

dofetilide CAP 500mcgPA

Epaned Sol 1MG/ML

pacerone TAB 100MG

Lotensin TAB 20MG

pacerone TAB 400MG

Lotensin TAB 40MG

propafenone CAP 225MG ER

Mavik TAB 1MG

propafenone CAP 325MG ER

Mavik TAB 2MG

propafenone CAP 425MG SR

Mavik TAB 4MG

Cordarone TAB 200MG

Prinivil TAB 10MG

Multaq TAB 400MG

Prinivil TAB 20MG

Norpace CAP 100MG

Prinivil TAB 5MG

Norpace CAP 150MG

Qbrelis Sol 1MG/ML

Rythmol SR CAP 225MG

Vasotec TAB 10MG

Rythmol SR CAP 325MG

Vasotec TAB 2.5MG

Rythmol SR CAP 425MG

Vasotec TAB 20MG

Rythmol TAB 150MG

Vasotec TAB 5MG

Rythmol TAB 225MG

Zestril TAB 10MG

Tikosyn CAP 125mcgPA

Zestril TAB 2.5MG

Tikosyn CAP 250mcgPA

Zestril TAB 20MG

Tikosyn CAP 500mcgPA

Zestril TAB 30MG

Zestril TAB 40MG

ACE INHIBITORS

Zestril TAB 5MG

TIER 01 GENERIC

ANGIOTENSIN RCPTR BLOCKER

benazepril TAB 10MG

benazepril TAB 20MG

TIER 01 GENERIC

benazepril TAB 40MG

irbesartan TAB 150MG

benazepril TAB 5MG

irbesartan TAB 300MG

captopril TAB 100MG

irbesartan TAB 75MG

captopril TAB 12.5MG

losartan pot TAB 100MG

captopril TAB 25MG

losartan pot TAB 25MG

captopril TAB 50MG

losartan pot TAB 50MG

enalapril TAB 10MG

valsartan TAB 160MG

enalapril TAB 2.5MG

valsartan TAB 320MG

enalapril TAB 20MG

valsartan TAB 40MG

enalapril TAB 5MG

valsartan TAB 80MG

fosinopril TAB 10MG

TIER 03 NON PREFERRED

fosinopril TAB 20MG

candesartan TAB 16MG

fosinopril TAB 40MG

candesartan TAB 32MG

lisinopril TAB 10MG

candesartan TAB 4MG

lisinopril TAB 2.5MG

candesartan TAB 8MG

lisinopril TAB 20MG

olmesa medox TAB 20MGST

lisinopril TAB 30MG

olmesa medox TAB 40MGST

lisinopril TAB 40MG

olmesa medox TAB 5MGST

lisinopril TAB 5MG

telmisartan TAB 20MG

moexipril TAB 15MG

telmisartan TAB 40MG

moexipril TAB 7.5MG

telmisartan TAB 80MG

perindopril TAB 2MG

Atacand TAB 16MG

perindopril TAB 4MG

Atacand TAB 32MG

perindopril TAB 8MG

Atacand TAB 4MG

quinapril TAB 10MG

Atacand TAB 8MG

quinapril TAB 20MG

Avapro TAB 150MG

quinapril TAB 40MG

Avapro TAB 300MG

quinapril TAB 5MG

Avapro TAB 75MG

ramipril CAP 1.25MG

Benicar TAB 20MGST

ramipril CAP 10MG

Benicar TAB 40MGST

Effective January 1, 2018

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Benicar TAB 5MGST

Inspra TAB 50MG

Cozaar TAB 100MG

Minipress CAP 1MG

Cozaar TAB 25MG

Minipress CAP 2MG

Cozaar TAB 50MG

Minipress CAP 5MG

Diovan TAB 160MG

Reserpine TAB 0.1MG

Diovan TAB 320MG

Reserpine TAB 0.25MG

Diovan TAB 40MG

Tenex TAB 1MG

Diovan TAB 80MG

Tenex TAB 2MG

Edarbi TAB 40MGST

Edarbi TAB 80MGST

ANTIHYPERTENSIVE COMBO

Eprosart Mes TAB 600MGST

TIER 01 GENERIC

Micardis TAB 20MG

amlod/benazp CAP 10-20MG

Micardis TAB 40MG

amlod/benazp CAP 10-40MG

Micardis TAB 80MG

amlod/benazp CAP 2.5-10MG

amlod/benazp CAP 5-10MG

DIRECT RENIN INHIBITORS

amlod/benazp CAP 5-20MG

TIER 03 NON PREFERRED

amlod/benazp CAP 5-40MG

Tekturna TAB 150MGST

atenol/chlor TAB 100-25MG

Tekturna TAB 300MGST

atenol/chlor TAB 50-25MG

benazep/hctz TAB 10-12.5

ANTIHYPERTENSIVES MISC.

benazep/hctz TAB 20-12.5

benazep/hctz TAB 20-25MG

TIER 01 GENERIC

benazep/hctz TAB 5-6.25

clonidine dis 0.1/24HR

bisoprl/hctz TAB 10/6.25

clonidine dis 0.2/24HR

bisoprl/hctz TAB 2.5/6.25

clonidine dis 0.3/24HR

bisoprl/hctz TAB 5-6.25MG

clonidine TAB 0.1MG

enalapr/hctz TAB 10-25MG

clonidine TAB 0.2MG

enalapr/hctz TAB 5-12.5MG

clonidine TAB 0.3MG

fosinop/hctz TAB 10/12.5

doxazosin TAB 1MG

fosinop/hctz TAB 20/12.5

doxazosin TAB 2MG

irbesar/hctz TAB 150-12.5

doxazosin TAB 4MG

irbesar/hctz TAB 300-12.5

doxazosin TAB 8MG

lisinop/hctz TAB 10-12.5

eplerenone TAB 25MG

lisinop/hctz TAB 20-12.5

eplerenone TAB 50MG

lisinop/hctz TAB 20-25MG

guanfacine TAB 1MG

losartan/HCT TAB 100-12.5

guanfacine TAB 2MG

losartan/HCT TAB 100-25

hydralazine TAB 10MG

losartan/HCT TAB 50-12.5

hydralazine TAB 100MG

metoprl/hctz TAB 100-25MG

hydralazine TAB 25MG

metoprl/hctz TAB 100-50MG

hydralazine TAB 50MG

metoprl/hctz TAB 50-25MG

methyldopa TAB 250MG

moexipr/hctz TAB 15-12.5

methyldopa TAB 500MG

moexipr/hctz TAB 15-25MG

minoxidil TAB 10MG

moexipr/hctz TAB 7.5-12.5

minoxidil TAB 2.5MG

qnapril/hctz TAB 10-12.5

prazosin HCL CAP 1MG

qnapril/hctz TAB 20-12.5

prazosin HCL CAP 2MG

qnapril/hctz TAB 20-25MG

prazosin HCL CAP 5MG

valsart/hctz TAB 160-12.5

terazosin CAP 1MG

valsart/hctz TAB 160-25MG

terazosin CAP 10MG

valsart/hctz TAB 320-12.5

terazosin CAP 2MG

valsart/hctz TAB 320-25MG

terazosin CAP 5MG

valsart/hctz TAB 80-12.5

Phentolamine Inj 5MG

Captopr/Hctz TAB 25-15MG

TIER 04 SPECIALTY

Captopr/Hctz TAB 25-25MG

phenoxybenza CAP 10MGQL

Captopr/Hctz TAB 50-15MG

Dibenzyline CAP 10MGQL,PA

Captopr/Hctz TAB 50-25MG

Vecamyl TAB 2.5MGQL,PA

Metoprl/Hctz TAB 100-50MG

TIER 03 NON PREFERRED

Propran/Hctz TAB 40/25

Cardura TAB 1MG

Propran/Hctz TAB 80/25

Cardura TAB 2MG

TIER 03 NON PREFERRED

Cardura TAB 4MG

amlod/olmesa TAB 10-20MGST

Cardura TAB 8MG

amlod/olmesa TAB 10-40MGST

Catapres TAB 0.1MG

amlod/olmesa TAB 5-20MGST

Catapres TAB 0.2MG

amlod/olmesa TAB 5-40MGST

Catapres TAB 0.3MG

amlod/valsar TAB /hctz

Catapres-tts Dis 0.1/24HR

amlod/valsar TAB 10-160MGST

Catapres-tts Dis 0.2/24HR

amlod/valsar TAB 10-320MGST

Catapres-tts Dis 0.3/24HR

amlod/valsar TAB 5-160MGST

Demser CAP 250MG

amlod/valsar TAB 5-320MGST

Inspra TAB 25MG

Effective January 1, 2018

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candesa/hctz TAB 16-12.5

Lotrel CAP 5-10MG

candesa/hctz TAB 32-12.5

Lotrel CAP 5-20MG

candesa/hctz TAB 32-25MG

Methyld/Hctz TAB 250/15

nadolol/bend TAB 40-5MG

Methyld/Hctz TAB 250/25

nadolol/bend TAB 80-5MG

Metopro/Hctz TAB 100-12.5

olm MED/amlo TAB /hctzST

Metopro/Hctz TAB 25-12.5

olm MED/hctz TAB 20-12.5ST

Metopro/Hctz TAB 50-12.5

olm MED/hctz TAB 40-12.5ST

Micardis HCT TAB 40/12.5

olm MED/hctz TAB 40-25MGST

Micardis HCT TAB 80-25MG

telmis/amlod TAB 40-10MG

Micardis HCT TAB 80/12.5

telmis/amlod TAB 40-5MG

Prestalia TAB 14-10MG

telmis/amlod TAB 80-10MG

Prestalia TAB 3.5-2.5

telmis/amlod TAB 80-5MG

Prestalia TAB 7-5MG

telmisa/hctz TAB 40-12.5

Tarka TAB 1-240 CR

telmisa/hctz TAB 80-12.5

Tarka TAB 2-180 CR

telmisa/hctz TAB 80-25MG

Tarka TAB 2-240 CR

trando/verap TAB 1-240 ER

Tarka TAB 4-240 CR

trando/verap TAB 2-180 ER

Tekturna HCT TAB 150-12.5ST

trando/verap TAB 2-240 ER

Tekturna HCT TAB 150-25MGST

trando/verap TAB 4-240 ER

Tekturna HCT TAB 300-12.5ST

Accuretic TAB 10-12.5

Tekturna HCT TAB 300-25MGST

Accuretic TAB 20-12.5

Tenoretic TAB 100

Accuretic TAB 20-25MG

Tenoretic TAB 50

Atacand HCT TAB 16-12.5

Tribenzor20- TAB 5-12.5MGST

Atacand HCT TAB 32-12.5

Tribenzor40- TAB 10-12.5ST

Atacand HCT TAB 32-25MG

Tribenzor40- TAB 10-25MGST

Avalide TAB 150-12.5

Tribenzor40- TAB 5-12.5MGST

Avalide TAB 300-12.5

Tribenzor40- TAB 5-25MGST

Azor TAB 10-20MGST

Twynsta TAB 40-10MG

Azor TAB 10-40MGST

Twynsta TAB 40-5MG

Azor TAB 5-20MGST

Twynsta TAB 80-10MG

Azor TAB 5-40MGST

Twynsta TAB 80-5MG

Benicar HCT TAB 20-12.5ST

Vaseretic TAB 10-25MG

Benicar HCT TAB 40-12.5ST

Zestoretic TAB 10-12.5

Benicar HCT TAB 40-25MGST

Zestoretic TAB 20-12.5

Byvalson TAB 5-80MG

Zestoretic TAB 20-25MG

Clorpres TAB 0.1-15MG

Ziac TAB 10/6.25

Clorpres TAB 0.2-15MG

Ziac TAB 2.5/6.25

Clorpres TAB 0.3-15MG

Ziac TAB 5-6.25MG

Corzide TAB 40-5MG

Corzide TAB 80-5MG

DIURETICS

Diovan HCT TAB 160-12.5

TIER 01 GENERIC

Diovan HCT TAB 160-25MG

acetazolamid CAP 500MG ER

Diovan HCT TAB 320-12.5

acetazolamid TAB 125MG

Diovan HCT TAB 320-25MG

acetazolamid TAB 250MG

Diovan HCT TAB 80/12.5

amilor/hctz TAB 5-50

Dutoprol TAB 100-12.5

amiloride TAB 5MG

Dutoprol TAB 25-12.5

bumetanide TAB 0.5MG

Dutoprol TAB 50-12.5

bumetanide TAB 1MG

Edarbyclor TAB 40-12.5ST

bumetanide TAB 2MG

Edarbyclor TAB 40-25MGST

chlorothiaz TAB 500MG

Exforge TAB 10-160MGST

chlorthalid TAB 25MG

Exforge TAB 10-320MGST

chlorthalid TAB 50MG

Exforge TAB 5-160MGST

ethacrynic TAB acd 25MG

Exforge TAB 5-320MGST

furosemide inj 10MG/ML

Exforgeh/10- TAB 160-12.5

furosemide inj 100/10ML

Exforgeh/10- TAB 160-25

furosemide inj 20MG/2ML

Exforgeh/10- TAB 320-25

furosemide inj 40MG/4ML

Exforgeh/5- TAB 160-12.5

furosemide sol 10MG/ML

Exforgeh/5- TAB 160-25

furosemide TAB 20MG

Hyzaar TAB 100-12.5

furosemide TAB 40MG

Hyzaar TAB 100-25

furosemide TAB 80MG

Hyzaar TAB 50-12.5

hydrochlorot CAP 12.5MG

Lopress HCT TAB 50-25MG

hydrochlorot TAB 12.5MG

Lotensin HCT TAB 10-12.5

hydrochlorot TAB 25MG

Lotensin HCT TAB 20-12.5

hydrochlorot TAB 50MG

Lotensin HCT TAB 20-25MG

indapamide TAB 1.25MG

Lotrel CAP 10-20MG

indapamide TAB 2.5MG

Lotrel CAP 10-40MG

methazolamid TAB 25MG

Lotrel CAP 2.5-10MG

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 13

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methazolamid TAB 50MG

Adrenaclick Inj 0.3MG

metolazone TAB 10MG

Adyphren Amp Kit 1MG/ML

metolazone TAB 2.5MG

Adyphren II Kit

metolazone TAB 5MG

Adyphren Kit

spirono/hctz TAB 25/25

Auvi-q Inj 0.15MG

spironolact TAB 100MG

Auvi-q Inj 0.3MG

spironolact TAB 25MG

Epinphephrin Kit Snap-v

spironolact TAB 50MG

Episnap Kit

torsemide TAB 10MG

Epy II Kit

torsemide TAB 100MG

Epy Kit

torsemide TAB 20MG

torsemide TAB 5MG

ANTIHYPERLIPIDEMICS

triamt/hctz TAB 37.5-25

TIER 01 GENERIC

triamt/hctz TAB 75-50MG

atorvastatin TAB 10MG

Chlorothiaz TAB 250MG

atorvastatin TAB 20MG

Edecrin TAB 25MG

atorvastatin TAB 40MG

Furosemide Sol 8MG/ML

atorvastatin TAB 80MG

Methyclothia TAB 5MG

cholestyram pow 4gm packets

TIER 02 PREFERRED

cholestyram pow 4gm lite packets

Aldactazide TAB 50/50

colestipol gra 5gm

Diuril Sus 250/5ML

colestipol TAB 1gm

Dyrenium CAP 100MG

ezetim/simva TAB 10-10MGPA

Dyrenium CAP 50MG

ezetim/simva TAB 10-20MGPA

TIER 04 SPECIALTY

ezetim/simva TAB 10-40MGPA

Keveyis TAB 50MGQL,PA

ezetim/simva TAB 10-80MGPA

TIER 03 NON PREFERRED

ezetimibe TAB 10MGPA

acetazolamid inj 500MG

fenofibrate CAP 130MG

triamt/hctz CAP 37.5-25

fenofibrate CAP 134MG

Aldactazide TAB 25/25

fenofibrate CAP 200MG

Aldactone TAB 100MG

fenofibrate CAP 43MG

Aldactone TAB 25MG

fenofibrate CAP 67MG

Aldactone TAB 50MG

fenofibrate TAB 160

Bumex TAB 0.5MG

fenofibrate TAB 160MG

Bumex TAB 1MG

fenofibrate TAB 54MG

Bumex TAB 2MG

gemfibrozil TAB 600MG

Demadex TAB 10MG

lovastatin TAB 10MG

Demadex TAB 20MG

lovastatin TAB 20MG

Demadex TAB 5MG

lovastatin TAB 40MG

Diamox Seque CAP 500MG CR

pravastatin TAB 10MG

Dyazide CAP 37.5-25

pravastatin TAB 20MG

Lasix TAB 20MG

pravastatin TAB 40MG

Lasix TAB 40MG

pravastatin TAB 80MG

Lasix TAB 80MG

prevalite pow 4gm

Maxzide TAB 75-50

prevalite pow 4gm pk

Maxzide-25 TAB

rosuvastatin TAB 10MG

Microzide CAP 12.5MG

rosuvastatin TAB 20MG

Neptazane TAB 25MG

rosuvastatin TAB 40MG

Neptazane TAB 50MG

rosuvastatin TAB 5MG

Triamt/Hctz CAP 50-25MG

simvastatin TAB 10MG

simvastatin TAB 20MG

VASOPRESSORS

simvastatin TAB 40MG

TIER 01 GENERIC

simvastatin TAB 5MG

epinephrine inj 0.1MG/ML

simvastatin TAB 80MG

epinephrine inj 1MG/ML

Fenofibric TAB 105MG

midodrine TAB 10MG

Fenofibric TAB 35MG

midodrine TAB 2.5MG

TIER 04 SPECIALTY

midodrine TAB 5MG

Juxtapid CAP 10MGQL,PA

Epinephrine Inj 0.15MG

Juxtapid CAP 20MGQL,PA

Epinephrine Inj 0.3MG

Juxtapid CAP 30MGQL,PA

Epinephrine Inj 1MG/ML

Juxtapid CAP 40MGQL,PA

TIER 02 PREFERRED

Juxtapid CAP 5MGQL,PA

Epipen 2-PAK Inj 0.3MG

Juxtapid CAP 60MGQL,PA

Epipen-JR Inj 2-PAK

Kynamro Inj 200MG/MLQL,PA

TIER 04 SPECIALTY

Praluent Inj 150MG/MLQL,PA

Northera CAP 100MGQL,PA

Praluent Inj 75MG/MLQL,PA

Northera CAP 200MGQL,PA

Repatha Inj 140MG/MLQL,PA

Northera CAP 300MGQL,PA

Repatha Push Inj 420/3.5QL,PA

TIER 03 NON PREFERRED

Repatha Sure Inj 140MG/MLQL,PA

Adrenaclick Inj 0.15MG

TIER 03

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NON PREFERRED

Simcor TAB 500-20MG

fenofibrate TAB 120MG

Simcor TAB 500-40MG

fenofibrate TAB 145MG

Simcor TAB 750-20MG

fenofibrate TAB 40MG

Tricor TAB 145MG

fenofibrate TAB 48MG

Tricor TAB 48MG

fenofibric CAP 135MG DR

Triglide TAB 160MG

fenofibric CAP 45MG DR

Trilipix CAP 135MG

fluvastatin CAP 20MG

Trilipix CAP 45MG

fluvastatin CAP 40MG

Vascepa CAP 0.5gmPA

fluvastatin TAB 80MG ER

Vascepa CAP 1gm

niacin ER TAB 1000MG

Vytorin TAB 10-10MGPA

niacin ER TAB 500MG

Vytorin TAB 10-20MGPA

niacin ER TAB 750MG

Vytorin TAB 10-40MGPA

omega-3-acid CAP 1gm

Vytorin TAB 10-80MGPA

triklo CAP 1gm

Welchol PAK 3.75gm

Advicor TAB 1000-20

Welchol TAB 625MG

Advicor TAB 1000-40

Zetia TAB 10MGPA

Advicor TAB 500-20MG

Zocor TAB 10MG

Advicor TAB 750-20MG

Zocor TAB 20MG

Altoprev TAB 20MG ER

Zocor TAB 40MG

Altoprev TAB 40MG ER

Zocor TAB 5MG

Altoprev TAB 60MG ER

Zocor TAB 80MG

Antara CAP 30MG

Antara CAP 90MG

CARDIOVASCULAR - MISC.

Colestid FLA Gra 5/7.5gm

TIER 01 GENERIC

Colestid FLA Gra 5gm

papaverine inj 30MG/ML

Colestid Gra 5gm

Papaverine Sol 30MG/ML

Colestid Pow 5gm

TIER 02 PREFERRED

Colestid TAB 1gm

Entresto TAB 24-26MGPA

Crestor TAB 10MG

Entresto TAB 49-51MGPA

Crestor TAB 20MG

Entresto TAB 97-103MGPA

Crestor TAB 40MG

TIER 04 SPECIALTY

Crestor TAB 5MG

sildenafil TAB 20MGQL,PA

Fenofibrate CAP 150MG

Adcirca TAB 20MGQL,PA

Fenofibrate CAP 50MG

Adempas TAB 0.5MGQL,PA

Fenoglide TAB 120MG

Adempas TAB 1.5MGQL,PA

Fenoglide TAB 40MG

Adempas TAB 1MGQL,PA

Fibricor TAB 105MG

Adempas TAB 2.5MGQL,PA

Fibricor TAB 35MG

Adempas TAB 2MGQL,PA

Flolipid Sus 20MG/5ML

Letairis TAB 10MGQL,PA

Flolipid Sus 40MG/5ML

Letairis TAB 5MGQL,PA

Lescol XL TAB 80MG

Opsumit TAB 10MGQL,PA

Lipitor TAB 10MG

Orenitram TAB 0.25MGQL,PA

Lipitor TAB 20MG

Orenitram TAB 1MGQL,PA

Lipitor TAB 40MG

Orenitram TAB 2.5MGQL,PA

Lipitor TAB 80MG

Orenitram TAB 5MGQL,PA

Lipofen CAP 150MG

Revatio Sus 10MG/MLQL,PA

Lipofen CAP 50MG

Revatio TAB 20MGQL,PA

Livalo TAB 1MG

Tracleer TAB 125MGQL,PA

Livalo TAB 2MG

Tracleer TAB 62.5MGQL,PA

Livalo TAB 4MG

Tyvaso Refil Sol 0.6MG/MLQL,PA

Lofibra CAP 134MG

Tyvaso Sol 0.6MG/MLQL,PA

Lofibra CAP 200MG

Tyvaso Start Sol 0.6MG/MLQL,PA

Lofibra CAP 67MG

Uptravi TAB 1000mcgQL,PA

Lofibra TAB 160MG

Uptravi TAB 1200mcgQL,PA

Lofibra TAB 54MG

Uptravi TAB 1400mcgQL,PA

Lopid TAB 600MG

Uptravi TAB 1600mcgQL,PA

Lovaza CAP 1gm

Uptravi TAB 200/800QL,PA

Mevacor TAB 40MG

Uptravi TAB 200mcgQL,PA

Niacor TAB 500MG

Uptravi TAB 400mcgQL,PA

Niaspan TAB 1000 ER

Uptravi TAB 600mcgQL,PA

Niaspan TAB 500MG ER

Uptravi TAB 800mcgQL,PA

Niaspan TAB 750MG ER

Ventavis Sol 10mcg/MLQL,PA

Pravachol TAB 20MG

Ventavis Sol 20mcg/MLQL,PA

Pravachol TAB 40MG

TIER 03 NON PREFERRED

Pravachol TAB 80MG

amlod/atorva TAB 10-10MG

Questran Pow 4gm

amlod/atorva TAB 10-20MG

Questran Pow 4gm Lite

amlod/atorva TAB 10-40MG

Simcor TAB 1000-20

amlod/atorva TAB 10-80MG

Simcor TAB 1000-40

Effective January 1, 2018

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amlod/atorva TAB 2.5-10MG

tretinoin gel 0.1%

amlod/atorva TAB 2.5-20MG

tretinoin gel 0.1%P.M.

amlod/atorva TAB 2.5-40MG

tretinoin CRE 0.025%

amlod/atorva TAB 5-10MG

tretinoin CRE 0.05%

amlod/atorva TAB 5-20MG

tretinoin CRE 0.1%

amlod/atorva TAB 5-40MG

zenatane CAP 10MG

amlod/atorva TAB 5-80MG

zenatane CAP 20MG

Bidil TAB

zenatane CAP 30MG

Caduet TAB 10-10MG

zenatane CAP 40MG

Caduet TAB 10-20MG

Adapalene Lot 0.1%

Caduet TAB 10-40MG

Differin CRE 0.1%

Caduet TAB 10-80MG

Retin-a CRE 0.025%

Caduet TAB 2.5-10MG

Retin-a CRE 0.05%

Caduet TAB 2.5-20MG

Retin-a CRE 0.1%

Caduet TAB 2.5-40MG

Retin-a Gel 0.01%

Caduet TAB 5-10MG

Retin-a Gel 0.025%

Caduet TAB 5-20MG

Retin-a Micr Gel 0.04%

Caduet TAB 5-40MG

Retin-a Micr Gel 0.04%pmp

Caduet TAB 5-80MG

Retin-a Micr Gel 0.1%

Cialis TAB 10MGPA

Retin-a Micr Gel 0.1%P.M.

Cialis TAB 2.5MGPA

Sod SUL/Sulf Emu 10-5%

Cialis TAB 20MGPA

Sod SUL/Sulf Lot 10-5%

Cialis TAB 5MGPA

TIER 02 PREFERRED

Corlanor TAB 5MGPA

Azelex CRE 20%

Corlanor TAB 7.5MGPA

Differin Lot 0.1%

Orenitram TAB 0.125MGPA

TIER 03 NON PREFERRED

adapal/ben p gel 0.1-2.5%

DERMATOLOGICALS

avar-e emoll CRE 10-5%

avar-e green CRE 10-5%

ACNE PRODUCTS

benzepro mis 6%

TIER 01 GENERIC

bp 10-1 emu

adapalene gel pmp 0.3%

bpo cloths mis 6%

adapalene gel 0.1%

cerisa wash emu 10-1%

adapalene gel 0.3%

clearplex X gel 10%

adapalene CRE 0.1%

clindamy/ben gel 1.2-5%

amnesteem CAP 10MG

clindamycin aer 1%

amnesteem CAP 20MG

clindamycin gel tretinoi

amnesteem CAP 40MG

ery pad 2%

avar cleanse emu 10-5%

erythromycin pad 2%

avita gel 0.025%

neuac gel 1.2-5%

avita CRE 0.025%

oscion clnsr lot 6%

claravis CAP 10MG

sod SUL/sulf liq wash

claravis CAP 20MG

sod SUL/sulf liq 10-2%

claravis CAP 30MG

sod SUL/sulf liq 9.8-4.8%

claravis CAP 40MG

sod SUL/sulf liq 9-4.5%

clindacin mis etz 1%

sod SUL/sulf lot 9.8-4.8%

clindacin-p pad 1%

sod SUL/sulf pad 10-4%

clindamy/ben gel 1-5%

sod SUL/sulf sus 8-4%

clindamycin gel 1%

sod SUL/sulf CRE 10-2%

clindamycin lot 1%

sod SUL/sulf CRE 10-5%

clindamycin lot 10MG/ML

sod SUL/sulf CRE 9.8-4.8%

clindamycin mis 1%

sss CRE 10%-5%

clindamycin pad 1%

sulfacleanse sus 8-4%

clindamycin sol 1%

tretinoin gel 0.05%

ery/benzoyl gel 5-3%

zencia liq 9-4%

erythromycin gel 2%

Absorica CAP 10MG

erythromycin sol 2%

Absorica CAP 20MG

myorisan CAP 10MG

Absorica CAP 25MG

myorisan CAP 20MG

Absorica CAP 30MG

myorisan CAP 30MG

Absorica CAP 35MG

myorisan CAP 40MG

Absorica CAP 40MG

rosanil emu cleanser

Acanya Gel 1.2-2.5%

sod SUL/sulf emu 10-5%

Aczone Gel 5%

sod SUL/sulf lot 10-5%

Aczone Gel 7.5%

sulfacetamid lot 10%

Atralin Gel 0.05%

sulfacetamid sus 10%

Avar Aer 9.5-5%

tretinoin gel 0.01%

Avar LS Aer 10-2%

tretinoin gel 0.025%

Avar LS Liq 10-2%

tretinoin gel 0.04%

Avar LS Pad 10-2%PA

tretinoin gel 0.04%pmp

Avar Pad 9.5-5%PA

Effective January 1, 2018

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Avar-e LS CRE 10-2%

ANTIBIOTICS - TOPICAL

Benzaclin Gel 1-5%

TIER 01 GENERIC

Benzaclin Gel 1-5%P.M.

gentamicin CRE 0.1%

Benzamycin Gel 5-3%

mupirocin oin 2%

Benziq Gel 5.25%

mupirocin CA CRE 2%

Benziq LS Gel 2.75%

mupirocin CRE 2%

Bp Cleansing Emu 10-4%

Gentamicin Oin 0.1%

Clarifoam EF Aer 10-5%

TIER 02 PREFERRED

Cleocin-t Gel 1%

Cortisporin Oin 1%

Cleocin-t Lot 1%

TIER 03 NON PREFERRED

Cleocin-t Pad 1%

Altabax Oin 1%

Cleocin-t Sol 1%

Bactroban CRE 2%

Clindagel Gel 1%

Bactroban Oin 2%

Differin Gel 0.1%

Centany Oin 2%

Differin Gel 0.3%

Cortisporin CRE 0.5%

Duac Gel 1.2-5%

Neo-synalar CRE

Epiduo Forte Gel 0.3-2.5%

Epiduo Gel 0.1-2.5%

ANTIFUNGALS - TOPICAL

Erygel Gel 2%

TIER 01 GENERIC

Evoclin Aer 1%

ciclodan sol 8%

Fabior Aer 0.1%

ciclodan CRE 0.77%

Klaron Lot 10%

ciclopirox gel 0.77%

Onexton Gel 1.2-3.75

ciclopirox sol 8%

Plexion Clth Pad 9.8-4.8%

ciclopirox sus 0.77%

Plexion CRE 9.8-4.8%

ciclopirox CRE 0.77%

Plexion Liq 9.8-4.8%

clotrim/beta lot diprop

Plexion Lot 9.8-4.8%

clotrim/beta CRE diprop

Retin-a Micr Gel 0.08%

clotrim/beta CRE 1-0.05%

Rosula Liq 10-4.5%

ketoconazole sha 2%

Rosula Pad 10-5%

ketoconazole CRE 2%

Sod SUL/Sulf Gel 10-5%

nyamyc pow 100000

Sod SUL/Sulf Sus 10-5%

nyata pow 100000

Sss 10-5 Aer 10-5%

nystat/triam oin

Sumadan Wash Liq 9-4.5%

nystat/triam CRE

Sumaxin Pad 10-4%

nystatin oin 100000

Sumaxin Ts Sus 8-4%

nystatin pow 100000

Sumaxin Wash Liq 9-4%

nystatin CRE 100000

SUL sod/sulf liq 10-2%

nystop pow 100000

SUL sod/sulf pad 10-4%

TIER 03 NON PREFERRED

Tretin-x CRE 0.0375%

ciclopirox sha 1%

Tretin-x CRE 0.075%

clotrimazole sol 1%

Vanoxide-HC Lot 5-0.5%

clotrimazole CRE 1%

Veltin Gel

econazole CRE 1%

Zaclir Lot 8%

ketoconazole aer 2%

Ziana Gel

ketodan aer 2%

naftifine CRE HCL 1%

ROSACEA AGENTS

naftifine CRE HCL 2%

TIER 01 GENERIC

oxiconazole CRE nitrate

metronidazol gel 0.75%

Ecoza Aer 1%

metronidazol CRE 0.75%

Ertaczo CRE 2%

rosadan gel 0.75%

Exelderm CRE 1%

rosadan CRE 0.75%

Exelderm Sol 1%

TIER 02 PREFERRED

Exoderm Lot 25-1%

Finacea Aer 15%

Extina Aer 2%

Finacea Gel 15%

Halotin CRE 1%

TIER 03 NON PREFERRED

Jublia Sol 10%PA

metronidazol gel 1%

Kerydin Sol 5%PA

metronidazol lot 0.75%

Loprox CRE 0.77%

Doxycycline CAP 40MG

Loprox Kit 0.77%

Metrocream CRE 0.75%

Loprox Sha 1%

Metrogel Gel 1%

Loprox Sus 0.77%

Metrolotion Lot 0.75%

Lotrisone CRE

Metronidazole 0.75% Jelly

Luzu CRE 1%

Mirvaso Gel 0.33%

Naftin CRE 1%

Noritate CRE 1%

Naftin CRE 2%

Oracea CAP 40MGPA

Naftin Gel 1%

Rhofade CRE 1%PA

Naftin Gel 2%

Rosadan Kit 0.75%

Nizoral Sha 2%

Soolantra CRE 1%

Oxistat CRE 1%

Effective January 1, 2018

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Oxistat Lot 1%

ANTISEBORRHEIC AGENTS

Penlac Sol 8%

TIER 01 GENERIC

Vusion Oin

selenium SUL lot 2.5%

Xolegel Gel 2%

sod sulfacet sha 10%

Selenium SUL Sha 2.25%

ANTIVIRALS - TOPICAL

TIER 03 NON PREFERRED

TIER 03 NON PREFERRED

seb-prev liq wash

acyclovir oin 5%

selenium SUL sha 2.25%

Denavir CRE 1%

sod sulfacet gel 10%

Xerese CRE 5-1%

sodium SULFA liq 10% wash

Zovirax CRE 5%

Loutrex CRE

Ovace Plus Aer 9.8%

ANTI-INFLAMMATORY AGENTS

Ovace Plus CRE 10%

Ovace Plus Gel 10% Wash

TIER 03 NON PREFERRED

Ovace Plus Liq 10% Wash

diclofenac gel 1%

Ovace Plus Sha 10%

diclofenac sol 1.5%

Ovace Wash Liq 10%

klofensaid sol II

Promiseb CRE

Diclofenac CRE Sodium

Selrx Sha 2.3%

Flector Dis 1.3%

Sodium SULFA Liq 10% Wash

Pennsaid Sol 2%

Tersi Foam Aer 2.25%

Rexaphenac CRE 1%

Voltaren Gel 1%

CORTICOSTEROIDS - TOPICAL

ANTIPRURITICS

TIER 01 GENERIC

ala-cort CRE 2.5%

TIER 03 NON PREFERRED

alphatrex gel 0.05%

Doxepin HCL CRE 5%

aug betamet gel 0.05%

Prudoxin CRE 5%

aug betamet lot 0.05%

Zonalon CRE 5%

aug betamet oin 0.05%

aug betamet CRE 0.05%

ANTIPSORIATICS

beta diprop gel 0.05%

TIER 01 GENERIC

betameth dip lot 0.05%

calcipotrien oin 0.005%

betameth dip oin 0.05%

calcipotrien sol 0.005%

betameth dip CRE 0.05%

calcipotrien CRE 0.005%

betameth val aer 0.12%

calcitrene oin 0.005%

betameth val lot 0.1%

tazarotene CRE 0.1%

betameth val oin 0.1%

Dritho-creme CRE HP 1%

betameth val CRE 0.1%

Tazorac CRE 0.1%

clobetasol gel 0.05%

Vectical Oin 3mcg/Gm

clobetasol sol 0.05%

TIER 02 PREFERRED

cormax scalp sol 0.05%

Tazorac CRE 0.05%

desonide lot 0.05%

Tazorac Gel 0.05%

desonide oin 0.05%

Tazorac Gel 0.1%

desonide CRE 0.05%

TIER 04 SPECIALTY

desoximetas gel 0.05%

acitretin CAP 10MGQL

desoximetas oin 0.05%

acitretin CAP 17.5MGQL

desoximetas oin 0.25%

acitretin CAP 25MGQL

desoximetas CRE 0.05%

methoxsalen CAP 10MGQL

desoximetas CRE 0.25%

Cosentyx Inj 150MG/MLQL,PA

fluocin acet oil body

Cosentyx Inj 300doseQL,PA

fluocin acet oil scalp

Cosentyx Pen Inj 150MG/MLQL,PA

fluocin acet oil 0.01% sc

Cosentyx Pen Inj 300doseQL,PA

fluocin acet oil 0.01%bdy

Oxsoralen-ul CAP 10MGQL,PA

fluocin acet oin 0.025%

Siliq Inj 210/1.5QL,PA

fluocin acet sol 0.01%

Soriatane CAP 10MGQL,PA

fluocin acet CRE 0.01%

Soriatane CAP 17.5MGQL,PA

fluocin acet CRE 0.025%

Soriatane CAP 25MGQL,PA

fluocinonide gel 0.05%

Stelara Inj 45MG/0.5QL,PA

fluocinonide oin 0.05%

Stelara Inj 90MG/MLQL,PA

fluocinonide sol 0.05%

Taltz Inj 80MG/MLQL,PA

fluocinonide CRE e 0.05%

Tremfya Inj 100MG/MLQL,PA

fluocinonide CRE 0.05%

8-mop CAP 10MGQL,PA

halobetasol oin 0.05%

TIER 03 NON PREFERRED

halobetasol CRE 0.05%

Calcitriol Oin 3mcg/Gm

hydrocort lot 2.5%

Dovonex CRE 0.005%

hydrocort oin 1%

Sorilux Aer 0.005%

hydrocort oin 2.5%

Zithranol Sha 1%

hydrocort CRE 2.5%

Zithranol-rr CRE 1.2%

hydrocort/ab oin 1%

Effective January 1, 2018

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hydrosortiso oin absorbas

Clobex Sha 0.05%

lokara lot 0.05%

Clobex Spr 0.05%

mometasone oin 0.1%

Clocortolone CRE Piv 0.1%

mometasone sol 0.1%

Cloderm CRE 0.1%

mometasone CRE 0.1%

Cloderm CRE 0.1% Pmp

triamcinolon lot 0.025%

Cordran CRE 0.05%

triamcinolon lot 0.1%

Cordran Lot 0.05%

triamcinolon oin 0.025%

Cordran Oin 0.05%

triamcinolon oin 0.1%

Cutivate CRE 0.05%

triamcinolon oin 0.5%

Cutivate Lot 0.05%

triamcinolon CRE 0.025%

Derma-smooth Oil /FS Body

triamcinolon CRE 0.1%

Derma-smooth Oil /FS Sclp

triamcinolon CRE 0.5%

Dermasorb HC Kit 2%

triderm CRE 0.1%

Dermatop CRE 0.1%

triderm CRE 0.5%

Dermatop Oin 0.1%

Desowen CRE 0.05%

Desonate Gel 0.05%

Desowen Lot 0.05%

Diflorasone CRE 0.05%

HC butyrate oin 0.1%

Diflorasone Oin 0.05%

HC butyrate sol 0.1%

Diprolene AF CRE 0.05%

HC butyrate CRE 0.1%

Diprolene Lot 0.05%

HC pramoxine CRE 2.5-1% (topical)

Diprolene Oin 0.05%

HC valerate oin 0.2%

Elocon CRE 0.1%

HC valerate CRE 0.2%

Elocon Lot 0.1%

Synalar CRE 0.025%

Elocon Oin 0.1%

Synalar Oin 0.025%

Enstilar Aer

Tridesilon CRE 0.05%

Epifoam Aer 1%

TIER 02 PREFERRED

Halog CRE 0.1%

Capex Sha 0.01%

Halog Oin 0.1%

Cordran 24X3 Tap 4mcg/CM

Kenalog Aer Spray

Cordran 80X3 Tap 4mcg/CM

Locoid CRE 0.1%

Pramosone CRE 1-1%

Locoid Lipo CRE 0.1%

Pramosone Lot 1%

Locoid Lot 0.1%

Pramosone Lot 2.5%

Locoid Oin 0.1%

TIER 04 SPECIALTY

Locoid Sol 0.1%

calcipotrien oin betamethQL,PA

Luxiq Aer 0.12%

Taclonex OinQL,PA

Micort-HC CRE 2.5%

Ultravate Lot 0.05%QL,PA

Novacort Gel

TIER 03 NON PREFERRED

Nucort Lot 2%

ala-cort CRE 1%

Olux Aer 0.05%

alclometason oin 0.05%

Olux-e Aer 0.05%

alclometason CRE 0.05%

Pandel CRE 0.1%

clobetasol aer 0.05%

Pediaderm HC Kit

clobetasol e CRE 0.05%ST

Pramosone CRE 1-2.5%

clobetasol lot 0.05%

Psorcon CRE 0.05%

clobetasol oin 0.05%ST

Sernivo Spr

clobetasol sha 0.05%

Synalar Sol 0.01%

clobetasol spr 0.05%

Taclonex Sus

clobetasol CRE 0.05%ST

Temovate CRE 0.05%ST

clodan sha 0.05%

Temovate E CRE 0.05%emlST

fluocinonide CRE 0.1%

Temovate Gel 0.05%

flurandrenol lot 0.05%

Temovate Oin 0.05%ST

flurandrenol oin 0.05%

Temovate Sol 0.05%

flurandrenol CRE 0.05%

Texacort Sol 2.5%

fluticasone lot 0.05%

Topicort CRE 0.05%

fluticasone oin 0.005%

Topicort CRE 0.25%

fluticasone CRE 0.05%

Topicort Gel 0.05%

hydrocort CRE 1%

Topicort Oin 0.05%

nolix lot 0.05%

Topicort Oin 0.25%

prednicarbat oin 0.1%

Topicort Spr 0.25%

prednicarbat CRE 0.1%

Trianex Oin 0.05%

scalacort lot 2%

Ultravate CRE 0.05%

triamcinolon aer spray

Ultravate Oin 0.05%

Aclovate CRE 0.05%

Vanos CRE 0.1%

Adv Allergy Kit Collecti

Verdeso Aer 0.05%

Ala Scalp Lot 2%

Westcort Oin 0.2%

Amcinonide CRE 0.1%

Amcinonide Lot 0.1%

IMMUNOMODULATING AGENTS

Amcinonide Oin 0.1%

TIER 01 GENERIC

Apexicon E CRE 0.05%

tacrolimus oin 0.03%

Clobex Lot 0.05%

Effective January 1, 2018

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tacrolimus oin 0.1%

lidocaine CRE 3%

TIER 02 PREFERRED

lidopin CRE 3%

Elidel CRE 1%

lindane lot 1%

TIER C ORAL CHEMO

lindane sha 1%

imiquimod CRE 5%

lorenza pad 4-1%

Aldara CRE 5%

malathion lot 0.5%

TIER 03 NON PREFERRED

migryl mis 0.0375-5

Protopic Oin 0.03%

pramox gel 1%

Protopic Oin 0.1%

rea LO 39 CRE 39%

Zyclara CRE 3.75%

releevia ML pad 4-1%

Zyclara P.M. CRE 2.5%

remeven CRE 50%

Zyclara P.M. CRE 3.75%

salacyn lot 6%

salacyn CRE 6%

DERMATOLOGICALS - MISC.

salicylic ac gel 6%

salicylic ac liq 26%

TIER 01 GENERIC

salicylic ac liq 27.5%

agoneaze kit 2.5-2.5%

salicylic ac lot 6%

anodyne lpt kit 2.5-2.5%

salicylic ac sha 6%

dermacinrx kit prizopak

salicylic ac CRE 6%

empricaine kit 2.5-2.5%

salicylic aer 6%

glydo gel 2%

salisol fort sol 26%

leva set kit

salitech lot forte

leva set kit 2.5-2.5%

synvexia pad 4-1%

lido bdk kit

umecta mouss aer 40%

lido-prilo kit 2.5-2.5%

ure-k CRE 50%

lido/prilocn kit 2.5-2.5%

ure-39 CRE 39%

lido/prilocn CRE 2.5-2.5%

urea gel 40%

lidocaine gel 2%

urea hydrati aer 35%

lidocaine gel 2% jelly

urea nail gel 45%

lidocaine pad 5%

urea CRE 39%

lidocaine-pr CRE

urea CRE 45%

lidopril kit 2.5-2.5%

urea CRE 47%

lidopril XR kit 2.5-2.5%

urea CRE 50%

liprozonepak kit 2.5-2.5%

urea 40% sus nail

livixil PAK kit 2.5-2.5%

xyphex mis

medolor PAK kit 2.5-2.5%

zeruvia pad 4-1%

permethrin CRE 5%

Acuicyn Liq

podofilox sol 0.5%

Adazin CRE

prilolid kit 2.5-2.5%

Aluvea CRE 39%

priloxx LP kit 2.5-2.5%

Anacaine Oin

rea LO 40 CRE 40%

Anastia Lot 2.75%

relador PAK kit plus

Astero Gel 4%

relador PAK kit 2.5-2.5%

Atopiclair CRE

urea CRE 40%

Avenova Sol Neutrox

LP lite PAK kit 2.5-2.5%

Avenova Sol 0.01%

TIER 02 PREFERRED

Bensal HP Oin

Condylox Gel 0.5%

Cem-urea Sol 45%

Drysol Sol 20%

Ceracade Emu

Eurax CRE 10%

Condylox Sol 0.5%

Eurax Lot 10%

Dexeryl CRE

Ulesfia Lot 5%

Eha Lot 4%

TIER 03 NON PREFERRED

Eletone CRE

ammonium lac lot 12%

Eletone CRE Twinpack

ammonium lac CRE 12%

Elimite CRE 5%

anodynz mis 0.0375-5

Emla CRE 2.5-2.5%

ceramax CRE

Emulsion SB Emu

cidaleaze CRE 3%

Entty Emu Spray

ethyl chlor aer spray

Epiceram Emu

geri-hydrola lot 5%

Ethyl Chlor Aer Fine Pin

geri-hydrola CRE 12%

Ethyl Chlor Aer Fn Strm

hyaluronate gel 0.2%

Ethyl Chlor Aer Mist

lac-hydrin lot five

Ethyl Chlor Aer MED Jet

lactic acid lot 10%

Ethyl Chlor Aer MED Strm

lactic acid CRE /vit e

Ethyl Chlor Aer Spray

lactic acid CRE e

Flexin Pad .0375-5%

lidenza pad 4-1%

Gebauers Spr Aer /Stretch

lidocaine oin PAK 5%

Hydro 35 Aer

lidocaine oin 5%

Hydro 40 Aer Foam

lidocaine sol 4%

Hylatopic Aer Plus

lidocaine CRE 3.88%

Hylatopic CRE Plus

Effective January 1, 2018

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Hylira Gel 0.2%

Urea Topical Sus 40%

Hylira Lot 0.1%

Urevaz CRE 44%

HPR Aer

Utopic CRE 41%

HPR Plus Aer

Veregen Oin 15%

HPR Plus CRE

Virasal Liq 27.5%

Kamdoy Emu

Xeralux CRE

Keralac CRE 47%

Xylocaine Sol 4%

Keralyt Gel 6%

Lac-hydrin CRE 12%

ENDOCRINE AND METABOLIC

Lac-hydrin Lot 12%

CORTICOSTEROIDS

Ldo Plus Gel 4%

TIER 01 GENERIC

Levatio Pad 0.3-5%

deltasone TAB 20MG

Lido-k Lot 3%

dexameth PHO inj 10MG/ML

Lidocaine Lot 3%

dexameth PHO inj 120MG/30

Lidoderm Dis 5%

dexameth PHO inj 20MG/5ML

Lidorx Gel 3%

dexameth PHO inj 4MG/ML

Lidothol Pad 4.5-5%

dexamethason elx 0.5/5ML

Lidotral CRE 3.88%

dexamethason TAB 0.5MG

Lidotrex Gel 2%

dexamethason TAB 0.75MG

Lidovin CRE 3.95%

dexamethason TAB 1.5MG

Lidozol CRE 3.75%

dexamethason TAB 4MG

Lindane Lot 1%

dexamethason TAB 6MG

Lindane Sha 1%

fludrocort TAB 0.1MG

Lycelle Gel

hydrocort TAB 10MG

Medi-patch Pad RX

hydrocort TAB 20MG

Menthocin Pad Lidocain

hydrocort TAB 5MG

Mentholix Spr 4-1%

methylpr ace inj 40MG/ML

Natroba Sus 0.9%

methylpr ace inj 80MG/ML

Neosalus Aer

methylpr ss inj 125MG

Neosalus CP CRE

methylpred TAB 16MG

Neosalus CRE

methylpred TAB 32MG

Neuvaxin Pad 0.0375-5

methylpred TAB 4MG

Nivatopic CRE Plus

methylpred TAB 8MG

Noble Mystiq CRE Emu-lac

pred sod PHO sol 5MG/5ML

Numbonex Lot 2.75%

prednisolone sol 15MG/5ML

Ovide Lot 0.5%

prednisolone syp 15MG/5ML

Oxsoralen Lot 1%

prednisone TAB 1MG

Pain Ease Aer Mist

prednisone TAB 10MG

Pain Ease Aer MD Strm

prednisone TAB 2.5MG

Pain Relief Pad Patch

prednisone TAB 20MG

Permavan Pad

prednisone TAB 5MG

Phlag Spr

Cortisone Ac TAB 25MG

Podocon Sol 25%

Dexameth PHO Inj 10MG/ML

Presera Aer

Dexamethason Sol 0.5/5ML

Pro:12 Aer Mousse

Dexamethason TAB 1MG

Pruclair CRE

Dexamethason TAB 2MG

Prumyx CRE

Prednisolone Sol 25MG/5ML

Pyrogall Acd Oin

Prednisone PAK 10MG

Releevia Mc Pad .0375-5%

Prednisone PAK 5MG

Releevia Pad .0375-5%

Prednisone Sol 5MG/5ML

Remaxazon Pad

Prednisone TAB 50MG

Renovo Pad 0.0375-5

TIER 02 PREFERRED

Rynoderm CRE 37.5%

Depo-medrol Inj 20MG/ML

Salex Sha 6%

Dexamethason CON 1MG/ML

Salitech Lot 5%

Medrol TAB 2MG

Salvax Aer 6%

Solu-cortef Inj 100MG

Sklice Lot 0.5%

TIER 04 SPECIALTY

Soothee Pad

Emflaza Sus 22.75/MLQL,PA

Spinosad Sus 0.9%

Emflaza TAB 18MGQL,PA

Synera Dis 70-70MG

Emflaza TAB 30MGQL,PA

Synerderm Emu

Emflaza TAB 36MGQL,PA

Tetramex Spr 2-1-3%

Emflaza TAB 6MGQL,PA

Tetrix CRE

Entocort EC CAP 3MG DRQL,PA

Tranzarel Gel 4%

Uceris TAB 9MGQL,PA

Umecta Emu

TIER 03 NON PREFERRED

Umecta Nail Sus Film

beta-phos/ac inj 3-3MG/ML

Umecta PD Emu 40-0.3%

budesonide CAP 3MG DRQL,PA

Uramaxin CRE 45%

prednisolone sol 10MG/5ML

Uramaxin Gel 45%

prednisolone sol 20MG/5ML

Uramaxin GT Gel 45%

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 21

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prednisolone TAB 10MG odt

Androxy TAB 10MG

prednisolone TAB 15MG odt

Axiron Sol 30MG/ActQL,PA

prednisolone TAB 30MG odt

Depo-testost Inj 100MG/MLPA

Celestone Inj Soluspan

Fortesta Gel 10MG/ActQL,PA

Cortef TAB 10MG

Methitest TAB 10MGPA

Cortef TAB 20MG

Natesto Gel 5.5MGQL,PA

Cortef TAB 5MG

Oxandrin TAB 10MG

Depo-medrol Inj 40MG/ML

Oxandrin TAB 2.5MG

Depo-medrol Inj 80MG/ML

Striant Mis 30MGQL,PA

Dex LA 16 Inj 16MG/ML

Testim Gel 1%(50MG)QL,PA

Dexpak PAK 10 Day

Testone Cik Kit 200MG/ML

Dexpak PAK 13 Day

Testosterone Gel 10MG/ActQL,PA

Dexpak PAK 6 Day

Vogelxo Gel P.M. 1%QL,PA

Kenalog-10 Inj 10MG/ML

Vogelxo Gel 1%(50MG)QL,PA

Kenalog-40 Inj 40MG/ML

Locort PAK 11-day

ESTROGENS

Locort PAK 7-day

TIER 01 GENERIC

Medrol TAB 16MG

estrad val inj 20MG/MLPA

Medrol TAB 32MG

estrad val inj 200MG/5PA

Medrol TAB 4MG

estradiol dis 0.025MG weeklyPA

Medrol TAB 8MG

estradiol dis 0.0375MG weeklyPA

Millipred DP PAK 5MG

estradiol dis 0.05MG weeklyPA

Millipred Sol 10MG/5ML

estradiol dis 0.06MG weeklyPA

Millipred TAB 5MG

estradiol dis 0.075MG weeklyPA

Orapred Odt TAB 10MG

estradiol dis 0.1MG weeklyPA

Orapred Odt TAB 15MG

estradiol TAB 0.5MGPA

Orapred Odt TAB 30MG

estradiol TAB 1MGPA

Pediapred Sol 6.7/5ML

estradiol TAB 2MGPA

Prednisone CON 5MG/ML

Climara Dis 0.025MGPA

Rayos TAB 1MGPA

Climara Dis 0.0375MGPA

Rayos TAB 2MGPA

Climara Dis 0.05MGPA

Rayos TAB 5MGPA

Climara Dis 0.06MGPA

Solu-medrol Inj 125MG

Climara Dis 0.075MGPA

Veripred 20 Sol 20MG/5ML

Climara Dis 0.1MGPA

Zodex PAK 12-day

Estropipate TAB 0.75MGPA

Zodex PAK 6 Day

Estropipate TAB 1.5MGPA

Zonacort PAK 11 Day

Estropipate TAB 3MGPA

Zonacort PAK 7 Day

TIER 02 PREFERRED

Delestrogen Inj 10MG/MLPA

ANDROGENS-ANABOLIC

Depo-estradi Inj 5MG/MLPA

TIER 01 GENERIC

TIER 03 NON PREFERRED

danazol CAP 100MG

amabelz TAB 0.5-0.1PA

danazol CAP 200MG

amabelz TAB 1-0.5MGPA

danazol CAP 50MG

covaryx HS TABPA

testost cyp inj 100MG/MLPA

covaryx TAB 1.25-2.5PA

testost cyp inj 200MG/MLPA

eemt HS TABPA

testost enan inj 200MG/MLPA

eemt TAB 1.25-2.5PA

testosterone gel P.M. 1%QL,PA

est estrogen TAB mtestPA

testosterone gel 1%(25MG)QL,PA

est estrogen TAB mtest HSPA

testosterone gel 1%(50MG)QL,PA

estra/noreth TAB 0.5-0.1PA

Depo-testost Inj 200MG/MLPA

estra/noreth TAB 1-0.5MGPA

Testosterone Gel P.M. 1%QL,PA

estrog/mtest TAB 1.25-2.5PA

Testosterone Gel 1%(25MG)QL,PA

fyavolv TAB 0.5-2.5PA

Testosterone Gel 1%(50MG)QL,PA

fyavolv TAB 1-5PA

QL,PA

jevantique l TAB 0.5-2.5PA

TIER 04 SPECIALTY

jinteli TAB 1MG-5mcgPA

Anadrol-50 TAB 50MGQL,PA

lopreeza TAB 0.5-0.1PA

Android CAP 10MGQL,PA

lopreeza TAB 1-0.5MGPA

Testred CAP 10MGQL,PA

mimvey LO TAB 0.5-0.1PA

TIER 03 NON PREFERRED

mimvey TAB 1-0.5MGPA

methyltestos CAP 10MGQL,PA

noreth/ethin TAB 0.5-2.5PA

oxandrolone TAB 10MG

noreth/ethin TAB 1MG-5mcgPA

oxandrolone TAB 2.5MG

Activella TAB 0.5-0.1PA

testosterone sol 30MG/actQL

Activella TAB 1-0.5MGPA

Androderm Dis 2MG/24HRQL,PA

Alora Dis 0.025MGPA

Androderm Dis 4MG/24HRQL,PA

Alora Dis 0.05MGPA

Androgel Gel 1.62%QL,PA

Alora Dis 0.075MGPA

Androgel Gel 1%(25MG)QL,PA

Alora Dis 0.1MGPA

Androgel Gel 1%(50MG)QL,PA

Angeliq TAB 0.25-0.5PA

Effective January 1, 2018

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Angeliq TAB 0.5-1MGPA

camila TAB 0.35MG

Climara Pro Dis WeeklyPA

camrese LO TAB

Combipatch Dis .05/.14PA

camrese TAB

Combipatch Dis .05/.25PA

caziant PAK

Delestrogen Inj 20MG/MLPA

chateal TAB 0.15/30

Delestrogen Inj 40MG/MLPA

cryselle-28 TAB 28 TABS

Divigel Gel 0.25MGPA

cyclafem TAB 1/35

Divigel Gel 0.5MGPA

cyclafem TAB 7/7/7

Divigel Gel 1MG/GmPA

cyred TAB

Duavee TAB 0.45-20PA

dasetta TAB 1/35

Elestrin Gel 0.06%PA

dasetta TAB 7/7/7

Enjuvia TAB 0.3MGPA

daysee TAB

Enjuvia TAB 0.45MGPA

deblitane TAB 0.35MG

Enjuvia TAB 0.625MGPA

delyla TAB 0.1-0.02

Enjuvia TAB 0.9MGPA

deso/ethinyl TAB estradio

Estrace TAB 0.5MGPA

drospir/ethi TAB 3-0.03MG

Estrace TAB 1MGPA

drospire/ETH TAB estr/lev

Estrace TAB 2MGPA

drospirenone TAB ethy est

Estrogel GelPA

econtra EZ TAB 1.5MG

Evamist Spr 1.53MGPA

elinest TAB

Femhrt TAB 0.5-2.5PA

emoquette TAB

Menest TAB 0.3MGPA

enpresse-28 TAB

Menest TAB 0.625MGPA

enskyce TAB

Menest TAB 1.25MGPA

errin TAB 0.35MG

Menest TAB 2.5MGPA

estarylla TAB 0.25-35

Menostar Dis 14mcgPA

ethy ETH est TAB 1-35

Minivelle Dis 0.025MGPA

ethynodiol TAB 1-50

Minivelle Dis 0.0375MGPA

fallback TAB 1.5MG

Minivelle Dis 0.05MGPA

falmina TAB

Minivelle Dis 0.075MGPA

fayosim TAB

Minivelle Dis 0.1MGPA

femynor TAB 0.25-35

Prefest TABPA

gianvi TAB 3-0.02MG

Premarin TAB 0.3MGPA,ST

gildagia TAB 0.4-35

Premarin TAB 0.45MGPA,ST

gildess FE TAB 1.5/30

Premarin TAB 0.625MGPA,ST

gildess FE TAB 1/20

Premarin TAB 0.9MGPA,ST

gildess TAB 1.5/30

Premarin TAB 1.25MGPA,ST

gildess TAB 1/20

Premphase TABPA

gildess 24 TAB FE 1/20

Prempro TAB .625-2.5PA

heather TAB 0.35MG

Prempro TAB 0.3-1.5PA

introvale TAB

Prempro TAB 0.45-1.5PA

isibloom TAB 0.15-30

Prempro TAB 0.625-5PA

jencycla TAB 0.35MG

Vivelle-dot Dis 0.025MGPA

jolessa TAB

Vivelle-dot Dis 0.0375MGPA

jolivette TAB 0.35MG

Vivelle-dot Dis 0.05MGPA

juleber TAB

Vivelle-dot Dis 0.075MGPA

junel FE TAB 1.5/30

Vivelle-dot Dis 0.1MGPA

junel FE TAB 1/20

junel FE 24 TAB 1/20

CONTRACEPTIVES

junel 1.5/30 TAB

junel 1/20 TAB

TIER P PREVENTIVE

kaitlib FE chw

aftera TAB 1.5MG

kariva TAB 28 day

altavera TAB

kelnor TAB 1/35

alyacen TAB 1/35

kimidess TAB

alyacen TAB 7/7/7

kurvelo TAB 0.15/30

amethia LO TAB

larin FE TAB 1.5/30

amethia TAB

larin FE TAB 1/20

amethyst TAB 90-20mcg

larin TAB 1.5/30

apri TAB

larin TAB 1/20

aranelle TAB

larin 24 TAB FE 1/20

ashlyna TAB

larissia TAB

aubra TAB 0.1-0.02

layolis FE chw

aviane TAB

leena TAB

azurette TAB 28 day

lessina TAB

balziva TAB

levonest TAB

bekyree TAB

levonor/ethi TAB

blisovi FE TAB 1.5/30

levonor/ethi TAB estradio

blisovi FE TAB 1/20

levonor/ethi TAB 0.1-0.02

blisovi 24 TAB FE 1/20

levonorgestr TAB 1.5MG

briellyn TAB

levora-28 TAB 0.15/30

Effective January 1, 2018

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lillow TAB 0.15/30

tri-LO- TAB sprintec

lomedia 24 TAB FE

trinessa LO TAB

loryna TAB 3-0.02MG

trinessa TAB

low-ogestrel TAB

trivora-28 TAB

lutera TAB

velivet PAK

lyza TAB 0.35MG

vestura TAB 3-0.02MG

marlissa TAB 0.15/30

vienva TAB 0.1-20

medroxypr ac inj 150MG/MLQL

viorele TAB

melodetta chw 24 FE

vyfemla TAB 0.4-35

mibelas 24 chw FE

wera TAB 0.5/35

micrgstin 24 TAB FE 1/20

wymzya FE chw 0.4MG-35

microgestin TAB FE 1/20

zarah TAB 3-0.03MG

microgestin TAB FE1.5/30

zenchent FE chw 0.4MG-35

microgestin TAB 1.5/30

zenchent TAB

microgestin TAB 1/20

zovia 1/35e TAB

mono-linyah TAB 0.25-35

zovia 1/50e TAB

mononessa TAB

Depo-sq Prov Inj 104QL

my way TAB 1.5MG

Ella TAB 30MG

myzilra TAB

Kyleena Iud 19.5MG

necon TAB 0.5/35

Levo-ETH Est TAB 90-20mcg

necon TAB 1/35

Liletta Iud 52MG

necon TAB 10/11-28

LO Loestrin TAB

necon TAB 7/7/7

Mirena Iud System

next choice TAB 1.5MG

Natazia TAB

nikki TAB 3-0.02MG

Necon TAB 1/50-28

nora-be TAB 0.35MG

Nexplanon Imp 68MG

nore/ETH/fer chw 0.4MG-35

Norinyl TAB 1+50-28

noreth/ethin chw FE

Nuvaring Mis

noreth/ethin chw FE 1/20

Ogestrel TAB

noreth/ethin TAB FE 1/20

Paragard Iud T380a

noreth/ethin TAB 1/20

Plan B TAB 1.5MG

norethindron TAB 0.35MG

Safyral TAB

norgest/ethi TAB estradio

Skyla Iud 13.5MG

norgest/ethi TAB 0.25/35

Taytulla CAP

norlyda TAB 0.35MG

Xulane Dis 150-35

norlyroc TAB 0.35MG

TIER 03 NON PREFERRED

nortrel TAB 0.5/35

Beyaz TAB

nortrel TAB 1/35

Brevicon TAB 0.5/35PA

nortrel TAB 7/7/7

Cyclessa PAK

ocella TAB 3-0.03MG

Depo-provera Inj 150MG/MLQL

opcicon TAB 1.5MG

Desogen-28 TAB

option 2 TAB 1.5MG

Estrostep FE TAB

orsythia TAB

Femcon FE Chw

philith TAB 0.4-35

Generess FE Chw

pimtrea TAB

Loestrin FE TAB 1.5/30

pirmella TAB 1/35

Loestrin FE TAB 1/20

pirmella TAB 7/7/7

Loestrin TAB 1/20-21

portia-28 TAB

Loestrin 21 TAB 1.5/30

previfem TAB

Loseasonique TAB

quasense TAB

Mircette TAB 28 Day

rajani TAB

Modicon TAB 0.5/35PA

react TAB 1.5MG

Nor-QD TAB 0.35MG

reclipsen TAB

Norinyl TAB 1/35

rivelsa TAB

Ortho Micron TAB 0.35MG

setlakin TAB

Ortho Tri- TAB Cyclen

sharobel TAB 0.35MG

Ortho Tri- TAB Cycln LO

sprintec 28 TAB 28 day

Ortho-cyclen TAB 0.25/35

sronyx TAB

Ortho-novum TAB 1/35

syeda TAB 3-0.03MG

Ortho-novum TAB 7/7/7

take action TAB 1.5MG

Ovcon-35 TAB

tarina FE TAB 1/20

Quartette TAB

tilia FE TAB

Seasonique TAB

tri femynor TAB

Tri-norinyl TAB 28

tri-estaryll TAB

Yasmin 28 TAB 3-0.03MG

tri-legest TAB FE

Yaz TAB 3-0.02MG

tri-linyah TAB

tri-previfem TAB

PROGESTINS

tri-sprintec TAB

TIER 01 GENERIC

tri-LO TAB estaryll

medroxypr ac TAB 10MG

tri-LO- TAB marzia

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medroxypr ac TAB 2.5MG

NON PREFERRED

medroxypr ac TAB 5MG

Adlyxin Inj 10/20mcgPA

norethin ace TAB 5MG

Adlyxin Inj 20mcgPA

progesterone inj 50MG/ML

Bydureon Inj 2MGST

progesterone CAP 100MG

Bydureon Pen Inj 2MGST

progesterone CAP 200MG

Byetta Inj 10mcgST

TIER 03 NON PREFERRED

Byetta Inj 5mcgST

megestrol sus 625MG/5m

Tanzeum Inj 30MGST

Aygestin TAB 5MG

Tanzeum Inj 50MGST

Megace ES Sus 625/5ML

Trulicity Inj 0.75/0.5ST

Prometrium CAP 100MG

Trulicity Inj 1.5/0.5ST

Prometrium CAP 200MG

Victoza Inj 18MG/3MLST

Provera TAB 10MG

SULFONYLUREAS

Provera TAB 2.5MG

TIER 01 GENERIC

Provera TAB 5MG

glimepiride TAB 1MG

glimepiride TAB 2MG

ANTIDIABETIC AGENTS

glimepiride TAB 4MG

glipizide ER TAB 10MG

INSULIN

glipizide ER TAB 2.5MG

TIER 01 GENERIC

glipizide ER TAB 5MG

Humulin Inj 70/30

glipizide TAB 10MG

Humulin Inj 70/30kwp

glipizide TAB 5MG

Humulin N Inj U-100

glipizide XL TAB 10MG

Humulin N Inj U-100kwp

glipizide XL TAB 2.5MG

Humulin R Inj U-100

glipizide XL TAB 5MG

Humulin R Inj U-500

glyburide TAB 1.25MG

TIER 02 PREFERRED

glyburide TAB 2.5MG

Humalog Inj 100/ML

glyburide TAB 5MG

Humalog JR Inj 100/ML

Tolazamide TAB 250MG

Humalog Kwik Inj 100/ML

Tolazamide TAB 500MG

Humalog Kwik Inj 200/ML

Tolbutamide TAB 500MG

Lantus Inj Solostar

TIER 03 NON PREFERRED

Lantus Inj 100/ML

glyburid mcr TAB 1.5MG

Levemir InjPA

glyburid mcr TAB 3MG

Levemir Inj FlextoucPA

glyburid mcr TAB 6MG

TIER 03 NON PREFERRED

Amaryl TAB 1MG

Afrezza Pow 12 UnitPA

Amaryl TAB 2MG

Afrezza Pow 4&8 UnitPA

Amaryl TAB 4MG

Afrezza Pow 4/8/12unPA

Chlorpropam TAB 100MG

Afrezza Pow 4unitPA

Chlorpropam TAB 250MG

Afrezza Pow 8 UnitPA

Diabeta TAB 1.25MG

Afrezza Pow 8&12unitPA

Diabeta TAB 2.5MG

Apidra Inj Solostar

Diabeta TAB 5MG

Apidra Inj U-100

Glucotrol TAB 10MG

Basaglar Inj 100unitPA

Glucotrol TAB 5MG

Fiasp Flex Inj Touch

Glucotrol XL TAB 10MG

Fiasp Inj 100/ML

Glucotrol XL TAB 2.5MG

Humalog Mix Inj 50/50

Glucotrol XL TAB 5MG

Humalog Mix Inj 50/50kwp

Glynase TAB 1.5MG

Humalog Mix Inj 75/25kwp

Glynase TAB 3MG

Humalog Mix Sus 75/25

Glynase TAB 6MG

Novolin Inj 70/30ST

BIGUANIDES

Novolin N Inj RelionST

TIER 01 GENERIC

Novolin N Inj U-100ST

metformin TAB 1000MG

Novolin R Inj RelionST

metformin TAB 500MG

Novolin R Inj U-100ST

metformin TAB 500MG ER

Novolin70/30 Inj RelionST

metformin TAB 750MG ER

Novolog Inj Flexpen

metformin TAB 850MG

Novolog Inj Penfill

TIER 02 PREFERRED

Novolog Inj 100/ML

Riomet Sol

Novolog Mix Inj Flexpen

Riomet Sol 500/5ML

Novolog Mix Inj 70/30

TIER 03 NON PREFERRED

Toujeo Solo Inj 300iu/MLPA

metformin ER TAB 1000MG

Tresiba Flex Inj 100unitPA

metformin TAB 1000 ERPA

Tresiba Flex Inj 200unitPA

Fortamet TAB 1000MG

AMYLIN ANALOGS

Fortamet TAB 500MG

TIER 03 NON PREFERRED

Glucophage TAB 1000MG

Symlinpen 60 Inj 1000mcg

Glucophage TAB 500MG

Symlnpen 120 Inj 1000mcg

Glucophage TAB 500MG XR

INCRETIN MIMETIC AGENTS

Glucophage TAB 750MG XR

TIER 03

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Glucophage TAB 850MG

ANTIDIABETIC COMBINATIONS

Glumetza TAB 1000MGPA

TIER 03 NON PREFERRED

Glumetza TAB 500MGPA

glip/metform TAB 2.5-250m

MEGLITINIDE ANALOGUES

glip/metform TAB 2.5-500m

TIER 03 NON PREFERRED

glip/metform TAB 5-500MG

nateglinide TAB 120MG

glyb/metform TAB 1.25-250

nateglinide TAB 60MG

glyb/metform TAB 2.5-500

repaglinide TAB 0.5MG

glyb/metform TAB 5-500MG

repaglinide TAB 1MG

pioglit/glim TAB 30-2MG

repaglinide TAB 2MG

pioglit/glim TAB 30-4MG

Prandin TAB 0.5MG

pioglita/met TAB 15-500MG

Prandin TAB 1MG

pioglita/met TAB 15-850MG

Prandin TAB 2MG

Actoplus Met TAB XR

Starlix TAB 120MG

Actoplus Met TAB 15-500MG

Starlix TAB 60MG

Actoplus Met TAB 15-850MG

DIABETIC OTHER

Alog/Pioglit TAB 12.5-15PA

TIER 02 PREFERRED

Alog/Pioglit TAB 12.5-30PA

Glucagen Inj Hypokit

Alog/Pioglit TAB 12.5-45PA

Glucagon Kit 1MG

Alog/Pioglit TAB 25-15MGPA

Jardiance TAB 10MGQL,PA

Alog/Pioglit TAB 25-30MGPA

Jardiance TAB 25MGQL,PA

Alog/Pioglit TAB 25-45MGPA

Proglycem Sus 50MG/ML

Alogliptin/ TAB MetformPA

TIER 04 SPECIALTY

Duetact TAB 30-2MG

Korlym TAB 300MGQL,PA

Duetact TAB 30-4MG

TIER 03 NON PREFERRED

Glucovance TAB 2.5-500

Cycloset TAB 0.8MGST

Glucovance TAB 5-500MG

Farxiga TAB 10MGPA

Glyxambi TAB 10-5 MGST

Farxiga TAB 5MGPA

Glyxambi TAB 25-5 MGST

Invokana TAB 100MGPA

Invokamet TAB 150-1000PA

Invokana TAB 300MGPA

Invokamet TAB 150-500PA

ALPHA-GLUCOSIDASE INHIBIT

Invokamet TAB 50-1000PA

TIER 01 GENERIC

Invokamet TAB 50-500MGPA

acarbose TAB 100MG

Invokamet XR TAB 150-1000PA

acarbose TAB 25MG

Invokamet XR TAB 150-500PA

acarbose TAB 50MG

Invokamet XR TAB 50-1000PA

TIER 03 NON PREFERRED

Invokamet XR TAB 50-500MGPA

miglitol TAB 100MG

Janumet TAB 50-1000PA

miglitol TAB 25MG

Janumet TAB 50-500MGPA

miglitol TAB 50MG

Janumet XR TAB 100-1000PA

Glyset TAB 100MG

Janumet XR TAB 50-1000PA

Glyset TAB 25MG

Janumet XR TAB 50-500MGPA

Glyset TAB 50MG

Jentadueto TAB XRST

Precose TAB 100MG

Jentadueto TAB 2.5-1000ST

Precose TAB 25MG

Jentadueto TAB 2.5-500ST

Precose TAB 50MG

Jentadueto TAB 2.5-850ST

DPP-4 INHIBITORS

Kazano 12.5- TAB 1000MGPA

TIER 03 NON PREFERRED

Kazano 12.5- TAB 500MGPA

Alogliptin TAB 12.5MGPA

Kombiglyz XR TAB 2.5-1000PA

Alogliptin TAB 25MGPA

Kombiglyz XR TAB 5-1000MGPA

Alogliptin TAB 6.25MGPA

Kombiglyz XR TAB 5-500MGPA

Januvia TAB 100MGPA

Oseni TAB 12.5-15PA

Januvia TAB 25MGPA

Oseni TAB 12.5-30PA

Januvia TAB 50MGPA

Oseni TAB 12.5-45PA

Nesina TAB 12.5MGPA

Oseni TAB 25-15MGPA

Nesina TAB 25MGPA

Oseni TAB 25-30MGPA

Nesina TAB 6.25MGPA

Oseni TAB 25-45MGPA

Onglyza TAB 2.5MGPA

Prandimet TAB 1-500MG

Onglyza TAB 5MGPA

Prandimet TAB 2-500MG

Tradjenta TAB 5MGST

Repaglinide TAB 1-500MG

INSULIN SENSITIZING AGENT

Repaglinide TAB 2-500MG

TIER 03 NON PREFERRED

Soliqua Inj 100/33PA

pioglitazone TAB 15MG

Synjardy TABQL,PA

pioglitazone TAB 30MG

Synjardy TAB 12.5-500QL,PA

pioglitazone TAB 45MG

Synjardy TAB 5-1000MGQL,PA

Actos TAB 15MG

Synjardy TAB 5-500MGQL,PA

Actos TAB 30MG

Synjardy XR TABPA

Actos TAB 45MG

Synjardy XR TAB 10-1000PA

Avandia TAB 2MG

Synjardy XR TAB 25-1000PA

Avandia TAB 4MG

Synjardy XR TAB 5-1000MGPA

Avandia TAB 8MG

Xigduo XR TAB 10-1000PA

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Xigduo XR TAB 10-500MGPA

TIER 03 NON PREFERRED

Xigduo XR TAB 5-1000MGPA

Lupaneta Kit 11.25-5PA

Xigduo XR TAB 5-500MGPA

Lupaneta Kit 3.75-5PA

Xultophy Inj 100/3.6PA

Lupr Dep-PED Inj 3m 30MG

Synarel Sol 2MG/MLQL

BISPHOSPHONATES

GROWTH HORMONES

TIER 01 GENERIC

alendronate TAB 10MG

TIER 04 SPECIALTY

alendronate TAB 35MG

Genotropin Inj 0.2MGQL,PA

alendronate TAB 5MG

Genotropin Inj 0.4MGQL,PA

alendronate TAB 70MG

Genotropin Inj 0.6MGQL,PA

risedronate TAB 150MGST

Genotropin Inj 0.8MGQL,PA

risedronate TAB 30MGST

Genotropin Inj 1.2MGQL,PA

risedronate TAB 35MG

Genotropin Inj 1.4MGQL,PA

risedronate TAB 5MGST

Genotropin Inj 1.6MGQL,PA

Alendronate Sol 70/75ML

Genotropin Inj 1.8MGQL,PA

Alendronate TAB 40MG

Genotropin Inj 1MGQL,PA

Etidron Disd TAB 200MG

Genotropin Inj 12MGQL,PA

Etidron Disd TAB 400MG

Genotropin Inj 2MGQL,PA

TIER M MEDICAL COPAY

Genotropin Inj 5MGQL,PA

zoledronic inj 4MG/5MLPA

Humatrope Inj 12MGQL,PA

Zoledronic Inj 4MGPA

Humatrope Inj 24MGQL,PA

TIER 03 NON PREFERRED

Humatrope Inj 5MGQL,PA

ibandronate TAB 150MG

Humatrope Inj 6MGQL,PA

risedron sod TAB 35MG DRST

Norditropin Inj 10/1.5MLQL,PA

Actonel TAB 150MGST

Norditropin Inj 15/1.5MLQL,PA

Actonel TAB 30MGST

Norditropin Inj 30/3MLQL,PA

Actonel TAB 35MG

Norditropin Inj 5/1.5MLQL,PA

Actonel TAB 5MGST

Nutropin AQ Inj Nuspin 5QL,PA

Atelvia TABST

Nutropin AQ Inj 10MG/2MLQL,PA

Binosto TAB 70MG

Nutropin AQ Inj 20MG/2MLQL,PA

Boniva TAB 150MG

Omnitrope Inj 10/1.5MLQL,PA

Fosamax + D TAB 70-2800

Omnitrope Inj 5.8MGQL,PA

Fosamax + D TAB 70-5600

Omnitrope Inj 5/1.5MLQL,PA

Fosamax TAB 70MG

Saizen Inj 5MGQL,PA

Saizen Inj 8.8MGQL,PA

CALCITONINS

Saizenprep Inj 8.8MGQL,PA

Serostim Inj 4MGQL,PA

TIER 03 NON PREFERRED

Serostim Inj 5MGQL,PA

calcitonin spr 200/act

Serostim Inj 6MGQL,PA

Fortical Spr 200/Act

Zomacton Inj 10MGQL,PA

Miacalcin Inj 200/ML

Zomacton Inj 5MGQL,PA

Miacalcin Spr 200/Act

Zorbtive Inj 8.8MGQL,PA

PARATHYROID HORMONE

GHRH

TIER 04 SPECIALTY

TIER 04 SPECIALTY

Forteo Sol 600/2.4QL,PA

Egrifta Sol 1MGQL,PA

Natpara Inj 100mcgQL,PA

Natpara Inj 25mcgQL,PA

SOMATOMEDINS

Natpara Inj 50mcgQL,PA

Natpara Inj 75mcgQL,PA

TIER 04 SPECIALTY

Tymlos InjPA

Increlex Inj 40MG/4MLQL,PA

RANK LIGAND INHIBITORS

SOMATOSTATIC AGENTS

TIER M MEDICAL COPAY

TIER 01 GENERIC

Prolia Sol 60MG/MLPA

octreotide inj 100mcg

Xgeva InjPA

octreotide inj 1000mcg

octreotide inj 200mcg

HORMONE RECEPTOR MDLTR

octreotide inj 50mcg/ML

octreotide inj 500mcg

TIER 01 GENERIC

TIER 04 SPECIALTY

raloxifene TAB 60MGPA

Sandostatin Kit Lar 10MGQL

TIER 03 NON PREFERRED

Sandostatin Kit Lar 20MGQL

Evista TAB 60MGPA

Sandostatin Kit Lar 30MGQL

Osphena TAB 60MGPA

Signifor Inj 0.3MG/MLQL,PA

Signifor Inj 0.6MG/MLQL,PA

LHRH/GNRH AGONIST

Signifor Inj 0.9MG/MLQL,PA

TIER 02 PREFERRED

Somatuline Inj 120/.5MLQL,PA

Lupr Dep-PED Inj 11.25MG

Somatuline Inj 60/0.2MLQL,PA

Lupr Dep-PED Inj 15MG

Somatuline Inj 90/0.3MLQL,PA

Lupr Dep-PED Inj 7.5MG

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TIER M MEDICAL COPAY

Nityr TAB 10MGQL,PA

Signifor Lar Inj 20MGPA

Nityr TAB 2MGQL,PA

Signifor Lar Inj 40MGPA

Nityr TAB 5MGQL,PA

Signifor Lar Inj 60MGPA

Orfadin CAP 10MGQL,PA

TIER 03 NON PREFERRED

Orfadin CAP 2MGQL,PA

Sandostatin Inj 100mcg

Orfadin CAP 20MGQL,PA

Sandostatin Inj 1000mcg

Orfadin CAP 5MGQL,PA

Sandostatin Inj 200mcg

Orfadin Sus 4MG/MLQL,PA

Sandostatin Inj 50mcg/ML

Ravicti Liq 1.1gm/MLQL,PA

Sandostatin Inj 500mcg

Sensipar TAB 30MGQL,ST

Sensipar TAB 60MGQL,ST

GH RECEPTOR ANTAGONISTS

Sensipar TAB 90MGQL,ST

Strensiq Inj 18/0.45QL,PA

TIER 04 SPECIALTY

Strensiq Inj 28/0.7MLQL,PA

Somavert Inj 10MGQL,PA

Strensiq Inj 40MG/MLQL,PA

Somavert Inj 15MGQL,PA

Strensiq Inj 80/0.8MLQL,PA

Somavert Inj 20MGQL,PA

TIER M MEDICAL COPAY

Somavert Inj 25MGQL,PA

Fabrazyme Inj 35MGPA

Somavert Inj 30MGQL,PA

Fabrazyme Inj 5MGPA

Lumizyme Inj 50MGPA

POSTERIOR PITUITARY

TIER 03 NON PREFERRED

TIER 01 GENERIC

doxercalcif CAP 0.5mcg

desmopressin inj 4mcg/ML

doxercalcif CAP 1mcg

desmopressin sol 0.01%

doxercalcif CAP 2.5mcg

desmopressin spr 0.01%

paricalcitol CAP 1 mcg

desmopressin TAB 0.1MG

paricalcitol CAP 2 mcg

desmopressin TAB 0.2MG

paricalcitol CAP 4 mcg

TIER 02 PREFERRED

Carnitor Sol 1gm/10ML

Stimate Sol 1.5MG/ML

Carnitor SF Sol 1gm/10ML

TIER 03 NON PREFERRED

Carnitor TAB 330MG

Ddavp Inj 4mcg/ML

Cystadane Pow

Ddavp Sol 0.01%

Hectorol CAP 0.5mcg

Ddavp Spr 0.01%

Hectorol CAP 1mcg

Ddavp TAB 0.1MG

Hectorol CAP 2.5mcg

Ddavp TAB 0.2MG

Rayaldee CAP 30mcgPA

Rocaltrol CAP 0.25mcg

CORTICOTROPIN

Rocaltrol CAP 0.5mcg

TIER 04 SPECIALTY

Rocaltrol Sol 1mcg/ML

H.p. Acthar Inj 80unitQL,PA

Zemplar CAP 1mcg

Zemplar CAP 2mcg

PROLACTIN INHIBITORS

TIER 01 GENERIC

THYROID AGENTS

cabergoline TAB 0.5MG

TIER 01 GENERIC

levothyroxin TAB 100mcg

VASOPRESSIN ANTAGONISTS

levothyroxin TAB 112mcg

TIER 04 SPECIALTY

levothyroxin TAB 125mcg

Samsca TAB 15MGQL,PA

levothyroxin TAB 137mcg

Samsca TAB 30MGQL,PA

levothyroxin TAB 150mcg

levothyroxin TAB 175mcg

PROGESTERONE ANTAGONISTS

levothyroxin TAB 200mcg

TIER 03 NON PREFERRED

levothyroxin TAB 25mcg

Mifeprex TAB 200MG

levothyroxin TAB 300mcg

levothyroxin TAB 50mcg

METABOLIC MODIFIERS

levothyroxin TAB 75mcg

TIER 01 GENERIC

levothyroxin TAB 88mcg

calcitriol sol 1mcg/ML

levothyroxine TAB 0.075MG

calcitriol CAP 0.25mcg

liothyronine TAB 25mcg

calcitriol CAP 0.5mcg

liothyronine TAB 5mcg

levocarnitin sol 1gm/10ML

liothyronine TAB 50mcg

levocarnitin TAB 330MG

methimazole TAB 10MG

TIER 04 SPECIALTY

methimazole TAB 5MG

phenylbutyra pow sodiumQL,PA

propylthiour TAB 50MG

sodium pheny TAB 500MGQL

TIER 03 NON PREFERRED

Buphenyl PowQL,PA

levo-t TAB 100mcg

Buphenyl TAB 500MGQL,PA

levo-t TAB 112mcg

Carbaglu TAB 200MGQL,PA

levo-t TAB 125mcg

Kuvan Pow 100MGQL,PA

levo-t TAB 137mcg

Kuvan Pow 500MGQL,PA

levo-t TAB 150mcg

Kuvan TAB 100MGQL,PA

levo-t TAB 175mcg

Myalept Inj 11.3MGQL,PA

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levo-t TAB 200 mcg

Synthroid TAB 125mcg

levo-t TAB 25mcg

Synthroid TAB 137mcg

levo-t TAB 300 mcg

Synthroid TAB 150mcg

levo-t TAB 50mcg

Synthroid TAB 175mcg

levo-t TAB 75mcg

Synthroid TAB 200mcg

levo-t TAB 88mcg

Synthroid TAB 25mcg

levo/liothyr TAB 30MG

Synthroid TAB 300mcg

levo/liothyr TAB 60MG

Synthroid TAB 50mcg

levo/liothyr TAB 90MG

Synthroid TAB 75mcg

levoxyl TAB 100mcg

Synthroid TAB 88mcg

levoxyl TAB 112mcg

Tapazole TAB 10MG

levoxyl TAB 125mcg

Tapazole TAB 5MG

levoxyl TAB 137mcg

Thyrolar-1 TAB 60MG

levoxyl TAB 150mcg

Thyrolar-1/2 TAB 30MG

levoxyl TAB 175mcg

Thyrolar-1/4 TAB 15MG

levoxyl TAB 200mcg

Thyrolar-2 TAB 120MG

levoxyl TAB 25mcg

Thyrolar-3 TAB 180MG

levoxyl TAB 50mcg

Tirosint CAP 100mcg

levoxyl TAB 75mcg

Tirosint CAP 112mcg

levoxyl TAB 88mcg

Tirosint CAP 125mcg

unith direct TAB 100mcg

Tirosint CAP 13mcg

unith direct TAB 112mcg

Tirosint CAP 137mcg

unith direct TAB 125mcg

Tirosint CAP 150mcg

unith direct TAB 150mcg

Tirosint CAP 25mcg

unith direct TAB 175mcg

Tirosint CAP 50mcg

unith direct TAB 200mcg

Tirosint CAP 75mcg

unith direct TAB 25mcg

Tirosint CAP 88mcg

unith direct TAB 300mcg

Westhroid TAB 130MG

unith direct TAB 50mcg

Westhroid TAB 195MG

unith direct TAB 75mcg

Westhroid TAB 32.5MG

unith direct TAB 88mcg

Westhroid TAB 65MG

unithroid TAB 100mcg

Westhroid TAB 97.5MG

unithroid TAB 112mcg

Wp Thyroid TAB 113.75MG

unithroid TAB 125mcg

Wp Thyroid TAB 130MG

unithroid TAB 137mcg

Wp Thyroid TAB 16.25MG

unithroid TAB 150mcg

Wp Thyroid TAB 32.5MG

unithroid TAB 175mcg

Wp Thyroid TAB 48.75MG

unithroid TAB 200mcg

Wp Thyroid TAB 65MG

unithroid TAB 25mcg

Wp Thyroid TAB 81.25MG

unithroid TAB 300mcg

Wp Thyroid TAB 97.5MG

unithroid TAB 50mcg

unithroid TAB 75mcg

GASTROINTESTINAL

unithroid TAB 88mcg

LAXATIVES

Armour Thyro TAB 120MG

TIER 01 GENERIC

Armour Thyro TAB 180MG

constulose sol 10gm/15

Armour Thyro TAB 240MG

lactulose sol 10gm/15

Armour Thyro TAB 300MG

lactulose sol 20gm/30

Cytomel TAB 25mcg

TIER P PREVENTIVE

Cytomel TAB 5mcg

alophen TAB 5MG EC

Cytomel TAB 50mcg

bisacodyl TAB 5MG EC

Nature Throi TAB 162.5MG

carters TAB 5MG EC

Nature-throi TAB 113.75MG

citroma sol cherry

Nature-throi TAB 130MG

citroma sol lemon

Nature-throi TAB 146.25MG

clearlax pow

Nature-throi TAB 16.25MG

correct TAB 5MG EC

Nature-throi TAB 195MG

correctol TAB 5MG EC

Nature-throi TAB 260MG

ducodyl TAB 5MG EC

Nature-throi TAB 32.5MG

dulcolax pow balance

Nature-throi TAB 325MG

eq clearlax pow

Nature-throi TAB 48.75MG

eql clearlax pow

Nature-throi TAB 65MG

eql gentle TAB laxative

Nature-throi TAB 81.25MG

eql laxative TAB 5MG EC

Nature-throi TAB 97.5MG

feenamint TAB 5MG EC

NP thyroid TAB 120MG

feminine LAX TAB 5MG EC

NP thyroid TAB 15MG

fleet laxati TAB 5MG EC

NP thyroid TAB 30MG

gavilax pow

NP thyroid TAB 60MG

gavilyte-c sol

NP thyroid TAB 90MG

gavilyte-n sol flav pk

Synthroid TAB 100mcg

gavilyte-G sol

Synthroid TAB 112mcg

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gentle laxat TAB 5MG EC

Motofen TAB 1-0.025

gentlelax pow

Mytesi TAB 125MG

glycolax pow 3350 NF

Paregoric Tin 2MG/5ML

gnp bisa-LAX TAB 5MG EC

gnp clearlax pow

ULCER DRUGS

gnp laxative TAB 5MG EC

TIER 01 GENERIC

kp bisacodyl TAB 5MG EC

chlord/clidi CAP 5-2.5MG

laxaclear pow

cimetidine sol 300/5ML

laxative pol pow glycol

cimetidine TAB 200MG

laxative TAB 5MG EC

cimetidine TAB 300MG

natura-LAX pow 3350 NF

cimetidine TAB 400MG

peg 3350 pow

cimetidine TAB 800MG

peg 3350 sol electrol

dicyclomine sol 10MG/5ML

peg-3350 sol electrol

dicyclomine CAP 10MG

peg-3350/KCL sol /sodium

dicyclomine TAB 20MG

pegylax pow

famotidine sus 40MG/5ML

peg3350 pow

famotidine TAB 20MG

polyeth GLYC pow 3350 NF

famotidine TAB 40MG

polyeth GLYC pow 3350-grx

glycopyrrol inj 0.2MG/ML

powderlax pow

glycopyrrol inj 0.4/2ML

qc laxative TAB 5MG EC

glycopyrrol inj 1MG/5ML

ra laxative pow

glycopyrrol inj 4MG/20ML

ra laxative TAB 5MG EC

glycopyrrol TAB 1MG

sm clearlax pow

glycopyrrol TAB 2MG

sm gentle TAB laxative

lansoprazole CAP 15MG DR

sm laxative TAB 5MG EC

lansoprazole CAP 30MG DRST

smooth LAX pow

misoprostol TAB 100mcg

stim laxat TAB 5MG EC

misoprostol TAB 200mcg

sw clearlax pow

omeprazole CAP 10MG

trilyte sol

omeprazole CAP 20MG

vercolate TAB 5MG EC

omeprazole CAP 40MG

womans laxat TAB 5MG EC

pantoprazole TAB 20MG

womens laxat TAB 5MG EC

pantoprazole TAB 40MG

CVS c-LAX TAB 5MG

rabeprazole TAB 20MGST

CVS purelax pow

ranitidine syp 15MG/ML

CVS purelax pow 3350

ranitidine syp 150/10ML

EX-LAX ultra TAB 5MG EC

ranitidine syp 75MG/5ML

HM clearlax pow

ranitidine TAB 150MG

HM laxative TAB 5MG

ranitidine TAB 300MG

HM laxative TAB 5MG EC

sucralfate TAB 1gm

MAG citrate sol

Bella/Opium Sup 16.2-30

MAG citrate sol cherry

Bella/Opium Sup 16.2-60

MAG citrate sol grape

Librax CAP 5-2.5MG

MAG citrate sol lemon

Propanthelin TAB 15MG

SB bisacodyl TAB 5MG EC

TIER 02 PREFERRED

TIER 03 NON PREFERRED

Carafate Sus 1gm/10ML

gavilyte-h kit

Pylera CAP

peg-prep kit

TIER 03 NON PREFERRED

Colyte/Flavr Sol Packs

dicyclomine inj 10MG/ML

CVS senna plus tablet

ed-spaz TAB 0.125MG

Golytely Sol

esomepra MAG CAP 20MG DRPA

Golytely Sol Pineappl

hyoscyamine dro 0.125/ML

Kristalose PAK 10gm

hyoscyamine elx 0.125/5

Kristalose PAK 20gm

hyoscyamine sub 0.125MG

Moviprep Sol

hyoscyamine TAB 0.125MG

Nulytely Sol Flav Pks

hyoscyamine TAB 0.375 ER

Osmoprep TAB 1.5gm

hyoscyamine TAB 0.375 SR

Prepopik PAK

hyosyne dro 0.125/ML

Suprep Bowel Sol Prep Kit

hyosyne elx 0.125/5

lansopr/amox mis /clarith

ANTIDIARRHEALS

methscopolam TAB 2.5MG

TIER 01 GENERIC

methscopolam TAB 5MG

diphen/atrop TAB 2.5MG

nizatidine CAP 150MG

loperamide CAP 2MG

nizatidine CAP 300MG

opium tin 10MG/ML

nulev TAB 0.125MG

Diphen/Atrop Liq 2.5/5

omeppi CAP 20-1100PA

TIER 03 NON PREFERRED

omeppi CAP 40-1100PA

Fulyzaq TAB 125MG

omepra/bicar pow 20-1680PA

Lomotil TAB 2.5MG

omepra/bicar pow 40-1680PA

Effective January 1, 2018

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omepra/bicar CAP 20-1100PA

dronabinol CAP 2.5MG

omepra/bicar CAP 40-1100PA

dronabinol CAP 5MG

oscimin sub 0.125MG

ondansetron inj 4MG/2ML

oscimin SR TAB 0.375MG

ondansetron inj 40/20ML

oscimin TAB 0.125MG

ondansetron sol 4MG/5ML

ranitidine CAP 150MG

ondansetron TAB 24MG

ranitidine CAP 300MG

ondansetron TAB 4MG

symax-SL sub 0.125MG

ondansetron TAB 4MG odt

symax-SR TAB 0.375MG

ondansetron TAB 8MG

Aciphex Spr CAP 10MGPA

ondansetron TAB 8MG odt

Aciphex Spr CAP 5MGPA

scopolamine dis 1MG/3day

Aciphex TAB 20MGST

Dimenhydrin Inj 50MG/ML

Anaspaz TAB 0.125MG

Transderm-sc Dis 1.5MG

Bentyl CAP 10MG

TIER M MEDICAL COPAY

Bentyl Inj 10MG/ML

Aloxi Inj 0.25MG/5PA

Bentyl TAB 20MG

TIER 03 NON PREFERRED

Cantil TAB 25MG

aprepitant CAP 40MG

Carafate TAB 1gm

granisetron TAB 1MGPA

Cuvposa Sol 1MG/5ML

meclizine TAB 12.5MG

Cytotec TAB 100mcg

meclizine TAB 25MG

Cytotec TAB 200mcg

trimethobenz CAP 300MG

Dexilant CAP 30MG DRPA

Akynzeo CAP 300-0.5

Dexilant CAP 60MG DRPA

Anzemet TAB 100MG

Esomeprazole CAP 24.65MGPA

Anzemet TAB 50MG

Esomeprazole CAP 49.3MGPA

Cesamet CAP 1MG

First-omepra Sus 2MG/ML

Diclegis TAB 10-10MG

Lansoprazole Sus 3MG/ML

Emend CAP 125MG

Levbid TAB 0.375 ER

Emend CAP 40MG

Levsin Inj 0.5MG/ML

Emend CAP 80MG

Levsin TAB 0.125MG

Emend Sus 125MG

Levsin/SL Sub 0.125MG

Emend Tripac PAK 80 & 125

Nizatidine Sol 15MG/ML

Marinol CAP 10MG

Omeclamox- Mis PAK

Marinol CAP 2.5MG

Omeprazole + Sus Syrspend

Marinol CAP 5MG

Pamine Forte TAB 5MG

Sancuso Dis 3.1MGPA

Pamine TAB 2.5MG

Tigan CAP 300MG

Pepcid Sus 40MG/5ML

Tigan Inj 100MG/ML

Pepcid TAB 20MG

Varubi TAB 90MGPA

Pepcid TAB 40MG

Zofran Sol 4MG/5ML

Prevacid CAP 15MG DR

Zofran TAB 4MG

Prevacid CAP 30MG DRST

Zofran TAB 4MG Odt

Prevacid TAB 15MG Stb

Zofran TAB 8MG

Prevacid TAB 30MG Stb

Zofran TAB 8MG Odt

Prevpac Mis

Zuplenz Mis 4MG

Prilosec CAP 10MG

Zuplenz Mis 8MG

Prilosec CAP 20MG

Prilosec CAP 40MG

DIGESTIVE AIDS

Prilosec Pow 10MG

TIER 01 GENERIC

Prilosec Pow 2.5MG

Pancrelipase CAP 5000unit

Protonix PAK

TIER 02 PREFERRED

Protonix TAB 20MG

Creon CAP 12000unt

Protonix TAB 40MG

Creon CAP 24000unt

Robinul Fort TAB 2MG

Creon CAP 3000unit

Robinul Inj 0.2MG/ML

Creon CAP 36000unt

Robinul TAB 1MG

Creon CAP 6000unit

Symax Duotab TAB

Pepsin Pow

Zantac TAB 150MG

Zenpep CAP 10000unt

Zantac TAB 300MG

Zenpep CAP 15000unt

Zegerid CAP 20-1100PA

Zenpep CAP 20000unt

Zegerid CAP 40-1100PA

Zenpep CAP 25000unt

Zegerid Pow 20-1680PA

Zenpep CAP 3000unit

Zegerid Pow 40-1680PA

Zenpep CAP 40000unt

Zenpep CAP 5000unit

ANTIEMETICS

TIER 04 SPECIALTY

TIER 01 GENERIC

Sucraid Sol 8500/MLQL,PA

aprepitant CAP 125MG

TIER 03 NON PREFERRED

aprepitant CAP 80MG

Pancreaze CAP

aprepitant PAK 80 & 125

Pancreaze CAP 10500unt

dronabinol CAP 10MG

Pancreaze CAP 16800unt

Effective January 1, 2018

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Pancreaze CAP 21000unt

Dipentum CAP 250MGQL,ST

Pancreaze CAP 4200unit

Fosrenol Chw 1000MGQL,PA

Pertzye CAP

Fosrenol Chw 500MGQL,PA

Ultresa CAP 13800unt

Fosrenol Chw 750MGQL,PA

Ultresa CAP 20700unt

Gattex Kit 5MGQL,PA

Ultresa CAP 23000unt

Lotronex TAB 0.5MGQL,PA

Viokace TAB

Lotronex TAB 1MGQL,PA

Viokace TAB 20880

Ocaliva TAB 10MGQL,PA

Ocaliva TAB 5MGQL,PA

GASTROINTESTINAL - MISC.

Relistor TAB 150MGQL,PA

Velphoro Chw 500MGQL,PA

TIER 01 GENERIC

Viberzi TAB 100MGQL,PA

balsalazide CAP 750MG

Viberzi TAB 75MGQL,PA

calc acetate CAP 667MG

Xermelo TAB 250MGQL,PA

calc acetate TAB 667MG

TIER M MEDICAL COPAY

colocort ene 100MG

Inflectra Inj 100MGPA

enulose sol 10gm/15

Remicade Inj 100MGPA

generlac sol 10gm/15

TIER 03 NON PREFERRED

hydrocort ene 100MG

anucort-HC sup 25MG

hydrocortiso CRE 2.5%

anusol-HC sup 25MG

lactulose sol 10gm/15

cromolyn sod CON 100/5ML

mesalamine ene 4gm

hemmorex-HC sup 25MG

mesalamine TAB 1.2gmST

hemmorex-HC sup 30MG

metoclopram inj 10MG/2ML

hydrocort ac sup 25MG

metoclopram inj 5MG/ML

hydrocort ac sup 30MG

metoclopram sol 10/10ML

hydrocort CRE 1%

metoclopram sol 5MG/5ML

lidocaine/HC kit 3%-0.5%

metoclopram TAB 10MG

lidocaine/HC kit 3%-1%

metoclopram TAB 5MG

lidocaine/HC CRE 3%-0.5%

procto-MED CRE HC 2.5%

mesalamine kit 4gm

proctosol HC CRE 2.5%

procto-PAK CRE 1%

proctozone CRE -HC 2.5%

Actigall CAP 300MG

sevelamer pow 0.8gm

Amitiza CAP 24mcgQL,PA

sevelamer pow 2.4gm

Amitiza CAP 8mcgQL,PA

sevelamer TAB 800MG

Analpram-HC CRE 1-1%

sulfasalazin TAB 500MG

Analpram-HC Lot 2.5%

sulfasalazin TAB 500MG DR

Anusol-HC CRE 2.5%

ursodiol CAP 300MG

Apriso CAP 0.375gmST

ursodiol TAB 250MG

Azulfidine TAB 500MG

ursodiol TAB 500MG

Azulfidine TAB 500MG En

Lialda TAB 1.2gmST

Colazal CAP 750MG

Mesalamine TAB 800MG DRST

Cortenema Ene 100MG

Renvela PAK 2.4gm

Delzicol CAP 400MGST

Renvela TAB 800MG

Eliphos TAB 667MG

TIER 02 PREFERRED

Entereg CAP 12MG

Asacol HD TAB 800MGST

Fosrenol Pow 1000MG

Canasa Sup 1000MG

Fosrenol Pow 750MG

Cortifoam Aer 90MG

Gastrocrom CON 100/5ML

Pentasa CAP 250MG CRST

Giazo TAB 1.1gm

Pentasa CAP 500MG CRST

Lido-hydro Gel 2.8-0.55

Proctofoam Aer HC 1%

Linzess CAP 145mcgQL,PA

Rectiv Oin 0.4%

Linzess CAP 290mcgQL,PA

Relistor Inj 12/0.6ML

Linzess CAP 72mcgQL,PA

Relistor Inj 8/0.4ML

Metoclopram TAB 5MG Odt

Renagel TAB 400MG

Metocloprami TAB 10MG Odt

Renagel TAB 800MG

Metozolv Odt TAB 5MG

Renvela PAK 0.8gm

Movantik TAB 12.5MGQL,PA

TIER 04 SPECIALTY

Movantik TAB 25MGQL,PA

alosetron TAB 0.5MGQL,PA

Phoslyra Sol

alosetron TAB 1MGQL,PA

Procort CRE

lanthanum chw 1000MGQL

Proctocort CRE 1%

lanthanum chw 500MGQL

Proctocort Sup 30MG

lanthanum chw 750MGQL

Reglan TAB 10MG

Auryxia TAB 210MGQL,PA

Reglan TAB 5MG

Chenodal TAB 250MGQL,PA

Rowasa Kit 4gm

Cholbam CAP 250MGQL,PA

Sfrowasa Ene 4gm

Cholbam CAP 50MGQL,PA

Trulance TAB 3MGPA

Cimzia KitQL,PA

Uceris Aer 2MG/Act

Cimzia Kit StarterQL,PA

Urso Forte TAB 500MG

Cimzia Prefl Kit 200MG/MLQL,PA

Urso 250 TAB 250MG

Effective January 1, 2018

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NON PREFERRED

GENITOURINARY

darifenacin TAB 15MGST

darifenacin TAB 7.5MGST

URINARY ANTI-INFECTIVES

Detrol LA CAP 2MG

TIER 01 GENERIC

Detrol LA CAP 4MG

methenam hip TAB 1gm

Detrol TAB 1MG

nitrofur mac CAP 100MG

Detrol TAB 2MG

nitrofur mac CAP 25MG

Ditropan XL TAB 10MG

nitrofur mac CAP 50MG

Ditropan XL TAB 15MG

nitrofurantn sus 25MG/5ML

Ditropan XL TAB 5MG

nitrofurantn CAP 100MG

Enablex TAB 15MGPA

TIER 03 NON PREFERRED

Enablex TAB 7.5MGPA

azuphen mb CAP 120MG

Gelnique Gel 10%ST

hyolev mb TAB 81MG

Gelnique Gel 10% P.M.ST

hyophen TAB

Gelnique Gel 3%ST

indiomin mb CAP 120MG

Myrbetriq TAB 25MGST

me/naphos/mb TAB hyo 1

Myrbetriq TAB 50MGST

methenam man TAB 1gm

Oxytrol Dis 3.9MG/24

methenam man TAB 1000MG

Toviaz TAB 4MGST

phosphasal TAB

Toviaz TAB 8MGST

ur n-c TAB

Urecholine TAB 10MG

uramit mb CAP 118MG

Urecholine TAB 25MG

urelle TAB

Urecholine TAB 5MG

uretron d/s TAB

Urecholine TAB 50MG

uribel CAP 118MG

Vesicare TAB 10MGST

urin d/s TAB

Vesicare TAB 5MGST

uro-blue TAB 81.6MG

uro-l TAB 81MG

VAGINAL PRODUCTS

uro-mp CAP 118MG

TIER 01 GENERIC

uro-458 TAB

clindamycin CRE 2% vag

uroav-b CAP

estradiol TAB 10mcg

uroav-81 TAB

metronidazol gel 0.75%vag

urolet mb TAB

vandazole gel 0.75%

urophen mb TAB 81.6MG

yuvafem TAB 10mcg

uryl TAB

TIER 02 PREFERRED

ustell CAP

Estrace Vag CRE 0.1MG/Gm

uta CAP 120MG

Estring Mis 2MG

uticap CAP

Femring Mis 0.05/24h

utira-c TAB

Femring Mis 0.1MG/24

utrona-c TAB

Premarin Vag CRE 0.625MG

Furadantin Sus 25MG/5ML

TIER P PREVENTIVE

Hiprex TAB 1gm

vcf vaginal aer contracp

Macrobid CAP 100MG

vcf vaginal gel contrace

Macrodantin CAP 100MG

Conceptrol Gel 4%

Macrodantin CAP 25MG

Encare Sup 100MG

Macrodantin CAP 50MG

Gynol II Gel 3%

Methenam Man TAB 500MG

Shur-seal Gel 2%

Monurol PAK Granules

Today Sponge Mis

Urimar-t TAB

Vcf Vaginal Aer Contracp

Urogesic- TAB Blue

Vcf Vaginal Mis Contracp

TIER 03 NON PREFERRED

URINARY ANTISPASMODICS

terconazole sup 80MG

TIER 01 GENERIC

terconazole CRE 0.4%

bethanechol TAB 10MG

terconazole CRE 0.8%

bethanechol TAB 25MG

zazole sup 80MG

bethanechol TAB 5MG

zazole CRE 0.8%

bethanechol TAB 50MG

Avc CRE 15%

flavoxate TAB 100MG

Cleocin CRE 2% Vag

oxybutynin syp 5MG/5ML

Cleocin Sup 100MG

oxybutynin TAB 10MG ER

Clindesse CRE 2%

oxybutynin TAB 15MG ER

Crinone Gel 4% Vag

oxybutynin TAB 5MG

Crinone Gel 8% Vag

oxybutynin TAB 5MG ER

Endometrin Sup 100MG

tolterodine CAP 2MG ER

Fem PH Gel

tolterodine CAP 4MG ER

Gynazole-1 CRE 2%

tolterodine TAB 1MG

Intrarosa Sup 6.5MGPA

tolterodine TAB 2MG

Metrogel-vag Gel 0.75%

trospium chl CAP 60MG ER

Miconazole 3 Sup 200MG

trospium CL TAB 20MG

Nuvessa Gel 1.3%

TIER 03

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Progesterone Sup VGS 100

Uroxatral TAB 10MG

Progesterone Sup VGS 200

Progesterone Sup VGS 25

HEMATOLOGICAL AGENTS

Progesterone Sup VGS 400

HEMATOPOIETIC AGENTS

Progesterone Sup VGS 50

TIER 01 GENERIC

Relagard Gel

cyanocobalam inj 1000mcg

Terazol 3 CRE 0.8%

TIER 02 PREFERRED

Terazol 7 CRE 0.4%

Epogen Inj 10000/MLQL,PA

Vagifem TAB 10mcg

Epogen Inj 2000/MLQL,PA

Epogen Inj 20000/MLQL,PA

GENITOURINARY - MISC.

Epogen Inj 3000/MLQL,PA

TIER 01 GENERIC

Epogen Inj 4000/MLQL,PA

acetic acid sol 0.25%irr

Procrit Inj 10000/MLQL,PA

alfuzosin TAB 10MG ER

Procrit Inj 2000/MLQL,PA

argyl saline sol 0.9%

Procrit Inj 20000/MLQL,PA

curity salin sol 0.9% irr

Procrit Inj 3000/MLQL,PA

cytra k gra crystals

Procrit Inj 4000/MLQL,PA

finasteride TAB 5MG

Procrit Inj 40000/MLQL,PA

k citrate sol citr acd

TIER P PREVENTIVE

k/NA citrate sol citr acd

carbonyl TAB FE 45MG

phenazo TAB 200MG

ezfe 200 CAP 200MG

phenazopyrid TAB 100MG

fa-8 CAP 800mcg

phenazopyrid TAB 200MG

fa-8 TAB 0.8MG

pot citrate TAB 1080MG

feosol TAB 65MG

pot citrate TAB 1620MG

fer-iron dro 15MG/ML

pot citrate TAB 540MG ER

ferate TAB 27MG

pot citrate- PAK CIT acid

fergon TAB 27MG

sod citrate sol citr acd

ferosul elx 220/5ML

sodium chlor sol 0.9% irr

ferrex 150 CAP 150MG

tamsulosin CAP 0.4MG

ferric x-150 CAP 150MG

taron gra crystals

ferro-bob TAB 325MG

tricitrates sol

ferrocite TAB 324MG

virtrate-k sol 1100-334

ferrotabs TAB

virtrate-2 sol

ferrous dro 15MG/ML

virtrate-2 sol 500-334

ferrous fum TAB 324MG

virtrate-3 sol

ferrous gluc TAB 225MG

TIER 02 PREFERRED

ferrous gluc TAB 240MG

Cystagon CAP 150MGPA

ferrous gluc TAB 324MG

Cystagon CAP 50MGPA

ferrous sulf dro 15MG/ML

Elmiron CAP 100MG

ferrous sulf elx 220/5ML

Oracit Sol

ferrous sulf TAB 325MG

TIER 04 SPECIALTY

ferrous sulf TAB 325MG fc

Procysbi CAP 25MGQL,PA

ferrous sulf TAB 325MG EC

Procysbi CAP 75MGQL,PA

ferrous sulf TAB 5gr

Thiola TAB 100MGQL,PA

ferrousul TAB 325MG

TIER 03 NON PREFERRED

folic acid CAP 800mcg

dutast/tamsu CAP 0.5-0.4

folic acid TAB 1MG

dutasteride CAP 0.5MG

folic acid TAB 1000mcg

neo/poly GU sol 40/ML IR

folic acid TAB 400mcg

Avodart CAP 0.5MG

folic acid TAB 800mcg

Cardura XL TAB 4MG

gnp iron TAB 325MG

Cardura XL TAB 8MG

gnp iron TAB 45MG

Flomax CAP 0.4MG

gnp iron TAB 65MG

Jalyn CAP

hgh-pot iron TAB 325MG

K-phos TAB NO 2

high potency TAB iron

Lithostat TAB 250MG

high potency TAB FE 27MG

Neosporin GU Sol 40/ML IR

iferex 150 CAP

Proscar TAB 5MG

iron slow TAB 45MG

Pyridium TAB 100MG

iron supplem TAB therapy

Pyridium TAB 200MG

iron supplem TAB 325MG

Rapaflo CAP 4MG

iron supplmt dro 15MG/ML

Rapaflo CAP 8MG

iron TAB 27MG

Renacidin Sol

iron TAB 325MG

Renacidin Sol Irr

iron TAB 45MG

Rimso-50 Sol 50%

iron TAB 50MG ER

Shohls Sol Modified

iron TAB 65MG

Urocit-k 10 TAB

myferon 150 CAP 150MG

Urocit-k 15 TAB

nat-rul iron TAB 325MG

Urocit-k 5 TAB

nu-iron 150 CAP 150MG

Effective January 1, 2018

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pedia iron dro 15MG/ML

TIER 04 SPECIALTY

poly-iron CAP 150MG

Cerdelga CAP 84MGQL,PA

px iron TAB 200MG

Endari Pow 5gmQL,PA

px iron TAB 27MG

Granix Inj 300/0.5QL,PA

ra iron TAB 27MG

Granix Inj 480/0.8QL,PA

ra iron TAB 325MG

Neulasta Inj 6MG/0.6mQL,PA

ra iron TAB 65MG

Neulasta Kit 6MG/0.6mQL,PA

slow iron TAB 160MG CR

Neupogen Inj 300/0.5QL

slow iron TAB 50MG

Neupogen Inj 300mcgQL

slow rel FE TAB 160MG CR

Neupogen Inj 480/0.8QL

slow release TAB iron 45

Neupogen Inj 480mcgQL

slow release TAB 143MG

Promacta TAB 12.5MGQL,PA

slow release TAB 45MG

Promacta TAB 25MGQL,PA

slow release TAB 47.5MG

Promacta TAB 50MGQL,PA

slow FE TAB 45MG

Promacta TAB 75MGQL,PA

slow-release TAB FE 45MG

Zarxio Inj 300/0.5QL

sm folic acd TAB 400mcg

Zarxio Inj 480/0.8QL

sm iron slow TAB 160MG CR

Zavesca CAP 100MGQL,PA

sm iron TAB

TIER M MEDICAL COPAY

sm iron TAB 325MG

Vpriv Inj 400unitPA

sm iron TAB 45MG

TIER 03 NON PREFERRED

wee care sus 15/1.25

Aranesp Inj 10mcgPA

yl folic aci TAB 400mcg

Aranesp Inj 100mcgPA

CVS iron TAB 27MG

Aranesp Inj 150mcgPA

CVS iron TAB 325MG

Aranesp Inj 200mcgPA

Elite Iron TAB 15MG

Aranesp Inj 25mcgPA

Femiron TAB

Aranesp Inj 300mcgPA

Feosol TAB 200MG

Aranesp Inj 40mcgPA

Feosol TAB 45MG

Aranesp Inj 500mcgPA

Fer-IN-sol Dro 15MG/ML

Aranesp Inj 60mcgPA

Fergon TAB 27MG

Mircera Inj 100mcgPA

Ferretts FE Chw 18MG

Mircera Inj 200mcgPA

Ferretts IPS Sol

Mircera Inj 50mcgPA

Ferretts TAB 325MG

Mircera Inj 75mcgPA

Ferrimin 150 TAB

Mircera Sol 150/0.3PA

Ferrous Fum TAB 29MG

Mircera Sol 30/0.3MLPA

Ferrous Gluc TAB 225MG

Ferrous Gluc TAB 324MG

ANTICOAGULANTS

Ferrous Sulf Syp 300/5ML

TIER 01 GENERIC

Ferrous Sulf TAB 140MG

enoxaparin inj 100MG/MLQL

Ferrous Sulf TAB 324MG EC

enoxaparin inj 120/0.8QL

Folic Acid Inj 5MG/ML

enoxaparin inj 150MG/MLQL

FE sulfate TAB 27MG

enoxaparin inj 30/0.3MLQL

FE Aspartate TAB

enoxaparin inj 300/3MLQL

FE TABS TAB 325MG EC

enoxaparin inj 40/0.4MLQL

Hemocyte TAB 324MG

enoxaparin inj 60/0.6MLQL

HM iron TAB 45MG

enoxaparin inj 80/0.8MLQL

HM iron TAB 65MG

heparin sod inj 1000/ML

Icar Peds Sus Grape

heparin sod inj 10000/ML

Iron Chews Chw Pediatri

heparin sod inj 5000/ML

Iron Chw Pediatri

heparin sod inj 5000/0.5

Iron High CAP Potency

jantoven TAB 1MG

Iron TAB 18MG

jantoven TAB 10MG

Iron TAB 18MG CR

jantoven TAB 2.5MG

Iron TAB 28MG

jantoven TAB 2MG

Iron Up Liq

jantoven TAB 3MG

Mykidz Iron Sus 15/1.5ML

jantoven TAB 4MG

Novaferrum CAP 50MG

jantoven TAB 5MG

Novaferrum Dro 15MG/ML

jantoven TAB 6MG

Perfect Iron TAB 25MG

jantoven TAB 7.5MG

Pic 200 CAP

warfarin TAB 1MG

Profe CAP 180MG

warfarin TAB 10MG

Proferrin ES TAB 12 MG

warfarin TAB 2.5MG

Slow FE TAB 142MG

warfarin TAB 2MG

Slow FE TAB 45MG

warfarin TAB 3MG

Slow Rel FE TAB 143MG CR

warfarin TAB 4MG

TIER C ORAL CHEMO

warfarin TAB 5MG

Droxia CAP 200MG

warfarin TAB 6MG

Droxia CAP 300MG

warfarin TAB 7.5MG

Droxia CAP 400MG

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Lovenox Inj 100MG/MLQL

dipyridamole TAB 75MG

Lovenox Inj 120/0.8QL

pentoxifylli TAB 400MG ER

Lovenox Inj 150MG/MLQL

prasugrel TAB 10MGPA

Lovenox Inj 30/0.3MLQL

prasugrel TAB 5MGPA

Lovenox Inj 300/3MLQL

TIER 02 PREFERRED

Lovenox Inj 40/0.4MLQL

Brilinta TAB 60MGPA

Lovenox Inj 60/0.6MLQL

Brilinta TAB 90MGPA

Lovenox Inj 80/0.8MLQL

Effient TAB 10MGPA

TIER 02 PREFERRED

Effient TAB 5MGPA

Pradaxa CAP 110MG

TIER 04 SPECIALTY

Pradaxa CAP 150MG

Berinert Inj 500unitQL,PA

Pradaxa CAP 75MG

Cinryze Sol 500 UnitQL,PA

TIER 04 SPECIALTY

Firazyr Inj 30MG/3MLQL,PA

fondaparinux inj 10/0.8MLQL

Haegarda Inj 2000unitQL,PA

fondaparinux inj 2.5/0.5QL

Haegarda Inj 3000unitQL,PA

fondaparinux inj 5/0.4MLQL

Ruconest Inj 2100unitQL,PA

fondaparinux inj 7.5/0.6QL

TIER 03 NON PREFERRED

Arixtra Inj 10/0.8MLQL,PA

Aggrenox CAP 25-200MG

Arixtra Inj 2.5/0.5QL,PA

Agrylin CAP 0.5MG

Arixtra Inj 5/0.4MLQL,PA

Durlaza CAP 162.5MG

Arixtra Inj 7.5/0.6QL,PA

Persantine TAB 25MG

TIER 03 NON PREFERRED

Persantine TAB 50MG

Coumadin TAB 1MG

Persantine TAB 75MG

Coumadin TAB 10MG

Plavix TAB 300MG

Coumadin TAB 2.5MG

Plavix TAB 75MG

Coumadin TAB 2MG

Pletal TAB 100MG

Coumadin TAB 3MG

Pletal TAB 50MG

Coumadin TAB 4MG

Yosprala TAB 325-40MG

Coumadin TAB 5MG

Yosprala TAB 81-40MG

Coumadin TAB 6MG

Zontivity TAB 2.08MG

Coumadin TAB 7.5MG

Eliquis TAB 2.5MGPA

MOUTH/THROAT/DENTAL AGENT

Eliquis TAB 5MGPA

Fragmin Inj 10000/MLQL,PA

TIER 01 GENERIC

Fragmin Inj 12500untQL,PA

clotrimazole loz 10MG

Fragmin Inj 15000untQL,PA

clotrimazole tro 10MG

Fragmin Inj 18000untQL,PA

lidocaine sol 2% visc

Fragmin Inj 2500/0.2QL,PA

nystatin sus 100000

Fragmin Inj 5000/0.2QL,PA

oralone dent pst 0.1%

Fragmin Inj 7500/0.3QL,PA

pilocarpine TAB 5MG

Fragmin Inj 95000untQL,PA

triamcinolon pst den 0.1%

Savaysa TAB 15MGPA

TIER 03 NON PREFERRED

Savaysa TAB 30MGPA

cevimeline CAP 30MG

Savaysa TAB 60MGPA

chlorhex glu sol 0.12%PA

Xarelto Star TAB 15/20MGPA

paroex sol 0.12%PA

Xarelto TAB 10MGPA

periogard sol 0.12%PA

Xarelto TAB 15MGPA

pilocarpine TAB 7.5MG

Xarelto TAB 20MGPA

Aquoral Aer

Aquoral Spr

HEMOSTATICS

Bocasal Pow

TIER 01 GENERIC

Caphosol Sol

tranex acid TAB 650MGQL

Debacterol Sol 30-50%

TIER 03 NON PREFERRED

Evoxac CAP 30MG

Amicar Sol 0.25/ML

First-mouthw Sus Blm

Amicar TAB 1000MG

Lidocaine Sol 4%

Amicar TAB 500MG

Neutrasal Pow

Lysteda TAB 650MGQL

Numoisyn Liq

Numoisyn Loz

HEMATOLOGICAL - MISC.

Oravig TAB 50MG

TIER 01 GENERIC

Salagen TAB 5MG

anagrelide CAP 0.5MG

Salagen TAB 7.5MG

anagrelide CAP 1MG

Salivamax Pow

asa/dipyrida CAP 25-200MG

Salivate RX Pow

cilostazol TAB 100MG

cilostazol TAB 50MG

NEUROLOGY, CNS, PSYCH

clopidogrel TAB 300MG

ANTIANXIETY AGENTS

clopidogrel TAB 75MG

TIER 01 GENERIC

dipyridamole TAB 25MG

alprazolam TAB 0.25MG

dipyridamole TAB 50MG

alprazolam TAB 0.5MG

Effective January 1, 2018

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alprazolam TAB 0.5MG ER

alprazolam TAB 0.5MG XR

ANTIDEPRESSANTS

alprazolam TAB 1MG

TIER 01 GENERIC

alprazolam TAB 1MG ER

amitriptylin TAB 10MG

alprazolam TAB 1MG XR

amitriptylin TAB 100MG

alprazolam TAB 2MG

amitriptylin TAB 150MG

alprazolam TAB 2MG ER

amitriptylin TAB 25MG

alprazolam TAB 2MG XR

amitriptylin TAB 50MG

alprazolam TAB 3MG ER

amitriptylin TAB 75MG

alprazolam TAB 3MG XR

bupropion TAB 100MG

buspirone TAB 10MG

bupropion TAB 100MG ER

buspirone TAB 15MG

bupropion TAB 100MG SR

buspirone TAB 30MG

bupropion TAB 150MG ER

buspirone TAB 5MG

bupropion TAB 150MG SR

chlordiazep CAP 10MG

bupropion TAB 200MG ER

chlordiazep CAP 25MG

bupropion TAB 200MG SR

chlordiazep CAP 5MG

bupropion TAB 75MG

cloraz dipot TAB 15MG

bupropn HCL TAB 150MG XL

cloraz dipot TAB 3.75MG

bupropn HCL TAB 300MG XL

cloraz dipot TAB 7.5MG

citalopram sol 10MG/5ML

diazepam TAB 10MG

citalopram TAB 10MG

diazepam TAB 2MG

citalopram TAB 20MG

diazepam TAB 5MG

citalopram TAB 40MG

hydroxyz pam CAP 25MG

clomipramine CAP 25MG

hydroxyz pam CAP 50MG

clomipramine CAP 50MG

hydroxyz HCL syp 10MG/5ML

clomipramine CAP 75MG

hydroxyz HCL TAB 10MG

desipramine TAB 10MG

hydroxyz HCL TAB 25MG

desipramine TAB 100MG

hydroxyz HCL TAB 50MG

desipramine TAB 150MG

lorazepam inj 2MG/ML

desipramine TAB 25MG

lorazepam CON 2MG/ML

desipramine TAB 50MG

lorazepam TAB 0.5MG

desipramine TAB 75MG

lorazepam TAB 1MG

doxepin HCL CAP 10MG

lorazepam TAB 2MG

doxepin HCL CAP 100MG

oxazepam CAP 10MG

doxepin HCL CAP 150MG

oxazepam CAP 15MG

doxepin HCL CAP 25MG

oxazepam CAP 30MG

doxepin HCL CAP 50MG

Diazepam Inj 10MG/2ML

doxepin HCL CAP 75MG

Diazepam Inj 5MG/ML

doxepin HCL CON 10MG/ML

Diazepam Sol 1MG/ML

duloxetine CAP 20MG

Hydroxyz Pam CAP 100MG

duloxetine CAP 30MG

TIER 03 NON PREFERRED

duloxetine CAP 60MG

alprazolam TAB 0.25 odt

escitalopram sol 5MG/5ML

alprazolam TAB 0.5MG od

escitalopram TAB 10MG

alprazolam TAB 1MG odt

escitalopram TAB 20MG

alprazolam TAB 2MG odt

escitalopram TAB 5MG

buspirone TAB 7.5MG

fluoxetine sol 20MG/5ML

diazepam CON 5MG/ML

fluoxetine CAP 10MG

meprobamate TAB 200MG

fluoxetine CAP 20MG

meprobamate TAB 400MG

fluoxetine CAP 40MG

Alprazolam CON 1 MG/ML

fluoxetine TAB 10MG

Ativan Inj 2MG/ML

fluoxetine TAB 20MG

Ativan TAB 0.5MG

fluvoxamine TAB 100MG

Ativan TAB 1MG

fluvoxamine TAB 25MG

Ativan TAB 2MG

fluvoxamine TAB 50MG

Tranxene T TAB 3.75MG

imipram HCL TAB 10MG

Tranxene T TAB 7.5MG

imipram HCL TAB 25MG

Valium TAB 10MG

imipram HCL TAB 50MG

Valium TAB 2MG

mirtazapine TAB 15MG

Valium TAB 5MG

mirtazapine TAB 15MG odt

Vistaril CAP 25MG

mirtazapine TAB 30MG

Vistaril CAP 50MG

mirtazapine TAB 30MG odt

Xanax TAB 0.25MG

mirtazapine TAB 45MG

Xanax TAB 0.5MG

mirtazapine TAB 45MG odt

Xanax TAB 1MG

mirtazapine TAB 7.5MG

Xanax TAB 2MG

nortriptylin CAP 10MG

Xanax XR TAB 0.5MG

nortriptylin CAP 25MG

Xanax XR TAB 1MG

nortriptylin CAP 50MG

Xanax XR TAB 2MG

nortriptylin CAP 75MG

Xanax XR TAB 3MG

Effective January 1, 2018

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paroxetine TAB 10MG

Celexa TAB 10MG

paroxetine TAB 20MG

Celexa TAB 20MG

paroxetine TAB 30MG

Celexa TAB 40MG

paroxetine TAB 40MG

Cymbalta CAP 20MG

phenelzine TAB 15MG

Cymbalta CAP 30MG

protriptylin TAB 10MG

Cymbalta CAP 60MG

protriptylin TAB 5MG

Desvenlafax TAB 100MG ERPA

sertraline CON 20MG/ML

Desvenlafax TAB 50MG ERPA

sertraline TAB 100MG

Duloxetine CAP 40MG

sertraline TAB 25MG

Effexor XR CAP 150MG

sertraline TAB 50MG

Effexor XR CAP 37.5MG

tranylcyprom TAB 10MG

Effexor XR CAP 75MG

trazodone TAB 100MG

Elavil TAB 25MG

trazodone TAB 150MG

Fetzima CAP TitratioPA

trazodone TAB 300MG

Fetzima CAP 120MGST

trazodone TAB 50MG

Fetzima CAP 20MGST

venlafaxine CAP 150MG ER

Fetzima CAP 40MGST

venlafaxine CAP 37.5 ER

Fetzima CAP 80MGST

venlafaxine CAP 75MG ER

Fluoxetine CAP 90MG DR

venlafaxine TAB 100MG

Forfivo XL TAB 450MGST

venlafaxine TAB 25MG

Khedezla TAB 100MG ERPA

venlafaxine TAB 37.5MG

Khedezla TAB 50MG ERPA

venlafaxine TAB 50MG

Lexapro Sol 5MG/5ML

venlafaxine TAB 75MG

Lexapro TAB 10MG

Amoxapine TAB 100MG

Lexapro TAB 20MG

Amoxapine TAB 150MG

Lexapro TAB 5MG

Amoxapine TAB 25MG

Marplan TAB 10MG

Amoxapine TAB 50MG

Nardil TAB 15MG

Fluoxetine TAB 60MG

Nefazodone TAB 100MG

Maprotiline TAB 25MG

Nefazodone TAB 150MG

Maprotiline TAB 50MG

Nefazodone TAB 200MG

Maprotiline TAB 75MG

Norpramin TAB 10MG

Nortriptylin Sol 10MG/5ML

Norpramin TAB 100MG

TIER 02 PREFERRED

Norpramin TAB 150MG

Paxil Sus 10MG/5ML

Norpramin TAB 25MG

TIER 04 SPECIALTY

Norpramin TAB 50MG

Emsam Dis 12MG/24hQL,PA

Norpramin TAB 75MG

Emsam Dis 6MG/24HRQL,PA

Pamelor CAP 10MG

Emsam Dis 9MG/24HRQL,PA

Pamelor CAP 25MG

TIER 03 NON PREFERRED

Pamelor CAP 50MG

desvenlafax TAB 100MG ERPA

Pamelor CAP 75MG

desvenlafax TAB 25MG ERPA

Parnate TAB 10MG

desvenlafax TAB 50MG ERPA

Paxil CR TAB 12.5MG

fluvoxamine CAP 100MG ER

Paxil CR TAB 25MG

fluvoxamine CAP 150MG ER

Paxil CR TAB 37.5MG

imipram pam CAP 100MG

Paxil TAB 10MG

imipram pam CAP 125MG

Paxil TAB 20MG

imipram pam CAP 150MG

Paxil TAB 30MG

imipram pam CAP 75MG

Paxil TAB 40MG

nefazodone TAB 250MG

Pexeva TAB 10MG

nefazodone TAB 50MG

Pexeva TAB 20MG

paroxetin ER TAB 12.5MG

Pexeva TAB 30MG

paroxetin ER TAB 37.5MG

Pexeva TAB 40MG

paroxetine TAB 25MG ER

Pristiq TAB 100MGPA

trimipramine CAP 100MG

Pristiq TAB 25MGPA

trimipramine CAP 25MG

Pristiq TAB 50MGPA

trimipramine CAP 50MG

Prozac CAP 10MG

venlafaxine TAB 150MG ER

Prozac CAP 20MG

venlafaxine TAB 225MG ER

Prozac CAP 40MG

venlafaxine TAB 37.5 ER

Prozac Weekl CAP 90MG

venlafaxine TAB 75MG ER

Remeron Sltb TAB 15MG

Anafranil CAP 25MG

Remeron Sltb TAB 30MG

Anafranil CAP 50MG

Remeron Sltb TAB 45MG

Anafranil CAP 75MG

Remeron TAB 15MG

Aplenzin TAB 174MG

Remeron TAB 30MG

Aplenzin TAB 348MG

Remeron TAB 45MG

Aplenzin TAB 522MG

Surmontil CAP 100MG

Brintellix TAB 10MGST

Surmontil CAP 25MG

Brintellix TAB 20MGST

Surmontil CAP 50MG

Brintellix TAB 5MGST

Tofranil TAB 10MG

Effective January 1, 2018

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Tofranil TAB 25MG

lithium CARB TAB 300MG ER

Tofranil TAB 50MG

lithium CARB TAB 450MG ER

Tofranil-PM CAP 100MG

loxapine CAP 10MG

Tofranil-PM CAP 125MG

loxapine CAP 25MG

Tofranil-PM CAP 150MG

loxapine CAP 5MG

Tofranil-PM CAP 75MG

loxapine CAP 50MG

Trintellix TAB 10MGST

olanzapine TAB 10MG

Trintellix TAB 20MGST

olanzapine TAB 15MG

Trintellix TAB 5MGST

olanzapine TAB 2.5MG

Venlafaxine TAB 150MG ER

olanzapine TAB 20MG

Venlafaxine TAB 225MG ER

olanzapine TAB 5MG

Venlafaxine TAB 37.5 ER

olanzapine TAB 7.5MG

Venlafaxine TAB 75MG ER

perphenazine TAB 16MG

Viibryd Kit Starter

perphenazine TAB 2MG

Viibryd TAB 10MGST

perphenazine TAB 4MG

Viibryd TAB 20MGST

perphenazine TAB 8MG

Viibryd TAB 40MGST

prochlorper inj 10MG/2ML

Wellbutrin TAB XL 150MG

prochlorper sup 25MG

Wellbutrin TAB XL 300MG

prochlorper TAB 10MG

Wellbutrin TAB 100MG

prochlorper TAB 5MG

Wellbutrin TAB 100MG SR

quetiapine TAB 100MG

Wellbutrin TAB 150MG SR

quetiapine TAB 200MG

Wellbutrin TAB 200MG SR

quetiapine TAB 25MG

Wellbutrin TAB 75MG

quetiapine TAB 300MG

Zoloft CON 20MG/ML

quetiapine TAB 400MG

Zoloft TAB 100MG

quetiapine TAB 50MG

Zoloft TAB 25MG

risperidone sol 1MG/ML

Zoloft TAB 50MG

risperidone TAB 0.25MG

risperidone TAB 0.5MG

ANTIPSYCHOTICS

risperidone TAB 1MG

risperidone TAB 2MG

TIER 01 GENERIC

risperidone TAB 3MG

aripiprazole sol 1MG/MLPA

risperidone TAB 4MG

aripiprazole TAB 10MGPA

thiothixene CAP 1MG

aripiprazole TAB 15MGPA

thiothixene CAP 10MG

aripiprazole TAB 2MGPA

thiothixene CAP 2MG

aripiprazole TAB 20MGPA

thiothixene CAP 5MG

aripiprazole TAB 30MGPA

trifluoperaz TAB 1MG

aripiprazole TAB 5MGPA

trifluoperaz TAB 10MG

chlorpromaz TAB 10MG

trifluoperaz TAB 2MG

chlorpromaz TAB 100MG

trifluoperaz TAB 5MG

chlorpromaz TAB 200MG

ziprasidone CAP 20MG

chlorpromaz TAB 25MG

ziprasidone CAP 40MG

chlorpromaz TAB 50MG

ziprasidone CAP 60MG

clozapine TAB 100MG

ziprasidone CAP 80MG

clozapine TAB 200MG

Chlorpromaz Inj 25MG/ML

clozapine TAB 25MG

Chlorpromaz Inj 50MG/2ML

clozapine TAB 50MG

Fluphenazine CON 5MG/ML

compro sup 25MG

Fluphenazine Elx 2.5/5ML

fluphenaz DE inj 25MG/ML

Fluphenazine Inj 2.5MG/ML

fluphenazine TAB 1MG

Lithium CARB CAP 150MG

fluphenazine TAB 10MG

Lithium CARB CAP 600MG

fluphenazine TAB 2.5MG

Lithium Sol 8meq/5ML

fluphenazine TAB 5MG

TIER 02 PREFERRED

haloper lac inj 5MG/ML

Risperdal Inj 12.5MG

haloper DEC inj 100MG/ML

Risperdal Inj 25MG

haloper DEC inj 50MG/ML

Risperdal Inj 37.5MG

haloperidol inj 5MG/ML

Risperdal Inj 50MG

haloperidol inj 50/10ML

TIER 04 SPECIALTY

haloperidol CON 2MG/ML

Abilify Main Inj 300MGQL,PA

haloperidol TAB 0.5MG

Abilify Main Inj 400MGQL,PA

haloperidol TAB 1MG

Aristada Inj 1064MGQL,ST

haloperidol TAB 10MG

Aristada Inj 441MG/1.QL,ST

haloperidol TAB 2MG

Aristada Inj 662MG/2QL,ST

haloperidol TAB 20MG

Aristada Inj 882MG/3QL,ST

haloperidol TAB 5MG

Invega Sust Inj 117/0.75QL,PA

lithium CARB CAP 150MG

Invega Sust Inj 156MG/MLQL,PA

lithium CARB CAP 300MG

Invega Sust Inj 234/1.5QL,PA

lithium CARB CAP 600MG

Invega Sust Inj 39/0.25QL,PA

lithium CARB TAB 300MG

Invega Sust Inj 78/0.5MLQL,PA

Effective January 1, 2018

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Invega Trinz Inj 273MGQL,PA

Fazaclo TAB 25MG Odt

Invega Trinz Inj 410MGQL,PA

Geodon CAP 20MG

Invega Trinz Inj 546MGQL,PA

Geodon CAP 40MG

Invega Trinz Inj 819MGQL,PA

Geodon CAP 60MG

Latuda TAB 120MGQL,ST

Geodon CAP 80MG

Latuda TAB 20MGQL,ST

Geodon Inj 20MG

Latuda TAB 40MGQL,ST

Haldol Decan Inj 100MG/ML

Latuda TAB 60MGQL,ST

Haldol Decan Inj 50MG/ML

Latuda TAB 80MGQL,ST

Haldol Inj 5MG/ML

Nuplazid TAB 17MGQL,PA

Invega TAB 1.5MGST

Vraylar CAP 1.5-3MGQL,PA

Invega TAB 3MGST

Vraylar CAP 1.5MGQL,PA

Invega TAB 6MGST

Vraylar CAP 3MGQL,PA

Invega TAB 9MGST

Vraylar CAP 4.5MGQL,PA

Lithobid TAB 300MG CR

Vraylar CAP 6MGQL,PA

Molindone TAB HCL 10MG

TIER 03 NON PREFERRED

Molindone TAB HCL 25MG

aripiprazole TAB 10MG odtPA

Molindone TAB HCL 5MG

aripiprazole TAB 15MG odtPA

Rexulti TAB 0.25MGPA

clozapine TAB 100/odt

Rexulti TAB 0.5MGPA

clozapine TAB 25MG odt

Rexulti TAB 1MGPA

olanzapine inj 10MG

Rexulti TAB 2MGPA

olanzapine TAB 10MG odt

Rexulti TAB 3MGPA

olanzapine TAB 15MG odt

Rexulti TAB 4MGPA

olanzapine TAB 20MG odt

Risperdal M TAB 0.5MG

olanzapine TAB 5MG odt

Risperdal M TAB 1MG

paliperidone TAB ER 1.5MGST

Risperdal M TAB 2MG

paliperidone TAB ER 3MGST

Risperdal M TAB 3MG

paliperidone TAB ER 6MGST

Risperdal M TAB 4MG

paliperidone TAB ER 9MGST

Risperdal Sol 1MG/ML

quetiapine TAB 150MG ERST

Risperdal TAB 0.25MG

quetiapine TAB 200MG ERST

Risperdal TAB 0.5MG

quetiapine TAB 300MG ERST

Risperdal TAB 1MG

quetiapine TAB 400MG ERST

Risperdal TAB 2MG

quetiapine TAB 50MG ERST

Risperdal TAB 3MG

risperidone TAB 0.25 odt

Risperdal TAB 4MG

risperidone TAB 0.5MG od

Saphris Sub 10MGST

risperidone TAB 1MG odt

Saphris Sub 2.5MGST

risperidone TAB 2MG odt

Saphris Sub 5MGST

risperidone TAB 3MG odt

Seroquel TAB 100MG

risperidone TAB 4MG odt

Seroquel TAB 200MG

thioridazine TAB 10MG

Seroquel TAB 25MG

thioridazine TAB 100MG

Seroquel TAB 300MG

thioridazine TAB 25MG

Seroquel TAB 400MG

thioridazine TAB 50MG

Seroquel TAB 50MG

Abilify TAB 10MGPA

Seroquel XR TAB 150MGST

Abilify TAB 15MGPA

Seroquel XR TAB 200MGST

Abilify TAB 2MGPA

Seroquel XR TAB 300MGST

Abilify TAB 20MGPA

Seroquel XR TAB 400MGST

Abilify TAB 30MGPA

Seroquel XR TAB 50MGST

Abilify TAB 5MGPA

Versacloz Sus 50MG/ML

Clozapine TAB 12.5/Odt

Zyprexa Inj 10MG

Clozapine TAB 150/Odt

Zyprexa Relp Inj 210MGST

Clozapine TAB 200/Odt

Zyprexa Relp Inj 300MGST

Clozaril TAB 100MG

Zyprexa Relp Inj 405MGST

Clozaril TAB 25MG

Zyprexa TAB 10MG

Equetro CAP 100MG

Zyprexa TAB 15MG

Equetro CAP 200MG

Zyprexa TAB 2.5MG

Equetro CAP 300MG

Zyprexa TAB 20MG

Fanapt PAKST

Zyprexa TAB 5MG

Fanapt TAB 1MGST

Zyprexa TAB 7.5MG

Fanapt TAB 10MGST

Zyprexa Zydi TAB 10MG

Fanapt TAB 12MGST

Zyprexa Zydi TAB 15MG

Fanapt TAB 2MGST

Zyprexa Zydi TAB 20MG

Fanapt TAB 4MGST

Zyprexa Zydi TAB 5MG

Fanapt TAB 6MGST

Fanapt TAB 8MGST

HYPNOTICS

Fazaclo TAB 100 Odt

TIER 01 GENERIC

Fazaclo TAB 12.5 Odt

eszopiclone TAB 1MG

Fazaclo TAB 150 Odt

eszopiclone TAB 2MG

Fazaclo TAB 200 Odt

Effective January 1, 2018

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eszopiclone TAB 3MG

Temazepam 7.5MG CAPS

midazolam inj 10MG/2ML

Zolpimist Spr 5MG

midazolam inj 5MG/ML

phenobarb elx 20MG/5ML

ADHD, NARCOLEPSY, ETC.

phenobarb sol 20MG/5ML

TIER 01 GENERIC

phenobarb TAB 16.2MG

amphet/dextr CAP 10MG ER

phenobarb TAB 32.4MG

amphet/dextr CAP 15MG ERQL

phenobarb TAB 64.8MG

amphet/dextr CAP 20MG ERQL

phenobarb TAB 97.2MG

amphet/dextr CAP 25MG ERQL

temazepam CAP 15MG

amphet/dextr CAP 30MG ERQL

temazepam CAP 30MG

amphet/dextr CAP 5MG ERQL

temazepam CAP 7.5MG

amphet/dextr TAB 10MG

triazolam TAB 0.25MG

amphet/dextr TAB 12.5MG

zaleplon CAP 10MG

amphet/dextr TAB 15MG

zaleplon CAP 5MG

amphet/dextr TAB 20MG

zolpidem TAB 10MG

amphet/dextr TAB 30MG

zolpidem TAB 5MG

amphet/dextr TAB 5MG

Flurazepam CAP 15MG

amphet/dextr TAB 7.5MG

Flurazepam CAP 30MG

atomoxetine CAP 10MGST

Phenobarb Inj 130MG/ML

atomoxetine CAP 100MGST

Phenobarb TAB 100MG

atomoxetine CAP 18MGST

Phenobarb TAB 15MG

atomoxetine CAP 25MGST

Phenobarb TAB 30MG

atomoxetine CAP 40MGST

Phenobarb TAB 60MG

atomoxetine CAP 60MGST

Triazolam TAB 0.125MG

atomoxetine CAP 80MGST

TIER 02 PREFERRED

caffeine CIT sol 20MG/ML

Seconal CAP 100MG

caffeine CIT sol 60MG/3ML

Seconal Sod CAP 100MG

dexedrine TAB 10MG

TIER 04 SPECIALTY

dexedrine TAB 5MG

Hetlioz CAP 20MGQL,PA

dexmethylph TAB 10MG

TIER 03 NON PREFERRED

dexmethylph TAB 2.5MG

estazolam TAB 1MG

dexmethylph TAB 5MG

estazolam TAB 2MG

dextroamphet CAP 10MG ERQL

midazolam syp 2MG/ML

dextroamphet CAP 15MG ERQL

pentobarb inj 1000/20

dextroamphet CAP 5MG ERQL

temazepam CAP 22.5MG

dextroamphet TAB 10MG

zolpidem ER TAB 12.5MG

dextroamphet TAB 5MG

zolpidem ER TAB 6.25MG

guanfacine TAB 1MG ER

zolpidem TAR sub 1.75MG

guanfacine TAB 2MG ER

zolpidem TAR sub 3.5MG

guanfacine TAB 3MG ER

Ambien CR TAB 12.5MG

guanfacine TAB 4MG ER

Ambien CR TAB 6.25MG

metadate TAB 20MG ERQL

Ambien TAB 10MG

methylphenid CAP 10MGQL

Ambien TAB 5MG

methylphenid CAP 20MGQL

Amytal Sod Inj 500MG

methylphenid CAP 20MG ERQL,ST

Belsomra TAB 10MGPA

methylphenid CAP 30MGQL

Belsomra TAB 15MGPA

methylphenid CAP 30MG ERQL,ST

Belsomra TAB 20MGPA

methylphenid CAP 40MGQL

Belsomra TAB 5MGPA

methylphenid CAP 40MG ERQL,ST

Butisol Sod TAB 30MG

methylphenid CAP 50MGQL

Doral TAB 15MG

methylphenid CAP 60MGQL

Edluar Sub 10MG

methylphenid TAB 10MG

Edluar Sub 5MG

methylphenid TAB 10MG ERQL

Halcion TAB 0.25MG

methylphenid TAB 18MG ERQL

Intermezzo Sub 1.75MG

methylphenid TAB 20MG

Intermezzo Sub 3.5MG

methylphenid TAB 20MG ERQL

Lunesta TAB 1MG

methylphenid TAB 27MG ERQL

Lunesta TAB 2MG

methylphenid TAB 36MG ERQL

Lunesta TAB 3MG

methylphenid TAB 5MG

Nembutal Sod Inj 50MG/ML

methylphenid TAB 54MG ERQL

Quazepam TAB 15MG

modafinil TAB 100MGPA

Restoril CAP 15MG

modafinil TAB 200MGPA

Restoril CAP 22.5MG

zenzedi TAB 10MG

Restoril CAP 30MG

zenzedi TAB 5MG

Restoril CAP 7.5MG

Adderall XR CAP 10MG

Rozerem TAB 8MG

Adderall XR CAP 15MGQL

Silenor TAB 3MG

Adderall XR CAP 20MGQL

Silenor TAB 6MG

Adderall XR CAP 25MGQL

Sonata CAP 10MG

Adderall XR CAP 30MGQL

Sonata CAP 5MG

Effective January 1, 2018

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Adderall XR CAP 5MGQL

Focalin XR CAP 5MGQL,ST

Concerta TAB 18MGQL

Intuniv TAB 1MG

Concerta TAB 27MGQL

Intuniv TAB 2MG

Concerta TAB 36MGQL

Intuniv TAB 3MG

Concerta TAB 54MGQL

Intuniv TAB 4MG

Methylphenid CAP 60MG LAQL,ST

Kapvay TAB 0.1 MG

Methylphenid TAB 18MG ERQL

Metadate CD CAP 10MGQL

Methylphenid TAB 27MG ERQL

Metadate CD CAP 20MGQL

Methylphenid TAB 36MG ERQL

Metadate CD CAP 30MGQL

Methylphenid TAB 54MG ERQL

Metadate CD CAP 40MGQL

TIER 03 NON PREFERRED

Metadate CD CAP 50MGQL

armodafinil TAB 150MGPA

Metadate CD CAP 60MGQL

armodafinil TAB 200MGPA

Methlphenida Chw 2.5MG

armodafinil TAB 250MGPA

Methylin Chw 10MG

armodafinil TAB 50MGPA

Methylin Chw 2.5MG

clonidine TAB 0.1MG ER

Methylin Chw 5MG

dexmethylph CAP 15MG ERQL,ST

Methylphenid Chw 10MG

dexmethylph CAP 30MG ERQL,ST

Methylphenid Chw 5MG

dexmethylph CAP 40MG ERQL,ST

Mydayis CAP 12.5MGPA

dexmethylphe CAP ER 25MGQL,ST

Mydayis CAP 25MGPA

dexmethylphe CAP ER 35MGQL,ST

Mydayis CAP 37.5MGPA

dexmethylphe CAP 10MG ERQL,ST

Mydayis CAP 50MGPA

dexmethylphe CAP 20MG ERQL,ST

Nuvigil TAB 150MGPA

dexmethylphe CAP 5MG ERQL,ST

Nuvigil TAB 200MGPA

dextroamphet sol 5MG/5ML

Nuvigil TAB 250MGPA

methamphetam TAB 5MG

Nuvigil TAB 50MGPA

Adderall TAB 10MG

Procentra Sol 5MG/5ML

Adderall TAB 12.5MG

Provigil TAB 100MGPA

Adderall TAB 15MG

Provigil TAB 200MGPA

Adderall TAB 20MG

Quillichew Chw 20MG ERPA

Adderall TAB 30MG

Quillichew Chw 30MG ERPA

Adderall TAB 5MG

Quillichew Chw 40MG ERPA

Adderall TAB 7.5MG

Quillivant Sus 25MG/5MLQL,ST

Adzenys XR TAB 12.5MGPA

Ritalin LA CAP 10MGQL,ST

Adzenys XR TAB 15.7 MGPA

Ritalin LA CAP 20MGQL,ST

Adzenys XR TAB 18.8MGPA

Ritalin LA CAP 30MGQL,ST

Adzenys XR TAB 3.1MGPA

Ritalin LA CAP 40MGQL,ST

Adzenys XR TAB 6.3MGPA

Ritalin LA CAP 60MGQL,ST

Adzenys XR TAB 9.4MGPA

Ritalin TAB 10MG

Aptensio XR CAP 10MGQL,ST

Ritalin TAB 20MG

Aptensio XR CAP 15MGQL,ST

Ritalin TAB 5MG

Aptensio XR CAP 20MGQL,ST

Strattera CAP 10MGST

Aptensio XR CAP 30MGQL,ST

Strattera CAP 100MGST

Aptensio XR CAP 40MGQL,ST

Strattera CAP 18MGST

Aptensio XR CAP 50MGQL,ST

Strattera CAP 25MGST

Aptensio XR CAP 60MGQL,ST

Strattera CAP 40MGST

Cotempla TAB 17.3MGPA

Strattera CAP 60MGST

Cotempla TAB 25.9MGPA

Strattera CAP 80MGST

Cotempla TAB 8.6MGPA

Vyvanse Chw 10MGQL,PA

Daytrana Dis 10MG/9HRQL,ST

Vyvanse Chw 20MGQL,PA

Daytrana Dis 15MG/9HRQL,ST

Vyvanse Chw 30MGQL,PA

Daytrana Dis 20MG/9HRQL,ST

Vyvanse Chw 40MGQL,PA

Daytrana Dis 30MG/9HRQL,ST

Vyvanse Chw 50MGQL,PA

Desoxyn TAB 5MG

Vyvanse Chw 60MGQL,PA

Dexedrine CAP 10MG CRQL

Vyvanse CAP 10MGQL,PA

Dexedrine CAP 15MG CRQL

Vyvanse CAP 20MGQL,PA

Dexedrine CAP 5MG CRQL

Vyvanse CAP 30MGQL,PA

Dyanavel XR Sus 2.5MG/MLST

Vyvanse CAP 40MGQL,PA

Evekeo TAB 10MGPA

Vyvanse CAP 50MGQL,PA

Evekeo TAB 5MGPA

Vyvanse CAP 60MGQL,PA

Focalin TAB 10MG

Vyvanse CAP 70MGQL,PA

Focalin TAB 2.5MG

Zenzedi TAB 15MG

Focalin TAB 5MG

Zenzedi TAB 2.5MG

Focalin XR CAP 10MGQL,ST

Zenzedi TAB 20MG

Focalin XR CAP 15MGQL,ST

Zenzedi TAB 30MG

Focalin XR CAP 20MGQL,ST

Zenzedi TAB 7.5MG

Focalin XR CAP 25MGQL,ST

Focalin XR CAP 30MGQL,ST

ANTICONVULSANTS

Focalin XR CAP 35MGQL,ST

TIER 01

Focalin XR CAP 40MGQL,ST

Effective January 1, 2018

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GENERIC

zonisamide CAP 25MG

carbamazepin chw 100MG

zonisamide CAP 50MG

carbamazepin sus 100/5ML

Diastat PED Gel 2.5m Gel

carbamazepin CAP 100MG ER

Diazepam Gel 10MG

carbamazepin CAP 200MG ER

Diazepam Gel 2.5MG

carbamazepin CAP 300MG ER

Diazepam Gel 20MG

carbamazepin TAB 100mger

TIER 02 PREFERRED

carbamazepin TAB 200MG

Celontin CAP 300MG

carbamazepin TAB 200MG ER

Dilantin CAP 30MG

carbamazepin TAB 400MG ER

TIER 04 SPECIALTY

clonazep odt TAB 0.125MG

felbamate sus 600/5MLQL,PA

clonazep odt TAB 0.25MG

felbamate TAB 400MGQL,PA

clonazep odt TAB 0.5MG

felbamate TAB 600MGQL,PA

clonazep odt TAB 1MG

vigabatrin PAK 500MGQL

clonazep odt TAB 2MG

Aptiom TAB 200MGQL,PA

clonazepam TAB 0.5MG

Aptiom TAB 400MGQL,PA

clonazepam TAB 1MG

Aptiom TAB 600MGQL,PA

clonazepam TAB 2MG

Aptiom TAB 800MGQL,PA

divalproex CAP 125MG

Banzel Sus 40MG/MLQL,PA

divalproex TAB 125MG DR

Banzel TAB 200MGQL,PA

divalproex TAB 250MG DR

Banzel TAB 400MGQL,PA

divalproex TAB 250MG ER

Briviact Sol 10MG/MLQL,PA

divalproex TAB 500MG DR

Briviact TAB 10MGQL,PA

divalproex TAB 500MG ER

Briviact TAB 100MGQL,PA

epitol TAB 200MG

Briviact TAB 25MGQL,PA

ethosuximide sol 250/5ML

Briviact TAB 50MGQL,PA

ethosuximide CAP 250MG

Briviact TAB 75MGQL,PA

gabapentin sol 250/5ML

Felbatol Sus 600/5MLQL,PA

gabapentin sol 300/6ML

Felbatol TAB 400MGQL,PA

gabapentin CAP 100MG

Felbatol TAB 600MGQL,PA

gabapentin CAP 300MG

Mysoline TAB 250MGQL

gabapentin CAP 400MG

Mysoline TAB 50MGQL

gabapentin TAB 600MG

Onfi Sus 2.5MG/MLQL,PA

gabapentin TAB 800MG

Onfi TAB 10MGQL,PA

lamotrigine chw 25MG

Onfi TAB 20MGQL,PA

lamotrigine chw 5MG

Sabril Pow 500MGQL

lamotrigine TAB 100MG

Sabril TAB 500MGQL,PA

lamotrigine TAB 150MG

Vimpat TAB 100MGQL,PA

lamotrigine TAB 200MG

Vimpat TAB 150MGQL,PA

lamotrigine TAB 25MG

Vimpat TAB 200MGQL,PA

levetiraceta sol 100MG/ML

Vimpat TAB 50MGQL,PA

levetiraceta sol 500/5ML

TIER 03 NON PREFERRED

levetiraceta TAB 1000MG

lamotrig odt kit 25/50MG

levetiraceta TAB 250MG

lamotrig odt kit 50/100MG

levetiraceta TAB 500MG

lamotrig odt TAB 100MG

levetiraceta TAB 500MG ER

lamotrigine kit odt

levetiraceta TAB 750MG

lamotrigine kit start 35

levetiraceta TAB 750MG ER

lamotrigine kit start 49

oxcarbazepin sus 300MG/5m

lamotrigine kit start 98

oxcarbazepin TAB 150MG

lamotrigine TAB 100MG ER

oxcarbazepin TAB 300MG

lamotrigine TAB 200MG ER

oxcarbazepin TAB 600MG

lamotrigine TAB 25MG odt

phenytoin chw 50MG

lamotrigine TAB 25MG ER

phenytoin inj 50MG/ML

lamotrigine TAB 250MG ER

phenytoin sus 125/5ML

lamotrigine TAB 300MG ER

phenytoin EX CAP 100MG

lamotrigine TAB 50MG odt

primidone TAB 250MGQL

lamotrigine TAB 50MG ER

primidone TAB 50MGQL

phenytoin EX CAP 200MG

roweepra TAB 1000MG

phenytoin EX CAP 300MG

roweepra TAB 500MG

tiagabine TAB 2MG

roweepra TAB 750MG

tiagabine TAB 4MG

topiramate CAP 15MG

Carbatrol CAP 100MG

topiramate CAP 25MG

Carbatrol CAP 200MG

topiramate TAB 100MG

Carbatrol CAP 300MG

topiramate TAB 200MG

Depakene CAP 250MG

topiramate TAB 25MG

Depakene Sol 250/5ML

topiramate TAB 50MG

Depakote ER TAB 250MG

valproic acd sol 250/5ML

Depakote ER TAB 500MG

valproic acd CAP 250MG

Depakote Spr CAP 125MG

zonisamide CAP 100MG

Depakote TAB 125MG DR

Effective January 1, 2018

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Depakote TAB 250MG DR

Potiga TAB 200MG

Depakote TAB 500MG DR

Potiga TAB 300MG

Diastat Acdl Gel 12.5-20

Potiga TAB 400MG

Diastat Acdl Gel 5-10MG

Potiga TAB 50MG

Dilantin Chw 50MG

Qudexy XR CAP 100/24HRPA

Dilantin CAP 100MG

Qudexy XR CAP 150/24HRPA

Dilantin-125 Sus 125/5ML

Qudexy XR CAP 200/24HRPA

Fycompa Sus 0.5MG/MLST

Qudexy XR CAP 25/24HRPA

Fycompa TAB 10MGQL,ST

Qudexy XR CAP 50/24HRPA

Fycompa TAB 12MGQL,ST

Spritam TAB 1000MG

Fycompa TAB 2MGQL,ST

Spritam TAB 250MG

Fycompa TAB 4MGQL,ST

Spritam TAB 500MG

Fycompa TAB 6MGQL,ST

Spritam TAB 750MG

Fycompa TAB 8MGQL,ST

Tegretol Sus 100/5ML

Gabitril TAB 12MG

Tegretol TAB 200MG

Gabitril TAB 16MG

Tegretol-XR TAB 100MG

Gabitril TAB 2MG

Tegretol-XR TAB 200MG

Gabitril TAB 4MG

Tegretol-XR TAB 400MG

Keppra Sol 100MG/ML

Topamax Spr CAP 15MG

Keppra TAB 1000MG

Topamax Spr CAP 25MG

Keppra TAB 250MG

Topamax TAB 100MG

Keppra TAB 500MG

Topamax TAB 200MG

Keppra TAB 750MG

Topamax TAB 25MG

Keppra XR TAB 500MG

Topamax TAB 50MG

Keppra XR TAB 750MG

Topiramate CAP ER 100MG

Klonopin TAB 0.5MG

Topiramate CAP ER 150MG

Klonopin TAB 1MG

Topiramate CAP ER 200MG

Klonopin TAB 2MG

Topiramate CAP ER 25MG

Lamictal Chw 25MG

Topiramate CAP ER 50MG

Lamictal Chw 5MG

Trileptal Sus 300MG/5m

Lamictal Kit Start 35

Trileptal TAB 150MG

Lamictal Kit Start 49

Trileptal TAB 300MG

Lamictal Kit Start 98

Trileptal TAB 600MG

Lamictal Odt Kit

Trokendi XR CAP 100MGPA

Lamictal Odt TAB 100MG

Trokendi XR CAP 200MGPA

Lamictal Odt TAB 200MG

Trokendi XR CAP 25MGPA

Lamictal Odt TAB 25MG

Trokendi XR CAP 50MGPA

Lamictal Odt TAB 50MG

Vimpat Sol 10MG/ML

Lamictal TAB 100MG

Zarontin CAP 250MG

Lamictal TAB 150MG

Zarontin Sol 250/5ML

Lamictal TAB 200MG

Zonegran CAP 100MG

Lamictal TAB 25MG

Zonegran CAP 25MG

Lamictal XR Kit

Lamictal XR TAB 100MG

ANTIPARKINSON AGENTS

Lamictal XR TAB 200MG

TIER 01 GENERIC

Lamictal XR TAB 25MG

amantadine syp 50MG/5ML

Lamictal XR TAB 250MG

amantadine CAP 100MG

Lamictal XR TAB 300MG

amantadine TAB 100MG

Lamictal XR TAB 50MG

benztropine inj 1MG/ML

Lyrica CAP 100MGQL,PA

benztropine TAB 0.5MG

Lyrica CAP 150MGQL,PA

benztropine TAB 1MG

Lyrica CAP 200MGQL,PA

benztropine TAB 2MG

Lyrica CAP 225MGQL,PA

bromocriptin CAP 5MG

Lyrica CAP 25MGQL,PA

bromocriptin TAB 2.5MG

Lyrica CAP 300MGQL,PA

carbidopa TAB 25MG

Lyrica CAP 50MGQL,PA

entacapone TAB 200MG

Lyrica CAP 75MGQL,PA

pramipexole TAB 0.125MG

Lyrica Sol 20MG/MLQL,PA

pramipexole TAB 0.25MG

Neurontin CAP 100MG

pramipexole TAB 0.5MG

Neurontin CAP 300MG

pramipexole TAB 0.75MG

Neurontin CAP 400MG

pramipexole TAB 1.5MG

Neurontin Sol 250/5ML

pramipexole TAB 1MG

Neurontin TAB 600MG

rasagiline TAB 0.5MGPA

Neurontin TAB 800MG

rasagiline TAB 1MGPA

Oxtellar XR TAB 150MG

ropinirole TAB 0.25MG

Oxtellar XR TAB 300MG

ropinirole TAB 0.5MG

Oxtellar XR TAB 600MG

ropinirole TAB 1MG

Peganone TAB 250MG

ropinirole TAB 2MG

Phenytek CAP 200MG

ropinirole TAB 3MG

Phenytek CAP 300MG

Effective January 1, 2018

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ropinirole TAB 4MG

Requip TAB 3MG

ropinirole TAB 5MG

Requip TAB 4MG

selegiline CAP 5MG

Requip TAB 5MG

selegiline TAB 5MG

Requip XL TAB 12MG

trihexyphen elx 0.4MG/ML

Requip XL TAB 2MG

trihexyphen TAB 2MG

Requip XL TAB 4MG

trihexyphen TAB 5MG

Requip XL TAB 6MG

CARB/levo ER TAB 25-100MG

Requip XL TAB 8MG

CARB/levo ER TAB 50-200MG

Rytary CAP 145MGPA

CARB/levo TAB 10-100MG

Rytary CAP 195MGPA

CARB/levo TAB 25-100MG

Rytary CAP 245MGPA

CARB/levo TAB 25-250MG

Rytary CAP 95MGPA

CARB/Levo 50 TAB /Entacap

Sinemet CR TAB 25-100MG

CARB/Levo 75 TAB /Entacap

Sinemet CR TAB 50-200MG

CARB/Levo100 TAB /Entacap

Sinemet TAB 10-100MG

CARB/Levo125 TAB /Entacap

Sinemet TAB 25-100MG

CARB/Levo150 TAB /Entacap

Sinemet TAB 25-250MG

CARB/Levo200 TAB /Entacap

Stalevo 100 TAB

TIER 04 SPECIALTY

Stalevo 125 TAB

tolcapone TAB 100MGQL,PA

Stalevo 150 TAB

Apokyn Inj 10MG/MLQL,PA

Stalevo 200 TAB

Duopa Sus 4.63-20QL,PA

Stalevo 50 TAB

Gocovri CAP 137MGQL,PA

Stalevo 75 TAB

Gocovri CAP 68.5MGQL,PA

Xadago TAB 100MGPA

Tasmar TAB 100MGQL,PA

Xadago TAB 50MGPA

Zelapar TAB 1.25MGQL,PA

TIER 03 NON PREFERRED

NEUROLOGY, PSYCH - MISC.

pramipexole TAB 0.375 ER

TIER 01 GENERIC

pramipexole TAB 0.75 ER

acampro CAL TAB 333MG

pramipexole TAB 1.5MG ER

disulfiram TAB 250MG

pramipexole TAB 2.25 ER

disulfiram TAB 500MG

pramipexole TAB 3.75 ER

donepezil TAB 10MG

pramipexole TAB 3MG ER

donepezil TAB 5MG

pramipexole TAB 4.5MG ER

galantamine CAP 16MG ER

ropinirole TAB 12MG ER

galantamine CAP 24MG ER

ropinirole TAB 2MG ER

galantamine CAP 8MG ER

ropinirole TAB 4MG ER

galantamine TAB 12MG

ropinirole TAB 6MG ER

galantamine TAB 4MG

ropinirole TAB 8MG ER

galantamine TAB 8MG

Azilect TAB 0.5MGPA

memantine TAB HCL 10MG

Azilect TAB 1MGPA

memantine TAB HCL 5MG

Cogentin Inj 1MG/ML

pimozide TAB 1MG

Comtan TAB 200MG

pimozide TAB 2MG

Eldepryl CAP 5MG

rivastigmine CAP 1.5MG

Lodosyn TAB 25MG

rivastigmine CAP 3MG

Mirapex ER TAB 0.375MG

rivastigmine CAP 4.5MG

Mirapex ER TAB 0.75MG

rivastigmine CAP 6MG

Mirapex ER TAB 1.5MG

Fluoxetine CAP 10MG

Mirapex ER TAB 2.25MG

Fluoxetine CAP 20MG

Mirapex ER TAB 3.75MG

Galantamine Sol 4MG/ML

Mirapex ER TAB 3MG

Perphen/Amit TAB 2-10MG

Mirapex ER TAB 4.5MG

Perphen/Amit TAB 2-25MG

Mirapex TAB 0.125MG

Perphen/Amit TAB 4-10MG

Mirapex TAB 0.25MG

Perphen/Amit TAB 4-25MG

Mirapex TAB 0.5MG

Perphen/Amit TAB 4-50MG

Mirapex TAB 0.75MG

TIER P PREVENTIVE

Mirapex TAB 1.5MG

buproban TAB 150MG

Mirapex TAB 1MG

bupropion TAB 150MG

Neupro Dis 1MG/24HR

eq nicotine dis 14MG/24h

Neupro Dis 2MG/24HR

eq nicotine dis 21MG/24h

Neupro Dis 3MG/24HR

eq nicotine dis 7MG/24HR

Neupro Dis 4MG/24HR

eq nicotine gum 2mgfruit

Neupro Dis 6MG/24HR

eq nicotine gum 2MG cinn

Neupro Dis 8MG/24HR

eq nicotine gum 2MG mint

Parlodel CAP 5MG

eq nicotine gum 2MG orig

Parlodel TAB 2.5MG

eq nicotine gum 4mgfruit

Requip TAB 0.25MG

eq nicotine gum 4MG cinn

Requip TAB 0.5MG

eq nicotine gum 4MG mint

Requip TAB 1MG

eq nicotine gum 4MG orig

Requip TAB 2MG

Effective January 1, 2018

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eq nicotine gum 4MG ref

nicotine pol loz 4MG cinn

eq nicotine gum 4MG strt

nicotine pol loz 4MG mint

eq nicotine loz 2MG cher

nicotine TD dis 14MG/24h

eq nicotine loz 2MG cinn

nicotine TD dis 21MG/24h

eq nicotine loz 2MG mint

nicotine TD dis 7MG/24HR

eq nicotine loz 4MG chry

qc nicotine gum 4MG

eq nicotine loz 4MG mint

ra nicotine dis 14MG/24h

eql nicotine dis 14MG/24h

ra nicotine dis 21MG/24h

eql nicotine dis 21MG/24h

ra nicotine dis 7MG/24HR

eql nicotine dis 7MG/24HR

ra nicotine gum 2mgfruit

eql nicotine gum 2MG

ra nicotine gum 2MG

eql nicotine gum 2MG ref

ra nicotine gum 2MG cinn

eql nicotine gum 2MG strt

ra nicotine gum 2MG mint

eql nicotine gum 4MG

ra nicotine gum 4MG

eql nicotine gum 4MG ref

ra nicotine gum 4MG frut

eql nicotine gum 4MG strt

ra nicotine gum 4MG mint

eql nicotine loz 2MG

ra nicotine loz 2MG mint

eql nicotine loz 2MG mint

ra nicotine loz 4MG mint

eql nicotine loz 4MG chry

sm nicotine dis 14MG/24h

eql nicotine loz 4MG mint

sm nicotine dis 21MG

gnp nicotine dis 21MG/24h

sm nicotine dis 21MG/24h

gnp nicotine dis 7MG/24HR

sm nicotine dis 7MG/24HR

gnp nicotine gum 2MG mint

sm nicotine gum 2MG

gnp nicotine gum 2MG orig

sm nicotine gum 2MG mint

gnp nicotine gum 4MG mint

sm nicotine gum 4MG

gnp nicotine gum 4MG orig

sm nicotine gum 4MG mint

gnp nicotine loz mini 2MG

sm nicotine loz 2MG mint

gnp nicotine loz 2MG mint

sm nicotine loz 4MG mint

gnp nicotine loz 4MG mint

stop smoking gum 2MG mint

kls quit2 gum 2MG

stop smoking gum 2MG orig

kls quit2 loz 2MG

stop smoking gum 4MG

kls quit4 gum 4MG

stop smoking loz 2MG

kls quit4 loz 4MG

stop smoking loz 2MG mint

nicorelief gum 2MG mint

stop smoking loz 4MG mint

nicorelief gum 2MG orig

sw nicotine gum 2MG mint

nicorelief gum 4MG mint

sw nicotine gum 4MG

nicorelief gum 4MG orig

sw nicotine loz 2MG mint

nicotine dis step 1

sw nicotine loz 4MG mint

nicotine dis step 2

tgt nicotine dis 14MG/24h

nicotine dis step 3

tgt nicotine dis 21MG/24h

nicotine dis 14MG/24h

tgt nicotine dis 7MG/24HR

nicotine dis 21MG/24h

tgt nicotine gum 2mgfruit

nicotine dis 7MG/24HR

tgt nicotine gum 2MG mint

nicotine gum 2mgfruit

tgt nicotine gum 2MG orig

nicotine gum 2MG

tgt nicotine gum 4MG

nicotine gum 4MG

tgt nicotine gum 4MG mint

nicotine loz mini 2MG

tgt nicotine gum 4MG orig

nicotine loz 2MG chry

tgt nicotine loz 2MG chry

nicotine loz 2MG mint

tgt nicotine loz 2MG mint

nicotine loz 4MG chry

tgt nicotine loz 4MG chry

nicotine loz 4MG cinn

tgt nicotine loz 4MG mint

nicotine loz 4MG mint

thrive gum 2MG mint

nicotine pol gum 2mgfruit

Chantix PAK 0.5& 1MG

nicotine pol gum 2MG

Chantix PAK 1MG

nicotine pol gum 2MG cinn

Chantix TAB 0.5MG

nicotine pol gum 2MG mint

Chantix TAB 1MG

nicotine pol gum 2MG orig

Commit Loz 2MG

nicotine pol gum 2MG ref

Commit Loz 4MG

nicotine pol gum 2MG strt

Commit Loz 4MG Chry

nicotine pol gum 4mgfruit

CVS nicotine dis 14MG/24h

nicotine pol gum 4MG

CVS nicotine dis 7MG/24HR

nicotine pol gum 4MG cinn

CVS nicotine gum 2mgfruit

nicotine pol gum 4MG mint

CVS nicotine gum 2MG cinn

nicotine pol gum 4MG orig

CVS nicotine gum 2MG mint

nicotine pol gum 4MG ref

CVS nicotine gum 2MG orig

nicotine pol gum 4MG strt

CVS nicotine gum 4mgfruit

nicotine pol loz 2MG chry

CVS nicotine gum 4MG cinn

nicotine pol loz 2MG cinn

CVS nicotine gum 4MG mint

nicotine pol loz 2MG mint

CVS nicotine gum 4MG orig

nicotine pol loz 4MG chry

CVS nicotine loz 2MG

Effective January 1, 2018

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CVS nicotine loz 2MG mint

Tecfidera Mis StarterQL,PA

CVS nicotine loz 4MG mint

Xenazine TAB 12.5MGQL,PA

CVS nts dis step 1

Xenazine TAB 25MGQL,PA

HM nicotine dis 14MG/24h

Xyrem Sol 500MG/MLQL,PA

HM nicotine dis 21MG/24h

Zinbryta Inj 150MG/MLQL,PA

HM nicotine gum 2MG mint

TIER M MEDICAL COPAY

HM nicotine gum 4MG mint

Tysabri Inj 300/15MLPA

HM nicotine loz 2MG mint

TIER 03 NON PREFERRED

HM nicotine loz 4MG mint

donepezil TAB HCL 23MG

Nicoderm CQ Dis 14MG/24h

donepezil TAB 10MG odt

Nicoderm CQ Dis 21MG/24h

donepezil TAB 5MG odt

Nicoderm CQ Dis 7MG/24HR

fluoxetine TAB 10MG

Nicorette Gum 2mgfruit

fluoxetine TAB 20MG

Nicorette Gum 2MG

memant titra PAK 5-10MG

Nicorette Gum 2MG Cinn

memantine HC sol 2MG/ML

Nicorette Gum 2MG Mint

olanza/fluox CAP 12-25MG

Nicorette Gum 2MG Orig

olanza/fluox CAP 12-50MG

Nicorette Gum 4mgfruit

olanza/fluox CAP 3-25MG

Nicorette Gum 4MG

olanza/fluox CAP 6-25MG

Nicorette Gum 4MG Cinn

olanza/fluox CAP 6-50MG

Nicorette Gum 4MG Mint

paroxetine CAP 7.5MG

Nicorette Gum 4MG Orig

rivastigmine dis 13.3/24

Nicorette Loz 2MG Chry

rivastigmine dis 4.6MG/24

Nicorette Loz 2MG Mint

rivastigmine dis 9.5MG/24

Nicorette Loz 2MG Orig

Addyi TAB 100MGQL,PA

Nicorette Loz 4MG Chry

Antabuse TAB 250MG

Nicorette Loz 4MG Mint

Antabuse TAB 500MG

Nicorette Loz 4MG Orig

Aricept TAB 10MG

Nicorette ST Gum 2MG

Aricept TAB 23MG

Nicorette ST Gum 2MG Mint

Aricept TAB 5MG

Nicorette ST Gum 2MG Orig

Brisdelle CAP 7.5MG

Nicorette ST Gum 4MG Mint

Cdp/Amitrip TAB 10-25MG

Nicorette ST Gum 4MG Orig

Cdp/Amitrip TAB 5-12.5MG

Nicotine SYS Kit Transder

Ergoloid Mes TAB 1MG Oral

Nicotrol Inh

Exelon CAP 1.5MG

Nicotrol Ns Spr 10MG/ML

Exelon CAP 3MG

SR nicotine gum 2MG

Exelon CAP 4.5MG

TIER 04 SPECIALTY

Exelon CAP 6MG

glatiramer inj 20MG/MLQL

Exelon Dis 13.3/24

glatiramer inj 40MG/MLQL

Exelon Dis 4.6MG/24

glatopa inj 20MG/MLQL

Exelon Dis 9.5MG/24

tetrabenazin TAB 12.5MGQL,PA

Gralise Star Mis 300/600

tetrabenazin TAB 25MGQL,PA

Gralise TAB 300MG

Ampyra TAB 10MGQL,PA

Gralise TAB 600MG

Aubagio TAB 14MGQL,PA

Horizant TAB 300MG

Aubagio TAB 7MGQL,PA

Horizant TAB 600MG

Austedo TAB 12MGQL,PA

Namenda Sol 10MG/5ML

Austedo TAB 6MGQL,PA

Namenda TAB 10MG

Austedo TAB 9MGQL,PA

Namenda TAB 5-10MG

Avonex Kit 30mcgQL,PA

Namenda TAB 5MG

Avonex Pen Kit 30mcgQL,PA

Namenda XR CAP TitratioPA

Avonex Prefl Kit 30mcgQL,PA

Namenda XR CAP 14MGPA

Betaseron Inj 0.3MGQL,PA

Namenda XR CAP 21MGPA

Copaxone Inj 20MG/MLQL,PA

Namenda XR CAP 28MGPA

Copaxone Inj 40MG/MLQL,PA

Namenda XR CAP 7MGPA

Extavia Inj 0.3MGQL

Namzaric CAP

Gilenya CAP 0.5MGQL,PA

Namzaric CAP 14-10MG

Ingrezza CAP 40MGQL,PA

Namzaric CAP 21-10MG

Plegridy InjQL,PA

Namzaric CAP 28-10MG

Plegridy Inj PenQL,PA

Namzaric CAP 7-10MG

Plegridy Inj StarterQL,PA

Nuedexta CAP 20-10MG

Plegridy Pen Inj StarterQL,PA

Orap TAB 1MG

Rebif Inj 22/0.5QL

Orap TAB 2MG

Rebif Inj 44/0.5QL

Razadyne ER CAP 16MG

Rebif Rebido Inj TitratnQL

Razadyne ER CAP 24MG

Rebif Rebido Inj 22/0.5QL

Razadyne ER CAP 8MG

Rebif Rebido Inj 44/0.5QL

Razadyne TAB 12MG

Rebif Titrtn Inj PackQL

Razadyne TAB 4MG

Tecfidera CAP 120MGQL,PA

Razadyne TAB 8MG

Tecfidera CAP 240MGQL,PA

Sarafem TAB 10MG

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Sarafem TAB 20MG

Zanaflex TAB 4MG

Savella Mis Titr PAKST

Savella TAB 100MGST

ANTIMYASTHENIC AGENTS

Savella TAB 12.5MGST

TIER 01 GENERIC

Savella TAB 25MGST

pyridostigm TAB 60MG

Savella TAB 50MGST

pyridostigmi TAB ER 180MG

Symbyax CAP 12-25MG

TIER 02 PREFERRED

Symbyax CAP 12-50MG

Mestinon Syp 60MG/5ML

Symbyax CAP 3-25MG

TIER 03 NON PREFERRED

Symbyax CAP 6-25MG

Enlon Inj 150/15ML

Symbyax CAP 6-50MG

Guanidine TAB 125MG

Zyban TAB 150MG SR

Mestinon TAB Timespan

Mestinon TAB 60MG

NEUROMUSCULAR AGENTS

TIER 01 GENERIC

OPHTHALMOLOGY AND OTIC

riluzole TAB 50MGQL

ANTI-INFECTIVES

TIER 04 SPECIALTY

TIER 01 GENERIC

Rilutek TAB 50MGQL,PA

ak-poly-bac oin op

bacit/polymy oin op

MUSCULOSKELETAL AGENTS

ciprofloxacn sol 0.3% op

TIER 01 GENERIC

erythromycin oin op

baclofen TAB 10MG

erythromycin oin 5MG/gm

baclofen TAB 20MG

gatifloxacin sol 0.5%

cyclobenzapr TAB 10MG

gentak oin 0.3% op

cyclobenzapr TAB 5MG

gentamicin oin 0.3% op

dantrolene CAP 100MG

gentamicin sol 0.3% op

dantrolene CAP 25MG

ilotycin oin op

dantrolene CAP 50MG

moxifloxacin sol 0.5%

methocarbam inj 100MG/ML

neo/poly/gra sol op

methocarbam inj 1000MG

ofloxacin dro 0.3% op

methocarbam TAB 500MG

polycin oin op

methocarbam TAB 750MG

polymyxin b/ sol trimethp

orphenadrine TAB 100MG ER

sod sulfacet sol 10% op

tizanidine TAB 2MG

sulfacet sod sol 10% op

tizanidine TAB 4MG

tobramycin sol 0.3% op

TIER 03 NON PREFERRED

trifluridine sol 1% op

carisopr/asa TAB 200-325PA

trimethoprim sol polymyxn

carisoprodol TAB asa/codPA

Bacitracin Oin Op

carisoprodol TAB 250MGPA

Gentak Oin 0.3% Op

carisoprodol TAB 350MGPA

Sulfacet Sod Oin 10% Op

chlorzoxazon TAB 500MG

TIER 02 PREFERRED

cyclobenzapr TAB 7.5MG

Ciloxan Oin 0.3% Op

metaxall TAB 800MG

Moxeza Sol 0.5%

metaxalone TAB 800MG

Natacyn Sus 5% Op

orphenadrine inj 30MG/ML

Tobrex Oin 0.3% Op

tizanidine CAP 2MG

TIER 03 NON PREFERRED

tizanidine CAP 4MG

levofloxacin sol 0.5%

tizanidine CAP 6MG

neo-polycin oin op

Amrix CAP 15MG

neo/bac/poly oin op

Amrix CAP 30MG

Azasite Sol 1%

Chlorzoxazon TAB 250MG

Besivance Sus 0.6%

Dantrium CAP 25MG

Betadine Sol 5% Op

Dantrium CAP 50MG

Bleph-10 Sol 10% Op

Fexmid TAB 7.5MG

Cefuroxime Inj 10MG/ML

First-baclof Sus 1

Ciloxan Sol 0.3% Op

First-baclof Sus 5 Kit

Neosporin Sol Op

Lorzone TAB 375MG

Ocuflox Dro 0.3% Op

Lorzone TAB 750MG

Polytrim Sol Op

Metaxalone TAB 400MG

Tobrex Sol 0.3% Op

Parafon Fort TAB 500MG

Vigamox Dro 0.5%

Robaxin Inj 100MG/ML

Viroptic Sol 1% Op

Robaxin TAB 500MG

Zirgan Gel 0.15%

Robaxin-750 TAB 750MG

Zymaxid Sol 0.5%

Skelaxin TAB 800MG

Soma TAB 250MGPA

ARTIFICIAL TEAR/LUBRICANT

Soma TAB 350MGPA

TIER 02 PREFERRED

Zanaflex CAP 2MG

Lacrisert Mis 5MG Op

Zanaflex CAP 4MG

Zanaflex CAP 6MG

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BETA-BLOCKERS

Zylet Sus 0.5-0.3%

TIER 01 GENERIC

PROSTAGLANDINS

betaxolol sol 0.5% op

carteolol sol 1% op

TIER 01 GENERIC

dorzol/timol sol 22.3-6.8

latanoprost sol 0.005%

levobunolol sol 0.5% op

Bimatoprost Sol 0.03%

timolol gel sol 0.25% op

Travoprost Dro 0.004%

timolol gel sol 0.5% op

TIER 02 PREFERRED

timolol mal sol 0.25% op

Lumigan Sol 0.01%

timolol mal sol 0.5% op

Travatan Z Dro 0.004%

Metipranolol Sol 0.3% Oph

TIER 03 NON PREFERRED

TIER 02 PREFERRED

Rescula Sol 0.15%

Betoptic-s Sus 0.25% Op

Xalatan Sol 0.005%

TIER 03 NON PREFERRED

Zioptan Dro 0.0015%

Betagan Sol 0.5% Op

Betimol Sol 0.25%

CYCLOPLEGIC MYDRIATICS

Betimol Sol 0.5%

TIER 01 GENERIC

Combigan Sol 0.2/0.5%

cyclopentol sol 1% op

Cosopt PF Sol

cyclopentol sol 2% op

Cosopt Sol 22.3-6.8

cyclopentola sol 0.5%

Istalol Sol 0.5% Op

homatropaire sol 5% op

Timoptic Ocu Sol 0.25% Op

homatropine sol 5% op

Timoptic Ocu Sol 0.5% Op

Atropine SUL Oin 1% Op

Timoptic Sol 0.25% Op

Atropine SUL Sol 1% Op

Timoptic Sol 0.5% Op

TIER 03 NON PREFERRED

Timoptic-xe Sol 0.25% Op

Cyclogyl Sol 0.5% Op

Timoptic-xe Sol 0.5% Op

Cyclogyl Sol 1% Op

Cyclogyl Sol 2% Op

OPHTHALMIC STEROIDS

Cyclomydril Sol Op

TIER 01 GENERIC

fluoromethol sus 0.1% op

DECONGESTANTS

neo-polycin oin HC 1%op

TIER 01 GENERIC

neo/poly/bac oin /HC 1%op

altafrin sol 10% op

neo/poly/dex oin 0.1% op

altafrin sol 2.5% op

neo/poly/dex sus 0.1% op

phenylephrin sol 10% op

prednisolone sus 1% op

phenylephrin sol 2.5% op

sulf/pred NA sol op

TIER 03 NON PREFERRED

tobra/dexame sus 0.3-0.1%

Naphazoline Sol 0.1% Op

Dexameth PHO Sol 0.1% Op

TIER 02 PREFERRED

MIOTICS

Blephamide Oin S.o.p.

TIER 01 GENERIC

Blephamide Sus Op

pilocarpine sol 1% op

Durezol Emu 0.05%

pilocarpine sol 2% op

FML Forte Sus 0.25% Op

pilocarpine sol 4% op

FML Oin 0.1% Op

TIER 03 NON PREFERRED

Pred Mild Sus 0.12% Op

Isopto Carp Sol 1% Op

Pred-G S.o.p Oin Op

Isopto Carp Sol 2% Op

Pred-G Sus Op

Isopto Carp Sol 4% Op

Tobradex Oin 0.3-0.1%

Phospholine Sol 0.125%op

Vexol Sus 1% Op

TIER 03 NON PREFERRED

ADRENERGIC AGENTS

Alrex Sus 0.2%

TIER 01 GENERIC

Flarex Sus 0.1% Op

brimonidine sol 0.2% op

FML Liquiflm Sus 0.1% Op

TIER 03 NON PREFERRED

Lotemax Gel 0.5%

apraclonidin sol 0.5% op

Lotemax Oin 0.5%

brimonidine sol 0.15%

Lotemax Sus 0.5%

Alphagan P Sol 0.1%

Maxidex Sus 0.1% Op

Alphagan P Sol 0.15%

Maxitrol Oin 0.1% Op

Iopidine Sol 0.5% Op

Maxitrol Sus 0.1% Op

Iopidine Sol 1% Op

Neo/Poly/HC Sus Op

Simbrinza Sus 1-0.2%

Omnipred Sus 1% Op

Pred Forte Sus 1% Op

IMMUNOMODULATORS

Pred Sod PHO Sol 1% Op

TIER 02 PREFERRED

Predni/Moxi/ Sol Bromfena

Restasis Emu 0.05%PA

Predni/Moxi/ Sol Ketorola

Restasis Mul Emu 0.05%PA

Prednisolone Sol Moxiflox

Tobradex Sus 0.3-0.1%

LOCAL ANESTHETICS

Tobradex ST Sus 0.3-0.05

TIER 03

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NON PREFERRED

Floxin Sol 0.3%

altacaine sol 0.5% op

HC/acet acid sol otic

proparacaine sol 0.5% op

Otovel Dro

tetcaine sol 0.5% op

Pramotic Dro 1-0.1%

tetracaine sol 0.5% op

tetravisc sol forte

OXYTOCICS

tetravisc sol 0.5% op

Akten Gel 3.5%

TIER 01 GENERIC

Alcaine Sol 0.5% Op

methylergon inj 0.2MG/ML

methylergon TAB 0.2MG

OPHTHALMICS - MISC.

Methergine TAB 0.2MG

TIER 01 GENERIC

TIER 02 PREFERRED

azelastine dro 0.05%

Cervidil Vag Mis 10MG INS

cromolyn sod sol 4% op

Prepidil Gel 0.5MG/3G

diclofenac sol 0.1% op

Prostin E2 Sup 20MG

dorzolamide sol 2% op

flurbiprofen sol 0.03% op

PAIN MANAGEMENT

ketorolac sol 0.4%

ANALGESICS - NONNARCOTIC

ketorolac sol 0.5%

TIER 01 GENERIC

olopatadine dro 0.1%

but/apap/caf TAB

Flurbiprofen Sol 0.03% Op

but/asa/caff CAP

TIER 02 PREFERRED

cho MAG tris liq 500/5ML

Alomide Sol 0.1% Op

diflunisal TAB 500MG

Azopt Sus 1% Op

salsalate TAB 500MG

Xiidra Dro 5%PA

salsalate TAB 750MG

TIER 04 SPECIALTY

TIER P PREVENTIVE

Cystaran Sol 0.44%QL,PA

asa low dose TAB 81MG EC

TIER 03 NON PREFERRED

aspir-low TAB 81MG EC

bromfenac sol 0.09% op

aspir-81 TAB 81MG EC

epinastine dro 0.05%

aspirin adlt TAB 81MG

olopatadine sol 0.2%

aspirin chil chw 81MGQL

Acular LS Sol 0.4%

aspirin chld chw 81MGQL

Acular Sol 0.5% Op

aspirin chw 81MGQL

Acuvail Sol 0.45%

aspirin low chw 81MGQL

Alocril Sol 2%

aspirin low TAB 81MG

Bepreve Dro 1.5%

aspirin low TAB 81MG EC

Bromfenac Sol 0.09% Op

aspirin TAB 325MGQL

Bromsite Dro 0.075%

aspirin TAB 325MG ECQL

Elestat Dro 0.05%

aspirin TAB 5gr ECQL

Emadine Sol 0.05% Op

aspirin TAB 81MG

Ilevro Dro 0.3% Op

aspirin TAB 81MG EC

Lastacaft Sol 0.25%

aspirin 81 TAB 81MG EC

Nevanac Sus 0.1%

aspirin-81 chw 81MGQL

Ocufen Sol 0.03% Op

aspirtab TAB 324MG ECQL

Pataday Sol 0.2%

bayer adv TAB 325MGQL

Patanol Sol 0.1% Op

bayer asa TAB 325MGQL

Pazeo Dro 0.7%

bayer low chw 81MGQL

Prolensa Sol 0.07%

bayer low TAB 81MG EC

Trusopt Sol 2% Op

child asa chw 81MGQL

child asa LS chw 81MGQL

OTIC AGENTS

ecotrin low TAB 81MG EC

TIER 01 GENERIC

ecotrin TAB 325MGQL

acetic acid sol 2% otic

ecpirin TAB 325MG ECQL

neo/poly/HC sol 1% otic

enteric asa TAB 325MGQL

neo/poly/HC sus 1% otic

eq aspirin TAB 325MGQL

ofloxacin dro 0.3%otic

eq aspirin TAB 325MG ECQL

TIER 02 PREFERRED

eq child asa chw 81MGQL

Cipro HC Sus Otic

eql aspirin chw 81MGQL

Ciprodex Sus 0.3-0.1%

eql aspirin TAB 325MGQL

TIER 03 NON PREFERRED

eql aspirin TAB 325MG ECQL

acetasol HC sol otic

eql aspirin TAB 81MG EC

fluocin acet oil ear0.01%

eql chld asa chw 81MGQL

fluocin acet oil 0.01%

gnp aspirin chw 81MGQL

Ace Acd/Alum Sol 2% Otic

gnp aspirin TAB 325MGQL

Cetraxal Sol 0.2%

gnp aspirin TAB 325MG ECQL

Ciprofloxacn Sol 0.2%

gnp aspirin TAB 81MG EC

Coly-mycin S Sus Otic

kls aspirin TAB 325MG ECQL

Cortisporin Sus -tc Otic

kls aspirin TAB 81MG EC

Dermotic Oil 0.01%

kp aspirin TAB 81MG EC

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miniprin low TAB 81MG EC

buprenorphin sub 2MG

norwich asa TAB 325MGQL

buprenorphin sub 8MG

px aspirin chw 81MGQL

butorphanol inj 2MG/ML

px aspirin TAB 325MGQL

codeine sulf TAB 15MGQL

px aspirin TAB 325MG ECQL

codeine sulf TAB 30MGQL

px aspirin TAB 81MG EC

codeine sulf TAB 60MGQL

qc aspirin TAB 325MGQL

endocet TAB 10-325MG

qc aspirin TAB 325MG ECQL

endocet TAB 2.5-325

qc child asa chw 81MGQL

endocet TAB 5-325MG

ra aspirin chw 81MGQL

endocet TAB 7.5-325

ra aspirin TAB 325MGQL

fentanyl dis 100mcg/hQL,PA

ra aspirin TAB 325MG ECQL

fentanyl dis 12mcg/HRQL,PA

ra aspirin TAB 81MG EC

fentanyl dis 25mcg/HRQL,PA

ra child asa chw 81MGQL

fentanyl dis 50mcg/HRQL,PA

sm aspirin chw 81MGQL

fentanyl dis 75mcg/HRQL,PA

sm aspirin TAB 325MGQL

hydroco/apap sol 7.5-325QL

sm aspirin TAB 325MG ECQL

hydroco/apap TAB 10-325MGQL

sm aspirin TAB 81MG EC

hydroco/apap TAB 5-325MGQL

sm child asa chw 81MGQL

hydroco/apap TAB 7.5-325QL

st joseph chw low 81MGQL

hydromorphon inj 1MG/ML

tgt aspirin chw childQL

hydromorphon inj 2MG/ML

tgt aspirin chw 81MGQL

hydromorphon inj 4MG/ML

tgt aspirin TAB 325MGQL

hydromorphon liq 1MG/ML

tgt aspirin TAB 81MG

hydromorphon TAB 2MGQL

tgt aspirin TAB 81MG EC

hydromorphon TAB 4MGQL

Aspirin TAB 81MGQL

hydromorphon TAB 8MGQL

CVS aspirin TAB 325MGQL

lorcet plus TAB 7.5-325QL

CVS aspirin TAB 325MG ECQL

lorcet HD TAB 10-325MGQL

CVS aspirin TAB 81MG EC

lorcet TAB 5-325MGQL

CVS chld asa chw 81MGQL

lortab TAB 10-325MGQL

Ecotrin TAB 325MG ECQL

lortab TAB 5-325MGQL

HM aspirin chw 81MGQL

lortab TAB 7.5-325QL

HM aspirin TAB 325MGQL

meperidine inj 100MG/ML

MM aspirin TAB 325MGQL

methadone sol 10MG/5MLQL,ST

SB aspirin TAB 325MGQL

methadone sol 5MG/5MLQL,ST

SB aspirin TAB 325MG ECQL

methadone CON 10MG/MLQL,ST

SB child asa chw 81MGQL

methadone TAB 10MGQL,ST

TIER 03 NON PREFERRED

methadone TAB 40MGQL,ST

bupap TAB 50-300MG

methadone TAB 5MGQL,ST

but/apap/caf CAP

methadose TAB 40MGQL,ST

butal/apap TAB 50-325MG

morphine SUL sol 10MG/5ML

butalb/aceta TAB 50-300MG

morphine SUL sol 100/5ML

capacet CAP

morphine SUL sol 20MG/5ML

esgic CAP

morphine SUL TAB 100MG ER

margesic CAP

morphine SUL TAB 15MG ER

marten-TAB tab 50-325MG

morphine SUL TAB 200MG ERQL,ST

phrenilin CAP forte

morphine SUL TAB 30MG ER

zebutal CAP

morphine SUL TAB 60MG ER

Allzital TAB 25-325MG

oxycod/apap TAB 10-325MG

Disalcid TAB 500MG

oxycod/apap TAB 2.5-325

Disalcid TAB 750MG

oxycod/apap TAB 5-325MG

Duraxin CAP

oxycod/apap TAB 7.5-325

Esgic TAB

oxycod/asa TABQL

Fioricet CAP

oxycodone sol 5MG/5ML

Fiorinal CAP

oxycodone CON 100/5ML

Levacet TAB

oxycodone CON 20MG/ML

Tencon TAB 50-325MG

oxycodone TAB 10MG

Vanatol LQ Sol

oxycodone TAB 15MGQL

Vanatol S Sol

oxycodone TAB 20MGQL

oxycodone TAB 30MGQL

ANALGESICS - OPIOID

oxycodone TAB 5MGQL

tramadl/apap TAB 37.5-325QL

TIER 01 GENERIC

tramadol HCL TAB 50MGQL

apap/codeine sol 120-12/5QL

Butorphanol Inj 1MG/ML

apap/codeine TAB 300-15MGQL

Codeine Sulf TAB 15MGQL

apap/codeine TAB 300-30MGQL

Codeine Sulf TAB 30MGQL

apap/codeine TAB 300-60MGQL

Codeine Sulf TAB 60MGQL

bupren/nalox sub 2-0.5MG

Hydromorphon Sup 3MG

bupren/nalox sub 8-2MG

Levorphanol TAB 2MGQL

buprenorphin inj 0.3MG/ML

Methadone Sol 10MG/5MLQL,ST

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Methadone Sol 5MG/5MLQL,ST

hydrocod/ibu TAB 10-200MGQL

Morphine SUL Inj 10/0.7ML

hydrocod/ibu TAB 2.5-200QL

Morphine SUL Sup 10MG

hydrocod/ibu TAB 5-200MGQL

Morphine SUL Sup 20MG

hydrocod/ibu TAB 7.5-200QL

Morphine SUL Sup 30MG

hydrocodone sol 10-325MGQL

Morphine SUL Sup 5MG

hydromorphon TAB 12MG ERQL,ST

Morphine SUL TAB 15MGQL

hydromorphon TAB 16MG ERQL,ST

Morphine SUL TAB 30MGQL

hydromorphon TAB 32MG ERQL,ST

Oxycodone TAB 10MG ERQL,ST

hydromorphon TAB 8MG ERQL,ST

Oxycodone TAB 20MG ERQL,ST

ibudone TAB 5-200MGQL

Oxycodone TAB 40MG ERQL,ST

meperidine TAB 100MGQL

Oxycodone TAB 60MG ERQL,ST

meperidine TAB 50MGQL

Oxycodone TAB 80MG ERQL,ST

morphine SUL CAP 10MG ERQL,PA

TIER 02 PREFERRED

morphine SUL CAP 100MG ERQL,PA

Oxycontin TAB 10MG CRQL,ST

morphine SUL CAP 20MG ERQL,PA

Oxycontin TAB 15MG CRQL,ST

morphine SUL CAP 30MG ERQL,PA

Oxycontin TAB 20MG CRQL,ST

morphine SUL CAP 50MG ERQL,PA

Oxycontin TAB 30MG CRQL,ST

morphine SUL CAP 60MG ERQL,PA

Oxycontin TAB 40MG CRQL,ST

morphine SUL CAP 80MG ERQL,PA

Oxycontin TAB 60MG CRQL,ST

oxycodone CAP 5MGQL

Oxycontin TAB 80MG CRQL,ST

oxymorphone TAB HCL 10MGQL

TIER 04 SPECIALTY

oxymorphone TAB HCL 5MGQL

fentanyl ot loz 1200mcgQL,PA

oxymorphone TAB 10MG ERQL,ST

fentanyl ot loz 1600mcgQL,PA

oxymorphone TAB 15MG ERQL,ST

fentanyl ot loz 200mcgQL,PA

oxymorphone TAB 20MG ERQL,ST

fentanyl ot loz 400mcgQL,PA

oxymorphone TAB 30MG ERQL,ST

fentanyl ot loz 600mcgQL,PA

oxymorphone TAB 40MG ERQL,ST

fentanyl ot loz 800mcgQL,PA

oxymorphone TAB 5MG ERQL,ST

Abstral Sub 100mcgQL,PA

oxymorphone TAB 7.5MG ERQL,ST

Abstral Sub 200mcgQL,PA

pentaz/nalox TAB 50-0.5MG

Abstral Sub 300mcgQL,PA

reprexain TAB 10-200MGQL

Abstral Sub 400mcgQL,PA

tramadol HCL TAB 100MG ERQL,ST

Abstral Sub 600mcgQL,PA

tramadol HCL TAB 200MG ERQL,ST

Abstral Sub 800mcgQL,PA

tramadol HCL TAB 300MG ERQL,ST

Actiq Loz 1200mcgQL,PA

verdrocet TAB 2.5-325QL

Actiq Loz 1600mcgQL,PA

vicodin ES TAB 7.5-300QL

Actiq Loz 200mcgQL,PA

vicodin HP TAB 10-300MGQL

Actiq Loz 400mcgQL,PA

vicodin TAB 5-300MGQL

Actiq Loz 600mcgQL,PA

xylon TAB 10-200MGQL

Actiq Loz 800mcgQL,PA

Alfentanil Inj 500/ML

Fentora TAB 100mcgQL,PA

Apap-caffein CAP DihydrocQL

Fentora TAB 200mcgQL,PA

Apap/Caffein TAB DihydrocQL

Fentora TAB 400mcgQL,PA

Arymo ER TAB 15MGPA

Fentora TAB 600mcgQL,PA

Arymo ER TAB 30MGPA

Fentora TAB 800mcgQL,PA

Arymo ER TAB 60MGPA

Lazanda Spr 100mcgQL,PA

Belbuca Mis 150mcgQL,PA

Lazanda Spr 300mcgQL,PA

Belbuca Mis 300mcgQL,PA

Lazanda Spr 400mcgQL,PA

Belbuca Mis 450mcgQL,PA

Subsys Spr 100mcgQL,PA

Belbuca Mis 600mcgQL,PA

Subsys Spr 1200mcgQL,PA

Belbuca Mis 75mcgQL,PA

Subsys Spr 1600mcgQL,PA

Belbuca Mis 750mcgQL,PA

Subsys Spr 200mcgQL,PA

Belbuca Mis 900mcgQL,PA

Subsys Spr 400mcgQL,PA

Bunavail Mis 2.1-0.3

Subsys Spr 600mcgQL,PA

Bunavail Mis 4.2-0.7

Subsys Spr 800mcgQL,PA

Bunavail Mis 6.3-1MG

Xtampza ER CAP 13.5MGQL,PA

Buprenex Inj 0.3MG/ML

Xtampza ER CAP 18MGQL,PA

Buprenorphin Dis 10mcg/HRQL,PA

Xtampza ER CAP 27MGQL,PA

Buprenorphin Dis 15mcg/HRQL,PA

Xtampza ER CAP 36MGQL,PA

Buprenorphin Dis 20mcg/HRQL,PA

Xtampza ER CAP 9MGQL,PA

Buprenorphin Dis 5mcg/HRQL,PA

TIER 03 NON PREFERRED

Buprenorphin Dis 7.5/HRQL,PA

alfentanil inj 500/ML

Butrans Dis 10mcg/HRQL,PA

ascomp/cod CAP 30MGQL

Butrans Dis 15mcg/HRQL,PA

but/apap/caf CAP codeineQL

Butrans Dis 20mcg/HRQL,PA

but/asa/caf/ CAP cod 30MGQL

Butrans Dis 5mcg/HRQL,PA

butorphanol sol 10MG/ML

Butrans Dis 7.5/HRQL,PA

hydroco/apap TAB 10-300MGQL

Capital/Cod Sus 120-12/5QL

hydroco/apap TAB 2.5-325QL

Conzip CAP 100MGQL,ST

hydroco/apap TAB 5-300MGQL

Conzip CAP 200MGQL,ST

hydroco/apap TAB 7.5-300QL

Conzip CAP 300MGQL,ST

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Demerol Inj 100MG/ML

MS Contin TAB 60MG ER

Demerol TAB 100MGQL

Norco TAB 10-325MGQL

Demerol TAB 50MGQL

Norco TAB 5-325MGQL

Dihydrocod/ CAP Asa/CaffQL

Norco TAB 7.5-325QL

Dilaudid Inj 1MG/ML

Nucynta ER TAB 100MGQL,ST

Dilaudid Inj 2MG/ML

Nucynta ER TAB 150MGQL,ST

Dilaudid Inj 4MG/ML

Nucynta ER TAB 200MGQL,ST

Dilaudid Liq 1MG/ML

Nucynta ER TAB 250MGQL,ST

Dilaudid TAB 2MGQL

Nucynta ER TAB 50MGQL,ST

Dilaudid TAB 4MGQL

Nucynta TAB 100MG

Dilaudid TAB 8MGQL

Nucynta TAB 50MG

Dolophine TAB 10MGQL,ST

Nucynta TAB 75MG

Dolophine TAB 5MGQL,ST

Opana ER TAB 10MGQL,ST

Duragesic Dis 100mcg/HQL,PA

Opana ER TAB 15MGQL,ST

Duragesic Dis 12mcg/HRQL,PA

Opana ER TAB 20MGQL,ST

Duragesic Dis 25mcg/HRQL,PA

Opana ER TAB 30MGQL,ST

Duragesic Dis 50mcg/HRQL,PA

Opana ER TAB 40MGQL,ST

Duragesic Dis 75mcg/HRQL,PA

Opana ER TAB 5MGQL,ST

Embeda CAP 100-4MGPA

Opana ER TAB 7.5MGQL,ST

Embeda CAP 20-0.8MGPA

Opana TAB 10MGQL

Embeda CAP 30-1.2MGPA

Opana TAB 5MGQL

Embeda CAP 50-2MGPA

Oxaydo TAB 5MG

Embeda CAP 60-2.4MGPA

Oxaydo TAB 7.5MG

Embeda CAP 80-3.2MGPA

Oxycod/Ibu TAB 5-400MGQL

Exalgo TAB 12MGQL,ST

Oxycodone TAB 15MG ERQL,ST

Exalgo TAB 16MGQL,ST

Oxycodone TAB 30MG ERQL,ST

Exalgo TAB 32MGQL,ST

Oxycodone/ Sol ApapQL

Exalgo TAB 8MGQL,ST

Oxymorphone TAB 10MG ERQL,ST

Fentanyl Dis 37.5mcgQL,PA

Oxymorphone TAB 15MG ERQL,ST

Fentanyl Dis 62.5mcgQL,PA

Oxymorphone TAB 20MG ERQL,ST

Fentanyl Dis 87.5mcgQL,PA

Oxymorphone TAB 30MG ERQL,ST

Fioricet CAP CodeineQL

Oxymorphone TAB 40MG ERQL,ST

Fiorinal/Cod CAP 30MGQL

Oxymorphone TAB 5MG ERQL,ST

Hycet Sol 7.5-325QL

Oxymorphone TAB 7.5MG ERQL,ST

Hysingla ER TAB 100 MGQL,PA

Percocet TAB 10-325MG

Hysingla ER TAB 120 MGQL,PA

Percocet TAB 2.5-325

Hysingla ER TAB 20 MGQL,PA

Percocet TAB 5-325MG

Hysingla ER TAB 30 MGQL,PA

Percocet TAB 7.5-325

Hysingla ER TAB 40 MGQL,PA

Primlev TAB 10-300MGQL

Hysingla ER TAB 60 MGQL,PA

Primlev TAB 5-300MGQL

Hysingla ER TAB 80 MGQL,PA

Primlev TAB 7.5-300QL

Ibudone TAB 10-200MGQL

Reprexain TAB 5-200MGQL

Ionsys Pad 40mcg/Ac

Roxicodone TAB 15MGQL

Kadian CAP 10MG ERQL,PA

Roxicodone TAB 30MGQL

Kadian CAP 100MG ERQL,PA

Roxicodone TAB 5MGQL

Kadian CAP 20MG ERQL,PA

Suboxone Mis 12-3MG

Kadian CAP 200MG ERQL,PA

Suboxone Mis 2-0.5MG

Kadian CAP 30MG ERQL,PA

Suboxone Mis 4-1MG

Kadian CAP 40MG ERQL,PA

Suboxone Mis 8-2MG

Kadian CAP 50MG ERQL,PA

Synalgos-dc CAPQL

Kadian CAP 60MG ERQL,PA

Tramadol HCL CAP ER 100MGQL,ST

Kadian CAP 80MG ERQL,PA

Tramadol HCL CAP ER 200MGQL,ST

Lortab Elx 10-300MGQL

Tramadol HCL CAP ER 300MGQL,ST

Methadone Inj 10MG/MLST

Tramadol HCL CAP 150MG ERQL,ST

Methadose CON 10MG/MLQL,ST

Tylenol/Cod TAB #3QL

Methadose SF CON 10MG/MLQL,ST

Tylenol/Cod TAB #4QL

Morphabond TAB 100MG ERPA

Ultracet TAB 37.5-325QL

Morphabond TAB 15MG ERPA

Ultram ER TAB 100MGQL,ST

Morphabond TAB 30MG ERPA

Ultram ER TAB 200MGQL,ST

Morphabond TAB 60MG ERPA

Ultram ER TAB 300MGQL,ST

Morphine SUL CAP 120MG ERQL,ST

Ultram TAB 50MGQL

Morphine SUL CAP 30MG ERQL,ST

Vicoprofen TAB 7.5-200QL

Morphine SUL CAP 45MG ERQL,ST

Xartemis XR TAB 7.5-325QL,ST

Morphine SUL CAP 60MG ERQL,ST

Xodol TAB 10-300MGQL

Morphine SUL CAP 75MG ERQL,ST

Xodol TAB 5-300MGQL

Morphine SUL CAP 90MG ERQL,ST

Xodol TAB 7.5-300QL

MS Contin TAB 100MG ER

Zohydro ER CAP 10MGQL,PA

MS Contin TAB 15MG ER

Zohydro ER CAP 15MGQL,PA

MS Contin TAB 200MG ERQL,ST

Zohydro ER CAP 20MGQL,PA

MS Contin TAB 30MG ER

Zohydro ER CAP 30MGQL,PA

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Zohydro ER CAP 40MGQL,PA

Rasuvo Inj 12.5MGPA

Zohydro ER CAP 50MGQL,PA

Rasuvo Inj 15MGPA

Zubsolv Sub 0.7-0.18

Rasuvo Inj 17.5MGPA

Zubsolv Sub 1.4-0.36

Rasuvo Inj 20MGPA

Zubsolv Sub 11.4-2.9

Rasuvo Inj 22.5MGPA

Zubsolv Sub 2.9-0.71

Rasuvo Inj 25MGPA

Zubsolv Sub 5.7-1.4

Rasuvo Inj 27.5MGPA

Zubsolv Sub 8.6-2.1

Rasuvo Inj 30MGPA

Rasuvo Inj 7.5MGPA

OPIOID ANTAGONIST

TIER 04 SPECIALTY

Actemra Inj 162/0.9QL,PA

TIER 01 GENERIC

Arcalyst Inj 220MGQL,PA

naloxone inj 0.4MG/ML

Duexis TAB 800-26.6QL,PA

naltrexone TAB 50MG

Enbrel Inj 25/0.5MLQL,PA

Naloxone Inj 0.4MG/ML

Enbrel Inj 25MGQL,PA

Naloxone Inj 1MG/ML

Enbrel Inj 50MG/MLQL,PA

TIER 02 PREFERRED

Enbrel Srclk Inj 50MG/MLQL,PA

Narcan Spr

Humira Inj 10MG/0.2QL,PA

TIER 04 SPECIALTY

Humira Kit 20MG/0.4QL,PA

Evzio InjQL,PA

Humira Kit 40MG/0.8QL,PA

Evzio Inj 2/0.4MLQL,PA

Humira Pedia Inj CrohnsQL,PA

Vivitrol Inj 380MGQL,PA

Humira Pen Inj CrohnsQL,PA

TIER 03 NON PREFERRED

Humira Pen Inj PsoriasiQL,PA

Revia TAB 50MG

Humira Pen Inj 40MG/0.8QL,PA

Kevzara Inj 150/1.14QL,PA

ANTI-INFLAMMATORY

Kevzara Inj 200/1.14QL,PA

TIER 01 GENERIC

Kineret InjQL,PA

diclofen pot TAB 50MG

Orencia Clck Inj 125MG/MLQL,PA

diclofenac TAB 100MG ER

Orencia Inj 125MG/MLQL,PA

diclofenac TAB 25MG DR

Orencia Inj 50/0.4QL,PA

diclofenac TAB 50MG DR

Orencia Inj 87.5/0.7QL,PA

diclofenac TAB 75MG DR

Otezla TAB 10/20/30QL,PA

etodolac CAP 200MG

Otezla TAB 30MGQL,PA

etodolac CAP 300MG

Ridaura CAP 3MGQL,PA

etodolac TAB 400MG

Simponi Inj 100MG/MLQL,PA

etodolac TAB 500MG

Simponi Inj 50/0.5MLQL,PA

flurbiprofen TAB 100MG

Vimovo TAB 375-20MGQL,PA

flurbiprofen TAB 50MG

Vimovo TAB 500-20MGQL,PA

ibuprofen TAB 400MG

Xeljanz TAB 5MGQL,PA

ibuprofen TAB 600MG

Xeljanz XR TAB 11MGQL,PA

ibuprofen TAB 800MG

TIER M MEDICAL COPAY

indomethacin CAP 25MG

Orencia Inj 250MGPA

indomethacin CAP 50MG

TIER 03 NON PREFERRED

ketorolac inj 15MG/ML

celecoxib CAP 100MGST

ketorolac inj 30MG/ML

celecoxib CAP 200MGST

ketorolac inj 60MG/2ML

celecoxib CAP 400MGST

leflunomide TAB 10MG

celecoxib CAP 50MGST

leflunomide TAB 20MG

diclo/misopr TAB 50-0.2MG

meloxicam TAB 15MG

diclo/misopr TAB 75-0.2MG

meloxicam TAB 7.5MG

etodolac ER TAB 400MG

nabumetone TAB 500MG

etodolac ER TAB 500MG

nabumetone TAB 750MG

etodolac ER TAB 600MG

naproxen sod TAB 275MG

fenoprofen TAB 600MG

naproxen sod TAB 550MG

ibuprofen sus 100/5ML

naproxen sus 125/5ML

indomethacin CAP 75MG ER

naproxen TAB 250MG

ketoprofen CAP 50MG

naproxen TAB 375MG

ketoprofen CAP 75MG

naproxen TAB 500MG

ketorolac TAB 10MG

piroxicam CAP 10MG

mefenam acid CAP 250MG

piroxicam CAP 20MG

naproxen sod TAB 375MG

sulindac TAB 150MG

naproxen sod TAB 375MG CR

sulindac TAB 200MG

naproxen sod TAB 500MG CR

tolmetin sod CAP 400MG

naproxen DR TAB 375MG

Meclofen Sod CAP 100MG

naproxen DR TAB 500MG

Meclofen Sod CAP 50MG

oxaprozin TAB 600MG

Naproxen Sus 125/5ML

profeno TAB 600MG

Tolmetin Sod CAP 400MG

Anaprox DS TAB 550MG

Tolmetin Sod TAB 200MG

Arava TAB 10MG

TIER 02 PREFERRED

Arava TAB 20MG

Rasuvo Inj 10MGPA

Arthrotec 50 TAB

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Arthrotec 75 TAB

PREFERRED

Celebrex CAP 100MGST

Ergomar Sub 2MG

Celebrex CAP 200MGST

Migergot Sup 2/100

Celebrex CAP 400MGST

TIER 04 SPECIALTY

Celebrex CAP 50MGST

dihydroergot inj 1MG/MLQL

Daypro TAB 600MG

D.h.e. 45 Inj 1MG/MLQL,PA

EC-naprosyn TAB 375MG

Dihydroergot Spr 4MG/MLQL

EC-naprosyn TAB 500MG

Migranal Spr 4MG/MLQL

Feldene CAP 10MG

TIER 03 NON PREFERRED

Feldene CAP 20MG

almotrip mal TAB 12.5MGQL,ST

Fenoprofen CAP 200MG

almotrip mal TAB 6.25MGQL,ST

Fenoprofen CAP 400MG

almotriptan TAB 12.5MGQL,ST

Fenortho CAP 200MG

almotriptan TAB 6.25MGQL,ST

Fenortho CAP 400MG

eletriptan TAB 20MGQL,ST

Indocin Sup 50MG

eletriptan TAB 40MGQL,ST

Indocin Sus 25MG/5ML

frovatriptan TAB 2.5MGQL,ST

Ketoprofen CAP 200MG ER

Amerge TAB 1MGQL

Lodine TAB 400MG

Amerge TAB 2.5MGQL

Meloxicam Sus 7.5/5ML

Axert TAB 12.5MGQL,ST

Mobic Sus 7.5/5ML

Axert TAB 6.25MGQL,ST

Mobic TAB 15MG

Cafergot TAB 1-100MG

Mobic TAB 7.5MG

Cambia Pow 50MG

Nalfon CAP 400MG

Frova TAB 2.5MGQL,ST

Naprelan TAB 375MG CR

Imitrex Inj 4MG/0.5QL

Naprelan TAB 500MG CR

Imitrex Inj 6MG/0.5

Naprelan TAB 750MG CR

Imitrex Spr 20MG/ActQL

Naprosyn Sus 125/5ML

Imitrex Spr 5MG/ActQL

Naprosyn TAB 500MG

Imitrex TAB 100MGQL

Otrexup Inj 10MGPA

Imitrex TAB 25MGQL

Otrexup Inj 12.5/0.4PA

Imitrex TAB 50MGQL

Otrexup Inj 15MGPA

Maxalt TAB 10MGQL

Otrexup Inj 17.5/0.4PA

Maxalt TAB 5MGQL

Otrexup Inj 20MGPA

Maxalt-MLT TAB 10MGQL

Otrexup Inj 22.5/0.4PA

Maxalt-MLT TAB 5MGQL

Otrexup Inj 25MGPA

Relpax TAB 20MGQL,ST

Otrexup Inj 7.5/0.4PA

Relpax TAB 40MGQL,ST

Ponstel CAP 250MG

Sumavel Dose Inj 4MG/0.5QL

Rheumatrex TAB 2.5MG

Sumavel Dose Inj 6MG/0.5QL

Sprix Spr 15.75MG

Treximet TAB 10-60MGPA

Tivorbex CAP 20MG

Treximet TAB 85-500MGQL,ST

Tivorbex CAP 40MG

Zecuity Pad 6.5MG/4hQL,ST

Tolmetin Sod TAB 600MG

Zembrace Sym Inj 3/0.5ML

Vivlodex CAP 10MG

Zomig Spr 2.5MGQL

Vivlodex CAP 5MG

Zomig Spr 5MGQL

Zipsor CAP 25MGPA

Zomig TAB 2.5MGQL

Zorvolex CAP 18MG

Zomig TAB 5MGQL

Zorvolex CAP 35MG

Zomig ZMT TAB 2.5 MGQL

Zomig ZMT TAB 5MGQL

MIGRAINE PRODUCTS

GOUT AGENTS

TIER 01 GENERIC

ergot/caffen TAB 1-100MG

TIER 01 GENERIC

naratriptan TAB 1MGQL

allopurinol TAB 100MG

naratriptan TAB 2.5MGQL

allopurinol TAB 300MG

rizatriptan TAB 10MGQL

proben/colch TAB 500-0.5

rizatriptan TAB 10MG odtQL

probenecid TAB 500MG

rizatriptan TAB 5MGQL

Colchicine CAP 0.6MG

rizatriptan TAB 5MG odtQL

Colchicine TAB 0.6MG

sumatriptan inj 4MG/0.5QL

TIER 02 PREFERRED

sumatriptan inj 6MG/0.5QL

Colcrys TAB 0.6MG

sumatriptan spr 20MG/actQL

TIER 03 NON PREFERRED

sumatriptan spr 5MG/actQL

Duzallo TAB 200-200PA

sumatriptan TAB 100MGQL

Duzallo TAB 200-300PA

sumatriptan TAB 25MGQL

Mitigare CAP 0.6MG

sumatriptan TAB 50MGQL

Uloric TAB 40MGPA

zolmitriptan TAB 2.5 MGQL

Uloric TAB 80MGPA

zolmitriptan TAB 2.5MG orally disintegratingQL

Zurampic TAB 200MGPA

zolmitriptan TAB 5MGQL

Zyloprim TAB 100MG

Sumatriptan Inj 6MG/0.5QL

Zyloprim TAB 300MG

TIER 02

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LOCAL ANESTHETICS-INJ

fluticasone spr 50mcg

ipratropium spr 0.03%

TIER 01 GENERIC

ipratropium spr 0.06%

lidocaine inj 1%

Flunisolide Spr 0.025%

lidocaine inj 2%

TIER 03 NON PREFERRED

TIER 03 NON PREFERRED

budesonide sus 32mcg

lido/epi 1%- inj 1:100000

mometasone spr 50mcg

Lidocain HCL Inj 10MG/ML

olopatadine spr 0.6%

Xylo/Epi 1%- Inj 1:100000

triamcinolon aer 55mcg/ac

Xylocaine Inj -mpf 2%

Adrenalin Sol 1:1000

Xylocaine Inj 1%

Astepro Spr 0.15%

Xylocaine Inj 2%

Atrovent Nas Sol 0.03%

Atrovent Nas Sol 0.06%

RESPIRATORY, ALLERGY, ETC

Azenase PAK Mis 137-50

ANTIHISTAMINES

Bactroban Oin Nasal 2%

TIER 01 GENERIC

Beconase AQ Sus 0.042%

arbinoxa sol 4MG/5ML

Dymista Spr 137-50

arbinoxa TAB 4MG

Nasonex Spr 50mcg/Ac

carbinoxamin sol 4MG/5ML

Omnaris Spr

carbinoxamin TAB 4MG

Patanase Spr 0.6%

clemastine TAB 2.68MG

Qnasl Aer 80mcg

cyproheptad syp 2MG/5ML

Qnasl Child Spr 40mcg

cyproheptad TAB 4MG

Rhinocort Sus Aqua

desloratadin TAB 5MG

Ticalast Kit 137/50

diphenhydram inj 50MG/ML

Tyzine PED Dro 0.05%

levocetirizi sol 2.5/5ML

Veramyst Spr 27.5mcg

levocetirizi TAB 5MG

Zetonna Aer 37mcg

pharbedryl CAP 50MG

phenadoz sup 12.5MG

COUGH/COLD/ALLERGY

phenadoz sup 25MG

TIER 01 GENERIC

phenergan sup 12.5MG

acetylcyst sol 10%

phenergan sup 25MG

acetylcyst sol 20%

phenergan sup 50MG

benzonatate CAP 100MG

promethazine sol 6.25/5ML

benzonatate CAP 200MG

promethazine sup 12.5MG

hydroc/homat TAB 5-1.5MG

promethazine sup 25MG

hydrocod/hom syp 5-1.5/5

promethazine sup 50MG

hydromet syp 5-1.5/5

promethazine syp 6.25/5ML

nebusal neb 3%

promethazine TAB 12.5MG

prometh VC sol plain

promethazine TAB 25MG

prometh VC/ syp codeine

promethazine TAB 50MG

prometh/cod syp 6.25-10

promethegan sup 12.5MG

prometh/PE syp 6.25-5/5

promethegan sup 25MG

prometh/PE/ syp codeine

promethegan sup 50MG

promethazine syp DM

Clemastine TAB 2.68MG

pulmosal neb 7%

Desloratadin TAB 2.5 Odt

sod chloride neb 0.9%

Desloratadin TAB 5MG Odt

sodium chlor neb 3%

TIER 03 NON PREFERRED

sodium chlor neb 7%

bpm TAB 6MG

tussigon TAB 5-1.5MG

cetirizine syp 1MG/ML

TIER 03 NON PREFERRED

diphenhydram elx 12.5/5ML

benzonatate CAP 150MG

promethazine inj 25MG/ML

biotuss liq

promethazine inj 50MG/ML

bpm pseudo TAB 6-45MG

Brompheniram Chw 12MG

brom/PSE/DM syp

Clarinex Syp 0.5MG/ML

bromfed DM syp

Clarinex TAB 5MG

hydr/CPM/PSE liq 5-4-60MG

Karbinal ER Sus 4MG/5ML

hydro/chlor/ liq 5-4-60MG

Phener Fort Syp 25MG/5ML

sodium chlor neb 10%

Phenergan Inj 25MG/ML

Carbaphen 12 Liq

Phenergan Inj 50MG/ML

Carbaphen 12 Sus PED

Respa-BR TAB 11MG

Clarinex-d TAB 2.5-120

Ryvent TAB 6MG

Flowtuss Sol 2.5-200

Xyzal Sol

Hycofenix Sol

Xyzal Sol 2.5/5ML

Hyper-sal Neb 7%

Xyzal TAB 5MG

Hypersal Neb 3.5%

Hypersal Neb 7%

NASAL AGENTS

HYD pol/CPM sus 10-8/5ML

TIER 01 GENERIC

Lexuss 210 Liq 2-10/5ML

azelastine spr 0.1%

Nebusal Neb 6%

azelastine spr 0.15%

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Nortuss-EX Liq 200-20/5

Dulera Aer 100-5mcgPA

Obredon Sol 2.5-200

Dulera Aer 200-5mcgPA

Panatuss Dxp Liq

Flovent Disk Aer 100mcgPA

PE/Guaifenes Dro 1.5-20MG

Flovent Disk Aer 250mcgPA

Relhist Chw

Flovent Disk Aer 50mcgPA

Rezira Sol 60-5/5ML

Flovent HFA Aer 110mcgPA

Semprex-d CAP 8-60MG

Flovent HFA Aer 220mcgPA

Tessalon Per CAP 100MG

Flovent HFA Aer 44mcg

Tussicaps CAP 10-8MG

Qvar Aer 40mcg

Tussicaps CAP 5-4MG

Qvar Aer 80mcg

Tussionex Sus 10-8/5ML

Serevent Dis Aer 50mcgST

Tuzistra XR Sus

Spiriva Aer 1.25mcgST

Vituz Sol 5-4MG

Spiriva CAP Handihlr

Zonatuss CAP 150MG

Spiriva Spr 2.5mcg

Zutripro Liq 60-4-5MG

Stiolto Aer 2.5-2.5

Striverdi Aer 2.5mcg

ANTIASTHMATIC/COPD AGENTS

Ventolin HFA AerQL

TIER 04 SPECIALTY

TIER 01 GENERIC

zileuton ER TAB 600MGQL,PA

albuterol neb 0.083%

Zyflo CR TAB 600MGQL,PA

albuterol neb 0.5%

Zyflo TAB 600MGQL,PA

albuterol neb 0.63MG/3

TIER 03 NON PREFERRED

albuterol neb 1.25MG/3

albuterol TAB 4MG ER

albuterol syp 2MG/5ML

albuterol TAB 8MG ER

albuterol TAB 2MG

difil-G fort liq 100-100

albuterol TAB 4MG

isoproteren inj 0.2MG/ML

budesonide sus 0.25MG/2

levalbuterol neb 0.31MG

budesonide sus 0.5MG/2

levalbuterol neb 0.63MG

budesonide sus 1MG/2ML

levalbuterol neb 1.25/0.5

ipratropium sol 0.02%inh

levalbuterol neb 1.25MG

ipratropium/ sol albuter

terbutaline inj 1MG/ML

montelukast chw 4MG

zafirlukast TAB 10MG

montelukast chw 5MG

zafirlukast TAB 20MG

montelukast gra 4MG

Accolate TAB 10MG

montelukast TAB 10MG

Accolate TAB 20MG

terbutaline TAB 2.5MG

Aerospan Aer 80mcg

terbutaline TAB 5MG

Airduo Respi Inh 113-14PA

theochron TAB 100MG CR

Airduo Respi Inh 232-14PA

theochron TAB 200MG CR

Airduo Respi Inh 55-14PA

theochron TAB 300MG CR

Alvesco Aer 160mcg

theophylline sol 80/15ML

Alvesco Aer 80mcg

theophylline TAB 100MG CR

Anoro Ellipt Aer 62.5-25PA

theophylline TAB 100MG ER

Arcapta CAP 75mcg

theophylline TAB 200MG CR

Armonair Aer 113/ActPA

theophylline TAB 200MG ER

Armonair Aer 232/ActPA

theophylline TAB 300MG ER

Armonair Aer 55/ActPA

theophylline TAB 400MG ER

Arnuity Elpt Inh 100mcg

theophylline TAB 450MG ER

Arnuity Elpt Inh 200mcg

theophylline TAB 600MG ER

Bevespi Aer 9-4.8mcgPA

Cromolyn Sod Neb 20MG/2ML

Breo Ellipta Inh 100-25PA

Metaproteren Syp 10MG/5ML

Breo Ellipta Inh 200-25PA

Metaproteren TAB 10MG

Brovana Neb 15mcgPA

Metaproteren TAB 20MG

Daliresp TAB 500mcg

TIER 02 PREFERRED

Elixophyllin Elx 80/15ML

Advair Disku Aer 100/50ST

Fluticasone Inh SalmeterPA

Advair Disku Aer 250/50ST

Foradil CAP Aerolize

Advair Disku Aer 500/50ST

Incruse Elpt Inh 62.5mcgPA

Advair HFA Aer 115/21ST

Isuprel Inj 0.2MG/ML

Advair HFA Aer 230/21ST

Levalbuterol Aer 45/ActQL

Advair HFA Aer 45/21ST

Perforomist Neb 20mcg

Asmanex HFA Aer 100 McgST

Proair HFA AerQL

Asmanex HFA Aer 200 McgST

Proair Respi AerQL

Asmanex 120 Aer 220mcgST

Proventil Aer HFAQL

Asmanex 14 Aer 220mcgST

Pulmicort Inh 180mcg

Asmanex 30 Aer 110mcgST

Pulmicort Inh 90mcg

Asmanex 30 Aer 220mcgST

Pulmicort Sus 0.25MG/2

Asmanex 60 Aer 220mcgST

Pulmicort Sus 0.5MG/2

Asmanex 7 Aer 110mcgST

Pulmicort Sus 1MG/2ML

Atrovent HFA Aer 17mcg

Seebri Neoha CAP 15.6mcgPA

Combivent Aer 20-100

Singulair Chw 4MG

Effective January 1, 2018

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Singulair Chw 5MG

Comvax Inj

Singulair Gra 4MG

Engerix-b Inj 10/0.5ML

Singulair TAB 10MG

Engerix-b Inj 20mcg/ML

Symbicort Aer 160-4.5PA

EZ Flu Shot Inj PF 14-15

Symbicort Aer 80-4.5PA

EZ Flu Shot Inj 2015-16

Theo-24 CAP 100MG CR

EZ Flu Shot Kit 2015-16

Theo-24 CAP 200MG CR

EZ Flu Shot Kit 2016-17

Theo-24 CAP 300MG CR

Fluad Inj 2016-17

Theo-24 CAP 400MG ER

Fluad Inj 2017-18

Tudorza Pres Aer 400/Act

Fluarix Quad Inj 2015-16

Utibron CAP NeohalerPA

Fluarix Quad Inj 2016-17

Vospire ER TAB 4MG

Fluarix Quad Inj 2017-18

Vospire ER TAB 8MG

Flublok Sol 2015-16

Xopenex CONC Neb 1.25/0.5

Flublok Sol 2016-17

Xopenex HFA AerQL

Flublok Sol 2017-18

Xopenex Neb 0.31MG

Flucelvax Inj 2015-16

Xopenex Neb 0.63MG

Fluclvx Quad Inj 2016-17

Xopenex Neb 1.25/3ML

Fluclvx Quad Inj 2017-18

Flulaval Qua Inj 2014-15

RESPIRATORY AGENTS - MISC

Flulaval Qua Inj 2015-16

Flulaval Qua Inj 2016-17

TIER 02 PREFERRED

Flulaval Qua Inj 2017-18

Survanta Inh

Flumist Quad Sus 2015-16

TIER 04 SPECIALTY

Flumist Quad Sus 2016-17

Esbriet CAP 267MGQL,PA

Flumist Quad Sus 2017-18

Esbriet TAB 267MGQL,PA

Fluvirin Inj 2015-16

Esbriet TAB 801MGQL,PA

Fluvirin Inj 2016-17

Kalydeco PAK 50MGQL,PA

Fluvirin Inj 2017-18

Kalydeco PAK 75MGQL,PA

Fluzone HD Inj PF 15-16

Kalydeco TAB 150MGQL,PA

Fluzone HD Inj PF 16-17

Ofev CAP 100MGQL,PA

Fluzone HD Inj PF 17-18

Ofev CAP 150MGQL,PA

Fluzone Quad Inj 15-16

Orkambi TAB 100-125QL,PA

Fluzone Quad Inj 2015-16

Orkambi TAB 200-125QL,PA

Fluzone Quad Inj 2016-17

Pulmozyme Sol 1MG/MLQL

Fluzone Quad Inj 2017-18

TIER 03 NON PREFERRED

Fluzone Splt Inj 2015-16

Curosurf Sus 120/1.5

Gardasil Inj

Curosurf Sus 240/3ML

Gardasil 9 Inj

Infasurf Sus 35MG/ML

Havrix Inj 1440unit

Havrix Inj 720unit

TOXOIDS

Hiberix Sol 10mcg

Influenza Firus Vaccine

TIER P PREVENTIVE

Ipol Inj Inactive

Adacel Inj

M-m-r II Inj

Boostrix Inj

Menactra Inj

Daptacel Inj

Menhibrix Inj

Dip/Tet PED Inj 25-5lfu

Menomune Inj A/C/Y/W

Infanrix Inj

Menveo Inj

Kinrix Inj

Pedvax HIB Inj

Pediarix Inj 0.5ML

Pneumovax 23 Inj 25/0.5

Pentacel Inj

Prevnar 13 Inj

Quadracel Inj

Proquad Inj

Tenivac Inj 5-2LF

Recombiva HB Inj 10mcg/ML

Tet/Dip Tox Inj 2-2 LF

Recombiva HB Inj 5mcg/0.5

Recombiva-HB Inj 40mcg/ML

VACCINES

Rotarix Sus

Rotateq Sol

TIER P PREVENTIVE

Trumenba Inj

Acthib Inj

Twinrix Inj

Afluria Inj PF 15-16

Vaqta Inj 25/0.5ML

Afluria Inj PF 16-17

Vaqta Inj 50unt/ML

Afluria Inj PF 17-18

Varivax Inj

Afluria Inj 2015-16

Zostavax Inj

Afluria Inj 2016-17

TIER 03 NON PREFERRED

Afluria Inj 2017-18

Biothrax Inj

Afluria Quad Inj PF 16-17

Afluria Quad Inj PF 17-18

VITAMINS

Afluria Quad Inj 2017-18

VITAMINS

Bexsero Inj

TIER 01

Cervarix Inj

Effective January 1, 2018

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Page 69:  · Drug Formulary . INTRODUCTION . What is a formulary? A formulary is a list of generic, brand, and specialty drugs. It is used by practitioners to identify drugs that offer the

GENERIC

vitamin d3 chw 1000unit

phytonadione inj 1MG/0.5

vitamin d3 chw 2000unit

vitamin d CAP 50000unt

vitamin d3 chw 400unit

vitamin k1 inj 1MG/0.5

vitamin d3 chw 5000unit

Vitamin K1 Inj 10MG/ML

vitamin d3 dro 400unit

TIER 02 PREFERRED

vitamin d3 dro 5000unit

Mephyton TAB 5MG

vitamin d3 CAP 1000unit

TIER P PREVENTIVE

vitamin d3 CAP 10000unt

bio-d-mulsio liq 2000unit

vitamin d3 CAP 2000unit

bio-d-mulsio liq 400unit

vitamin d3 CAP 400unit

cvd d3 chw 1000unit

vitamin d3 CAP 5000unit

d 1000 chw 1000unit

vitamin d3 CAP 50000unt

d 1000 CAP 1000unit

vitamin d3 TAB 1000unit

d 1000 TAB 1000unit

vitamin d3 TAB 2000unit

d 400 chw 400unit

vitamin d3 TAB 400unit

d 400 TAB 400unit

vitamin d3 TAB 5000unit

d-vita liq 400unit

vitamin d3 TAB 50000uni

d-3 gummy chw 400unit

vitamin d3 TAB 50000unt

d-400 TAB 400unit

Baby Ddrops Liq 400unit

decara CAP 50000unt

Baby Super Dro Daily D3

delta d3 TAB 400unit

Baby Vit D Dro 400/.028

dialyvite d CAP 5000unit

CVS d3 chw 1000 unt

d3 adult chw 1000unit

CVS d3 CAP 1000unit

d3 kids chw 400unit

CVS d3 CAP 2000unit

d3 max ST dro 5000unit

CVS d3 CAP 400unit

d3 maximum CAP 5000unit

CVS d3 CAP 5000unit

d3 super str CAP 2000unit

D-VI-sol Liq 400unit

d3 CAP 1000unit

Daily D3 Dro 1000unit

d3 CAP 10000

Ddrops Boost Liq 600/.028

d3 CAP 2000unit

Ddrops Liq

d3 CAP 400unit

Ddrops Liq 1000unit

d3 TAB 1000unit

Ddrops Liq 2000unit

d3 TAB 2000unit

Decara CAP 25000unt

d3 TAB 400unit

D3 Dots TAB 2000unit

d3 2000 TAB 2000unit

HM vit d3 CAP 2000unit

d3-1000 CAP 1000unit

HM vitamin d TAB 1000unit

d3-50 CAP 50000unt

Optimal D3 M CAP

eql vitamin CAP d3

PA vitamin CAP 2000unit

gnp d chw 2000unit

Replesta Nx Waf 14000unt

gnp d CAP 1000unit

Replesta Waf 14000unt

gnp vit d TAB 1000unit

Replesta Waf 50000unt

gnp vit d TAB 5000unit

Super Daily Dro D3

gnp vit d3 TAB 1000unit

Thera-d TAB 4000unit

just d liq 400unit

Upspringbaby Dro Vit D3

optimal-d CAP 50000unt

Vit D3 Drops Liq 400unit

opurity vit chw d 5000un

Vitamelts D TAB 1000 Iu

pedia d-vite dro 400unit

Vitamin D3 Chw 5000unit

ra vitamin CAP 2000unit

Vitamin D3 CAP 4000unit

sm vitamin d TAB 400unit

Vitamin D3 Liq 1000unit

thera-d sprt TAB 2000unit

Vitamin D3 Liq 1200unit

thera-d TAB 2000unit

Vitamin D3 Spr 1000unit

vit d child chw 1000unit

Vitamin D3 TAB 10000unt

vit d gummie chw 400unit

Vitamin D3 TAB 3000unit

vit d3 gumm chw 1000unit

Vitamin D3 TAB 5000unit

vitajoy daly chw d 1000iu

vitamin d chw 1000unit

TIER 03 NON PREFERRED

vitamin d chw 400unit

Drisdol CAP 50000unt

vitamin d dro 400unit

vitamin d CAP 1000unit

MULTIVITAMINS

vitamin d CAP 2000unit

TIER P PREVENTIVE

vitamin d CAP 400unit

sm prenatal TAB vitamins

vitamin d TAB 1000unit

Atabex Chw Prenatal

vitamin d TAB 2000unit

Be Well PAK Rounded

vitamin d TAB 400unit

Brainstrong Mis Prenatal

vitamin d TAB 5000iu

Cadeau DHA CAP

vitamin d-3 CAP 1000unit

Centrum Spec PAK Prenatal

vitamin d-3 CAP 2000unit

CL Prenatal TAB 28-0.8MG

vitamin d-3 TAB 1000unit

CVS Prenatal Chw Gummy

vitamin d-3 TAB 2000unit

CVS Prenatal TAB

vitamin d-3 TAB 5000unit

Effective January 1, 2018

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 59

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Enfamil Mis Expecta

Acura Contrl Sol High

Eql Prenatal TAB Formula

Acura Contrl Sol Low

Gnp Daily Mis Prenatal

Acura Contrl Sol Normal

Gnp Prenatal TAB 28-0.8MG

Adj Lancing Mis Device

Goodsense TAB 28-0.8MG

Adv Lancing Mis Device

HM One Daily Mis Prenatal

Adv Travel Mis Lanc 28G

HM Prenatal TAB

Advance Liq Control

Kp Prenatal TAB Multivit

Advance Liq Intuitio

Multi Prenat TAB

Advance Norm Liq Control

One A Day CAP Prenatal

Advcate Safe Mis Lanc 26G

One A Day Mis Prenatal

Advocate Liq High

One A Day PAK Prenatal

Advocate Liq Low

One-a-day PAK Prenatal

Advocate Mis Lanc Dev

Perry Prenat CAP

Advocate Mis Lanc 30G

Pre-natal TAB Formula

Advocate Mis Lancets

Prenat Multi CAP +dha

Advocate+ Sol Redi-cod

Prenatal CAP Formula

Agamatrix Mis 33G

Prenatal CAP Omega-3

Agamatrix Sol High

Prenatal Mul CAP +dha

Agamatrix Sol Norm/Hgh

Prenatal MV Mis + DHA

Agamatrix Sol Normal

Prenatal One TAB Daily

Altrnate Sit Mis Device

Prenatal TAB

Aqua Lance Mis Lanc Dev

Prenatal TAB Complete

Assure Cmfrt Mis 28G

Prenatal TAB Formula

Assure Cmfrt Mis 30G

Prenatal TAB Forte

Assure Dose Sol Norm/Hgh

Prenatal TAB Iron

Assure Dose Sol Normal

Prenatal TAB Low Iron

Assure II Liq Level 1

Prenatal TAB Multivit

Assure II Liq Level1/2

Prenatal TAB Plus DHA

Assure Lance Mis Low Flow

Prenatal TAB Vitamins

Assure Lance Mis Micro

Prenatal TAB 27-0.8MG

Assure Lance Mis Safe 25G

Prenatal TAB 28-0.8MG

Assure Lance Mis Safe 30G

Prenatal Vit TAB Minerals

Assure Lance Mis 21G

Prenatal Vit TAB 28-0.8MG

Assure Mis Lancets

Prenatal/FE TAB

Assure Plus Mis High 18G

Prenatl Mult CAP + DHA

Assure Plus Mis Low 25G

Prentat Mult CAP Plus DHA

Assure Plus Mis Mcro 28G

Px Prenatal TAB Multivit

Assure Plus Mis Norm 21G

Qc Prenatal TAB 28-0.8MG

Assure Plus Mis Pediatri

Ra One Daily Mis

Assure Prism Sol Level1/2

Ra Prenatal TAB Formula

Assure Pro Liq Level1/2

Ra Prenatal TAB 28-0.8MG

Assure 3 Liq Control

Right Step TAB Prenatal

Assure 4 Liq Level1/2

Similac Pren PAK Early Sh

Aurora Lance Mis Thin 23G

Sm One Daily Mis Prenatal

Aurora Lance Mis 30G

Sm Prenatal TAB Vitamins

Auto Lancet Mis

Stuart One CAP

Auto-lancet Mis

Your Life CAP Prenatal

Auto-lancet Mis Mini

Autolet Impr Mis Lanc Dev

MEDICAL DEVICES

Autolet II Kit Clinisaf

Autolet Lanc Mis Device

DIABETIC SUPPLIES

Autolet Lite Kit

TIER 01 GENERIC

Autolet Lite Kit Clinisaf

lancet carry mis case

Autolet Lite Kit Starter

lancets mis 23G

Autolet Mini Mis

Accu-chek Kit Fastclix

Autolet Plat Mis 1.8MM

Accu-chek Kit Mlticlix

Autolet Plat Mis 2.4MM

Accu-chek Kit Softclix

Autolet Plat Mis 3.0MM

Accu-chek Liq Act/Gluc

Autolet Plus Mis

Accu-chek Liq Guide

Autolet Plus Mis Lanc Dev

Accu-chek Liq Smart

Autoshield Mis 29X3/16"

Accu-chek Mis Mlticlix

Autoshield Mis 29X5/16"

Accu-chek Sol

Autoshield Mis 30GX3/16

Accu-chek Sol Compact

AF Lancets Mis Thin

Accutrend Sol Glucose

AT Last Mis Lancets

Acti-lance Mis Lite 28G

AT Last Sol Control

Acti-lance Mis Spec 17G

Bayer Breeze Liq High Cnt

Acti-lance Mis Univ 23G

Bayer Breeze Liq Low Cntl

Acti-lance Mis 28G

Bayer Breeze Liq Norm Cnt

Active 1ST Mis Lanc 30G

Bayer Breeze Mis 2 TestQL,PA

Effective January 1, 2018

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Bayer Micrlt Mis Lanc Dvc

Cool Control Sol A

Bayer Micrlt Mis Lancets

Cool Control Sol B

Bullseye Mis Lancets

CVS Lancets Mis Original

Bullseye Mis Mini Lnc

CVS Lancets Mis Thin 26G

BD Lancet Mis Device

CVS Lancets Mis Thin 30G

BD Lancet UF Mis 30G

CVS Lancets Mis Thin 33G

BD Lancet UF Mis 33G

CVS Lancets Mis 21G

BD Microtain Mis Lancets

CVS Lancets Mis 30G

BD Pen Needl Mis 29GX1/2"

CVS Lancets Mis 33G

BD Pen Needl Mis 31GX3/16

CVS Lancing Mis Device

BD Pen Needl Mis 31GX5/16

Diastar Easy Mis Lancets

BD Pen Needl Mis 32GX4MM

Diastar Mis Lancets

BD U-500 Mis 31GX6MM

Diatrue Cont Sol Level 1

BD Ultra-fin Mis 32GX6MM

Diatrue Cont Sol Level 2

Cardiocom Mis Lancing

Diatrue Cont Sol Level 3

Carefine Mis 31GX8MM

Droplet Lanc Mis Device

Carefine Mis 32GX4MM

Droplet Lanc Mis 30G

Carefine Mis 32GX5MM

Duo-care Liq Level1/2

Carefine Mis 32GX6MM

E-z Ject Mis Lanc 21G

Careone Adv Mis Lancing

E-z Ject Mis Lancets

Careone Lanc Mis Thin 23G

E-z Ject Mis Thin 26G

Careone Lanc Mis 28G

E-z Ject Mis 21G

Caresens Sol Control

E-z Ject Mis 21G Colr

Caretouch Mis Ejector

E-z Ject Mis 30G

Caretouch Mis Twist 28

E-z Ject Mis 32G Colr

Caretouch Mis Twist 30

E-ZJECT Lanc Mis 33G

Caretouch Mis Twist 33

Easy Comfort Mis Lanc/30G

Caretouch Mis 31GX5MM

Easy Comfort Mis 30G

Caretouch Mis 31GX6MM

Easy Comfort Mis 31GX1/4"

Caretouch Mis 31GX8MM

Easy Comfort Mis 31GX3/16

Caretouch Mis 32GX4MM

Easy Comfort Mis 31GX5/16

Caretouch Mis 32GX5MM

Easy Comfort Mis 32GX5/32

Cleanlet 28G Mis Lancets

Easy Mini Mis

Clever Check Mis

Easy Mini Mis Eject

Clever Check Mis 30G

Easy Plus II Sol High

Clevr Choice Liq High

Easy Plus II Sol Low

Clevr Choice Liq Low

Easy Talk Sol High

Clickfine Mis 31GX1/4"

Easy Talk Sol Low

Clickfine Mis 31GX5/16

Easy Talk Sol Normal

Clickfine Mis 32GX5/32

Easy Touch Mis

Closercare Mis

Easy Touch Mis Lanc/21G

Coaguchek Mis Lancets

Easy Touch Mis Lanc/23G

Comfort Assu Mis Lanc 28G

Easy Touch Mis Lanc/26G

Comfort Assu Mis Lanc 33G

Easy Touch Mis Lanc/28G

Comfort EZ Mis 29GX12MM

Easy Touch Mis Lanc/30G

Comfort EZ Mis 31GX5MM

Easy Touch Mis Lanc/32G

Comfort EZ Mis 31GX6MM

Easy Touch Mis Lanc/33G

Comfort EZ Mis 31GX8MM

Easy Touch Mis 29GX1/2"

Comfort EZ Mis 32GX4MM

Easy Touch Mis 31GX1/4"

Comfort EZ Mis 32GX5MM

Easy Touch Mis 31GX3/16

Comfort EZ Mis 32GX6MM

Easy Touch Mis 31GX5/16

Comfort EZ Mis 32GX8MM

Easy Touch Mis 32GX1/4"

Comfort EZ Mis 33GX4MM

Easy Touch Mis 32GX3/16

Comfort EZ Mis 33GX5MM

Easy Touch Mis 32GX5/32

Comfort EZ Mis 33GX6MM

Easy Touch Mis 32GX5MM

Comfort EZ Mis 33GX8MM

Easy Touch Mis 32GX6MM

Comfort Mis Lancets

Easy Touch Sol Control

Comfortouch Mis Lancet

Easy Touch Sol High/Low

Contour Liq High Cnt

Easy Trak Sol High

Contour Liq Low Cntl

Easy Trak Sol Low

Contour Liq Norm Cnt

Easy Trak Sol Normal

Contour Sol Next

Easygluco Sol High

Contour Tes NextQL,PA

Easygluco Sol Low

Control High Sol Unistrip

Easygluco Sol Normal

Control Low Sol Unistrip

Easygluco Sol Plus

Control Norm Sol Easy Stp

Easymax Sol High

Control Sol Liq High/Low

Easymax Sol Low

Control Sol Liq HI/Mid/L

Easymax Sol Norm/Low

Control Sol Liq Mid

Easymax Sol Normal

Control Sol Normal

Easymax 15 Sol Level 1

Effective January 1, 2018

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Easymax 15 Sol Level 2

Gluc Control Sol Level 1

Easymax 15 Sol Level1-2

Gluc Control Sol Level 2

Easystep Hgh Sol Control

Gluc Control Sol Mid

Easystep Low Sol Control

Gluc Control Sol Normal

Easytest II Mis Lancets

Glucocard Liq Level 1

Easytest Mis Lancets

Glucocard Sol Normal

Element Cont Liq Normal

Glucocard Sol Shine

Element Liq High

Glucocard 01 Liq Norm/Hgh

Element Liq Low

Glucocard 01 Sol Normal

Elemnt Compa Sol Level 2

Glucocom Mis 28G

Elemnt Compa Sol Level 3

Glucocom Mis 30G

Embrace Cntr Liq High

Glucocom Mis 33G

Embrace Evo Liq Level 1

Glucocom Tes High CON

Embrace Evo Liq Level 2

Glucocom Tes Norm CON

Embrace Lanc Mis Thin 30G

Glucolet 2 Mis Lancing

Embrace Pro Liq Glucose

Glucose Cont Liq High/Low

Embrace Sol Low

Glucose Cont Sol High

Eql Lancets Mis Thin 26G

Glucose Cont Sol Normal

Eql Lancets Mis Thin 30G

Glucose Cont Sol Precisio

Eql Lancets Mis 21G Colr

Glucosource Mis Lanc Dev

Eql Lancets Mis 33G Colr

Glucosource Mis Lancets

Evencar Mini Sol Normal

Gmate Contro Sol Level 2

Evencare G2 Sol Low/High

Gmate Lancet Mis 30G

Evencare G3 Sol Low/High

Gmate Lancin Mis Device

Evencare Sol Liq Low/High

Gnp Lancets Mis

Evolution Sol Normal

Gnp Lancets Mis Micro

EZ Smart Mis Lancets

Gnp Lancets Mis Sup Thin

EZ-lets 21G Mis Lancets

Gnp Lancets Mis Thin

EZ-lets 23G Mis Lancets

Gnp Lancets Mis Thin 26G

EZ-lets 26G Mis Lancets

Gnp Lancets Mis 21G

EZ-lets 28G Mis Lancets

Goodsense Mis Lanc Dvc

EZ-lets 30G Mis Lancets

Goodsense Mis Lanc 30G

Fastclix Mis Lancets

Haemolance Mis High FLO

Fifty50 Mis Lanc Dev

Haemolance Mis Low Flow

Fifty50 Mis 31GX3/16

Haemolance Mis Plus

Fifty50 Mis 31GX5/16

Haemolance Mis Plus Low

Fifty50 Mis 31GX5MM

Haemolance Mis Plus Max

Fifty50 Pen Mis 31GX8MM

Haemolance Mis Plus PED

Fifty50 Pen Mis 32GX4MM

Haemolance Mis Retract

Fifty50 Pen Mis 32GX6MM

Healthpro Sol High/Low

Fifty50 Safe Mis Lancets

Hlthy Accnts Mis Lanc 30G

Fifty50 Sol 2.0

Hypolance Kit Lancing

Fine 30 Mis

HC Lancing Mis Device

Fingerstix Mis Lancets

Incontrol Mis Lanc Dev

Fora Control Sol High

Incontrol Mis Lanc 28G

Fora Control Sol Low

Incontrol Mis Lanc 30G

Fora Control Sol Normal

Incontrol Mis Lanc 33G

Fora Lancets Mis 30G

Incontrol Mis 29GX12MM

Fora Mis Lancets

Infinity Sol High CON

Fora Mis Lancing

Infinity Sol Low CON

Foracare Gdh Sol High

Infinity Sol Norm CON

Foracare Gdh Sol Low

Insulin Pen Mis 29GX12MM

Foracare Gdh Sol Normal

Insulin Pen Mis 31GX4MM

Fortiscare Sol Cntl HI

Insulin Pen Mis 31GX8MM

Fortiscare Sol Cntl Low

Insulin Syrg Mis 0.3/28G

Fortiscare Sol Cntl Nml

Insulin Syrg Mis 0.3/29G

Freestyle Liq Control

Insulin Syrg Mis 0.3/30G

Freestyle Mis Lancets

Insulin Syrg Mis 0.3/31G

Freestyle Mis Unistick

Insulin Syrg Mis 0.5/27G

Freestyle TesQL,PA

Insulin Syrg Mis 0.5/28G

Gentle-let Mis Lancets

Insulin Syrg Mis 0.5/29G

Gentle-let Mis Platform

Insulin Syrg Mis 0.5/30G

Gentle-let Mis 26G

Insulin Syrg Mis 0.5/31G

Gentle-let Mis 28G

Insulin Syrg Mis 1ML

Ge100 Contrl Sol Normal

Insulin Syrg Mis 1ML/25G

Global Lanc Mis Device

Insulin Syrg Mis 1ML/26G

Global 28G Mis Lancets

Insulin Syrg Mis 1ML/27G

Global 30G Mis Lancets

Insulin Syrg Mis 1ML/28G

Gluc Control Liq Normal

Insulin Syrg Mis 1ML/29G

Gluc Control Sol

Insulin Syrg Mis 1ML/30G

Effective January 1, 2018

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Insulin Syrg Mis 1ML/31G

Lancets Ultr Mis Thin 28G

Insulin Syrg Mis 1MLX30G

Lancets Ultr Mis Thin 30G

Insulin Syrg Mis 2/27.5G

Lancing Devi Mis

Insulin Syrg Mis 27GX1/2"

Lancing Devi Mis Adjust

Insulin Syrg Mis 28GX1/2"

Lancing Devi Mis 25G

Insulin Syrg Mis 29GX1/2"

Lancing Devi Mis 30G

Insulin Syrg Mis 30GX1/2"

Lancing Mis Device

Insulin Syrg Mis 30GX5/16

Lancing Pen Mis

Insulin Syrg Mis 30GX8MM

Lanzo Mis Lancing

Insulin Syrg Mis 31GX5/16

Lb Lancet Mis 28G

Insulin Syrg Mis 31GX8MM

Lb Lancing Mis Device

Insulin SYR Mis 0.3/31G

Lifescan Mis Unistik2

Insulin SYR Mis 0.5/31G

Lite Touch Mis Lanc Dev

Insulin SYR Mis 1ML/31G

Lite Touch Mis Lanc Pen

Insulin SYR Mis 31GX6MM

Lite Touch Mis Lancets

Insupen Mis 29GX12MM

Litetouch Mis Lancets

Insupen Mis 31GX5MM

Litetouch Mis 29GX12.7

Insupen Mis 31GX8MM

Litetouch Mis 31GX8MM

Insupen Mis 32GX4MM

Longs Lancet Mis Standard

Insupen Mis 33GX4MM

Longs Lancet Mis Thin

Insupen Sens Mis 32GX6MM

Longs Lancet Mis Ultra Th

Insupen Sens Mis 32GX8MM

Maxima Sol Control

Insupen Ultr Mis 29GX12MM

Medichoice Mis Lancet

Insupen Ultr Mis 30GX8MM

Medisense Liq Gluc-ket

Insupen Ultr Mis 31GX6MM

Medisense Liq Gluc/Ket

Insupen Ultr Mis 31GX8MM

Medlance Mis Extr 21G

IN Control Mis 31GX5MM

Medlance Mis Lite 25G

IN Control Mis 31GX6MM

Medlance Mis Plus

IN Control Mis 31GX8MM

Medlance Mis Plus 30G

IN Touch Lan Mis Device

Medlance Mis Unv 21G

IN Touch Lan Mis 30G

Medlance Mis 30G Plus

IN Touch Sol Glucose

Medlance Pls Mis Extr 21G

Kinney Mis Lancets

Medlance Pls Mis Lite 25G

Kinney Thin Mis Lancets

Medlance Pls Mis Univ 21G

Kroger Lance Mis

Medlance Pls Mis 0.8MM

Kroger Lance Mis Thin

Meijer Lance Mis Color

Kroger Lance Mis Thin 30G

Meijer Lance Mis Univ 21G

Lancet Alter Mis Site 26G

Meijer Lance Mis Univ 30G

Lancet Auto Mis Injector

Meijer Lance Mis Universa

Lancet Carry Mis Case

Meijer Mis Lancets

Lancet Devic Mis Adjust

Micro Thin Mis Lanc 33G

Lancet Micro Mis Thin 33G

Microdot CON Sol High/Low

Lancet Stand Mis 21G

Microlet Mis Lancets

Lancet Super Mis Thin 30G

Microlet Mis Next

Lancet Ultra Mis Fine

Microtainer Mis Lancet

Lancet Ultra Mis Thin 28G

Mini Lancing Mis Device

Lancet Ultra Mis Thin 30G

Monojector Mis End CAPS

Lancet Ultra Mis 28G

Monolet Mis Lancets

Lancet With Mis Ejector

Monolet Opd Mis Lancets

Lancets Micr Mis Thin 33G

Monolettor Mis Lancets

Lancets Mis

Multi-lancet Kit Device

Lancets Mis Colored

Multi-lancet Mis Device

Lancets Mis Orange

Myglucohealt Mis Lanc 30G

Lancets Mis Original

Myglucohealt Sol LO/Nl/HI

Lancets Mis Thin

MM Pentips Mis 29GX12MM

Lancets Mis Thin 26G

MM Pentips Mis 31GX5MM

Lancets Mis Thin 30G

MM Pentips Mis 31GX8MM

Lancets Mis 21G

MM Pentips Mis 32GX4MM

Lancets Mis 21G Colr

Neutek 2tek Sol Control

Lancets Mis 23G

Nexgen Tes Norm CON

Lancets Mis 26G

Nova Max Glu Liq /Ket CON

Lancets Mis 28G

Nova Safety Mis Lanc 23G

Lancets Mis 30G

Nova Safety Mis Lanc 28G

Lancets Mis 31G

Nova Sure Mis Lancets

Lancets Mis 33G

Nova Sureflx Mis Lanc Dev

Lancets Supr Mis Thin 28G

Novofine Aut Mis 30GX8MM

Lancets Thin Mis

Novofine Mis 30GX8MM

Lancets Thin Mis 26G

Novofine Mis 32GX6MM

Lancets Thin Mis 30G

Novofine Pls Mis 32GX4MM

Lancets Ultr Mis Thin

Novotwist Mis 30GX8MM

Effective January 1, 2018

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Novotwist Mis 32GX5MM

Prodigy NO Tes CodingQL,PA

On Call Expr Sol Glucose

Prodigy Sol High

On Call Lanc Mis Device

Prodigy Sol Low

On Call Mis Lancets

Pss Safe Lan Mis

On Call Plus Mis Lanc Dev

Pss Sel Lanc Mis

On Call Plus Mis Lancets

Pss Sel Plat Mis

On Call Plus Sol Control

Px Lancets Mis Ult Thin

On Call Vivd Sol Control

Px Lancets Mis 28G

On-the-go Mis Lanc 30G

PC Lancets Mis 30G

Onetouch Fp Mis Lancets

Qc Lancets Mis 28G

Onetouch Mis Combo

Qc Lancets Mis 30G

Onetouch Mis Lanc Dev

Qc Lancing Mis Device

Onetouch Mis Lancets

Quicktek Liq Solution

Onetouch Mis 30G

Quintet Cont Sol Hgh/Norm

Onetouch Sol Ult Cont

Ra E-ZJECT Mis Thin 26G

Onetouch Sol Verio

Ra E-ZJECT Mis Thin 28G

Onetouch Sol Verio-HI

Ra E-ZJECT Mis Ult Thin

Onetouch Tes UltraQL

Ra E-ZJECT Mis 28G

Onetouch Tes Ultra BLQL

Ra E-ZJECT Mis 33G

Onetouch Tes VerioQL

Ra Pen Needl Mis 31GX3/16

Onetouch Us Mis Lancets

Rapid-safe Mis Lancing

Optumrx Cont Sol Level1/2

Readylance Mis 21G

Pen Needle Mis 29GX1/2"

Readylance Mis 23G

Pen Needle Mis 32GX4MM

Readylance Mis 26G

Pen Needles Mis 29GX1/2"

Readylance Mis 28G

Pen Needles Mis 29GX10MM

Readylance Mis 30G

Pen Needles Mis 29GX12.7

Reality Mis Lancets

Pen Needles Mis 29GX12MM

Reality Trig Mis Lancets

Pen Needles Mis 30GX5/16

Refuah Plus Sol Control

Pen Needles Mis 30GX5MM

Relion Kit Lancing

Pen Needles Mis 30GX8MM

Relion Lance Mis Stnd 21G

Pen Needles Mis 31GX1/4"

Relion Lance Mis Thin 26G

Pen Needles Mis 31GX3/16

Relion Lance Mis Thin 30G

Pen Needles Mis 31GX5/16

Relion Lanci Mis Device

Pen Needles Mis 31GX5MM

Relion Micro Mis Thin 33G

Pen Needles Mis 31GX6MM

Relion Pen Mis 29GX12MM

Pen Needles Mis 31GX8MM

Relion Pen Mis 31GX6MM

Pen Needles Mis 32GX4MM

Relion Pen Mis 31GX8MM

Pen Needles Mis 32GX5/32

Relion Pen Mis 32GX4MM

Pen Needles Mis 32GX5MM

Relion Thin Mis Lancets

Pen Needles Mis 32GX6MM

Relion Ultra Mis Thin

Pen Needles Mis 32GX8MM

Relion Ultra Mis Thin Pls

Pen Needles Mis 33GX4MM

Relion Ultra Mis Thin 32G

Penlet II Kit Blood

Rightest Alt Mis Adaptor

Penlet II Mis Repl CAP

Rightest Liq High CON

Pentips Mis 29GX12MM

Rightest Liq Norm CON

Pentips Mis 31GX5MM

Rightest Mis Gl300

Pentips Mis 31GX6MM

Rightest Mis GD500

Pentips Mis 31GX8MM

Safe-t-lance Mis HI Flow

Pentips Mis 32GX4MM

Safe-t-lance Mis Low Flow

Perfect 28G Mis Lancets

Safe-t-lance Mis Nor Flow

Perfect 30G Mis Lancets

Safe-t-lance Mis 21G

Pharmacy Cou Mis Lancets

Safe-t-lance Mis 25G

Pocketchem Sol EZ

Safe-t-pro Mis Lancets

Precision Liq Control

Safe-t-pro Mis Plus

Precision Liq Gluc/Ket

Safety Let Mis Lancets

Precision Liq Nrml/Mid

Safety Mis Lancets

Precision Mis 28g(t)

Safety Seal Mis 28G

Precision Mis 28G

Safety Seal Mis 30G

Pressure Act Mis Lancet

Safety 21G Mis Lancets

Pressure Act Mis Lancets

Safety 28G Mis Lancets

Pro Comfort Mis Lancets

Saps Health Mis Twist

Pro Comfort Mis 31G

Sapscare Mis Twist

Pro Comfort Mis 31GX8MM

Select-lite Kit Dev/Lanc

Pro Comfort Mis 32GX4MM

Select-lite Mis Lanc Dev

Pro Comfort Mis 32GX5MM

Shopko Lanc Mis Device

Pro Comfort Mis 32GX6MM

Side Button Mis Safety

Prodigy Mis Lanc Dev

Simple Diag Mis Lancing

Prodigy Mis 26G

Single-let Mis 23G

Prodigy Mis 28G

Sm Lancets Mis Thin 26G

Effective January 1, 2018

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Sm Lancets Mis Thin 30G

Tgt Lancing Mis Device

Sm Lancets Mis 21G

Thin Lancets Mis

Sm Lancets Mis 33G

Thin Lancets Mis 26G

Sm Truedraw Mis Lanc Dev

Thin Lancets Mis 30G

Smart Sense Mis Lanc 21G

Thinlets GP Mis 26G

Smart Sense Mis Lanc 26G

Thinlets Mis 28g(t)

Smart Sense Mis Lanc 30G

Tier Uni Pls Mis 31GX8MM

Smart Sense Mis Lanc 33G

Topcare Mis Lanc 33G

Smartest Mis Lancets

Travel Lance Mis Adv 28G

Smartest Sol Control

Travel Lance Mis 30G

Soft Touch Mis Lancets

True Metrix Sol Level 1

Softclix Mis Lancets

True Metrix Sol Level 2

Solus V2 Mis Lanc Dev

True Metrix Sol Level 3

Solus V2 Mis Lanc 28G

Truecontrol Liq Level 0

Solus V2 Mis Lanc 30G

Truecontrol Liq Level 1

Solus V2 Sol High

Truedraw Mis Lanc Dev

Solus V2 Sol Low

Truetest Liq Level 1

Sterilance Mis TL 28G

Truetest Liq Level 2

Sterilance Mis TL 30G

Truetest Liq Level 3

Sterilance Mis TL 32G

Truplus Lanc Mis 26G

Sterilance Mis 1.8MM

Truplus Lanc Mis 28G

Super Thin Mis Lanc 28G

Truplus Lanc Mis 30G

Super Thin Mis Lancet

Truplus Lanc Mis 33G

Super Thin Mis Lancets

Ulti-lance Mis CLR Tip

Supreme II Liq High/Low

Ulticare Pen Mis 31GX5MM

Sure Comfort Mis Lanc Pen

Ultilet Insu Mis 30X12.7

Sure Comfort Mis Lanc 18G

Ultilet Insu Mis 31GX6MM

Sure Comfort Mis Lanc 21G

Ultilet Mis Lancets

Sure Comfort Mis Lanc 23G

Ultilet Mis Safety

Sure Comfort Mis Lanc 30G

Ultilet Mis 26G

Sure Comfort Mis Lancets

Ultilet Mis 28G

Sure Comfort Mis 0.5/31G

Ultilet Mis 30G

Sure Comfort Mis 29GX1/2"

Ultilet Mis 33G

Sure Comfort Mis 30GX5/16

Ultilet Pen Mis 29GX12.7

Sure Comfort Mis 31GX3/16

Ultilet Pen Mis 31GX5MM

Sure Comfort Mis 31GX5/16

Ultilet Pen Mis 31GX8MM

Sure Comfort Mis 31GX6MM

Ultilet Pen Mis 32GX4MM

Sure Comfort Mis 32GX5/32

Ultilet Safe Mis 21G

Sure Comfort Mis 32GX6MM

Ultra Thin Mis Lanc 26G

Sure-fine Mis 29GX1/2"

Ultra Thin Mis Lanc 28G

Sure-fine Mis 31GX3/16

Ultra Thin Mis Lanc 30G

Sure-fine Mis 31GX5/16

Ultra Thin Mis Lancets

Sure-lance Mis Lancets

Ultra Thin Mis 28G

Sure-lance Mis 26G

Ultra Thin Mis 30G

Sure-pen Mis

Ultra Thin Mis 31G

Sure-touch Mis Unv Lanc

Ultra Thin Mis 33G

Sureflex Mis Lancets

Ultralance Mis 1.8MM

Surelite Mis Lancets

Ultratrk Pro Sol

Surestep Glu Sol

Ultratrk Pro Sol High/Low

Surestep Glu Sol High/Low

Ultratrk Ult Sol High/Low

Surestep Pro Tes High CON

Unfine Pntp Mis 32GX4MM

Surestep Pro Tes Low CON

Unifine Pntp Mis 29GX1/2"

Surestep Pro Tes Norm CON

Unifine Pntp Mis 29GX12MM

Surestep Sol Control

Unifine Pntp Mis 31GX3/16

Syringe Mis 0.5/30G

Unifine Pntp Mis 31GX5/16

Syringe 0.5 Mis 30G

Unifine Pntp Mis 31GX5MM

SB Lancets Mis Thin

Unifine Pntp Mis 31GX6MM

SB Lancets Mis Ultr Thn

Unifine Pntp Mis 31GX8MM

Tai Doc Sol Norm CON

Unifine Pntp Mis 32GX4MM

Techlite AST Mis Lancets

Unifine Pntp Mis 32GX5/32

Techlite Mis Lanc 30G

Unilet Cmfr Mis Tch 28G

Techlite Mis Lancets

Unilet Cmfr Mis Tch 30G

Telcare Sol Level1/2

Unilet Excel Mis 23G

Tgt Lancet Mis Alternat

Unilet EX II Mis 28G

Tgt Lancet Mis 23G

Unilet G.p Mis Supr 23G

Tgt Lancet Mis 26G

Unilet G.p. Mis 21G

Tgt Lancet Mis 28G

Unilet GP 28 Mis Ult Thin

Tgt Lancet Mis 30G

Unilet Lanc Mis 33G

Tgt Lancet Mis 33G

Unilet Lance Mis 21G

Tgt Lancing Mis Adv Dev

Unilet Lance Mis 28G

Effective January 1, 2018

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Unilet Lance Mis 33G

Breatherite Mis Spacer

Unilet Lanct Mis 28G

Breatherite Mis W/Mask

Unilet Lanct Mis 30G

Compact Spac Mis Chamber

Unilet Lanct Mis 33G

Compact Spac Mis LG Mask

Unilet Mis 21G

Compact Spac Mis MD Mask

Unilet Super Mis G.p. 23G

Compact Spac Mis Sm Mask

Unilet Super Mis 23G

E-z Spacer Mis

Unistik CZT Mis Comfort

E-z Spacer Mis Body Grd

Unistik CZT Mis Normal

Easivent Mis

Unistik II Mis Lancets

Easivent Mis Mask LG

Unistik Safe Mis Lanc 28G

Easivent Mis Mask MED

Unistik Safe Mis Lanc 30G

Easivent Mis Mask Sm

Unistik Touc Mis Lanc 21G

Flexichamber Mis

Unistik Touc Mis Lanc 23G

Flexichamber Mis Mask Lrg

Unistik Touc Mis Lanc 28G

Flexichamber Mis Mask Sm

Unistik Touc Mis Lanc 30G

Hold Chamber Mis Adlt LG

Unistik 1 Mis 2.4MM

Hold Chamber Mis Medium

Unistik 1 Mis 3.0MM

Hold Chamber Mis Small

Unistik 2 Mis

Inspirachamb Mis Large

Unistik 2 Mis Comfort

Inspirachamb Mis Medium

Unistik 2 Mis Extra

Inspirachamb Mis Mouthpce

Unistik 2 Mis Neonatal

Inspirachamb Mis Small

Unistik 2 Mis Normal

Inspirease Mis Dd Syst

Unistik 2 Mis Super

Inspirease Mis Res Bag

Unistik 2 Mis 1.8MM

Liteaire Mis

Unistik 2 Mis 2.4MM

Mask Vortex/ Mis Baby Duc

Unistik 3 Mis Comfort

Mask Vortex/ Mis Duck

Unistik 3 Mis Extra

Mask Vortex/ Mis Frog

Unistik 3 Mis Gent 30G

Mask Vortex/ Mis Lady Bug

Unistik 3 Mis Neonatal

Microchamber Mis

Unistik 3 Mis Normal

Microspacer Mis

Unistik 3 Mis Xtr 21G

Optichamber Mis Adv Lrg

Unistik 3 Mis 1.8MM

Optichamber Mis Adv MED

Universal 1 Mis Lanc 26G

Optichamber Mis Adv Sm

Universal 1 Mis Lanc 30G

Optichamber Mis Advantag

Universal 1 Mis 33G

Optichamber Mis Dia LG

Vantage Lanc Mis Device

Optichamber Mis Dia MD

Verasens Liq Level 1

Optichamber Mis Dia Sm

Victory Sol Control

Optichamber Mis Diamond

Vitalet Pro Mis

Optichamber Mis Face Mas

Vitalet Pro Mis Plus

Optihaler Mis

W&f Lancets Mis 21G

Panda Mask Mis Large

W&f Lancets Mis 26G

Panda Mask Mis Medium

1ML Syringe Mis 29G

Panda Mask Mis Pediatri

1ML Syringe Mis 30G

Panda Mask Mis Small

1ST Choice Mis Lancets

Pocket Chamb Mis

1ST Tier Uni Mis 29GX12MM

Pocket Space Mis

1ST Tier Uni Mis 31GX5MM

Riteflo Mis

1ST Tier Uni Mis 31GX6MM

Valvd Holdng Mis Chamber

1ST Tier Uni Mis 31GX8MM

Vortex Valve Mis Chamber

1ST Tier Uni Mis 32GX4MM

Watchhaler Mis

MEDICAL DEVICES - MISC

MISCELLANEOUS AGENTS

TIER 02 PREFERRED

Aerchmbr Pls Mis Flow-VU

TIER 04 SPECIALTY

Aerchmbr Pls Mis Lrg Mask

Cuprimine CAP 250MGQL,PA

Aerchmbr Pls Mis MED Mask

Depen Titra TAB 250MGQL,PA

Aerchmbr Pls Mis Sm Mask

Exjade TAB 125MGQL,PA

Aerchmbr Z- Mis Stat Pls

Exjade TAB 250MGQL,PA

Aerochamber Mis Chamber

Exjade TAB 500MGQL,PA

Aerochamber Mis Flosigna

Ferriprox TAB 500MGQL,PA

Aerochamber Mis MV

Jadenu Sprkl Gra 180MGQL,PA

Aerochamber Mis Plus

Jadenu Sprkl Gra 360MGQL,PA

Aerovent Mis Plus

Jadenu Sprkl Gra 90MGQL,PA

Arial Mis Chamber

Jadenu TAB 180MGQL,PA

Breatherite Mis

Jadenu TAB 360MGQL,PA

Breatherite Mis LG Mask

Jadenu TAB 90MGQL,PA

Breatherite Mis MED Mask

TIER 03 NON PREFERRED

Breatherite Mis Sm Mask

Chemet CAP 100MGPA

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Ferriprox Sol 100MG/MLPA

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Index

A

Aciphex TAB 20MG, 31

Adderall TAB 5MG, 42

acitretin CAP 10MG, 18

Adderall TAB 7.5MG, 42

abaca/lamivu TAB 600-300, 4

acitretin CAP 17.5MG, 18

Adderall XR CAP 10MG, 41

abacav/lamiv TAB /zidovud, 4

acitretin CAP 25MG, 18

Adderall XR CAP 15MG, 41

abacavir sol 20MG/ML, 3

Aclovate CRE 0.05%, 19

Adderall XR CAP 20MG, 41

abacavir TAB 300MG, 3

Actemra Inj 162/0.9, 54

Adderall XR CAP 25MG, 41

Abilify Main Inj 300MG, 39

Acthib Inj, 58

Adderall XR CAP 30MG, 41

Abilify Main Inj 400MG, 39

Acti-lance Mis 28G, 60

Adderall XR CAP 5MG, 42

Abilify TAB 10MG, 40

Acti-lance Mis Lite 28G, 60

Addyi TAB 100MG, 47

Abilify TAB 15MG, 40

Acti-lance Mis Spec 17G, 60

adefov dipiv TAB 10MG, 4

Abilify TAB 20MG, 40

Acti-lance Mis Univ 23G, 60

Adempas TAB 0.5MG, 15

Abilify TAB 2MG, 40

Acticlate TAB 150MG, 2

Adempas TAB 1.5MG, 15

Abilify TAB 30MG, 40

Acticlate TAB 75MG, 2

Adempas TAB 1MG, 15

Abilify TAB 5MG, 40

Actigall CAP 300MG, 32

Adempas TAB 2.5MG, 15

Absorica CAP 10MG, 16

Actimmune Inj 2mu/0.5, 8

Adempas TAB 2MG, 15

Absorica CAP 20MG, 16

Actiq Loz 1200mcg, 52

Adj Lancing Mis Device, 60

Absorica CAP 25MG, 16

Actiq Loz 1600mcg, 52

Adlyxin Inj 10/20mcg, 25

Absorica CAP 30MG, 16

Actiq Loz 200mcg, 52

Adlyxin Inj 20mcg, 25

Absorica CAP 35MG, 16

Actiq Loz 400mcg, 52

Adoxa CAP 150MG, 2

Absorica CAP 40MG, 16

Actiq Loz 600mcg, 52

Adoxa PAK 1/ TAB 100MG, 2

Abstral Sub 100mcg, 52

Actiq Loz 800mcg, 52

Adoxa PAK 1/ TAB 150MG, 2

Abstral Sub 200mcg, 52

Active 1ST Mis Lanc 30G, 60

Adoxa PAK 2/ TAB 100MG, 2

Abstral Sub 300mcg, 52

Activella TAB 0.5-0.1, 22

Adoxa TAB 100MG, 2

Abstral Sub 400mcg, 52

Activella TAB 1-0.5MG, 22

Adoxa TAB 50MG, 2

Abstral Sub 600mcg, 52

Actonel TAB 150MG, 27

Adoxa TAB 75MG, 2

Abstral Sub 800mcg, 52

Actonel TAB 30MG, 27

Adrenaclick Inj 0.15MG, 14

acampro CAL TAB 333MG, 45

Actonel TAB 35MG, 27

Adrenaclick Inj 0.3MG, 14

Acanya Gel 1.2-2.5%, 16

Actonel TAB 5MG, 27

Adrenalin Sol 1:1000, 56

acarbose TAB 100MG, 26

Actoplus Met TAB 15-500MG, 26

Adv Allergy Kit Collecti, 19

acarbose TAB 25MG, 26

Actoplus Met TAB 15-850MG, 26

Adv Lancing Mis Device, 60

acarbose TAB 50MG, 26

Actoplus Met TAB XR, 26

Adv Travel Mis Lanc 28G, 60

Accolate TAB 10MG, 57

Actos TAB 15MG, 26

Advair Disku Aer 100/50, 57

Accolate TAB 20MG, 57

Actos TAB 30MG, 26

Advair Disku Aer 250/50, 57

Accu-chek Kit Fastclix, 60

Actos TAB 45MG, 26

Advair Disku Aer 500/50, 57

Accu-chek Kit Mlticlix, 60

Acuicyn Liq, 20

Advair HFA Aer 115/21, 57

Accu-chek Kit Softclix, 60

Acular LS Sol 0.4%, 50

Advair HFA Aer 230/21, 57

Accu-chek Liq Act/Gluc, 60

Acular Sol 0.5% Op, 50

Advair HFA Aer 45/21, 57

Accu-chek Liq Guide, 60

Acura Contrl Sol High, 60

Advance Liq Control, 60

Accu-chek Liq Smart, 60

Acura Contrl Sol Low, 60

Advance Liq Intuitio, 60

Accu-chek Mis Mlticlix, 60

Acura Contrl Sol Normal, 60

Advance Norm Liq Control, 60

Accu-chek Sol, 60

Acuvail Sol 0.45%, 50

Advcate Safe Mis Lanc 26G, 60

Accu-chek Sol Compact, 60

acyclovir CAP 200MG, 3

Advicor TAB 1000-20, 15

Accupril TAB 10MG, 11

acyclovir oin 5%, 18

Advicor TAB 1000-40, 15

Accupril TAB 20MG, 11

acyclovir sus 200/5ML, 3

Advicor TAB 500-20MG, 15

Accupril TAB 40MG, 11

acyclovir TAB 400MG, 3

Advicor TAB 750-20MG, 15

Accupril TAB 5MG, 11

acyclovir TAB 800MG, 3

Advocate Liq High, 60

Accuretic TAB 10-12.5, 13

Aczone Gel 5%, 16

Advocate Liq Low, 60

Accuretic TAB 20-12.5, 13

Aczone Gel 7.5%, 16

Advocate Mis Lanc 30G, 60

Accuretic TAB 20-25MG, 13

Adacel Inj, 58

Advocate Mis Lanc Dev, 60

Accutrend Sol Glucose, 60

Adalat CC TAB 30MG ER, 10

Advocate Mis Lancets, 60

Ace Acd/Alum Sol 2% Otic, 50

Adalat CC TAB 60MG ER, 10

Advocate+ Sol Redi-cod, 60

acebutolol CAP 200MG, 9

Adalat CC TAB 90MG ER, 10

Adyphren Amp Kit 1MG/ML, 14

acebutolol CAP 400MG, 9

adapal/ben p gel 0.1-2.5%, 16

Adyphren II Kit, 14

Aceon TAB 4MG, 11

adapalene CRE 0.1%, 16

Adyphren Kit, 14

Aceon TAB 8MG, 11

adapalene gel 0.1%, 16

Adzenys XR TAB 12.5MG, 42

acetasol HC sol otic, 50

adapalene gel 0.3%, 16

Adzenys XR TAB 15.7 MG, 42

acetazolamid CAP 500MG ER, 13

adapalene gel pmp 0.3%, 16

Adzenys XR TAB 18.8MG, 42

acetazolamid inj 500MG, 14

Adapalene Lot 0.1%, 16

Adzenys XR TAB 3.1MG, 42

acetazolamid TAB 125MG, 13

Adazin CRE, 20

Adzenys XR TAB 6.3MG, 42

acetazolamid TAB 250MG, 13

Adcirca TAB 20MG, 15

Adzenys XR TAB 9.4MG, 42

acetic acid sol 0.25%irr, 34

Adderall TAB 10MG, 42

Aerchmbr Pls Mis Flow-VU, 66

acetic acid sol 2% otic, 50

Adderall TAB 12.5MG, 42

Aerchmbr Pls Mis Lrg Mask, 66

acetylcyst sol 10%, 56

Adderall TAB 15MG, 42

Aerchmbr Pls Mis MED Mask, 66

acetylcyst sol 20%, 56

Adderall TAB 20MG, 42

Aerchmbr Pls Mis Sm Mask, 66

Aciphex Spr CAP 10MG, 31

Adderall TAB 30MG, 42

Aerchmbr Z- Mis Stat Pls, 66

Aciphex Spr CAP 5MG, 31

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Aerochamber Mis Chamber, 66

Alendronate Sol 70/75ML, 27

altafrin sol 2.5% op, 49

Aerochamber Mis Flosigna, 66

alendronate TAB 10MG, 27

altavera TAB, 23

Aerochamber Mis MV, 66

alendronate TAB 35MG, 27

Altoprev TAB 20MG ER, 15

Aerochamber Mis Plus, 66

Alendronate TAB 40MG, 27

Altoprev TAB 40MG ER, 15

Aerospan Aer 80mcg, 57

alendronate TAB 5MG, 27

Altoprev TAB 60MG ER, 15

Aerovent Mis Plus, 66

alendronate TAB 70MG, 27

Altrnate Sit Mis Device, 60

AF Lancets Mis Thin, 60

alfentanil inj 500/ML, 52

Alunbrig TAB 30MG, 7

afeditab TAB 30MG CR, 9

Alfentanil Inj 500/ML, 52

Aluvea CRE 39%, 20

afeditab TAB 60MG CR, 9

Alferon N Inj 5mu/ML, 8

Alvesco Aer 160mcg, 57

Afinitor Dis TAB 2MG, 7

alfuzosin TAB 10MG ER, 34

Alvesco Aer 80mcg, 57

Afinitor Dis TAB 3MG, 7

Alinia Sus 100/5ML, 5

alyacen TAB 1/35, 23

Afinitor Dis TAB 5MG, 7

Alinia TAB 500MG, 5

alyacen TAB 7/7/7, 23

Afinitor TAB 10MG, 7

Alkeran TAB 2MG, 6

amabelz TAB 0.5-0.1, 22

Afinitor TAB 2.5MG, 7

allopurinol TAB 100MG, 55

amabelz TAB 1-0.5MG, 22

Afinitor TAB 5MG, 7

allopurinol TAB 300MG, 55

amantadine CAP 100MG, 44

Afinitor TAB 7.5MG, 7

Allzital TAB 25-325MG, 51

amantadine syp 50MG/5ML, 44

Afluria Inj 2015-16, 58

almotrip mal TAB 12.5MG, 55

amantadine TAB 100MG, 44

Afluria Inj 2016-17, 58

almotrip mal TAB 6.25MG, 55

Amaryl TAB 1MG, 25

Afluria Inj 2017-18, 58

almotriptan TAB 12.5MG, 55

Amaryl TAB 2MG, 25

Afluria Inj PF 15-16, 58

almotriptan TAB 6.25MG, 55

Amaryl TAB 4MG, 25

Afluria Inj PF 16-17, 58

Alocril Sol 2%, 50

Ambien CR TAB 12.5MG, 41

Afluria Inj PF 17-18, 58

Alog/Pioglit TAB 12.5-15, 26

Ambien CR TAB 6.25MG, 41

Afluria Quad Inj 2017-18, 58

Alog/Pioglit TAB 12.5-30, 26

Ambien TAB 10MG, 41

Afluria Quad Inj PF 16-17, 58

Alog/Pioglit TAB 12.5-45, 26

Ambien TAB 5MG, 41

Afluria Quad Inj PF 17-18, 58

Alog/Pioglit TAB 25-15MG, 26

Amcinonide CRE 0.1%, 19

Afrezza Pow 12 Unit, 25

Alog/Pioglit TAB 25-30MG, 26

Amcinonide Lot 0.1%, 19

Afrezza Pow 4&8 Unit, 25

Alog/Pioglit TAB 25-45MG, 26

Amcinonide Oin 0.1%, 19

Afrezza Pow 4/8/12un, 25

Alogliptin TAB 12.5MG, 26

Amerge TAB 1MG, 55

Afrezza Pow 4unit, 25

Alogliptin TAB 25MG, 26

Amerge TAB 2.5MG, 55

Afrezza Pow 8 Unit, 25

Alogliptin TAB 6.25MG, 26

amethia LO TAB, 23

Afrezza Pow 8&12unit, 25

Alogliptin/ TAB Metform, 26

amethia TAB, 23

aftera TAB 1.5MG, 23

Alomide Sol 0.1% Op, 50

amethyst TAB 90-20mcg, 23

Agamatrix Mis 33G, 60

alophen TAB 5MG EC, 29

Amicar Sol 0.25/ML, 36

Agamatrix Sol High, 60

Alora Dis 0.025MG, 22

Amicar TAB 1000MG, 36

Agamatrix Sol Norm/Hgh, 60

Alora Dis 0.05MG, 22

Amicar TAB 500MG, 36

Agamatrix Sol Normal, 60

Alora Dis 0.075MG, 22

amilor/hctz TAB 5-50, 13

Aggrenox CAP 25-200MG, 36

Alora Dis 0.1MG, 22

amiloride TAB 5MG, 13

agoneaze kit 2.5-2.5%, 20

alosetron TAB 0.5MG, 32

amiodarone TAB 100MG, 11

Agrylin CAP 0.5MG, 36

alosetron TAB 1MG, 32

amiodarone TAB 200MG, 10

Airduo Respi Inh 113-14, 57

Aloxi Inj 0.25MG/5, 31

amiodarone TAB 400MG, 11

Airduo Respi Inh 232-14, 57

Alphagan P Sol 0.1%, 49

Amitiza CAP 24mcg, 32

Airduo Respi Inh 55-14, 57

Alphagan P Sol 0.15%, 49

Amitiza CAP 8mcg, 32

ak-poly-bac oin op, 48

alphatrex gel 0.05%, 18

amitriptylin TAB 100MG, 37

Akten Gel 3.5%, 50

Alprazolam CON 1 MG/ML, 37

amitriptylin TAB 10MG, 37

Akynzeo CAP 300-0.5, 31

alprazolam TAB 0.25 odt, 37

amitriptylin TAB 150MG, 37

Ala Scalp Lot 2%, 19

alprazolam TAB 0.25MG, 36

amitriptylin TAB 25MG, 37

ala-cort CRE 1%, 19

alprazolam TAB 0.5MG, 36

amitriptylin TAB 50MG, 37

ala-cort CRE 2.5%, 18

alprazolam TAB 0.5MG ER, 37

amitriptylin TAB 75MG, 37

Albenza TAB 200MG, 5

alprazolam TAB 0.5MG od, 37

amlod/atorva TAB 10-10MG, 15

albuterol neb 0.083%, 57

alprazolam TAB 0.5MG XR, 37

amlod/atorva TAB 10-20MG, 15

albuterol neb 0.5%, 57

alprazolam TAB 1MG, 37

amlod/atorva TAB 10-40MG, 15

albuterol neb 0.63MG/3, 57

alprazolam TAB 1MG ER, 37

amlod/atorva TAB 10-80MG, 15

albuterol neb 1.25MG/3, 57

alprazolam TAB 1MG odt, 37

amlod/atorva TAB 2.5-10MG, 16

albuterol syp 2MG/5ML, 57

alprazolam TAB 1MG XR, 37

amlod/atorva TAB 2.5-20MG, 16

albuterol TAB 2MG, 57

alprazolam TAB 2MG, 37

amlod/atorva TAB 2.5-40MG, 16

albuterol TAB 4MG, 57

alprazolam TAB 2MG ER, 37

amlod/atorva TAB 5-10MG, 16

albuterol TAB 4MG ER, 57

alprazolam TAB 2MG odt, 37

amlod/atorva TAB 5-20MG, 16

albuterol TAB 8MG ER, 57

alprazolam TAB 2MG XR, 37

amlod/atorva TAB 5-40MG, 16

Alcaine Sol 0.5% Op, 50

alprazolam TAB 3MG ER, 37

amlod/atorva TAB 5-80MG, 16

alclometason CRE 0.05%, 19

alprazolam TAB 3MG XR, 37

amlod/benazp CAP 10-20MG, 12

alclometason oin 0.05%, 19

Alrex Sus 0.2%, 49

amlod/benazp CAP 10-40MG, 12

Aldactazide TAB 25/25, 14

Altabax Oin 1%, 17

amlod/benazp CAP 2.5-10MG, 12

Aldactazide TAB 50/50, 14

altacaine sol 0.5% op, 50

amlod/benazp CAP 5-10MG, 12

Aldactone TAB 100MG, 14

Altace CAP 1.25MG, 11

amlod/benazp CAP 5-20MG, 12

Aldactone TAB 25MG, 14

Altace CAP 10MG, 11

amlod/benazp CAP 5-40MG, 12

Aldactone TAB 50MG, 14

Altace CAP 2.5MG, 11

amlod/olmesa TAB 10-20MG, 12

Aldara CRE 5%, 20

Altace CAP 5MG, 11

amlod/olmesa TAB 10-40MG, 12

Alecensa CAP 150MG, 7

altafrin sol 10% op, 49

amlod/olmesa TAB 5-20MG, 12

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amlod/olmesa TAB 5-40MG, 12

Anadrol-50 TAB 50MG, 22

Aqua Lance Mis Lanc Dev, 60

amlod/valsar TAB /hctz, 12

Anafranil CAP 25MG, 38

Aquoral Aer, 36

amlod/valsar TAB 10-160MG, 12

Anafranil CAP 50MG, 38

Aquoral Spr, 36

amlod/valsar TAB 10-320MG, 12

Anafranil CAP 75MG, 38

aranelle TAB, 23

amlod/valsar TAB 5-160MG, 12

anagrelide CAP 0.5MG, 36

Aranesp Inj 100mcg, 35

amlod/valsar TAB 5-320MG, 12

anagrelide CAP 1MG, 36

Aranesp Inj 10mcg, 35

amlodipine TAB 10MG, 9

Analpram-HC CRE 1-1%, 32

Aranesp Inj 150mcg, 35

amlodipine TAB 2.5MG, 9

Analpram-HC Lot 2.5%, 32

Aranesp Inj 200mcg, 35

amlodipine TAB 5MG, 9

Anaprox DS TAB 550MG, 54

Aranesp Inj 25mcg, 35

ammonium lac CRE 12%, 20

Anaspaz TAB 0.125MG, 31

Aranesp Inj 300mcg, 35

ammonium lac lot 12%, 20

Anastia Lot 2.75%, 20

Aranesp Inj 40mcg, 35

amnesteem CAP 10MG, 16

anastrozole TAB 1MG, 6

Aranesp Inj 500mcg, 35

amnesteem CAP 20MG, 16

Ancobon CAP 250MG, 3

Aranesp Inj 60mcg, 35

amnesteem CAP 40MG, 16

Ancobon CAP 500MG, 3

Arava TAB 10MG, 54

amox-pot cla TAB ER, 1

Androderm Dis 2MG/24HR, 22

Arava TAB 20MG, 54

Amox/K Clav Chw 200MG, 1

Androderm Dis 4MG/24HR, 22

arbinoxa sol 4MG/5ML, 56

Amox/K Clav Chw 400MG, 1

Androgel Gel 1%(25MG), 22

arbinoxa TAB 4MG, 56

amox/k clav sus 200/5ML, 1

Androgel Gel 1%(50MG), 22

Arcalyst Inj 220MG, 54

amox/k clav sus 250/5ML, 1

Androgel Gel 1.62%, 22

Arcapta CAP 75mcg, 57

amox/k clav sus 400/5ML, 1

Android CAP 10MG, 22

argyl saline sol 0.9%, 34

amox/k clav sus 600/5ML, 1

Androxy TAB 10MG, 22

Arial Mis Chamber, 66

amox/k clav TAB 250-125, 1

Angeliq TAB 0.25-0.5, 22

Aricept TAB 10MG, 47

amox/k clav TAB 500-125, 1

Angeliq TAB 0.5-1MG, 23

Aricept TAB 23MG, 47

amox/k clav TAB 875-125, 1

anodyne lpt kit 2.5-2.5%, 20

Aricept TAB 5MG, 47

Amoxapine TAB 100MG, 38

anodynz mis 0.0375-5, 20

Arimidex TAB 1MG, 6

Amoxapine TAB 150MG, 38

Anoro Ellipt Aer 62.5-25, 57

aripiprazole sol 1MG/ML, 39

Amoxapine TAB 25MG, 38

Antabuse TAB 250MG, 47

aripiprazole TAB 10MG, 39

Amoxapine TAB 50MG, 38

Antabuse TAB 500MG, 47

aripiprazole TAB 10MG odt, 40

amoxicillin CAP 250MG, 1

Antara CAP 30MG, 15

aripiprazole TAB 15MG, 39

amoxicillin CAP 500MG, 1

Antara CAP 90MG, 15

aripiprazole TAB 15MG odt, 40

Amoxicillin Chw 125MG, 1

anucort-HC sup 25MG, 32

aripiprazole TAB 20MG, 39

Amoxicillin Chw 250MG, 1

Anusol-HC CRE 2.5%, 32

aripiprazole TAB 2MG, 39

amoxicillin sus 125/5ML, 1

anusol-HC sup 25MG, 32

aripiprazole TAB 30MG, 39

amoxicillin sus 200/5ML, 1

Anzemet TAB 100MG, 31

aripiprazole TAB 5MG, 39

amoxicillin sus 250/5ML, 1

Anzemet TAB 50MG, 31

Aristada Inj 1064MG, 39

amoxicillin sus 250MG/5m, 1

Apap-caffein CAP Dihydroc, 52

Aristada Inj 441MG/1., 39

amoxicillin sus 400/5ML, 1

Apap/Caffein TAB Dihydroc, 52

Aristada Inj 662MG/2, 39

amoxicillin TAB 500MG, 1

apap/codeine sol 120-12/5, 51

Aristada Inj 882MG/3, 39

Amoxicillin TAB 775MG, 1

apap/codeine TAB 300-15MG, 51

Arixtra Inj 10/0.8ML, 36

amoxicillin TAB 875MG, 1

apap/codeine TAB 300-30MG, 51

Arixtra Inj 2.5/0.5, 36

amphet/dextr CAP 10MG ER, 41

apap/codeine TAB 300-60MG, 51

Arixtra Inj 5/0.4ML, 36

amphet/dextr CAP 15MG ER, 41

Apexicon E CRE 0.05%, 19

Arixtra Inj 7.5/0.6, 36

amphet/dextr CAP 20MG ER, 41

Apidra Inj Solostar, 25

armodafinil TAB 150MG, 42

amphet/dextr CAP 25MG ER, 41

Apidra Inj U-100, 25

armodafinil TAB 200MG, 42

amphet/dextr CAP 30MG ER, 41

Aplenzin TAB 174MG, 38

armodafinil TAB 250MG, 42

amphet/dextr CAP 5MG ER, 41

Aplenzin TAB 348MG, 38

armodafinil TAB 50MG, 42

amphet/dextr TAB 10MG, 41

Aplenzin TAB 522MG, 38

Armonair Aer 113/Act, 57

amphet/dextr TAB 12.5MG, 41

Apokyn Inj 10MG/ML, 45

Armonair Aer 232/Act, 57

amphet/dextr TAB 15MG, 41

apraclonidin sol 0.5% op, 49

Armonair Aer 55/Act, 57

amphet/dextr TAB 20MG, 41

aprepitant CAP 125MG, 31

Armour Thyro TAB 120MG, 29

amphet/dextr TAB 30MG, 41

aprepitant CAP 40MG, 31

Armour Thyro TAB 180MG, 29

amphet/dextr TAB 5MG, 41

aprepitant CAP 80MG, 31

Armour Thyro TAB 240MG, 29

amphet/dextr TAB 7.5MG, 41

aprepitant PAK 80 & 125, 31

Armour Thyro TAB 300MG, 29

Amphotericin Inj 50MG, 3

apri TAB, 23

Arnuity Elpt Inh 100mcg, 57

ampicillin CAP 250MG, 1

Apriso CAP 0.375gm, 32

Arnuity Elpt Inh 200mcg, 57

ampicillin CAP 500MG, 1

Aptensio XR CAP 10MG, 42

Aromasin TAB 25MG, 6

Ampicillin CAP 500MG, 1

Aptensio XR CAP 15MG, 42

Arthrotec 50 TAB, 54

Ampicillin Inj 125MG, 1

Aptensio XR CAP 20MG, 42

Arthrotec 75 TAB, 55

ampicillin inj 1gm, 1

Aptensio XR CAP 30MG, 42

Arymo ER TAB 15MG, 52

ampicillin inj 250MG, 1

Aptensio XR CAP 40MG, 42

Arymo ER TAB 30MG, 52

ampicillin inj 500MG, 1

Aptensio XR CAP 50MG, 42

Arymo ER TAB 60MG, 52

Ampicillin Sus 125/5ML, 1

Aptensio XR CAP 60MG, 42

asa low dose TAB 81MG EC, 50

Ampicillin Sus 250/5ML, 1

Aptiom TAB 200MG, 43

asa/dipyrida CAP 25-200MG, 36

Ampyra TAB 10MG, 47

Aptiom TAB 400MG, 43

Asacol HD TAB 800MG, 32

Amrix CAP 15MG, 48

Aptiom TAB 600MG, 43

ascomp/cod CAP 30MG, 52

Amrix CAP 30MG, 48

Aptiom TAB 800MG, 43

ashlyna TAB, 23

Amytal Sod Inj 500MG, 41

Aptivus CAP 250MG, 4

Asmanex 120 Aer 220mcg, 57

Anacaine Oin, 20

Aptivus Sol, 4

Asmanex 14 Aer 220mcg, 57

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Asmanex 30 Aer 110mcg, 57

Ativan TAB 1MG, 37

Avapro TAB 150MG, 11

Asmanex 30 Aer 220mcg, 57

Ativan TAB 2MG, 37

Avapro TAB 300MG, 11

Asmanex 60 Aer 220mcg, 57

atomoxetine CAP 100MG, 41

Avapro TAB 75MG, 11

Asmanex 7 Aer 110mcg, 57

atomoxetine CAP 10MG, 41

Avar Aer 9.5-5%, 16

Asmanex HFA Aer 100 Mcg, 57

atomoxetine CAP 18MG, 41

avar cleanse emu 10-5%, 16

Asmanex HFA Aer 200 Mcg, 57

atomoxetine CAP 25MG, 41

Avar LS Aer 10-2%, 16

aspir-81 TAB 81MG EC, 50

atomoxetine CAP 40MG, 41

Avar LS Liq 10-2%, 16

aspir-low TAB 81MG EC, 50

atomoxetine CAP 60MG, 41

Avar LS Pad 10-2%, 16

aspirin 81 TAB 81MG EC, 50

atomoxetine CAP 80MG, 41

Avar Pad 9.5-5%, 16

aspirin adlt TAB 81MG, 50

Atopiclair CRE, 20

avar-e emoll CRE 10-5%, 16

aspirin chil chw 81MG, 50

atorvastatin TAB 10MG, 14

avar-e green CRE 10-5%, 16

aspirin chld chw 81MG, 50

atorvastatin TAB 20MG, 14

Avar-e LS CRE 10-2%, 17

aspirin chw 81MG, 50

atorvastatin TAB 40MG, 14

Avc CRE 15%, 33

aspirin low chw 81MG, 50

atorvastatin TAB 80MG, 14

Avelox Abc TAB 400MG, 3

aspirin low TAB 81MG, 50

atovaq/progu TAB 250-100, 5

Avelox TAB 400MG, 3

aspirin low TAB 81MG EC, 50

atovaq/progu TAB 62.5-25, 5

Avenova Sol 0.01%, 20

aspirin TAB 325MG, 50

atovaquone sus 750/5ML, 5

Avenova Sol Neutrox, 20

aspirin TAB 325MG EC, 50

Atralin Gel 0.05%, 16

aviane TAB, 23

aspirin TAB 5gr EC, 50

Atripla TAB, 4

avidoxy TAB 100MG, 2

aspirin TAB 81MG, 50

Atropine SUL Oin 1% Op, 49

avita CRE 0.025%, 16

Aspirin TAB 81MG, 51

Atropine SUL Sol 1% Op, 49

avita gel 0.025%, 16

aspirin TAB 81MG EC, 50

Atrovent HFA Aer 17mcg, 57

Avodart CAP 0.5MG, 34

aspirin-81 chw 81MG, 50

Atrovent Nas Sol 0.03%, 56

Avonex Kit 30mcg, 47

aspirtab TAB 324MG EC, 50

Atrovent Nas Sol 0.06%, 56

Avonex Pen Kit 30mcg, 47

Assure 3 Liq Control, 60

Aubagio TAB 14MG, 47

Avonex Prefl Kit 30mcg, 47

Assure 4 Liq Level1/2, 60

Aubagio TAB 7MG, 47

Axert TAB 12.5MG, 55

Assure Cmfrt Mis 28G, 60

aubra TAB 0.1-0.02, 23

Axert TAB 6.25MG, 55

Assure Cmfrt Mis 30G, 60

aug betamet CRE 0.05%, 18

Axiron Sol 30MG/Act, 22

Assure Dose Sol Norm/Hgh, 60

aug betamet gel 0.05%, 18

Aygestin TAB 5MG, 25

Assure Dose Sol Normal, 60

aug betamet lot 0.05%, 18

Azasan TAB 100MG, 7

Assure II Liq Level 1, 60

aug betamet oin 0.05%, 18

Azasan TAB 75 MG, 7

Assure II Liq Level1/2, 60

Augmentin Sus 125/5ML, 1

Azasite Sol 1%, 48

Assure Lance Mis 21G, 60

Augmentin Sus 250/5ML, 1

azathioprine TAB 50MG, 7

Assure Lance Mis Low Flow, 60

Augmentin Sus ES-600, 1

azelastine dro 0.05%, 50

Assure Lance Mis Micro, 60

Augmentin TAB 500MG, 1

azelastine spr 0.1%, 56

Assure Lance Mis Safe 25G, 60

Augmentin TAB 875MG, 1

azelastine spr 0.15%, 56

Assure Lance Mis Safe 30G, 60

Augmentin XR TAB 12HR, 1

Azelex CRE 20%, 16

Assure Mis Lancets, 60

Aurora Lance Mis 30G, 60

Azenase PAK Mis 137-50, 56

Assure Plus Mis High 18G, 60

Aurora Lance Mis Thin 23G, 60

Azilect TAB 0.5MG, 45

Assure Plus Mis Low 25G, 60

Auryxia TAB 210MG, 32

Azilect TAB 1MG, 45

Assure Plus Mis Mcro 28G, 60

Austedo TAB 12MG, 47

Azithromycin Pow 1gm PAK, 2

Assure Plus Mis Norm 21G, 60

Austedo TAB 6MG, 47

azithromycin sus 100/5ML, 2

Assure Plus Mis Pediatri, 60

Austedo TAB 9MG, 47

azithromycin sus 200/5ML, 2

Assure Prism Sol Level1/2, 60

Auto Lancet Mis, 60

azithromycin TAB 250MG, 2

Assure Pro Liq Level1/2, 60

Auto-lancet Mis, 60

azithromycin TAB 500MG, 2

Astagraf XL CAP 0.5MG, 7

Auto-lancet Mis Mini, 60

azithromycin TAB 600MG, 2

Astagraf XL CAP 1MG, 7

Autolet II Kit Clinisaf, 60

Azopt Sus 1% Op, 50

Astagraf XL CAP 5MG, 7

Autolet Impr Mis Lanc Dev, 60

Azor TAB 10-20MG, 13

Astepro Spr 0.15%, 56

Autolet Lanc Mis Device, 60

Azor TAB 10-40MG, 13

Astero Gel 4%, 20

Autolet Lite Kit, 60

Azor TAB 5-20MG, 13

AT Last Mis Lancets, 60

Autolet Lite Kit Clinisaf, 60

Azor TAB 5-40MG, 13

AT Last Sol Control, 60

Autolet Lite Kit Starter, 60

Azulfidine TAB 500MG, 32

Atabex Chw Prenatal, 59

Autolet Mini Mis, 60

Azulfidine TAB 500MG En, 32

Atacand HCT TAB 16-12.5, 13

Autolet Plat Mis 1.8MM, 60

azuphen mb CAP 120MG, 33

Atacand HCT TAB 32-12.5, 13

Autolet Plat Mis 2.4MM, 60

azurette TAB 28 day, 23

Atacand HCT TAB 32-25MG, 13

Autolet Plat Mis 3.0MM, 60

B

Atacand TAB 16MG, 11

Autolet Plus Mis, 60

Baby Ddrops Liq 400unit, 59

Atacand TAB 32MG, 11

Autolet Plus Mis Lanc Dev, 60

Baby Super Dro Daily D3, 59

Atacand TAB 4MG, 11

Autoshield Mis 29X3/16", 60

Baby Vit D Dro 400/.028, 59

Atacand TAB 8MG, 11

Autoshield Mis 29X5/16", 60

bacit/polymy oin op, 48

Atelvia TAB, 27

Autoshield Mis 30GX3/16, 60

Bacitracin Oin Op, 48

atenol/chlor TAB 100-25MG, 12

Auvi-q Inj 0.15MG, 14

baclofen TAB 10MG, 48

atenol/chlor TAB 50-25MG, 12

Auvi-q Inj 0.3MG, 14

baclofen TAB 20MG, 48

atenolol TAB 100MG, 9

Avalide TAB 150-12.5, 13

Bactrim DS TAB 800-160, 6

atenolol TAB 25MG, 9

Avalide TAB 300-12.5, 13

Bactrim TAB 400-80MG, 6

atenolol TAB 50MG, 9

Avandia TAB 2MG, 26

Bactroban CRE 2%, 17

Ativan Inj 2MG/ML, 37

Avandia TAB 4MG, 26

Bactroban Oin 2%, 17

Ativan TAB 0.5MG, 37

Avandia TAB 8MG, 26

Bactroban Oin Nasal 2%, 56

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balsalazide CAP 750MG, 32

Benziq Gel 5.25%, 17

bisoprol fum TAB 5MG, 9

balziva TAB, 23

Benziq LS Gel 2.75%, 17

Bleph-10 Sol 10% Op, 48

Banzel Sus 40MG/ML, 43

benzonatate CAP 100MG, 56

Blephamide Oin S.o.p., 49

Banzel TAB 200MG, 43

benzonatate CAP 150MG, 56

Blephamide Sus Op, 49

Banzel TAB 400MG, 43

benzonatate CAP 200MG, 56

blisovi 24 TAB FE 1/20, 23

Baraclude Sol .05MG/ML, 4

benztropine inj 1MG/ML, 44

blisovi FE TAB 1.5/30, 23

Baraclude TAB 0.5MG, 4

benztropine TAB 0.5MG, 44

blisovi FE TAB 1/20, 23

Baraclude TAB 1MG, 4

benztropine TAB 1MG, 44

Bocasal Pow, 36

Basaglar Inj 100unit, 25

benztropine TAB 2MG, 44

Boniva TAB 150MG, 27

Baxdela TAB 450MG, 2

Bepreve Dro 1.5%, 50

Boostrix Inj, 58

bayer adv TAB 325MG, 50

Berinert Inj 500unit, 36

Bosulif TAB 100MG, 7

bayer asa TAB 325MG, 50

Besivance Sus 0.6%, 48

Bosulif TAB 500MG, 7

Bayer Breeze Liq High Cnt, 60

beta diprop gel 0.05%, 18

bp 10-1 emu, 16

Bayer Breeze Liq Low Cntl, 60

beta-phos/ac inj 3-3MG/ML, 21

Bp Cleansing Emu 10-4%, 17

Bayer Breeze Liq Norm Cnt, 60

Betadine Sol 5% Op, 48

bpm pseudo TAB 6-45MG, 56

Bayer Breeze Mis 2 Test, 60

Betagan Sol 0.5% Op, 49

bpm TAB 6MG, 56

bayer low chw 81MG, 50

betameth dip CRE 0.05%, 18

bpo cloths mis 6%, 16

bayer low TAB 81MG EC, 50

betameth dip lot 0.05%, 18

Brainstrong Mis Prenatal, 59

Bayer Micrlt Mis Lanc Dvc, 61

betameth dip oin 0.05%, 18

Breatherite Mis, 66

Bayer Micrlt Mis Lancets, 61

betameth val aer 0.12%, 18

Breatherite Mis LG Mask, 66

BD Lancet Mis Device, 61

betameth val CRE 0.1%, 18

Breatherite Mis MED Mask, 66

BD Lancet UF Mis 30G, 61

betameth val lot 0.1%, 18

Breatherite Mis Sm Mask, 66

BD Lancet UF Mis 33G, 61

betameth val oin 0.1%, 18

Breatherite Mis Spacer, 66

BD Microtain Mis Lancets, 61

Betapace AF TAB 120MG, 9

Breatherite Mis W/Mask, 66

BD Pen Needl Mis 29GX1/2", 61

Betapace AF TAB 160MG, 9

Breo Ellipta Inh 100-25, 57

BD Pen Needl Mis 31GX3/16, 61

Betapace AF TAB 80MG, 9

Breo Ellipta Inh 200-25, 57

BD Pen Needl Mis 31GX5/16, 61

Betapace TAB 120MG, 9

Brevicon TAB 0.5/35, 24

BD Pen Needl Mis 32GX4MM, 61

Betapace TAB 160MG, 9

briellyn TAB, 23

BD U-500 Mis 31GX6MM, 61

Betapace TAB 80MG, 9

Brilinta TAB 60MG, 36

BD Ultra-fin Mis 32GX6MM, 61

Betaseron Inj 0.3MG, 47

Brilinta TAB 90MG, 36

Be Well PAK Rounded, 59

betaxolol sol 0.5% op, 49

brimonidine sol 0.15%, 49

Beconase AQ Sus 0.042%, 56

betaxolol TAB 10MG, 9

brimonidine sol 0.2% op, 49

bekyree TAB, 23

betaxolol TAB 20MG, 9

Brintellix TAB 10MG, 38

Belbuca Mis 150mcg, 52

bethanechol TAB 10MG, 33

Brintellix TAB 20MG, 38

Belbuca Mis 300mcg, 52

bethanechol TAB 25MG, 33

Brintellix TAB 5MG, 38

Belbuca Mis 450mcg, 52

bethanechol TAB 50MG, 33

Brisdelle CAP 7.5MG, 47

Belbuca Mis 600mcg, 52

bethanechol TAB 5MG, 33

Briviact Sol 10MG/ML, 43

Belbuca Mis 750mcg, 52

Bethkis Neb 300/4ML, 3

Briviact TAB 100MG, 43

Belbuca Mis 75mcg, 52

Betimol Sol 0.25%, 49

Briviact TAB 10MG, 43

Belbuca Mis 900mcg, 52

Betimol Sol 0.5%, 49

Briviact TAB 25MG, 43

Bella/Opium Sup 16.2-30, 30

Betoptic-s Sus 0.25% Op, 49

Briviact TAB 50MG, 43

Bella/Opium Sup 16.2-60, 30

Bevespi Aer 9-4.8mcg, 57

Briviact TAB 75MG, 43

Belsomra TAB 10MG, 41

bexarotene CAP 75MG, 8

brom/PSE/DM syp, 56

Belsomra TAB 15MG, 41

Bexsero Inj, 58

bromfed DM syp, 56

Belsomra TAB 20MG, 41

Beyaz TAB, 24

bromfenac sol 0.09% op, 50

Belsomra TAB 5MG, 41

Biaxin Sus 250/5ML, 2

Bromfenac Sol 0.09% Op, 50

benazep/hctz TAB 10-12.5, 12

Biaxin TAB 250MG, 2

bromocriptin CAP 5MG, 44

benazep/hctz TAB 20-12.5, 12

Biaxin TAB 500MG, 2

bromocriptin TAB 2.5MG, 44

benazep/hctz TAB 20-25MG, 12

bicalutamide TAB 50MG, 6

Brompheniram Chw 12MG, 56

benazep/hctz TAB 5-6.25, 12

Bicillin L-a Inj 1200000, 1

Bromsite Dro 0.075%, 50

benazepril TAB 10MG, 11

Bicillin L-a Inj 2400000, 1

Brovana Neb 15mcg, 57

benazepril TAB 20MG, 11

Bicillin L-a Inj 600000, 1

budesonide CAP 3MG DR, 21

benazepril TAB 40MG, 11

Bidil TAB, 16

budesonide sus 0.25MG/2, 57

benazepril TAB 5MG, 11

Biltricide TAB 600MG, 5

budesonide sus 0.5MG/2, 57

Benicar HCT TAB 20-12.5, 13

Bimatoprost Sol 0.03%, 49

budesonide sus 1MG/2ML, 57

Benicar HCT TAB 40-12.5, 13

Binosto TAB 70MG, 27

budesonide sus 32mcg, 56

Benicar HCT TAB 40-25MG, 13

bio-d-mulsio liq 2000unit, 59

Bullseye Mis Lancets, 61

Benicar TAB 20MG, 11

bio-d-mulsio liq 400unit, 59

Bullseye Mis Mini Lnc, 61

Benicar TAB 40MG, 11

Bio-statin CAP 1000000, 3

bumetanide TAB 0.5MG, 13

Benicar TAB 5MG, 12

Bio-statin CAP 500000, 3

bumetanide TAB 1MG, 13

Bensal HP Oin, 20

bio-statin pow, 3

bumetanide TAB 2MG, 13

Bentyl CAP 10MG, 31

Biothrax Inj, 58

Bumex TAB 0.5MG, 14

Bentyl Inj 10MG/ML, 31

biotuss liq, 56

Bumex TAB 1MG, 14

Bentyl TAB 20MG, 31

bisacodyl TAB 5MG EC, 29

Bumex TAB 2MG, 14

Benzaclin Gel 1-5%, 17

bisoprl/hctz TAB 10/6.25, 12

Bunavail Mis 2.1-0.3, 52

Benzaclin Gel 1-5%P.M., 17

bisoprl/hctz TAB 2.5/6.25, 12

Bunavail Mis 4.2-0.7, 52

Benzamycin Gel 5-3%, 17

bisoprl/hctz TAB 5-6.25MG, 12

Bunavail Mis 6.3-1MG, 52

benzepro mis 6%, 16

bisoprol fum TAB 10MG, 9

bupap TAB 50-300MG, 51

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Buphenyl Pow, 28

Caduet TAB 5-10MG, 16

carbamazepin CAP 100MG ER, 43

Buphenyl TAB 500MG, 28

Caduet TAB 5-20MG, 16

carbamazepin CAP 200MG ER, 43

bupren/nalox sub 2-0.5MG, 51

Caduet TAB 5-40MG, 16

carbamazepin CAP 300MG ER, 43

bupren/nalox sub 8-2MG, 51

Caduet TAB 5-80MG, 16

carbamazepin chw 100MG, 43

Buprenex Inj 0.3MG/ML, 52

Cafergot TAB 1-100MG, 55

carbamazepin sus 100/5ML, 43

Buprenorphin Dis 10mcg/HR, 52

caffeine CIT sol 20MG/ML, 41

carbamazepin TAB 100mger, 43

Buprenorphin Dis 15mcg/HR, 52

caffeine CIT sol 60MG/3ML, 41

carbamazepin TAB 200MG, 43

Buprenorphin Dis 20mcg/HR, 52

Calan SR TAB 120MG, 10

carbamazepin TAB 200MG ER, 43

Buprenorphin Dis 5mcg/HR, 52

Calan SR TAB 180MG, 10

carbamazepin TAB 400MG ER, 43

Buprenorphin Dis 7.5/HR, 52

Calan SR TAB 240MG, 10

Carbaphen 12 Liq, 56

buprenorphin inj 0.3MG/ML, 51

Calan TAB 120MG, 10

Carbaphen 12 Sus PED, 56

buprenorphin sub 2MG, 51

Calan TAB 80MG, 10

Carbatrol CAP 100MG, 43

buprenorphin sub 8MG, 51

calc acetate CAP 667MG, 32

Carbatrol CAP 200MG, 43

buproban TAB 150MG, 45

calc acetate TAB 667MG, 32

Carbatrol CAP 300MG, 43

bupropion TAB 100MG, 37

calcipotrien CRE 0.005%, 18

carbidopa TAB 25MG, 44

bupropion TAB 100MG ER, 37

calcipotrien oin 0.005%, 18

carbinoxamin sol 4MG/5ML, 56

bupropion TAB 100MG SR, 37

calcipotrien oin betameth, 19

carbinoxamin TAB 4MG, 56

bupropion TAB 150MG, 45

calcipotrien sol 0.005%, 18

carbonyl TAB FE 45MG, 34

bupropion TAB 150MG ER, 37

calcitonin spr 200/act, 27

Cardiocom Mis Lancing, 61

bupropion TAB 150MG SR, 37

calcitrene oin 0.005%, 18

Cardizem CD CAP 120MG/24, 10

bupropion TAB 200MG ER, 37

calcitriol CAP 0.25mcg, 28

Cardizem CD CAP 180MG/24, 10

bupropion TAB 200MG SR, 37

calcitriol CAP 0.5mcg, 28

Cardizem CD CAP 240MG/24, 10

bupropion TAB 75MG, 37

Calcitriol Oin 3mcg/Gm, 18

Cardizem CD CAP 300MG/24, 10

bupropn HCL TAB 150MG XL, 37

calcitriol sol 1mcg/ML, 28

Cardizem CD CAP 360MG/24, 10

bupropn HCL TAB 300MG XL, 37

Cambia Pow 50MG, 55

Cardizem LA TAB 120MG, 10

buspirone TAB 10MG, 37

camila TAB 0.35MG, 23

Cardizem LA TAB 180MG, 10

buspirone TAB 15MG, 37

camrese LO TAB, 23

Cardizem LA TAB 240MG, 10

buspirone TAB 30MG, 37

camrese TAB, 23

Cardizem LA TAB 300MG/24, 10

buspirone TAB 5MG, 37

Canasa Sup 1000MG, 32

Cardizem LA TAB 360MG, 10

buspirone TAB 7.5MG, 37

candesa/hctz TAB 16-12.5, 13

Cardizem LA TAB 420MG/24, 10

but/apap/caf CAP, 51

candesa/hctz TAB 32-12.5, 13

Cardizem TAB 120MG, 10

but/apap/caf CAP codeine, 52

candesa/hctz TAB 32-25MG, 13

Cardizem TAB 30MG, 10

but/apap/caf TAB, 50

candesartan TAB 16MG, 11

Cardizem TAB 60MG, 10

but/asa/caf/ CAP cod 30MG, 52

candesartan TAB 32MG, 11

Cardura TAB 1MG, 12

but/asa/caff CAP, 50

candesartan TAB 4MG, 11

Cardura TAB 2MG, 12

butal/apap TAB 50-325MG, 51

candesartan TAB 8MG, 11

Cardura TAB 4MG, 12

butalb/aceta TAB 50-300MG, 51

Cantil TAB 25MG, 31

Cardura TAB 8MG, 12

Butisol Sod TAB 30MG, 41

capacet CAP, 51

Cardura XL TAB 4MG, 34

Butorphanol Inj 1MG/ML, 51

capecitabine TAB 150MG, 6

Cardura XL TAB 8MG, 34

butorphanol inj 2MG/ML, 51

capecitabine TAB 500MG, 6

Carefine Mis 31GX8MM, 61

butorphanol sol 10MG/ML, 52

Capex Sha 0.01%, 19

Carefine Mis 32GX4MM, 61

Butrans Dis 10mcg/HR, 52

Caphosol Sol, 36

Carefine Mis 32GX5MM, 61

Butrans Dis 15mcg/HR, 52

Capital/Cod Sus 120-12/5, 52

Carefine Mis 32GX6MM, 61

Butrans Dis 20mcg/HR, 52

Caprelsa TAB 100MG, 7

Careone Adv Mis Lancing, 61

Butrans Dis 5mcg/HR, 52

Caprelsa TAB 300MG, 7

Careone Lanc Mis 28G, 61

Butrans Dis 7.5/HR, 52

Captopr/Hctz TAB 25-15MG, 12

Careone Lanc Mis Thin 23G, 61

Bydureon Inj 2MG, 25

Captopr/Hctz TAB 25-25MG, 12

Caresens Sol Control, 61

Bydureon Pen Inj 2MG, 25

Captopr/Hctz TAB 50-15MG, 12

Caretouch Mis 31GX5MM, 61

Byetta Inj 10mcg, 25

Captopr/Hctz TAB 50-25MG, 12

Caretouch Mis 31GX6MM, 61

Byetta Inj 5mcg, 25

captopril TAB 100MG, 11

Caretouch Mis 31GX8MM, 61

Bystolic TAB 10MG, 9

captopril TAB 12.5MG, 11

Caretouch Mis 32GX4MM, 61

Bystolic TAB 2.5MG, 9

captopril TAB 25MG, 11

Caretouch Mis 32GX5MM, 61

Bystolic TAB 20MG, 9

captopril TAB 50MG, 11

Caretouch Mis Ejector, 61

Bystolic TAB 5MG, 9

Carac CRE 0.5%, 6

Caretouch Mis Twist 28, 61

Byvalson TAB 5-80MG, 13

Carafate Sus 1gm/10ML, 30

Caretouch Mis Twist 30, 61

C

Carafate TAB 1gm, 31

Caretouch Mis Twist 33, 61

CARB/Levo 50 TAB /Entacap, 45

carisopr/asa TAB 200-325, 48

cabergoline TAB 0.5MG, 28

CARB/Levo 75 TAB /Entacap, 45

carisoprodol TAB 250MG, 48

Cabometyx TAB 20MG, 7

CARB/levo ER TAB 25-100MG, 45

carisoprodol TAB 350MG, 48

Cabometyx TAB 40MG, 7

CARB/levo ER TAB 50-200MG, 45

carisoprodol TAB asa/cod, 48

Cabometyx TAB 60MG, 7

CARB/levo TAB 10-100MG, 45

Carnitor SF Sol 1gm/10ML, 28

Cadeau DHA CAP, 59

CARB/levo TAB 25-100MG, 45

Carnitor Sol 1gm/10ML, 28

Caduet TAB 10-10MG, 16

CARB/levo TAB 25-250MG, 45

Carnitor TAB 330MG, 28

Caduet TAB 10-20MG, 16

CARB/Levo100 TAB /Entacap, 45

carteolol sol 1% op, 49

Caduet TAB 10-40MG, 16

CARB/Levo125 TAB /Entacap, 45

carters TAB 5MG EC, 29

Caduet TAB 10-80MG, 16

CARB/Levo150 TAB /Entacap, 45

cartia XT CAP 120/24HR, 9

Caduet TAB 2.5-10MG, 16

CARB/Levo200 TAB /Entacap, 45

cartia XT CAP 180/24HR, 9

Caduet TAB 2.5-20MG, 16

Carbaglu TAB 200MG, 28

cartia XT CAP 240/24HR, 9

Caduet TAB 2.5-40MG, 16

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cartia XT CAP 300/24HR, 9

Celexa TAB 10MG, 38

ciclodan CRE 0.77%, 17

carvedilol TAB 12.5MG, 9

Celexa TAB 20MG, 38

ciclodan sol 8%, 17

carvedilol TAB 25MG, 9

Celexa TAB 40MG, 38

ciclopirox CRE 0.77%, 17

carvedilol TAB 3.125MG, 9

Cellcept CAP 250MG, 7

ciclopirox gel 0.77%, 17

carvedilol TAB 6.25MG, 9

Cellcept Sus 200MG/ML, 7

ciclopirox sha 1%, 17

Casodex TAB 50MG, 6

Cellcept TAB 500MG, 7

ciclopirox sol 8%, 17

Catapres TAB 0.1MG, 12

Celontin CAP 300MG, 43

ciclopirox sus 0.77%, 17

Catapres TAB 0.2MG, 12

Cem-urea Sol 45%, 20

cidaleaze CRE 3%, 20

Catapres TAB 0.3MG, 12

Centany Oin 2%, 17

cilostazol TAB 100MG, 36

Catapres-tts Dis 0.1/24HR, 12

Centrum Spec PAK Prenatal, 59

cilostazol TAB 50MG, 36

Catapres-tts Dis 0.2/24HR, 12

cephalexin CAP 250MG, 1

Ciloxan Oin 0.3% Op, 48

Catapres-tts Dis 0.3/24HR, 12

cephalexin CAP 500MG, 1

Ciloxan Sol 0.3% Op, 48

Cayston Inh 75MG, 5

cephalexin CAP 750MG, 1

cimetidine sol 300/5ML, 30

caziant PAK, 23

cephalexin sus 125/5ML, 1

cimetidine TAB 200MG, 30

Cdp/Amitrip TAB 10-25MG, 47

cephalexin sus 250/5ML, 1

cimetidine TAB 300MG, 30

Cdp/Amitrip TAB 5-12.5MG, 47

Cephalexin TAB 250MG, 1

cimetidine TAB 400MG, 30

Cedax CAP 400MG, 1

Cephalexin TAB 500MG, 1

cimetidine TAB 800MG, 30

Cedax Sus 180/5ML, 1

Ceracade Emu, 20

Cimzia Kit, 32

cefaclor CAP 250MG, 1

ceramax CRE, 20

Cimzia Kit Starter, 32

cefaclor CAP 500MG, 1

Cerdelga CAP 84MG, 35

Cimzia Prefl Kit 200MG/ML, 32

Cefaclor ER TAB 500MG, 1

cerisa wash emu 10-1%, 16

Cinryze Sol 500 Unit, 36

Cefaclor Sus 125/5ML, 1

Cervarix Inj, 58

Cipro (10%) Sus 500MG/5, 3

Cefaclor Sus 250/5ML, 1

Cervidil Vag Mis 10MG INS, 50

Cipro (5%) Sus 250MG/5, 3

Cefaclor Sus 375/5ML, 1

Cesamet CAP 1MG, 31

Cipro HC Sus Otic, 50

cefadroxil CAP 500MG, 1

cetirizine syp 1MG/ML, 56

Cipro TAB 250MG, 3

cefadroxil sus 250/5ML, 1

Cetraxal Sol 0.2%, 50

Cipro TAB 500MG, 3

cefadroxil sus 500/5ML, 1

cevimeline CAP 30MG, 36

Cipro XR TAB 1000MG, 3

cefadroxil TAB 1gm, 1

Chantix PAK 0.5& 1MG, 46

Cipro XR TAB 500MG, 3

cefazolin inj 1gm, 1

Chantix PAK 1MG, 46

Ciprodex Sus 0.3-0.1%, 50

cefdinir CAP 300MG, 1

Chantix TAB 0.5MG, 46

Ciprofloxacn Sol 0.2%, 50

cefdinir sus 125/5ML, 1

Chantix TAB 1MG, 46

ciprofloxacn sol 0.3% op, 48

cefdinir sus 250/5ML, 1

chateal TAB 0.15/30, 23

ciprofloxacn sus 250MG/5, 2

Cefditoren TAB 200MG, 1

Chemet CAP 100MG, 66

ciprofloxacn sus 500MG/5, 2

Cefditoren TAB 400MG, 1

Chenodal TAB 250MG, 32

ciprofloxacn TAB 1000MG, 2

cefepime inj 1gm, 1

child asa chw 81MG, 50

Ciprofloxacn TAB 100MG, 2

cefixime sus 100/5ML, 1

child asa LS chw 81MG, 50

ciprofloxacn TAB 250MG, 2

cefixime sus 200/5ML, 1

chlord/clidi CAP 5-2.5MG, 30

ciprofloxacn TAB 500MG, 2

cefpodo prox sus 100/5ML, 1

chlordiazep CAP 10MG, 37

ciprofloxacn TAB 500MG ER, 2

cefpodo prox sus 50MG/5ML, 1

chlordiazep CAP 25MG, 37

ciprofloxacn TAB 750MG, 2

cefpodoxime TAB 100MG, 1

chlordiazep CAP 5MG, 37

citalopram sol 10MG/5ML, 37

cefpodoxime TAB 200MG, 1

chlorhex glu sol 0.12%, 36

citalopram TAB 10MG, 37

cefprozil sus 125/5ML, 1

chloroquine TAB 250MG, 5

citalopram TAB 20MG, 37

cefprozil sus 250/5ML, 1

Chloroquine TAB 250MG, 5

citalopram TAB 40MG, 37

cefprozil TAB 250MG, 1

chloroquine TAB 500MG, 5

citroma sol cherry, 29

cefprozil TAB 500MG, 1

Chlorothiaz TAB 250MG, 14

citroma sol lemon, 29

ceftazidime inj 1gm, 1

chlorothiaz TAB 500MG, 13

CL Prenatal TAB 28-0.8MG, 59

Ceftibuten CAP 400MG, 1

Chlorpromaz Inj 25MG/ML, 39

claravis CAP 10MG, 16

Ceftibuten Sus 180/5ML, 1

Chlorpromaz Inj 50MG/2ML, 39

claravis CAP 20MG, 16

Ceftin Sus 125/5ML, 1

chlorpromaz TAB 100MG, 39

claravis CAP 30MG, 16

Ceftin Sus 250/5ML, 1

chlorpromaz TAB 10MG, 39

claravis CAP 40MG, 16

Ceftin TAB 250MG, 1

chlorpromaz TAB 200MG, 39

Clarifoam EF Aer 10-5%, 17

Ceftin TAB 500MG, 1

chlorpromaz TAB 25MG, 39

Clarinex Syp 0.5MG/ML, 56

ceftriaxone inj 1gm, 1

chlorpromaz TAB 50MG, 39

Clarinex TAB 5MG, 56

ceftriaxone inj 250MG, 1

Chlorpropam TAB 100MG, 25

Clarinex-d TAB 2.5-120, 56

ceftriaxone inj 2gm, 1

Chlorpropam TAB 250MG, 25

clarithromyc sus 125/5ML, 2

ceftriaxone inj 500MG, 1

chlorthalid TAB 25MG, 13

Clarithromyc Sus 125/5ML, 2

Cefuroxime Inj 10MG/ML, 48

chlorthalid TAB 50MG, 13

clarithromyc sus 250/5ML, 2

cefuroxime TAB 250MG, 1

Chlorzoxazon TAB 250MG, 48

Clarithromyc Sus 250/5ML, 2

cefuroxime TAB 500MG, 1

chlorzoxazon TAB 500MG, 48

clarithromyc TAB 250MG, 2

Celebrex CAP 100MG, 55

cho MAG tris liq 500/5ML, 50

clarithromyc TAB 500MG, 2

Celebrex CAP 200MG, 55

Cholbam CAP 250MG, 32

clarithromyc TAB 500MG ER, 2

Celebrex CAP 400MG, 55

Cholbam CAP 50MG, 32

Cleanlet 28G Mis Lancets, 61

Celebrex CAP 50MG, 55

cholestyram pow 4gm, 14

clearlax pow, 29

celecoxib CAP 100MG, 54

cholestyram pow 4gm lite, 14

clearplex X gel 10%, 16

celecoxib CAP 200MG, 54

Cialis TAB 10MG, 16

clemastine TAB 2.68MG, 56

celecoxib CAP 400MG, 54

Cialis TAB 2.5MG, 16

Clemastine TAB 2.68MG, 56

celecoxib CAP 50MG, 54

Cialis TAB 20MG, 16

Cleocin CAP 150MG, 6

Celestone Inj Soluspan, 22

Cialis TAB 5MG, 16

Cleocin CAP 300MG, 6

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Cleocin CAP 75MG, 6

clonazep odt TAB 2MG, 43

Cometriq Kit 100MG, 7

Cleocin CRE 2% Vag, 33

clonazepam TAB 0.5MG, 43

Cometriq Kit 140MG, 7

Cleocin PED Sol 75MG/5ML, 6

clonazepam TAB 1MG, 43

Cometriq Kit 60MG, 7

Cleocin Phos Inj 300MG, 6

clonazepam TAB 2MG, 43

Comfort Assu Mis Lanc 28G, 61

Cleocin Sup 100MG, 33

clonidine dis 0.1/24HR, 12

Comfort Assu Mis Lanc 33G, 61

Cleocin-t Gel 1%, 17

clonidine dis 0.2/24HR, 12

Comfort EZ Mis 29GX12MM, 61

Cleocin-t Lot 1%, 17

clonidine dis 0.3/24HR, 12

Comfort EZ Mis 31GX5MM, 61

Cleocin-t Pad 1%, 17

clonidine TAB 0.1MG, 12

Comfort EZ Mis 31GX6MM, 61

Cleocin-t Sol 1%, 17

clonidine TAB 0.1MG ER, 42

Comfort EZ Mis 31GX8MM, 61

Clever Check Mis, 61

clonidine TAB 0.2MG, 12

Comfort EZ Mis 32GX4MM, 61

Clever Check Mis 30G, 61

clonidine TAB 0.3MG, 12

Comfort EZ Mis 32GX5MM, 61

Clevr Choice Liq High, 61

clopidogrel TAB 300MG, 36

Comfort EZ Mis 32GX6MM, 61

Clevr Choice Liq Low, 61

clopidogrel TAB 75MG, 36

Comfort EZ Mis 32GX8MM, 61

Clickfine Mis 31GX1/4", 61

cloraz dipot TAB 15MG, 37

Comfort EZ Mis 33GX4MM, 61

Clickfine Mis 31GX5/16, 61

cloraz dipot TAB 3.75MG, 37

Comfort EZ Mis 33GX5MM, 61

Clickfine Mis 32GX5/32, 61

cloraz dipot TAB 7.5MG, 37

Comfort EZ Mis 33GX6MM, 61

Climara Dis 0.025MG, 22

Clorpres TAB 0.1-15MG, 13

Comfort EZ Mis 33GX8MM, 61

Climara Dis 0.0375MG, 22

Clorpres TAB 0.2-15MG, 13

Comfort Mis Lancets, 61

Climara Dis 0.05MG, 22

Clorpres TAB 0.3-15MG, 13

Comfortouch Mis Lancet, 61

Climara Dis 0.06MG, 22

Closercare Mis, 61

Commit Loz 2MG, 46

Climara Dis 0.075MG, 22

clotrim/beta CRE 1-0.05%, 17

Commit Loz 4MG, 46

Climara Dis 0.1MG, 22

clotrim/beta CRE diprop, 17

Commit Loz 4MG Chry, 46

Climara Pro Dis Weekly, 23

clotrim/beta lot diprop, 17

Compact Spac Mis Chamber, 66

clindacin mis etz 1%, 16

clotrimazole CRE 1%, 17

Compact Spac Mis LG Mask, 66

clindacin-p pad 1%, 16

clotrimazole loz 10MG, 36

Compact Spac Mis MD Mask, 66

Clindagel Gel 1%, 17

clotrimazole sol 1%, 17

Compact Spac Mis Sm Mask, 66

clindamy/ben gel 1-5%, 16

clotrimazole tro 10MG, 36

Complera TAB, 4

clindamy/ben gel 1.2-5%, 16

clozapine TAB 100/odt, 40

compro sup 25MG, 39

clindamycin aer 1%, 16

clozapine TAB 100MG, 39

Comtan TAB 200MG, 45

clindamycin CAP 150MG, 5

Clozapine TAB 12.5/Odt, 40

Comvax Inj, 58

clindamycin CAP 300MG, 5

Clozapine TAB 150/Odt, 40

Conceptrol Gel 4%, 33

clindamycin CAP 75MG, 5

Clozapine TAB 200/Odt, 40

Concerta TAB 18MG, 42

clindamycin CRE 2% vag, 33

clozapine TAB 200MG, 39

Concerta TAB 27MG, 42

clindamycin gel 1%, 16

clozapine TAB 25MG, 39

Concerta TAB 36MG, 42

clindamycin gel tretinoi, 16

clozapine TAB 25MG odt, 40

Concerta TAB 54MG, 42

clindamycin inj 150MG/ML, 5

clozapine TAB 50MG, 39

Condylox Gel 0.5%, 20

clindamycin inj 300/2ML, 5

Clozaril TAB 100MG, 40

Condylox Sol 0.5%, 20

clindamycin inj 300MG, 5

Clozaril TAB 25MG, 40

constulose sol 10gm/15, 29

clindamycin lot 1%, 16

Coaguchek Mis Lancets, 61

Contour Liq High Cnt, 61

clindamycin lot 10MG/ML, 16

Coartem TAB 20-120MG, 5

Contour Liq Low Cntl, 61

clindamycin mis 1%, 16

codeine sulf TAB 15MG, 51

Contour Liq Norm Cnt, 61

clindamycin pad 1%, 16

Codeine Sulf TAB 15MG, 51

Contour Sol Next, 61

clindamycin sol 1%, 16

codeine sulf TAB 30MG, 51

Contour Tes Next, 61

clindamycin sol 75MG/5ML, 5

Codeine Sulf TAB 30MG, 51

Control High Sol Unistrip, 61

Clindesse CRE 2%, 33

codeine sulf TAB 60MG, 51

Control Low Sol Unistrip, 61

clobetasol aer 0.05%, 19

Codeine Sulf TAB 60MG, 51

Control Norm Sol Easy Stp, 61

clobetasol CRE 0.05%, 19

Cogentin Inj 1MG/ML, 45

Control Sol Liq HI/Mid/L, 61

clobetasol e CRE 0.05%, 19

Colazal CAP 750MG, 32

Control Sol Liq High/Low, 61

clobetasol gel 0.05%, 18

Colchicine CAP 0.6MG, 55

Control Sol Liq Mid, 61

clobetasol lot 0.05%, 19

Colchicine TAB 0.6MG, 55

Control Sol Normal, 61

clobetasol oin 0.05%, 19

Colcrys TAB 0.6MG, 55

Conzip CAP 100MG, 52

clobetasol sha 0.05%, 19

Colestid FLA Gra 5/7.5gm, 15

Conzip CAP 200MG, 52

clobetasol sol 0.05%, 18

Colestid FLA Gra 5gm, 15

Conzip CAP 300MG, 52

clobetasol spr 0.05%, 19

Colestid Gra 5gm, 15

Cool Control Sol A, 61

Clobex Lot 0.05%, 19

Colestid Pow 5gm, 15

Cool Control Sol B, 61

Clobex Sha 0.05%, 19

Colestid TAB 1gm, 15

Copaxone Inj 20MG/ML, 47

Clobex Spr 0.05%, 19

colestipol gra 5gm, 14

Copaxone Inj 40MG/ML, 47

Clocortolone CRE Piv 0.1%, 19

colestipol TAB 1gm, 14

Copegus TAB 200MG, 5

clodan sha 0.05%, 19

colistimeth inj 150MG, 5

Cordarone TAB 200MG, 11

Cloderm CRE 0.1%, 19

colocort ene 100MG, 32

Cordran 24X3 Tap 4mcg/CM, 19

Cloderm CRE 0.1% Pmp, 19

Coly-mycin M Inj 150MG, 6

Cordran 80X3 Tap 4mcg/CM, 19

clomipramine CAP 25MG, 37

Coly-mycin S Sus Otic, 50

Cordran CRE 0.05%, 19

clomipramine CAP 50MG, 37

Colyte/Flavr Sol Packs, 30

Cordran Lot 0.05%, 19

clomipramine CAP 75MG, 37

Combigan Sol 0.2/0.5%, 49

Cordran Oin 0.05%, 19

clonazep odt TAB 0.125MG, 43

Combipatch Dis .05/.14, 23

Coreg CR CAP 10MG, 9

clonazep odt TAB 0.25MG, 43

Combipatch Dis .05/.25, 23

Coreg CR CAP 20MG, 9

clonazep odt TAB 0.5MG, 43

Combivent Aer 20-100, 57

Coreg CR CAP 40MG, 9

clonazep odt TAB 1MG, 43

Combivir TAB 150-300, 5

Coreg CR CAP 80MG, 9

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Coreg TAB 12.5MG, 9

Curosurf Sus 240/3ML, 58

Cymbalta CAP 20MG, 38

Coreg TAB 25MG, 9

Cutivate CRE 0.05%, 19

Cymbalta CAP 30MG, 38

Coreg TAB 3.125MG, 9

Cutivate Lot 0.05%, 19

Cymbalta CAP 60MG, 38

Coreg TAB 6.25MG, 9

Cuvposa Sol 1MG/5ML, 31

cyproheptad syp 2MG/5ML, 56

Corgard TAB 20MG, 9

cvd d3 chw 1000unit, 59

cyproheptad TAB 4MG, 56

Corgard TAB 40MG, 9

CVS aspirin TAB 325MG, 51

cyred TAB, 23

Corgard TAB 80MG, 9

CVS aspirin TAB 325MG EC, 51

Cystadane Pow, 28

Corlanor TAB 5MG, 16

CVS aspirin TAB 81MG EC, 51

Cystagon CAP 150MG, 34

Corlanor TAB 7.5MG, 16

CVS c-LAX TAB 5MG, 30

Cystagon CAP 50MG, 34

cormax scalp sol 0.05%, 18

CVS chld asa chw 81MG, 51

Cystaran Sol 0.44%, 50

correct TAB 5MG EC, 29

CVS d3 CAP 1000unit, 59

Cytomel TAB 25mcg, 29

correctol TAB 5MG EC, 29

CVS d3 CAP 2000unit, 59

Cytomel TAB 50mcg, 29

Cortef TAB 10MG, 22

CVS d3 CAP 400unit, 59

Cytomel TAB 5mcg, 29

Cortef TAB 20MG, 22

CVS d3 CAP 5000unit, 59

Cytotec TAB 100mcg, 31

Cortef TAB 5MG, 22

CVS d3 chw 1000 unt, 59

Cytotec TAB 200mcg, 31

Cortenema Ene 100MG, 32

CVS iron TAB 27MG, 35

cytra k gra crystals, 34

Cortifoam Aer 90MG, 32

CVS iron TAB 325MG, 35

D

Cortisone Ac TAB 25MG, 21

CVS Lancets Mis 21G, 61

d 1000 CAP 1000unit, 59

Cortisporin CRE 0.5%, 17

CVS Lancets Mis 30G, 61

d 1000 chw 1000unit, 59

Cortisporin Oin 1%, 17

CVS Lancets Mis 33G, 61

d 1000 TAB 1000unit, 59

Cortisporin Sus -tc Otic, 50

CVS Lancets Mis Original, 61

d 400 chw 400unit, 59

Corzide TAB 40-5MG, 13

CVS Lancets Mis Thin 26G, 61

d 400 TAB 400unit, 59

Corzide TAB 80-5MG, 13

CVS Lancets Mis Thin 30G, 61

d-3 gummy chw 400unit, 59

Cosentyx Inj 150MG/ML, 18

CVS Lancets Mis Thin 33G, 61

d-400 TAB 400unit, 59

Cosentyx Inj 300dose, 18

CVS Lancing Mis Device, 61

D-VI-sol Liq 400unit, 59

Cosentyx Pen Inj 150MG/ML, 18

CVS nicotine dis 14MG/24h, 46

d-vita liq 400unit, 59

Cosentyx Pen Inj 300dose, 18

CVS nicotine dis 7MG/24HR, 46

D.h.e. 45 Inj 1MG/ML, 55

Cosopt PF Sol, 49

CVS nicotine gum 2MG cinn, 46

d3 2000 TAB 2000unit, 59

Cosopt Sol 22.3-6.8, 49

CVS nicotine gum 2MG mint, 46

d3 adult chw 1000unit, 59

Cotellic TAB 20MG, 7

CVS nicotine gum 2MG orig, 46

d3 CAP 10000, 59

Cotempla TAB 17.3MG, 42

CVS nicotine gum 2mgfruit, 46

d3 CAP 1000unit, 59

Cotempla TAB 25.9MG, 42

CVS nicotine gum 4MG cinn, 46

d3 CAP 2000unit, 59

Cotempla TAB 8.6MG, 42

CVS nicotine gum 4MG mint, 46

d3 CAP 400unit, 59

Coumadin TAB 10MG, 36

CVS nicotine gum 4MG orig, 46

D3 Dots TAB 2000unit, 59

Coumadin TAB 1MG, 36

CVS nicotine gum 4mgfruit, 46

d3 kids chw 400unit, 59

Coumadin TAB 2.5MG, 36

CVS nicotine loz 2MG, 46

d3 max ST dro 5000unit, 59

Coumadin TAB 2MG, 36

CVS nicotine loz 2MG mint, 47

d3 maximum CAP 5000unit, 59

Coumadin TAB 3MG, 36

CVS nicotine loz 4MG mint, 47

d3 super str CAP 2000unit, 59

Coumadin TAB 4MG, 36

CVS nts dis step 1, 47

d3 TAB 1000unit, 59

Coumadin TAB 5MG, 36

CVS Prenatal Chw Gummy, 59

d3 TAB 2000unit, 59

Coumadin TAB 6MG, 36

CVS Prenatal TAB, 59

d3 TAB 400unit, 59

Coumadin TAB 7.5MG, 36

CVS purelax pow, 30

d3-1000 CAP 1000unit, 59

covaryx HS TAB, 22

CVS purelax pow 3350, 30

d3-50 CAP 50000unt, 59

covaryx TAB 1.25-2.5, 22

CVS senna plus tablet, 30

Daily D3 Dro 1000unit, 59

Cozaar TAB 100MG, 12

cyanocobalam inj 1000mcg, 34

Daklinza TAB 30MG, 4

Cozaar TAB 25MG, 12

cyclafem TAB 1/35, 23

Daklinza TAB 60MG, 4

Cozaar TAB 50MG, 12

cyclafem TAB 7/7/7, 23

Daklinza TAB 90MG, 4

Creon CAP 12000unt, 31

Cyclessa PAK, 24

Daliresp TAB 500mcg, 57

Creon CAP 24000unt, 31

cyclobenzapr TAB 10MG, 48

danazol CAP 100MG, 22

Creon CAP 3000unit, 31

cyclobenzapr TAB 5MG, 48

danazol CAP 200MG, 22

Creon CAP 36000unt, 31

cyclobenzapr TAB 7.5MG, 48

danazol CAP 50MG, 22

Creon CAP 6000unit, 31

Cyclogyl Sol 0.5% Op, 49

Dantrium CAP 25MG, 48

Cresemba CAP 186 MG, 3

Cyclogyl Sol 1% Op, 49

Dantrium CAP 50MG, 48

Crestor TAB 10MG, 15

Cyclogyl Sol 2% Op, 49

dantrolene CAP 100MG, 48

Crestor TAB 20MG, 15

Cyclomydril Sol Op, 49

dantrolene CAP 25MG, 48

Crestor TAB 40MG, 15

cyclopentol sol 1% op, 49

dantrolene CAP 50MG, 48

Crestor TAB 5MG, 15

cyclopentol sol 2% op, 49

dapsone TAB 100MG, 5

Crinone Gel 4% Vag, 33

cyclopentola sol 0.5%, 49

dapsone TAB 25MG, 5

Crinone Gel 8% Vag, 33

Cyclophosph CAP 25MG, 6

Daptacel Inj, 58

Crixivan CAP 200MG, 4

Cyclophosph CAP 50MG, 6

Daraprim TAB 25MG, 5

Crixivan CAP 400MG, 4

Cycloserine CAP 250MG, 3

darifenacin TAB 15MG, 33

cromolyn sod CON 100/5ML, 32

Cycloset TAB 0.8MG, 26

darifenacin TAB 7.5MG, 33

Cromolyn Sod Neb 20MG/2ML, 57

cyclosporine CAP 100MG, 7

dasetta TAB 1/35, 23

cromolyn sod sol 4% op, 50

cyclosporine CAP 100MG MD, 7

dasetta TAB 7/7/7, 23

cryselle-28 TAB 28 TABS, 23

cyclosporine CAP 25MG, 7

Daxbia CAP 333MG, 1

Cuprimine CAP 250MG, 66

cyclosporine CAP 25MG mod, 7

Daypro TAB 600MG, 55

curity salin sol 0.9% irr, 34

Cyclosporine CAP 50MG Mod, 7

daysee TAB, 23

Curosurf Sus 120/1.5, 58

cyclosporine sol modified, 7

Daytrana Dis 10MG/9HR, 42

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Daytrana Dis 15MG/9HR, 42

desmopressin inj 4mcg/ML, 28

dextroamphet CAP 15MG ER, 41

Daytrana Dis 20MG/9HR, 42

desmopressin sol 0.01%, 28

dextroamphet CAP 5MG ER, 41

Daytrana Dis 30MG/9HR, 42

desmopressin spr 0.01%, 28

dextroamphet sol 5MG/5ML, 42

Ddavp Inj 4mcg/ML, 28

desmopressin TAB 0.1MG, 28

dextroamphet TAB 10MG, 41

Ddavp Sol 0.01%, 28

desmopressin TAB 0.2MG, 28

dextroamphet TAB 5MG, 41

Ddavp Spr 0.01%, 28

deso/ethinyl TAB estradio, 23

Diabeta TAB 1.25MG, 25

Ddavp TAB 0.1MG, 28

Desogen-28 TAB, 24

Diabeta TAB 2.5MG, 25

Ddavp TAB 0.2MG, 28

Desonate Gel 0.05%, 19

Diabeta TAB 5MG, 25

Ddrops Boost Liq 600/.028, 59

desonide CRE 0.05%, 18

dialyvite d CAP 5000unit, 59

Ddrops Liq, 59

desonide lot 0.05%, 18

Diamox Seque CAP 500MG CR, 14

Ddrops Liq 1000unit, 59

desonide oin 0.05%, 18

Diastar Easy Mis Lancets, 61

Ddrops Liq 2000unit, 59

Desowen CRE 0.05%, 19

Diastar Mis Lancets, 61

Debacterol Sol 30-50%, 36

Desowen Lot 0.05%, 19

Diastat Acdl Gel 12.5-20, 44

deblitane TAB 0.35MG, 23

desoximetas CRE 0.05%, 18

Diastat Acdl Gel 5-10MG, 44

Decara CAP 25000unt, 59

desoximetas CRE 0.25%, 18

Diastat PED Gel 2.5m Gel, 43

decara CAP 50000unt, 59

desoximetas gel 0.05%, 18

Diatrue Cont Sol Level 1, 61

Delestrogen Inj 10MG/ML, 22

desoximetas oin 0.05%, 18

Diatrue Cont Sol Level 2, 61

Delestrogen Inj 20MG/ML, 23

desoximetas oin 0.25%, 18

Diatrue Cont Sol Level 3, 61

Delestrogen Inj 40MG/ML, 23

Desoxyn TAB 5MG, 42

diazepam CON 5MG/ML, 37

delta d3 TAB 400unit, 59

desvenlafax TAB 100MG ER, 38

Diazepam Gel 10MG, 43

deltasone TAB 20MG, 21

Desvenlafax TAB 100MG ER, 38

Diazepam Gel 2.5MG, 43

delyla TAB 0.1-0.02, 23

desvenlafax TAB 25MG ER, 38

Diazepam Gel 20MG, 43

Delzicol CAP 400MG, 32

desvenlafax TAB 50MG ER, 38

Diazepam Inj 10MG/2ML, 37

Demadex TAB 10MG, 14

Desvenlafax TAB 50MG ER, 38

Diazepam Inj 5MG/ML, 37

Demadex TAB 20MG, 14

Detrol LA CAP 2MG, 33

Diazepam Sol 1MG/ML, 37

Demadex TAB 5MG, 14

Detrol LA CAP 4MG, 33

diazepam TAB 10MG, 37

demeclocycl TAB 150MG, 2

Detrol TAB 1MG, 33

diazepam TAB 2MG, 37

demeclocycl TAB 300MG, 2

Detrol TAB 2MG, 33

diazepam TAB 5MG, 37

Demerol Inj 100MG/ML, 53

Dex LA 16 Inj 16MG/ML, 22

Dibenzyline CAP 10MG, 12

Demerol TAB 100MG, 53

dexameth PHO inj 10MG/ML, 21

Diclegis TAB 10-10MG, 31

Demerol TAB 50MG, 53

Dexameth PHO Inj 10MG/ML, 21

diclo/misopr TAB 50-0.2MG, 54

Demser CAP 250MG, 12

dexameth PHO inj 120MG/30, 21

diclo/misopr TAB 75-0.2MG, 54

Denavir CRE 1%, 18

dexameth PHO inj 20MG/5ML, 21

diclofen pot TAB 50MG, 54

Depakene CAP 250MG, 43

dexameth PHO inj 4MG/ML, 21

Diclofenac CRE Sodium, 18

Depakene Sol 250/5ML, 43

Dexameth PHO Sol 0.1% Op, 49

diclofenac gel 1%, 18

Depakote ER TAB 250MG, 43

Dexamethason CON 1MG/ML, 21

diclofenac sol 0.1% op, 50

Depakote ER TAB 500MG, 43

dexamethason elx 0.5/5ML, 21

diclofenac sol 1.5%, 18

Depakote Spr CAP 125MG, 43

Dexamethason Sol 0.5/5ML, 21

diclofenac TAB 100MG ER, 54

Depakote TAB 125MG DR, 43

dexamethason TAB 0.5MG, 21

diclofenac TAB 25MG DR, 54

Depakote TAB 250MG DR, 44

dexamethason TAB 0.75MG, 21

diclofenac TAB 50MG DR, 54

Depakote TAB 500MG DR, 44

dexamethason TAB 1.5MG, 21

diclofenac TAB 75MG DR, 54

Depen Titra TAB 250MG, 66

Dexamethason TAB 1MG, 21

dicloxacill CAP 250MG, 1

Depo-estradi Inj 5MG/ML, 22

Dexamethason TAB 2MG, 21

dicloxacill CAP 500MG, 1

Depo-medrol Inj 20MG/ML, 21

dexamethason TAB 4MG, 21

dicyclomine CAP 10MG, 30

Depo-medrol Inj 40MG/ML, 22

dexamethason TAB 6MG, 21

dicyclomine inj 10MG/ML, 30

Depo-medrol Inj 80MG/ML, 22

Dexedrine CAP 10MG CR, 42

dicyclomine sol 10MG/5ML, 30

Depo-provera Inj 150MG/ML, 24

Dexedrine CAP 15MG CR, 42

dicyclomine TAB 20MG, 30

Depo-provera Inj 400/ML, 7

Dexedrine CAP 5MG CR, 42

didanosine CAP 125MG, 3

Depo-sq Prov Inj 104, 24

dexedrine TAB 10MG, 41

didanosine CAP 200MG, 3

Depo-testost Inj 100MG/ML, 22

dexedrine TAB 5MG, 41

didanosine CAP 250MG, 3

Depo-testost Inj 200MG/ML, 22

Dexeryl CRE, 20

didanosine CAP 400MG, 3

Derma-smooth Oil /FS Body, 19

Dexilant CAP 30MG DR, 31

Differin CRE 0.1%, 16

Derma-smooth Oil /FS Sclp, 19

Dexilant CAP 60MG DR, 31

Differin Gel 0.1%, 17

dermacinrx kit prizopak, 20

dexmethylph CAP 15MG ER, 42

Differin Gel 0.3%, 17

Dermasorb HC Kit 2%, 19

dexmethylph CAP 30MG ER, 42

Differin Lot 0.1%, 16

Dermatop CRE 0.1%, 19

dexmethylph CAP 40MG ER, 42

Dificid TAB 200MG, 2

Dermatop Oin 0.1%, 19

dexmethylph TAB 10MG, 41

difil-G fort liq 100-100, 57

Dermotic Oil 0.01%, 50

dexmethylph TAB 2.5MG, 41

Diflorasone CRE 0.05%, 19

Descovy TAB 200/25, 4

dexmethylph TAB 5MG, 41

Diflorasone Oin 0.05%, 19

desipramine TAB 100MG, 37

dexmethylphe CAP 10MG ER, 42

Diflucan Sus 10MG/ML, 3

desipramine TAB 10MG, 37

dexmethylphe CAP 20MG ER, 42

Diflucan Sus 40MG/ML, 3

desipramine TAB 150MG, 37

dexmethylphe CAP 5MG ER, 42

Diflucan TAB 100MG, 3

desipramine TAB 25MG, 37

dexmethylphe CAP ER 25MG, 42

Diflucan TAB 150MG, 3

desipramine TAB 50MG, 37

dexmethylphe CAP ER 35MG, 42

Diflucan TAB 200MG, 3

desipramine TAB 75MG, 37

Dexpak PAK 10 Day, 22

Diflucan TAB 50MG, 3

Desloratadin TAB 2.5 Odt, 56

Dexpak PAK 13 Day, 22

diflunisal TAB 500MG, 50

desloratadin TAB 5MG, 56

Dexpak PAK 6 Day, 22

digitek TAB 0.125MG, 8

Desloratadin TAB 5MG Odt, 56

dextroamphet CAP 10MG ER, 41

digitek TAB 0.25MG, 8

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digox TAB 0.125MG, 8

Diprolene Lot 0.05%, 19

doxycycl HYC TAB 150MG DR, 2

digox TAB 0.25MG, 8

Diprolene Oin 0.05%, 19

doxycycl HYC TAB 200MG DR, 2

digoxin inj 0.25MG/1, 8

dipyridamole TAB 25MG, 36

doxycycl HYC TAB 50MG DR, 2

Digoxin Sol 50mcg/ML, 8

dipyridamole TAB 50MG, 36

doxycycl HYC TAB 75MG DR, 2

digoxin TAB 0.125MG, 8

dipyridamole TAB 75MG, 36

Doxycycline CAP 40MG, 17

digoxin TAB 0.25MG, 8

Disalcid TAB 500MG, 51

doxycycline sus 25MG/5ML, 2

Dihydrocod/ CAP Asa/Caff, 53

Disalcid TAB 750MG, 51

doxycycline TAB 150MG, 2

dihydroergot inj 1MG/ML, 55

disopyramide CAP 100MG, 10

doxycycline TAB 75MG, 2

Dihydroergot Spr 4MG/ML, 55

disopyramide CAP 150MG, 10

Drisdol CAP 50000unt, 59

Dilantin CAP 100MG, 44

disulfiram TAB 250MG, 45

Dritho-creme CRE HP 1%, 18

Dilantin CAP 30MG, 43

disulfiram TAB 500MG, 45

dronabinol CAP 10MG, 31

Dilantin Chw 50MG, 44

Ditropan XL TAB 10MG, 33

dronabinol CAP 2.5MG, 31

Dilantin-125 Sus 125/5ML, 44

Ditropan XL TAB 15MG, 33

dronabinol CAP 5MG, 31

Dilatrate SR CAP 40MG, 8

Ditropan XL TAB 5MG, 33

Droplet Lanc Mis 30G, 61

Dilaudid Inj 1MG/ML, 53

Diuril Sus 250/5ML, 14

Droplet Lanc Mis Device, 61

Dilaudid Inj 2MG/ML, 53

divalproex CAP 125MG, 43

drospir/ethi TAB 3-0.03MG, 23

Dilaudid Inj 4MG/ML, 53

divalproex TAB 125MG DR, 43

drospire/ETH TAB estr/lev, 23

Dilaudid Liq 1MG/ML, 53

divalproex TAB 250MG DR, 43

drospirenone TAB ethy est, 23

Dilaudid TAB 2MG, 53

divalproex TAB 250MG ER, 43

Droxia CAP 200MG, 35

Dilaudid TAB 4MG, 53

divalproex TAB 500MG DR, 43

Droxia CAP 300MG, 35

Dilaudid TAB 8MG, 53

divalproex TAB 500MG ER, 43

Droxia CAP 400MG, 35

dilt-XR CAP 120MG, 9

Divigel Gel 0.25MG, 23

Drysol Sol 20%, 20

dilt-XR CAP 180MG, 9

Divigel Gel 0.5MG, 23

Duac Gel 1.2-5%, 17

dilt-XR CAP 240MG, 9

Divigel Gel 1MG/Gm, 23

Duavee TAB 0.45-20, 23

diltiazem CAP 120MG CD, 9

dofetilide CAP 125mcg, 11

ducodyl TAB 5MG EC, 29

diltiazem CAP 120MG ER, 9

dofetilide CAP 250mcg, 11

Duetact TAB 30-2MG, 26

diltiazem CAP 120MG/24, 10

dofetilide CAP 500mcg, 11

Duetact TAB 30-4MG, 26

diltiazem CAP 180MG CD, 10

Dolophine TAB 10MG, 53

Duexis TAB 800-26.6, 54

diltiazem CAP 180MG ER, 10

Dolophine TAB 5MG, 53

dulcolax pow balance, 29

diltiazem CAP 180MG/24, 10

donepezil TAB 10MG, 45

Dulera Aer 100-5mcg, 57

diltiazem CAP 240MG CD, 10

donepezil TAB 10MG odt, 47

Dulera Aer 200-5mcg, 57

diltiazem CAP 240MG ER, 10

donepezil TAB 5MG, 45

duloxetine CAP 20MG, 37

diltiazem CAP 240MG/24, 10

donepezil TAB 5MG odt, 47

duloxetine CAP 30MG, 37

diltiazem CAP 300MG CD, 10

donepezil TAB HCL 23MG, 47

Duloxetine CAP 40MG, 38

diltiazem CAP 300MG ER, 10

Doral TAB 15MG, 41

duloxetine CAP 60MG, 37

diltiazem CAP 300MG/24, 10

Doryx Mpc TAB 120MG, 2

Duo-care Liq Level1/2, 61

diltiazem CAP 360MG CD, 10

Doryx TAB 200MG, 2

Duopa Sus 4.63-20, 45

diltiazem CAP 360MG ER, 10

Doryx TAB 50MG, 2

Duragesic Dis 100mcg/H, 53

diltiazem CAP 360MG/24, 10

dorzol/timol sol 22.3-6.8, 49

Duragesic Dis 12mcg/HR, 53

diltiazem CAP 420MG/24, 10

dorzolamide sol 2% op, 50

Duragesic Dis 25mcg/HR, 53

diltiazem CAP 60MG ER, 10

Dovonex CRE 0.005%, 18

Duragesic Dis 50mcg/HR, 53

diltiazem CAP 90MG ER, 10

doxazosin TAB 1MG, 12

Duragesic Dis 75mcg/HR, 53

diltiazem ER TAB 180MG, 10

doxazosin TAB 2MG, 12

Duraxin CAP, 51

diltiazem ER TAB 240MG, 10

doxazosin TAB 4MG, 12

Durezol Emu 0.05%, 49

diltiazem ER TAB 300MG, 10

doxazosin TAB 8MG, 12

Durlaza CAP 162.5MG, 36

diltiazem ER TAB 360MG, 10

doxepin HCL CAP 100MG, 37

dutast/tamsu CAP 0.5-0.4, 34

diltiazem ER TAB 420MG, 10

doxepin HCL CAP 10MG, 37

dutasteride CAP 0.5MG, 34

diltiazem TAB 120MG, 10

doxepin HCL CAP 150MG, 37

Dutoprol TAB 100-12.5, 13

diltiazem TAB 30MG, 10

doxepin HCL CAP 25MG, 37

Dutoprol TAB 25-12.5, 13

diltiazem TAB 60MG, 10

doxepin HCL CAP 50MG, 37

Dutoprol TAB 50-12.5, 13

diltiazem TAB 90MG, 10

doxepin HCL CAP 75MG, 37

Duzallo TAB 200-200, 55

Dimenhydrin Inj 50MG/ML, 31

doxepin HCL CON 10MG/ML, 37

Duzallo TAB 200-300, 55

Diovan HCT TAB 160-12.5, 13

Doxepin HCL CRE 5%, 18

Dyanavel XR Sus 2.5MG/ML, 42

Diovan HCT TAB 160-25MG, 13

doxercalcif CAP 0.5mcg, 28

Dyazide CAP 37.5-25, 14

Diovan HCT TAB 320-12.5, 13

doxercalcif CAP 1mcg, 28

Dymista Spr 137-50, 56

Diovan HCT TAB 320-25MG, 13

doxercalcif CAP 2.5mcg, 28

Dyrenium CAP 100MG, 14

Diovan HCT TAB 80/12.5, 13

doxycyc mono CAP 100MG, 2

Dyrenium CAP 50MG, 14

Diovan TAB 160MG, 12

doxycyc mono CAP 150MG, 2

E

Diovan TAB 320MG, 12

doxycyc mono CAP 50MG, 2

E-z Ject Mis 21G, 61

Diovan TAB 40MG, 12

doxycyc mono CAP 75MG, 2

E-z Ject Mis 21G Colr, 61

Diovan TAB 80MG, 12

doxycyc mono TAB 100MG, 2

E-z Ject Mis 30G, 61

Dip/Tet PED Inj 25-5lfu, 58

doxycyc mono TAB 150MG, 2

E-z Ject Mis 32G Colr, 61

Dipentum CAP 250MG, 32

doxycyc mono TAB 50MG, 2

E-z Ject Mis Lanc 21G, 61

Diphen/Atrop Liq 2.5/5, 30

doxycyc mono TAB 75MG, 2

E-z Ject Mis Lancets, 61

diphen/atrop TAB 2.5MG, 30

doxycycl HYC CAP 100MG, 2

E-z Ject Mis Thin 26G, 61

diphenhydram elx 12.5/5ML, 56

doxycycl HYC CAP 50MG, 2

E-z Spacer Mis, 66

diphenhydram inj 50MG/ML, 56

doxycycl HYC TAB 100MG, 2

E-z Spacer Mis Body Grd, 66

Diprolene AF CRE 0.05%, 19

doxycycl HYC TAB 100MG DR, 2

E-ZJECT Lanc Mis 33G, 61

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E.e.s. 400 TAB 400MG, 2

Edarbyclor TAB 40-12.5, 13

Emflaza TAB 36MG, 21

E.e.s. Gran Sus 200/5ML, 2

Edarbyclor TAB 40-25MG, 13

Emflaza TAB 6MG, 21

Easivent Mis, 66

Edecrin TAB 25MG, 14

Emla CRE 2.5-2.5%, 20

Easivent Mis Mask LG, 66

Edluar Sub 10MG, 41

emoquette TAB, 23

Easivent Mis Mask MED, 66

Edluar Sub 5MG, 41

empricaine kit 2.5-2.5%, 20

Easivent Mis Mask Sm, 66

Edurant TAB 25MG, 4

Emsam Dis 12MG/24h, 38

Easy Comfort Mis 30G, 61

eemt HS TAB, 22

Emsam Dis 6MG/24HR, 38

Easy Comfort Mis 31GX1/4", 61

eemt TAB 1.25-2.5, 22

Emsam Dis 9MG/24HR, 38

Easy Comfort Mis 31GX3/16, 61

Effexor XR CAP 150MG, 38

Emtriva CAP 200MG, 4

Easy Comfort Mis 31GX5/16, 61

Effexor XR CAP 37.5MG, 38

Emtriva Sol 10MG/ML, 4

Easy Comfort Mis 32GX5/32, 61

Effexor XR CAP 75MG, 38

Emulsion SB Emu, 20

Easy Comfort Mis Lanc/30G, 61

Effient TAB 10MG, 36

Emverm Chw 100MG, 5

Easy Mini Mis, 61

Effient TAB 5MG, 36

Enablex TAB 15MG, 33

Easy Mini Mis Eject, 61

Efudex CRE 5%, 6

Enablex TAB 7.5MG, 33

Easy Plus II Sol High, 61

Egrifta Sol 1MG, 27

enalapr/hctz TAB 10-25MG, 12

Easy Plus II Sol Low, 61

Eha Lot 4%, 20

enalapr/hctz TAB 5-12.5MG, 12

Easy Talk Sol High, 61

Elavil TAB 25MG, 38

enalapril TAB 10MG, 11

Easy Talk Sol Low, 61

Eldepryl CAP 5MG, 45

enalapril TAB 2.5MG, 11

Easy Talk Sol Normal, 61

Element Cont Liq Normal, 62

enalapril TAB 20MG, 11

Easy Touch Mis, 61

Element Liq High, 62

enalapril TAB 5MG, 11

Easy Touch Mis 29GX1/2", 61

Element Liq Low, 62

Enbrel Inj 25/0.5ML, 54

Easy Touch Mis 31GX1/4", 61

Elemnt Compa Sol Level 2, 62

Enbrel Inj 25MG, 54

Easy Touch Mis 31GX3/16, 61

Elemnt Compa Sol Level 3, 62

Enbrel Inj 50MG/ML, 54

Easy Touch Mis 31GX5/16, 61

Elestat Dro 0.05%, 50

Enbrel Srclk Inj 50MG/ML, 54

Easy Touch Mis 32GX1/4", 61

Elestrin Gel 0.06%, 23

Encare Sup 100MG, 33

Easy Touch Mis 32GX3/16, 61

Eletone CRE, 20

Endari Pow 5gm, 35

Easy Touch Mis 32GX5/32, 61

Eletone CRE Twinpack, 20

endocet TAB 10-325MG, 51

Easy Touch Mis 32GX5MM, 61

eletriptan TAB 20MG, 55

endocet TAB 2.5-325, 51

Easy Touch Mis 32GX6MM, 61

eletriptan TAB 40MG, 55

endocet TAB 5-325MG, 51

Easy Touch Mis Lanc/21G, 61

Elidel CRE 1%, 20

endocet TAB 7.5-325, 51

Easy Touch Mis Lanc/23G, 61

Eligard Inj 22.5MG, 6

Endometrin Sup 100MG, 33

Easy Touch Mis Lanc/26G, 61

Eligard Inj 30MG, 6

Enfamil Mis Expecta, 60

Easy Touch Mis Lanc/28G, 61

Eligard Inj 45MG, 6

Engerix-b Inj 10/0.5ML, 58

Easy Touch Mis Lanc/30G, 61

Eligard Inj 7.5MG, 6

Engerix-b Inj 20mcg/ML, 58

Easy Touch Mis Lanc/32G, 61

Elimite CRE 5%, 20

Enjuvia TAB 0.3MG, 23

Easy Touch Mis Lanc/33G, 61

elinest TAB, 23

Enjuvia TAB 0.45MG, 23

Easy Touch Sol Control, 61

Eliphos TAB 667MG, 32

Enjuvia TAB 0.625MG, 23

Easy Touch Sol High/Low, 61

Eliquis TAB 2.5MG, 36

Enjuvia TAB 0.9MG, 23

Easy Trak Sol High, 61

Eliquis TAB 5MG, 36

Enlon Inj 150/15ML, 48

Easy Trak Sol Low, 61

Elite Iron TAB 15MG, 35

enoxaparin inj 100MG/ML, 35

Easy Trak Sol Normal, 61

Elixophyllin Elx 80/15ML, 57

enoxaparin inj 120/0.8, 35

Easygluco Sol High, 61

Ella TAB 30MG, 24

enoxaparin inj 150MG/ML, 35

Easygluco Sol Low, 61

Elmiron CAP 100MG, 34

enoxaparin inj 30/0.3ML, 35

Easygluco Sol Normal, 61

Elocon CRE 0.1%, 19

enoxaparin inj 300/3ML, 35

Easygluco Sol Plus, 61

Elocon Lot 0.1%, 19

enoxaparin inj 40/0.4ML, 35

Easymax 15 Sol Level 1, 61

Elocon Oin 0.1%, 19

enoxaparin inj 60/0.6ML, 35

Easymax 15 Sol Level 2, 62

Emadine Sol 0.05% Op, 50

enoxaparin inj 80/0.8ML, 35

Easymax 15 Sol Level1-2, 62

Embeda CAP 100-4MG, 53

enpresse-28 TAB, 23

Easymax Sol High, 61

Embeda CAP 20-0.8MG, 53

enskyce TAB, 23

Easymax Sol Low, 61

Embeda CAP 30-1.2MG, 53

Enstilar Aer, 19

Easymax Sol Norm/Low, 61

Embeda CAP 50-2MG, 53

entacapone TAB 200MG, 44

Easymax Sol Normal, 61

Embeda CAP 60-2.4MG, 53

entecavir TAB 0.5MG, 3

Easystep Hgh Sol Control, 62

Embeda CAP 80-3.2MG, 53

entecavir TAB 1MG, 3

Easystep Low Sol Control, 62

Embrace Cntr Liq High, 62

Entereg CAP 12MG, 32

Easytest II Mis Lancets, 62

Embrace Evo Liq Level 1, 62

enteric asa TAB 325MG, 50

Easytest Mis Lancets, 62

Embrace Evo Liq Level 2, 62

Entocort EC CAP 3MG DR, 21

EC-naprosyn TAB 375MG, 55

Embrace Lanc Mis Thin 30G, 62

Entresto TAB 24-26MG, 15

EC-naprosyn TAB 500MG, 55

Embrace Pro Liq Glucose, 62

Entresto TAB 49-51MG, 15

econazole CRE 1%, 17

Embrace Sol Low, 62

Entresto TAB 97-103MG, 15

econtra EZ TAB 1.5MG, 23

Emcyt CAP 140MG, 6

Entty Emu Spray, 20

ecotrin low TAB 81MG EC, 50

Emend CAP 125MG, 31

enulose sol 10gm/15, 32

ecotrin TAB 325MG, 50

Emend CAP 40MG, 31

Envarsus XR TAB 0.75MG, 7

Ecotrin TAB 325MG EC, 51

Emend CAP 80MG, 31

Envarsus XR TAB 1MG, 7

Ecoza Aer 1%, 17

Emend Sus 125MG, 31

Envarsus XR TAB 4MG, 7

ecpirin TAB 325MG EC, 50

Emend Tripac PAK 80 & 125, 31

Epaned Sol 1MG/ML, 11

ed-spaz TAB 0.125MG, 30

Emflaza Sus 22.75/ML, 21

Epclusa TAB 400-100, 4

Edarbi TAB 40MG, 12

Emflaza TAB 18MG, 21

Epiceram Emu, 20

Edarbi TAB 80MG, 12

Emflaza TAB 30MG, 21

Epiduo Forte Gel 0.3-2.5%, 17

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Epiduo Gel 0.1-2.5%, 17

eql nicotine gum 2MG strt, 46

estradiol TAB 0.5MG, 22

Epifoam Aer 1%, 19

eql nicotine gum 4MG, 46

estradiol TAB 10mcg, 33

epinastine dro 0.05%, 50

eql nicotine gum 4MG ref, 46

estradiol TAB 1MG, 22

Epinephrine Inj 0.15MG, 14

eql nicotine gum 4MG strt, 46

estradiol TAB 2MG, 22

epinephrine inj 0.1MG/ML, 14

eql nicotine loz 2MG, 46

Estring Mis 2MG, 33

Epinephrine Inj 0.3MG, 14

eql nicotine loz 2MG mint, 46

estrog/mtest TAB 1.25-2.5, 22

epinephrine inj 1MG/ML, 14

eql nicotine loz 4MG chry, 46

Estrogel Gel, 23

Epinephrine Inj 1MG/ML, 14

eql nicotine loz 4MG mint, 46

Estropipate TAB 0.75MG, 22

Epinphephrin Kit Snap-v, 14

Eql Prenatal TAB Formula, 60

Estropipate TAB 1.5MG, 22

Epipen 2-PAK Inj 0.3MG, 14

eql vitamin CAP d3, 59

Estropipate TAB 3MG, 22

Epipen-JR Inj 2-PAK, 14

Equetro CAP 100MG, 40

Estrostep FE TAB, 24

Episnap Kit, 14

Equetro CAP 200MG, 40

eszopiclone TAB 1MG, 40

epitol TAB 200MG, 43

Equetro CAP 300MG, 40

eszopiclone TAB 2MG, 40

Epivir HBV Sol 5MG/ML, 4

Ergoloid Mes TAB 1MG Oral, 47

eszopiclone TAB 3MG, 41

Epivir HBV TAB 100MG, 5

Ergomar Sub 2MG, 55

ethacrynic TAB acd 25MG, 13

Epivir Sol 10MG/ML, 5

ergot/caffen TAB 1-100MG, 55

ethambutol TAB 100MG, 3

Epivir TAB 150MG, 5

errin TAB 0.35MG, 23

ethambutol TAB 400MG, 3

Epivir TAB 300MG, 5

Ertaczo CRE 2%, 17

ethosuximide CAP 250MG, 43

eplerenone TAB 25MG, 12

ery pad 2%, 16

ethosuximide sol 250/5ML, 43

eplerenone TAB 50MG, 12

Ery-TAB Tab 250MG EC, 2

ethy ETH est TAB 1-35, 23

Epogen Inj 10000/ML, 34

Ery-TAB Tab 333MG EC, 2

Ethyl Chlor Aer Fine Pin, 20

Epogen Inj 2000/ML, 34

Ery-TAB Tab 500MG EC, 2

Ethyl Chlor Aer Fn Strm, 20

Epogen Inj 20000/ML, 34

ery/benzoyl gel 5-3%, 16

Ethyl Chlor Aer MED Jet, 20

Epogen Inj 3000/ML, 34

Erygel Gel 2%, 17

Ethyl Chlor Aer MED Strm, 20

Epogen Inj 4000/ML, 34

Eryped Sus 200/5ML, 2

Ethyl Chlor Aer Mist, 20

Eprosart Mes TAB 600MG, 12

Eryped Sus 400/5ML, 2

ethyl chlor aer spray, 20

Epy II Kit, 14

Erythrocin TAB 250MG, 2

Ethyl Chlor Aer Spray, 20

Epy Kit, 14

erythrom ETH sus 200/5ML, 2

ethynodiol TAB 1-50, 23

Epzicom TAB 600-300, 4

Erythrom ETH TAB 400MG, 2

Etidron Disd TAB 200MG, 27

eq aspirin TAB 325MG, 50

erythromycin CAP 250MG EC, 2

Etidron Disd TAB 400MG, 27

eq aspirin TAB 325MG EC, 50

erythromycin gel 2%, 16

etodolac CAP 200MG, 54

eq child asa chw 81MG, 50

erythromycin oin 5MG/gm, 48

etodolac CAP 300MG, 54

eq clearlax pow, 29

erythromycin oin op, 48

etodolac ER TAB 400MG, 54

eq nicotine dis 14MG/24h, 45

erythromycin pad 2%, 16

etodolac ER TAB 500MG, 54

eq nicotine dis 21MG/24h, 45

erythromycin sol 2%, 16

etodolac ER TAB 600MG, 54

eq nicotine dis 7MG/24HR, 45

Erythromycin TAB 250MG Bs, 2

etodolac TAB 400MG, 54

eq nicotine gum 2MG cinn, 45

Erythromycin TAB 500MG Bs, 2

etodolac TAB 500MG, 54

eq nicotine gum 2MG mint, 45

Esbriet CAP 267MG, 58

Etoposide CAP 50MG, 7

eq nicotine gum 2MG orig, 45

Esbriet TAB 267MG, 58

Eurax CRE 10%, 20

eq nicotine gum 2mgfruit, 45

Esbriet TAB 801MG, 58

Eurax Lot 10%, 20

eq nicotine gum 4MG cinn, 45

escitalopram sol 5MG/5ML, 37

Evamist Spr 1.53MG, 23

eq nicotine gum 4MG mint, 45

escitalopram TAB 10MG, 37

Evekeo TAB 10MG, 42

eq nicotine gum 4MG orig, 45

escitalopram TAB 20MG, 37

Evekeo TAB 5MG, 42

eq nicotine gum 4MG ref, 46

escitalopram TAB 5MG, 37

Evencar Mini Sol Normal, 62

eq nicotine gum 4MG strt, 46

esgic CAP, 51

Evencare G2 Sol Low/High, 62

eq nicotine gum 4mgfruit, 45

Esgic TAB, 51

Evencare G3 Sol Low/High, 62

eq nicotine loz 2MG cher, 46

esomepra MAG CAP 20MG DR, 30

Evencare Sol Liq Low/High, 62

eq nicotine loz 2MG cinn, 46

Esomeprazole CAP 24.65MG, 31

Evista TAB 60MG, 27

eq nicotine loz 2MG mint, 46

Esomeprazole CAP 49.3MG, 31

Evoclin Aer 1%, 17

eq nicotine loz 4MG chry, 46

est estrogen TAB mtest, 22

Evolution Sol Normal, 62

eq nicotine loz 4MG mint, 46

est estrogen TAB mtest HS, 22

Evotaz TAB 300-150, 4

eql aspirin chw 81MG, 50

estarylla TAB 0.25-35, 23

Evoxac CAP 30MG, 36

eql aspirin TAB 325MG, 50

estazolam TAB 1MG, 41

Evzio Inj, 54

eql aspirin TAB 325MG EC, 50

estazolam TAB 2MG, 41

Evzio Inj 2/0.4ML, 54

eql aspirin TAB 81MG EC, 50

estra/noreth TAB 0.5-0.1, 22

EX-LAX ultra TAB 5MG EC, 30

eql chld asa chw 81MG, 50

estra/noreth TAB 1-0.5MG, 22

Exalgo TAB 12MG, 53

eql clearlax pow, 29

Estrace TAB 0.5MG, 23

Exalgo TAB 16MG, 53

eql gentle TAB laxative, 29

Estrace TAB 1MG, 23

Exalgo TAB 32MG, 53

Eql Lancets Mis 21G Colr, 62

Estrace TAB 2MG, 23

Exalgo TAB 8MG, 53

Eql Lancets Mis 33G Colr, 62

Estrace Vag CRE 0.1MG/Gm, 33

Exelderm CRE 1%, 17

Eql Lancets Mis Thin 26G, 62

estrad val inj 200MG/5, 22

Exelderm Sol 1%, 17

Eql Lancets Mis Thin 30G, 62

estrad val inj 20MG/ML, 22

Exelon CAP 1.5MG, 47

eql laxative TAB 5MG EC, 29

estradiol dis 0.025MG, 22

Exelon CAP 3MG, 47

eql nicotine dis 14MG/24h, 46

estradiol dis 0.0375MG, 22

Exelon CAP 4.5MG, 47

eql nicotine dis 21MG/24h, 46

estradiol dis 0.05MG, 22

Exelon CAP 6MG, 47

eql nicotine dis 7MG/24HR, 46

estradiol dis 0.06MG, 22

Exelon Dis 13.3/24, 47

eql nicotine gum 2MG, 46

estradiol dis 0.075MG, 22

Exelon Dis 4.6MG/24, 47

eql nicotine gum 2MG ref, 46

estradiol dis 0.1MG, 22

Exelon Dis 9.5MG/24, 47

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exemestane TAB 25MG, 6

Fazaclo TAB 150 Odt, 40

Fentora TAB 400mcg, 52

Exforge TAB 10-160MG, 13

Fazaclo TAB 200 Odt, 40

Fentora TAB 600mcg, 52

Exforge TAB 10-320MG, 13

Fazaclo TAB 25MG Odt, 40

Fentora TAB 800mcg, 52

Exforge TAB 5-160MG, 13

FE Aspartate TAB, 35

Feosol TAB 200MG, 35

Exforge TAB 5-320MG, 13

FE sulfate TAB 27MG, 35

Feosol TAB 45MG, 35

Exforgeh/10- TAB 160-12.5, 13

FE TABS TAB 325MG EC, 35

feosol TAB 65MG, 34

Exforgeh/10- TAB 160-25, 13

feenamint TAB 5MG EC, 29

Fer-IN-sol Dro 15MG/ML, 35

Exforgeh/10- TAB 320-25, 13

felbamate sus 600/5ML, 43

fer-iron dro 15MG/ML, 34

Exforgeh/5- TAB 160-12.5, 13

felbamate TAB 400MG, 43

ferate TAB 27MG, 34

Exforgeh/5- TAB 160-25, 13

felbamate TAB 600MG, 43

fergon TAB 27MG, 34

Exjade TAB 125MG, 66

Felbatol Sus 600/5ML, 43

Fergon TAB 27MG, 35

Exjade TAB 250MG, 66

Felbatol TAB 400MG, 43

ferosul elx 220/5ML, 34

Exjade TAB 500MG, 66

Felbatol TAB 600MG, 43

Ferretts FE Chw 18MG, 35

Exoderm Lot 25-1%, 17

Feldene CAP 10MG, 55

Ferretts IPS Sol, 35

Extavia Inj 0.3MG, 47

Feldene CAP 20MG, 55

Ferretts TAB 325MG, 35

Extina Aer 2%, 17

felodipine TAB 10MG ER, 10

ferrex 150 CAP 150MG, 34

EZ Flu Shot Inj 2015-16, 58

felodipine TAB 2.5MG ER, 10

ferric x-150 CAP 150MG, 34

EZ Flu Shot Inj PF 14-15, 58

felodipine TAB 5MG ER, 10

Ferrimin 150 TAB, 35

EZ Flu Shot Kit 2015-16, 58

Fem PH Gel, 33

Ferriprox Sol 100MG/ML, 67

EZ Flu Shot Kit 2016-17, 58

Femara TAB 2.5MG, 6

Ferriprox TAB 500MG, 66

EZ Smart Mis Lancets, 62

Femcon FE Chw, 24

ferro-bob TAB 325MG, 34

EZ-lets 21G Mis Lancets, 62

Femhrt TAB 0.5-2.5, 23

ferrocite TAB 324MG, 34

EZ-lets 23G Mis Lancets, 62

feminine LAX TAB 5MG EC, 29

ferrotabs TAB, 34

EZ-lets 26G Mis Lancets, 62

Femiron TAB, 35

ferrous dro 15MG/ML, 34

EZ-lets 28G Mis Lancets, 62

Femring Mis 0.05/24h, 33

Ferrous Fum TAB 29MG, 35

EZ-lets 30G Mis Lancets, 62

Femring Mis 0.1MG/24, 33

ferrous fum TAB 324MG, 34

ezetim/simva TAB 10-10MG, 14

femynor TAB 0.25-35, 23

ferrous gluc TAB 225MG, 34

ezetim/simva TAB 10-20MG, 14

fenofibrate CAP 130MG, 14

Ferrous Gluc TAB 225MG, 35

ezetim/simva TAB 10-40MG, 14

fenofibrate CAP 134MG, 14

ferrous gluc TAB 240MG, 34

ezetim/simva TAB 10-80MG, 14

Fenofibrate CAP 150MG, 15

ferrous gluc TAB 324MG, 34

ezetimibe TAB 10MG, 14

fenofibrate CAP 200MG, 14

Ferrous Gluc TAB 324MG, 35

ezfe 200 CAP 200MG, 34

fenofibrate CAP 43MG, 14

ferrous sulf dro 15MG/ML, 34

F

Fenofibrate CAP 50MG, 15

ferrous sulf elx 220/5ML, 34

fenofibrate CAP 67MG, 14

Ferrous Sulf Syp 300/5ML, 35

fa-8 CAP 800mcg, 34

fenofibrate TAB 120MG, 15

Ferrous Sulf TAB 140MG, 35

fa-8 TAB 0.8MG, 34

fenofibrate TAB 145MG, 15

Ferrous Sulf TAB 324MG EC, 35

Fabior Aer 0.1%, 17

fenofibrate TAB 160, 14

ferrous sulf TAB 325MG, 34

Fabrazyme Inj 35MG, 28

fenofibrate TAB 160MG, 14

ferrous sulf TAB 325MG EC, 34

Fabrazyme Inj 5MG, 28

fenofibrate TAB 40MG, 15

ferrous sulf TAB 325MG fc, 34

Factive TAB 320MG, 3

fenofibrate TAB 48MG, 15

ferrous sulf TAB 5gr, 34

fallback TAB 1.5MG, 23

fenofibrate TAB 54MG, 14

ferrousul TAB 325MG, 34

falmina TAB, 23

fenofibric CAP 135MG DR, 15

Fetzima CAP 120MG, 38

famciclovir TAB 125MG, 5

fenofibric CAP 45MG DR, 15

Fetzima CAP 20MG, 38

famciclovir TAB 250MG, 5

Fenofibric TAB 105MG, 14

Fetzima CAP 40MG, 38

famciclovir TAB 500MG, 5

Fenofibric TAB 35MG, 14

Fetzima CAP 80MG, 38

famotidine sus 40MG/5ML, 30

Fenoglide TAB 120MG, 15

Fetzima CAP Titratio, 38

famotidine TAB 20MG, 30

Fenoglide TAB 40MG, 15

Fexmid TAB 7.5MG, 48

famotidine TAB 40MG, 30

Fenoprofen CAP 200MG, 55

Fiasp Flex Inj Touch, 25

Famvir TAB 125MG, 5

Fenoprofen CAP 400MG, 55

Fiasp Inj 100/ML, 25

Famvir TAB 250MG, 5

fenoprofen TAB 600MG, 54

Fibricor TAB 105MG, 15

Famvir TAB 500MG, 5

Fenortho CAP 200MG, 55

Fibricor TAB 35MG, 15

Fanapt PAK, 40

Fenortho CAP 400MG, 55

Fifty50 Mis 31GX3/16, 62

Fanapt TAB 10MG, 40

fentanyl dis 100mcg/h, 51

Fifty50 Mis 31GX5/16, 62

Fanapt TAB 12MG, 40

fentanyl dis 12mcg/HR, 51

Fifty50 Mis 31GX5MM, 62

Fanapt TAB 1MG, 40

fentanyl dis 25mcg/HR, 51

Fifty50 Mis Lanc Dev, 62

Fanapt TAB 2MG, 40

Fentanyl Dis 37.5mcg, 53

Fifty50 Pen Mis 31GX8MM, 62

Fanapt TAB 4MG, 40

fentanyl dis 50mcg/HR, 51

Fifty50 Pen Mis 32GX4MM, 62

Fanapt TAB 6MG, 40

Fentanyl Dis 62.5mcg, 53

Fifty50 Pen Mis 32GX6MM, 62

Fanapt TAB 8MG, 40

fentanyl dis 75mcg/HR, 51

Fifty50 Safe Mis Lancets, 62

Fareston TAB 60MG, 6

Fentanyl Dis 87.5mcg, 53

Fifty50 Sol 2.0, 62

Farxiga TAB 10MG, 26

fentanyl ot loz 1200mcg, 52

Finacea Aer 15%, 17

Farxiga TAB 5MG, 26

fentanyl ot loz 1600mcg, 52

Finacea Gel 15%, 17

Farydak CAP 10MG, 7

fentanyl ot loz 200mcg, 52

finasteride TAB 5MG, 34

Farydak CAP 15MG, 7

fentanyl ot loz 400mcg, 52

Fine 30 Mis, 62

Farydak CAP 20MG, 7

fentanyl ot loz 600mcg, 52

Fingerstix Mis Lancets, 62

Fastclix Mis Lancets, 62

fentanyl ot loz 800mcg, 52

Fioricet CAP, 51

fayosim TAB, 23

Fentora TAB 100mcg, 52

Fioricet CAP Codeine, 53

Fazaclo TAB 100 Odt, 40

Fentora TAB 200mcg, 52

Fiorinal CAP, 51

Fazaclo TAB 12.5 Odt, 40

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Fiorinal/Cod CAP 30MG, 53

fluocin acet oil ear0.01%, 50

Fluzone Quad Inj 2017-18, 58

Firazyr Inj 30MG/3ML, 36

fluocin acet oil scalp, 18

Fluzone Splt Inj 2015-16, 58

Firmagon Inj 120MG, 6

fluocin acet oin 0.025%, 18

FML Forte Sus 0.25% Op, 49

Firmagon Inj 80MG, 6

fluocin acet sol 0.01%, 18

FML Liquiflm Sus 0.1% Op, 49

First-baclof Sus 1, 48

fluocinonide CRE 0.05%, 18

FML Oin 0.1% Op, 49

First-baclof Sus 5 Kit, 48

fluocinonide CRE 0.1%, 19

Focalin TAB 10MG, 42

First-mouthw Sus Blm, 36

fluocinonide CRE e 0.05%, 18

Focalin TAB 2.5MG, 42

First-omepra Sus 2MG/ML, 31

fluocinonide gel 0.05%, 18

Focalin TAB 5MG, 42

Flagyl CAP 375MG, 6

fluocinonide oin 0.05%, 18

Focalin XR CAP 10MG, 42

Flagyl TAB 250MG, 6

fluocinonide sol 0.05%, 18

Focalin XR CAP 15MG, 42

Flagyl TAB 500MG, 6

fluoromethol sus 0.1% op, 49

Focalin XR CAP 20MG, 42

Flarex Sus 0.1% Op, 49

Fluoroplex CRE 1%, 6

Focalin XR CAP 25MG, 42

flavoxate TAB 100MG, 33

Fluorouracil CRE 0.5%, 6

Focalin XR CAP 30MG, 42

flecainide TAB 100MG, 10

fluorouracil CRE 5%, 6

Focalin XR CAP 35MG, 42

flecainide TAB 150MG, 10

fluorouracil dro 2%, 6

Focalin XR CAP 40MG, 42

flecainide TAB 50MG, 10

fluorouracil dro 5%, 6

Focalin XR CAP 5MG, 42

Flector Dis 1.3%, 18

Fluorouracil Sol 2%, 6

folic acid CAP 800mcg, 34

fleet laxati TAB 5MG EC, 29

Fluorouracil Sol 5%, 6

Folic Acid Inj 5MG/ML, 35

Flexichamber Mis, 66

fluoxetine CAP 10MG, 37

folic acid TAB 1000mcg, 34

Flexichamber Mis Mask Lrg, 66

Fluoxetine CAP 10MG, 45

folic acid TAB 1MG, 34

Flexichamber Mis Mask Sm, 66

fluoxetine CAP 20MG, 37

folic acid TAB 400mcg, 34

Flexin Pad .0375-5%, 20

Fluoxetine CAP 20MG, 45

folic acid TAB 800mcg, 34

Flolipid Sus 20MG/5ML, 15

fluoxetine CAP 40MG, 37

fondaparinux inj 10/0.8ML, 36

Flolipid Sus 40MG/5ML, 15

Fluoxetine CAP 90MG DR, 38

fondaparinux inj 2.5/0.5, 36

Flomax CAP 0.4MG, 34

fluoxetine sol 20MG/5ML, 37

fondaparinux inj 5/0.4ML, 36

Flovent Disk Aer 100mcg, 57

fluoxetine TAB 10MG, 37, 47

fondaparinux inj 7.5/0.6, 36

Flovent Disk Aer 250mcg, 57

fluoxetine TAB 20MG, 37, 47

Fora Control Sol High, 62

Flovent Disk Aer 50mcg, 57

Fluoxetine TAB 60MG, 38

Fora Control Sol Low, 62

Flovent HFA Aer 110mcg, 57

fluphenaz DE inj 25MG/ML, 39

Fora Control Sol Normal, 62

Flovent HFA Aer 220mcg, 57

Fluphenazine CON 5MG/ML, 39

Fora Lancets Mis 30G, 62

Flovent HFA Aer 44mcg, 57

Fluphenazine Elx 2.5/5ML, 39

Fora Mis Lancets, 62

Flowtuss Sol 2.5-200, 56

Fluphenazine Inj 2.5MG/ML, 39

Fora Mis Lancing, 62

Floxin Sol 0.3%, 50

fluphenazine TAB 10MG, 39

Foracare Gdh Sol High, 62

Fluad Inj 2016-17, 58

fluphenazine TAB 1MG, 39

Foracare Gdh Sol Low, 62

Fluad Inj 2017-18, 58

fluphenazine TAB 2.5MG, 39

Foracare Gdh Sol Normal, 62

Fluarix Quad Inj 2015-16, 58

fluphenazine TAB 5MG, 39

Foradil CAP Aerolize, 57

Fluarix Quad Inj 2016-17, 58

flurandrenol CRE 0.05%, 19

Forfivo XL TAB 450MG, 38

Fluarix Quad Inj 2017-18, 58

flurandrenol lot 0.05%, 19

Fortamet TAB 1000MG, 25

Flublok Sol 2015-16, 58

flurandrenol oin 0.05%, 19

Fortamet TAB 500MG, 25

Flublok Sol 2016-17, 58

Flurazepam CAP 15MG, 41

Fortaz Inj 1gm, 1

Flublok Sol 2017-18, 58

Flurazepam CAP 30MG, 41

Forteo Sol 600/2.4, 27

Flucelvax Inj 2015-16, 58

flurbiprofen sol 0.03% op, 50

Fortesta Gel 10MG/Act, 22

Fluclvx Quad Inj 2016-17, 58

Flurbiprofen Sol 0.03% Op, 50

Fortical Spr 200/Act, 27

Fluclvx Quad Inj 2017-18, 58

flurbiprofen TAB 100MG, 54

Fortiscare Sol Cntl HI, 62

fluconazole sus 10MG/ML, 3

flurbiprofen TAB 50MG, 54

Fortiscare Sol Cntl Low, 62

fluconazole sus 40MG/ML, 3

flutamide CAP 125MG, 6

Fortiscare Sol Cntl Nml, 62

fluconazole TAB 100MG, 3

fluticasone CRE 0.05%, 19

Fosamax + D TAB 70-2800, 27

fluconazole TAB 150MG, 3

Fluticasone Inh Salmeter, 57

Fosamax + D TAB 70-5600, 27

fluconazole TAB 200MG, 3

fluticasone lot 0.05%, 19

Fosamax TAB 70MG, 27

fluconazole TAB 50MG, 3

fluticasone oin 0.005%, 19

fosamprenavi TAB 700MG, 4

flucytosine CAP 250MG, 3

fluticasone spr 50mcg, 56

fosinop/hctz TAB 10/12.5, 12

flucytosine CAP 500MG, 3

fluvastatin CAP 20MG, 15

fosinop/hctz TAB 20/12.5, 12

fludrocort TAB 0.1MG, 21

fluvastatin CAP 40MG, 15

fosinopril TAB 10MG, 11

Flulaval Qua Inj 2014-15, 58

fluvastatin TAB 80MG ER, 15

fosinopril TAB 20MG, 11

Flulaval Qua Inj 2015-16, 58

Fluvirin Inj 2015-16, 58

fosinopril TAB 40MG, 11

Flulaval Qua Inj 2016-17, 58

Fluvirin Inj 2016-17, 58

Fosrenol Chw 1000MG, 32

Flulaval Qua Inj 2017-18, 58

Fluvirin Inj 2017-18, 58

Fosrenol Chw 500MG, 32

Flumadine TAB 100MG, 5

fluvoxamine CAP 100MG ER, 38

Fosrenol Chw 750MG, 32

Flumist Quad Sus 2015-16, 58

fluvoxamine CAP 150MG ER, 38

Fosrenol Pow 1000MG, 32

Flumist Quad Sus 2016-17, 58

fluvoxamine TAB 100MG, 37

Fosrenol Pow 750MG, 32

Flumist Quad Sus 2017-18, 58

fluvoxamine TAB 25MG, 37

Fragmin Inj 10000/ML, 36

Flunisolide Spr 0.025%, 56

fluvoxamine TAB 50MG, 37

Fragmin Inj 12500unt, 36

fluocin acet CRE 0.01%, 18

Fluzone HD Inj PF 15-16, 58

Fragmin Inj 15000unt, 36

fluocin acet CRE 0.025%, 18

Fluzone HD Inj PF 16-17, 58

Fragmin Inj 18000unt, 36

fluocin acet oil 0.01%, 50

Fluzone HD Inj PF 17-18, 58

Fragmin Inj 2500/0.2, 36

fluocin acet oil 0.01% sc, 18

Fluzone Quad Inj 15-16, 58

Fragmin Inj 5000/0.2, 36

fluocin acet oil 0.01%bdy, 18

Fluzone Quad Inj 2015-16, 58

Fragmin Inj 7500/0.3, 36

fluocin acet oil body, 18

Fluzone Quad Inj 2016-17, 58

Fragmin Inj 95000unt, 36

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Freestyle Liq Control, 62

Genotropin Inj 0.2MG, 27

Global 28G Mis Lancets, 62

Freestyle Mis Lancets, 62

Genotropin Inj 0.4MG, 27

Global 30G Mis Lancets, 62

Freestyle Mis Unistick, 62

Genotropin Inj 0.6MG, 27

Global Lanc Mis Device, 62

Freestyle Tes, 62

Genotropin Inj 0.8MG, 27

Gluc Control Liq Normal, 62

Frova TAB 2.5MG, 55

Genotropin Inj 1.2MG, 27

Gluc Control Sol, 62

frovatriptan TAB 2.5MG, 55

Genotropin Inj 1.4MG, 27

Gluc Control Sol Level 1, 62

Fulyzaq TAB 125MG, 30

Genotropin Inj 1.6MG, 27

Gluc Control Sol Level 2, 62

Furadantin Sus 25MG/5ML, 33

Genotropin Inj 1.8MG, 27

Gluc Control Sol Mid, 62

furosemide inj 100/10ML, 13

Genotropin Inj 12MG, 27

Gluc Control Sol Normal, 62

furosemide inj 10MG/ML, 13

Genotropin Inj 1MG, 27

Glucagen Inj Hypokit, 26

furosemide inj 20MG/2ML, 13

Genotropin Inj 2MG, 27

Glucagon Kit 1MG, 26

furosemide inj 40MG/4ML, 13

Genotropin Inj 5MG, 27

Glucocard 01 Liq Norm/Hgh, 62

furosemide sol 10MG/ML, 13

gentak oin 0.3% op, 48

Glucocard 01 Sol Normal, 62

Furosemide Sol 8MG/ML, 14

Gentak Oin 0.3% Op, 48

Glucocard Liq Level 1, 62

furosemide TAB 20MG, 13

gentamicin CRE 0.1%, 17

Glucocard Sol Normal, 62

furosemide TAB 40MG, 13

gentamicin inj 40MG/ML, 3

Glucocard Sol Shine, 62

furosemide TAB 80MG, 13

Gentamicin Oin 0.1%, 17

Glucocom Mis 28G, 62

Fuzeon Inj 90MG, 4

gentamicin oin 0.3% op, 48

Glucocom Mis 30G, 62

fyavolv TAB 0.5-2.5, 22

gentamicin sol 0.3% op, 48

Glucocom Mis 33G, 62

fyavolv TAB 1-5, 22

gentle laxat TAB 5MG EC, 30

Glucocom Tes High CON, 62

Fycompa Sus 0.5MG/ML, 44

Gentle-let Mis 26G, 62

Glucocom Tes Norm CON, 62

Fycompa TAB 10MG, 44

Gentle-let Mis 28G, 62

Glucolet 2 Mis Lancing, 62

Fycompa TAB 12MG, 44

Gentle-let Mis Lancets, 62

Glucophage TAB 1000MG, 25

Fycompa TAB 2MG, 44

Gentle-let Mis Platform, 62

Glucophage TAB 500MG, 25

Fycompa TAB 4MG, 44

gentlelax pow, 30

Glucophage TAB 500MG XR, 25

Fycompa TAB 6MG, 44

Genvoya TAB, 4

Glucophage TAB 750MG XR, 25

Fycompa TAB 8MG, 44

Geodon CAP 20MG, 40

Glucophage TAB 850MG, 26

G

Geodon CAP 40MG, 40

Glucose Cont Liq High/Low, 62

Geodon CAP 60MG, 40

Glucose Cont Sol High, 62

gabapentin CAP 100MG, 43

Geodon CAP 80MG, 40

Glucose Cont Sol Normal, 62

gabapentin CAP 300MG, 43

Geodon Inj 20MG, 40

Glucose Cont Sol Precisio, 62

gabapentin CAP 400MG, 43

geri-hydrola CRE 12%, 20

Glucosource Mis Lanc Dev, 62

gabapentin sol 250/5ML, 43

geri-hydrola lot 5%, 20

Glucosource Mis Lancets, 62

gabapentin sol 300/6ML, 43

gianvi TAB 3-0.02MG, 23

Glucotrol TAB 10MG, 25

gabapentin TAB 600MG, 43

Giazo TAB 1.1gm, 32

Glucotrol TAB 5MG, 25

gabapentin TAB 800MG, 43

gildagia TAB 0.4-35, 23

Glucotrol XL TAB 10MG, 25

Gabitril TAB 12MG, 44

gildess 24 TAB FE 1/20, 23

Glucotrol XL TAB 2.5MG, 25

Gabitril TAB 16MG, 44

gildess FE TAB 1.5/30, 23

Glucotrol XL TAB 5MG, 25

Gabitril TAB 2MG, 44

gildess FE TAB 1/20, 23

Glucovance TAB 2.5-500, 26

Gabitril TAB 4MG, 44

gildess TAB 1.5/30, 23

Glucovance TAB 5-500MG, 26

galantamine CAP 16MG ER, 45

gildess TAB 1/20, 23

Glumetza TAB 1000MG, 26

galantamine CAP 24MG ER, 45

Gilenya CAP 0.5MG, 47

Glumetza TAB 500MG, 26

galantamine CAP 8MG ER, 45

Gilotrif TAB 20MG, 7

glyb/metform TAB 1.25-250, 26

Galantamine Sol 4MG/ML, 45

Gilotrif TAB 30MG, 7

glyb/metform TAB 2.5-500, 26

galantamine TAB 12MG, 45

Gilotrif TAB 40MG, 7

glyb/metform TAB 5-500MG, 26

galantamine TAB 4MG, 45

glatiramer inj 20MG/ML, 47

glyburid mcr TAB 1.5MG, 25

galantamine TAB 8MG, 45

glatiramer inj 40MG/ML, 47

glyburid mcr TAB 3MG, 25

Gardasil 9 Inj, 58

glatopa inj 20MG/ML, 47

glyburid mcr TAB 6MG, 25

Gardasil Inj, 58

Gleevec TAB 100MG, 7

glyburide TAB 1.25MG, 25

Gastrocrom CON 100/5ML, 32

Gleevec TAB 400MG, 7

glyburide TAB 2.5MG, 25

gatifloxacin sol 0.5%, 48

Gleostine CAP 100MG, 6

glyburide TAB 5MG, 25

Gattex Kit 5MG, 32

Gleostine CAP 10MG, 6

glycolax pow 3350 NF, 30

gavilax pow, 29

Gleostine CAP 40MG, 6

glycopyrrol inj 0.2MG/ML, 30

gavilyte-c sol, 29

Gleostine CAP 5MG, 6

glycopyrrol inj 0.4/2ML, 30

gavilyte-G sol, 29

glimepiride TAB 1MG, 25

glycopyrrol inj 1MG/5ML, 30

gavilyte-h kit, 30

glimepiride TAB 2MG, 25

glycopyrrol inj 4MG/20ML, 30

gavilyte-n sol flav pk, 29

glimepiride TAB 4MG, 25

glycopyrrol TAB 1MG, 30

Ge100 Contrl Sol Normal, 62

glip/metform TAB 2.5-250m, 26

glycopyrrol TAB 2MG, 30

Gebauers Spr Aer /Stretch, 20

glip/metform TAB 2.5-500m, 26

glydo gel 2%, 20

Gelnique Gel 10%, 33

glip/metform TAB 5-500MG, 26

Glynase TAB 1.5MG, 25

Gelnique Gel 10% P.M., 33

glipizide ER TAB 10MG, 25

Glynase TAB 3MG, 25

Gelnique Gel 3%, 33

glipizide ER TAB 2.5MG, 25

Glynase TAB 6MG, 25

gemfibrozil TAB 600MG, 14

glipizide ER TAB 5MG, 25

Glyset TAB 100MG, 26

Generess FE Chw, 24

glipizide TAB 10MG, 25

Glyset TAB 25MG, 26

generlac sol 10gm/15, 32

glipizide TAB 5MG, 25

Glyset TAB 50MG, 26

gengraf CAP 100MG, 7

glipizide XL TAB 10MG, 25

Glyxambi TAB 10-5 MG, 26

gengraf CAP 25MG, 7

glipizide XL TAB 2.5MG, 25

Glyxambi TAB 25-5 MG, 26

gengraf CAP 50MG, 7

glipizide XL TAB 5MG, 25

Gmate Contro Sol Level 2, 62

gengraf sol 100MG/ML, 7

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Gmate Lancet Mis 30G, 62

Haemolance Mis High FLO, 62

HM nicotine dis 14MG/24h, 47

Gmate Lancin Mis Device, 62

Haemolance Mis Low Flow, 62

HM nicotine dis 21MG/24h, 47

gnp aspirin chw 81MG, 50

Haemolance Mis Plus, 62

HM nicotine gum 2MG mint, 47

gnp aspirin TAB 325MG, 50

Haemolance Mis Plus Low, 62

HM nicotine gum 4MG mint, 47

gnp aspirin TAB 325MG EC, 50

Haemolance Mis Plus Max, 62

HM nicotine loz 2MG mint, 47

gnp aspirin TAB 81MG EC, 50

Haemolance Mis Plus PED, 62

HM nicotine loz 4MG mint, 47

gnp bisa-LAX TAB 5MG EC, 30

Haemolance Mis Retract, 62

HM One Daily Mis Prenatal, 60

gnp clearlax pow, 30

Halcion TAB 0.25MG, 41

HM Prenatal TAB, 60

gnp d CAP 1000unit, 59

Haldol Decan Inj 100MG/ML, 40

HM vit d3 CAP 2000unit, 59

gnp d chw 2000unit, 59

Haldol Decan Inj 50MG/ML, 40

HM vitamin d TAB 1000unit, 59

Gnp Daily Mis Prenatal, 60

Haldol Inj 5MG/ML, 40

Hold Chamber Mis Adlt LG, 66

gnp iron TAB 325MG, 34

halobetasol CRE 0.05%, 18

Hold Chamber Mis Medium, 66

gnp iron TAB 45MG, 34

halobetasol oin 0.05%, 18

Hold Chamber Mis Small, 66

gnp iron TAB 65MG, 34

Halog CRE 0.1%, 19

homatropaire sol 5% op, 49

Gnp Lancets Mis, 62

Halog Oin 0.1%, 19

homatropine sol 5% op, 49

Gnp Lancets Mis 21G, 62

haloper DEC inj 100MG/ML, 39

Horizant TAB 300MG, 47

Gnp Lancets Mis Micro, 62

haloper DEC inj 50MG/ML, 39

Horizant TAB 600MG, 47

Gnp Lancets Mis Sup Thin, 62

haloper lac inj 5MG/ML, 39

HPR Aer, 21

Gnp Lancets Mis Thin, 62

haloperidol CON 2MG/ML, 39

HPR Plus Aer, 21

Gnp Lancets Mis Thin 26G, 62

haloperidol inj 50/10ML, 39

HPR Plus CRE, 21

gnp laxative TAB 5MG EC, 30

haloperidol inj 5MG/ML, 39

Humalog Inj 100/ML, 25

gnp nicotine dis 21MG/24h, 46

haloperidol TAB 0.5MG, 39

Humalog JR Inj 100/ML, 25

gnp nicotine dis 7MG/24HR, 46

haloperidol TAB 10MG, 39

Humalog Kwik Inj 100/ML, 25

gnp nicotine gum 2MG mint, 46

haloperidol TAB 1MG, 39

Humalog Kwik Inj 200/ML, 25

gnp nicotine gum 2MG orig, 46

haloperidol TAB 20MG, 39

Humalog Mix Inj 50/50, 25

gnp nicotine gum 4MG mint, 46

haloperidol TAB 2MG, 39

Humalog Mix Inj 50/50kwp, 25

gnp nicotine gum 4MG orig, 46

haloperidol TAB 5MG, 39

Humalog Mix Inj 75/25kwp, 25

gnp nicotine loz 2MG mint, 46

Halotin CRE 1%, 17

Humalog Mix Sus 75/25, 25

gnp nicotine loz 4MG mint, 46

Harvoni TAB 90-400MG, 4

Humatrope Inj 12MG, 27

gnp nicotine loz mini 2MG, 46

Havrix Inj 1440unit, 58

Humatrope Inj 24MG, 27

Gnp Prenatal TAB 28-0.8MG, 60

Havrix Inj 720unit, 58

Humatrope Inj 5MG, 27

gnp vit d TAB 1000unit, 59

HC butyrate CRE 0.1%, 19

Humatrope Inj 6MG, 27

gnp vit d TAB 5000unit, 59

HC butyrate oin 0.1%, 19

Humira Inj 10MG/0.2, 54

gnp vit d3 TAB 1000unit, 59

HC butyrate sol 0.1%, 19

Humira Kit 20MG/0.4, 54

Gocovri CAP 137MG, 45

HC Lancing Mis Device, 62

Humira Kit 40MG/0.8, 54

Gocovri CAP 68.5MG, 45

HC pramoxine CRE 2.5-1%, 19

Humira Pedia Inj Crohns, 54

Golytely Sol, 30

HC valerate CRE 0.2%, 19

Humira Pen Inj 40MG/0.8, 54

Golytely Sol Pineappl, 30

HC valerate oin 0.2%, 19

Humira Pen Inj Crohns, 54

Gonitro Pow 400mcg, 9

HC/acet acid sol otic, 50

Humira Pen Inj Psoriasi, 54

Goodsense Mis Lanc 30G, 62

Healthpro Sol High/Low, 62

Humulin Inj 70/30, 25

Goodsense Mis Lanc Dvc, 62

heather TAB 0.35MG, 23

Humulin Inj 70/30kwp, 25

Goodsense TAB 28-0.8MG, 60

Hectorol CAP 0.5mcg, 28

Humulin N Inj U-100, 25

Gralise Star Mis 300/600, 47

Hectorol CAP 1mcg, 28

Humulin N Inj U-100kwp, 25

Gralise TAB 300MG, 47

Hectorol CAP 2.5mcg, 28

Humulin R Inj U-100, 25

Gralise TAB 600MG, 47

Hemangeol Sol 4.28/ML, 9

Humulin R Inj U-500, 25

granisetron TAB 1MG, 31

hemmorex-HC sup 25MG, 32

hyaluronate gel 0.2%, 20

Granix Inj 300/0.5, 35

hemmorex-HC sup 30MG, 32

Hycamtin CAP 0.25MG, 8

Granix Inj 480/0.8, 35

Hemocyte TAB 324MG, 35

Hycamtin CAP 1MG, 8

Grifulvin V TAB 500MG, 3

heparin sod inj 1000/ML, 35

Hycet Sol 7.5-325, 53

Gris-peg TAB 125MG, 3

heparin sod inj 10000/ML, 35

Hycofenix Sol, 56

Gris-peg TAB 250MG, 3

heparin sod inj 5000/0.5, 35

HYD pol/CPM sus 10-8/5ML, 56

griseofulvin sus 125/5ML, 3

heparin sod inj 5000/ML, 35

hydr/CPM/PSE liq 5-4-60MG, 56

griseofulvin TAB micr 500, 3

Hepsera TAB 10MG, 4

hydralazine TAB 100MG, 12

griseofulvin TAB ultr 125, 3

Hetlioz CAP 20MG, 41

hydralazine TAB 10MG, 12

griseofulvin TAB ultr 250, 3

Hexalen CAP 50MG, 6

hydralazine TAB 25MG, 12

guanfacine TAB 1MG, 12

hgh-pot iron TAB 325MG, 34

hydralazine TAB 50MG, 12

guanfacine TAB 1MG ER, 41

Hiberix Sol 10mcg, 58

Hydrea CAP 500MG, 8

guanfacine TAB 2MG, 12

high potency TAB FE 27MG, 34

Hydro 35 Aer, 20

guanfacine TAB 2MG ER, 41

high potency TAB iron, 34

Hydro 40 Aer Foam, 20

guanfacine TAB 3MG ER, 41

Hiprex TAB 1gm, 33

hydro/chlor/ liq 5-4-60MG, 56

guanfacine TAB 4MG ER, 41

Hlthy Accnts Mis Lanc 30G, 62

hydroc/homat TAB 5-1.5MG, 56

Guanidine TAB 125MG, 48

HM aspirin chw 81MG, 51

hydrochlorot CAP 12.5MG, 13

Gynazole-1 CRE 2%, 33

HM aspirin TAB 325MG, 51

hydrochlorot TAB 12.5MG, 13

Gynol II Gel 3%, 33

HM clearlax pow, 30

hydrochlorot TAB 25MG, 13

H

HM iron TAB 45MG, 35

hydrochlorot TAB 50MG, 13

HM iron TAB 65MG, 35

hydroco/apap sol 7.5-325, 51

H.p. Acthar Inj 80unit, 28

HM laxative TAB 5MG, 30

hydroco/apap TAB 10-300MG, 52

Haegarda Inj 2000unit, 36

HM laxative TAB 5MG EC, 30

hydroco/apap TAB 10-325MG, 51

Haegarda Inj 3000unit, 36

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hydroco/apap TAB 2.5-325, 52

Hysingla ER TAB 30 MG, 53

Indocin Sup 50MG, 55

hydroco/apap TAB 5-300MG, 52

Hysingla ER TAB 40 MG, 53

Indocin Sus 25MG/5ML, 55

hydroco/apap TAB 5-325MG, 51

Hysingla ER TAB 60 MG, 53

indomethacin CAP 25MG, 54

hydroco/apap TAB 7.5-300, 52

Hysingla ER TAB 80 MG, 53

indomethacin CAP 50MG, 54

hydroco/apap TAB 7.5-325, 51

Hyzaar TAB 100-12.5, 13

indomethacin CAP 75MG ER, 54

hydrocod/hom syp 5-1.5/5, 56

Hyzaar TAB 100-25, 13

Infanrix Inj, 58

hydrocod/ibu TAB 10-200MG, 52

Hyzaar TAB 50-12.5, 13

Infasurf Sus 35MG/ML, 58

hydrocod/ibu TAB 2.5-200, 52

I

Infinity Sol High CON, 62

hydrocod/ibu TAB 5-200MG, 52

Infinity Sol Low CON, 62

ibandronate TAB 150MG, 27

hydrocod/ibu TAB 7.5-200, 52

Infinity Sol Norm CON, 62

Ibrance CAP 100MG, 7

hydrocodone sol 10-325MG, 52

Inflectra Inj 100MG, 32

Ibrance CAP 125MG, 7

hydrocort ac sup 25MG, 32

Influenza Firus Vaccine, 58

Ibrance CAP 75MG, 7

hydrocort ac sup 30MG, 32

Ingrezza CAP 40MG, 47

Ibudone TAB 10-200MG, 53

hydrocort CRE 1%, 19, 32

Inlyta TAB 1MG, 7

ibudone TAB 5-200MG, 52

hydrocort CRE 2.5%, 18

Inlyta TAB 5MG, 7

ibuprofen sus 100/5ML, 54

hydrocort ene 100MG, 32

Innopran XL CAP 120MG, 9

ibuprofen TAB 400MG, 54

hydrocort lot 2.5%, 18

Innopran XL CAP 80MG, 9

ibuprofen TAB 600MG, 54

hydrocort oin 1%, 18

Inspirachamb Mis Large, 66

ibuprofen TAB 800MG, 54

hydrocort oin 2.5%, 18

Inspirachamb Mis Medium, 66

Icar Peds Sus Grape, 35

hydrocort TAB 10MG, 21

Inspirachamb Mis Mouthpce, 66

Iclusig TAB 15MG, 7

hydrocort TAB 20MG, 21

Inspirachamb Mis Small, 66

Iclusig TAB 45MG, 7

hydrocort TAB 5MG, 21

Inspirease Mis Dd Syst, 66

Idhifa TAB 100MG, 7

hydrocort/ab oin 1%, 18

Inspirease Mis Res Bag, 66

Idhifa TAB 50MG, 7

hydrocortiso CRE 2.5%, 32

Inspra TAB 25MG, 12

iferex 150 CAP, 34

hydromet syp 5-1.5/5, 56

Inspra TAB 50MG, 12

Ilevro Dro 0.3% Op, 50

hydromorphon inj 1MG/ML, 51

Insulin Pen Mis 29GX12MM, 62

ilotycin oin op, 48

hydromorphon inj 2MG/ML, 51

Insulin Pen Mis 31GX4MM, 62

imatinib mes TAB 100MG, 7

hydromorphon inj 4MG/ML, 51

Insulin Pen Mis 31GX8MM, 62

imatinib mes TAB 400MG, 7

hydromorphon liq 1MG/ML, 51

Insulin SYR Mis 0.3/31G, 63

Imbruvica CAP 140MG, 7

Hydromorphon Sup 3MG, 51

Insulin SYR Mis 0.5/31G, 63

imipram HCL TAB 10MG, 37

hydromorphon TAB 12MG ER, 52

Insulin SYR Mis 1ML/31G, 63

imipram HCL TAB 25MG, 37

hydromorphon TAB 16MG ER, 52

Insulin SYR Mis 31GX6MM, 63

imipram HCL TAB 50MG, 37

hydromorphon TAB 2MG, 51

Insulin Syrg Mis 0.3/28G, 62

imipram pam CAP 100MG, 38

hydromorphon TAB 32MG ER, 52

Insulin Syrg Mis 0.3/29G, 62

imipram pam CAP 125MG, 38

hydromorphon TAB 4MG, 51

Insulin Syrg Mis 0.3/30G, 62

imipram pam CAP 150MG, 38

hydromorphon TAB 8MG, 51

Insulin Syrg Mis 0.3/31G, 62

imipram pam CAP 75MG, 38

hydromorphon TAB 8MG ER, 52

Insulin Syrg Mis 0.5/27G, 62

imiquimod CRE 5%, 20

hydrosortiso oin absorbas, 19

Insulin Syrg Mis 0.5/28G, 62

Imitrex Inj 4MG/0.5, 55

hydroxychlor TAB 200MG, 5

Insulin Syrg Mis 0.5/29G, 62

Imitrex Inj 6MG/0.5, 55

hydroxyurea CAP 500MG, 8

Insulin Syrg Mis 0.5/30G, 62

Imitrex Spr 20MG/Act, 55

hydroxyz HCL syp 10MG/5ML, 37

Insulin Syrg Mis 0.5/31G, 62

Imitrex Spr 5MG/Act, 55

hydroxyz HCL TAB 10MG, 37

Insulin Syrg Mis 1ML, 62

Imitrex TAB 100MG, 55

hydroxyz HCL TAB 25MG, 37

Insulin Syrg Mis 1ML/25G, 62

Imitrex TAB 25MG, 55

hydroxyz HCL TAB 50MG, 37

Insulin Syrg Mis 1ML/26G, 62

Imitrex TAB 50MG, 55

Hydroxyz Pam CAP 100MG, 37

Insulin Syrg Mis 1ML/27G, 62

Impavido CAP 50MG, 5

hydroxyz pam CAP 25MG, 37

Insulin Syrg Mis 1ML/28G, 62

Imuran TAB 50MG, 7

hydroxyz pam CAP 50MG, 37

Insulin Syrg Mis 1ML/29G, 62

IN Control Mis 31GX5MM, 63

Hylatopic Aer Plus, 20

Insulin Syrg Mis 1ML/30G, 62

IN Control Mis 31GX6MM, 63

Hylatopic CRE Plus, 20

Insulin Syrg Mis 1ML/31G, 63

IN Control Mis 31GX8MM, 63

Hylira Gel 0.2%, 21

Insulin Syrg Mis 1MLX30G, 63

IN Touch Lan Mis 30G, 63

Hylira Lot 0.1%, 21

Insulin Syrg Mis 2/27.5G, 63

IN Touch Lan Mis Device, 63

hyolev mb TAB 81MG, 33

Insulin Syrg Mis 27GX1/2", 63

IN Touch Sol Glucose, 63

hyophen TAB, 33

Insulin Syrg Mis 28GX1/2", 63

Incontrol Mis 29GX12MM, 62

hyoscyamine dro 0.125/ML, 30

Insulin Syrg Mis 29GX1/2", 63

Incontrol Mis Lanc 28G, 62

hyoscyamine elx 0.125/5, 30

Insulin Syrg Mis 30GX1/2", 63

Incontrol Mis Lanc 30G, 62

hyoscyamine sub 0.125MG, 30

Insulin Syrg Mis 30GX5/16, 63

Incontrol Mis Lanc 33G, 62

hyoscyamine TAB 0.125MG, 30

Insulin Syrg Mis 30GX8MM, 63

Incontrol Mis Lanc Dev, 62

hyoscyamine TAB 0.375 ER, 30

Insulin Syrg Mis 31GX5/16, 63

Increlex Inj 40MG/4ML, 27

hyoscyamine TAB 0.375 SR, 30

Insulin Syrg Mis 31GX8MM, 63

Incruse Elpt Inh 62.5mcg, 57

hyosyne dro 0.125/ML, 30

Insupen Mis 29GX12MM, 63

indapamide TAB 1.25MG, 13

hyosyne elx 0.125/5, 30

Insupen Mis 31GX5MM, 63

indapamide TAB 2.5MG, 13

Hyper-sal Neb 7%, 56

Insupen Mis 31GX8MM, 63

Inderal LA CAP 120MG, 9

Hypersal Neb 3.5%, 56

Insupen Mis 32GX4MM, 63

Inderal LA CAP 160MG, 9

Hypersal Neb 7%, 56

Insupen Mis 33GX4MM, 63

Inderal LA CAP 60MG, 9

Hypolance Kit Lancing, 62

Insupen Sens Mis 32GX6MM, 63

Inderal LA CAP 80MG, 9

Hysingla ER TAB 100 MG, 53

Insupen Sens Mis 32GX8MM, 63

Inderal XL CAP 120MG, 9

Hysingla ER TAB 120 MG, 53

Insupen Ultr Mis 29GX12MM, 63

Inderal XL CAP 80MG, 9

Hysingla ER TAB 20 MG, 53

Insupen Ultr Mis 30GX8MM, 63

indiomin mb CAP 120MG, 33

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Insupen Ultr Mis 31GX6MM, 63

iron TAB 325MG, 34

jencycla TAB 0.35MG, 23

Insupen Ultr Mis 31GX8MM, 63

iron TAB 45MG, 34

Jentadueto TAB 2.5-1000, 26

Intelence TAB 100MG, 4

iron TAB 50MG ER, 34

Jentadueto TAB 2.5-500, 26

Intelence TAB 200MG, 4

iron TAB 65MG, 34

Jentadueto TAB 2.5-850, 26

Intelence TAB 25MG, 4

Iron Up Liq, 35

Jentadueto TAB XR, 26

Intermezzo Sub 1.75MG, 41

Isentress Chw 100MG, 4

jevantique l TAB 0.5-2.5, 22

Intermezzo Sub 3.5MG, 41

Isentress Chw 25MG, 4

jinteli TAB 1MG-5mcg, 22

Intrarosa Sup 6.5MG, 33

Isentress HD TAB 600MG, 4

jolessa TAB, 23

Intron A Inj 10mu, 8

Isentress Pow 100MG, 5

jolivette TAB 0.35MG, 23

Intron A Inj 18mu, 8

Isentress TAB 400MG, 4

Jublia Sol 10%, 17

Intron A Inj 25mu, 8

isibloom TAB 0.15-30, 23

juleber TAB, 23

Intron A Inj 50mu, 8

Isoniazid Syp 50MG/5ML, 3

junel 1.5/30 TAB, 23

introvale TAB, 23

isoniazid TAB 100MG, 3

junel 1/20 TAB, 23

Intuniv TAB 1MG, 42

isoniazid TAB 300MG, 3

junel FE 24 TAB 1/20, 23

Intuniv TAB 2MG, 42

isoproteren inj 0.2MG/ML, 57

junel FE TAB 1.5/30, 23

Intuniv TAB 3MG, 42

Isopto Carp Sol 1% Op, 49

junel FE TAB 1/20, 23

Intuniv TAB 4MG, 42

Isopto Carp Sol 2% Op, 49

just d liq 400unit, 59

Invanz Inj 1gm, 5

Isopto Carp Sol 4% Op, 49

Juxtapid CAP 10MG, 14

Invega Sust Inj 117/0.75, 39

Isordil TAB 40MG, 8

Juxtapid CAP 20MG, 14

Invega Sust Inj 156MG/ML, 39

Isordil TAB 5MG, 9

Juxtapid CAP 30MG, 14

Invega Sust Inj 234/1.5, 39

isosorb din TAB 10MG, 8

Juxtapid CAP 40MG, 14

Invega Sust Inj 39/0.25, 39

isosorb din TAB 20MG, 8

Juxtapid CAP 5MG, 14

Invega Sust Inj 78/0.5ML, 39

isosorb din TAB 30MG, 8

Juxtapid CAP 60MG, 14

Invega TAB 1.5MG, 40

Isosorb Din TAB 40MG ER, 9

K

Invega TAB 3MG, 40

isosorb din TAB 5MG, 8

k citrate sol citr acd, 34

Invega TAB 6MG, 40

isosorb mono TAB 10MG, 8

K-phos TAB NO 2, 34

Invega TAB 9MG, 40

isosorb mono TAB 120MG ER, 8

k/NA citrate sol citr acd, 34

Invega Trinz Inj 273MG, 40

isosorb mono TAB 20MG, 8

Kadian CAP 100MG ER, 53

Invega Trinz Inj 410MG, 40

isosorb mono TAB 30MG ER, 8

Kadian CAP 10MG ER, 53

Invega Trinz Inj 546MG, 40

isosorb mono TAB 60MG ER, 8

Kadian CAP 200MG ER, 53

Invega Trinz Inj 819MG, 40

isradipine CAP 2.5MG, 10

Kadian CAP 20MG ER, 53

Invirase CAP 200MG, 4

isradipine CAP 5MG, 10

Kadian CAP 30MG ER, 53

Invirase TAB 500MG, 4

Istalol Sol 0.5% Op, 49

Kadian CAP 40MG ER, 53

Invokamet TAB 150-1000, 26

Isuprel Inj 0.2MG/ML, 57

Kadian CAP 50MG ER, 53

Invokamet TAB 150-500, 26

itraconazole CAP 100MG, 3

Kadian CAP 60MG ER, 53

Invokamet TAB 50-1000, 26

ivermectin TAB 3MG, 5

Kadian CAP 80MG ER, 53

Invokamet TAB 50-500MG, 26

J

kaitlib FE chw, 23

Invokamet XR TAB 150-1000, 26

Jadenu Sprkl Gra 180MG, 66

Kaletra Sol, 5

Invokamet XR TAB 150-500, 26

Jadenu Sprkl Gra 360MG, 66

Kaletra TAB 100-25MG, 4

Invokamet XR TAB 50-1000, 26

Jadenu Sprkl Gra 90MG, 66

Kaletra TAB 200-50MG, 4

Invokamet XR TAB 50-500MG, 26

Jadenu TAB 180MG, 66

Kalydeco PAK 50MG, 58

Invokana TAB 100MG, 26

Jadenu TAB 360MG, 66

Kalydeco PAK 75MG, 58

Invokana TAB 300MG, 26

Jadenu TAB 90MG, 66

Kalydeco TAB 150MG, 58

Ionsys Pad 40mcg/Ac, 53

Jakafi TAB 10MG, 7

Kamdoy Emu, 21

Iopidine Sol 0.5% Op, 49

Jakafi TAB 15MG, 7

Kapvay TAB 0.1 MG, 42

Iopidine Sol 1% Op, 49

Jakafi TAB 20MG, 7

Karbinal ER Sus 4MG/5ML, 56

Ipol Inj Inactive, 58

Jakafi TAB 25MG, 7

kariva TAB 28 day, 23

ipratropium sol 0.02%inh, 57

Jakafi TAB 5MG, 7

Kazano 12.5- TAB 1000MG, 26

ipratropium spr 0.03%, 56

Jalyn CAP, 34

Kazano 12.5- TAB 500MG, 26

ipratropium spr 0.06%, 56

jantoven TAB 10MG, 35

Keflex CAP 250MG, 1

ipratropium/ sol albuter, 57

jantoven TAB 1MG, 35

Keflex CAP 500MG, 1

irbesar/hctz TAB 150-12.5, 12

jantoven TAB 2.5MG, 35

Keflex CAP 750MG, 1

irbesar/hctz TAB 300-12.5, 12

jantoven TAB 2MG, 35

kelnor TAB 1/35, 23

irbesartan TAB 150MG, 11

jantoven TAB 3MG, 35

Kenalog Aer Spray, 19

irbesartan TAB 300MG, 11

jantoven TAB 4MG, 35

Kenalog-10 Inj 10MG/ML, 22

irbesartan TAB 75MG, 11

jantoven TAB 5MG, 35

Kenalog-40 Inj 40MG/ML, 22

Iressa TAB 250MG, 7

jantoven TAB 6MG, 35

Keppra Sol 100MG/ML, 44

Iron Chews Chw Pediatri, 35

jantoven TAB 7.5MG, 35

Keppra TAB 1000MG, 44

Iron Chw Pediatri, 35

Janumet TAB 50-1000, 26

Keppra TAB 250MG, 44

Iron High CAP Potency, 35

Janumet TAB 50-500MG, 26

Keppra TAB 500MG, 44

iron slow TAB 45MG, 34

Janumet XR TAB 100-1000, 26

Keppra TAB 750MG, 44

iron supplem TAB 325MG, 34

Janumet XR TAB 50-1000, 26

Keppra XR TAB 500MG, 44

iron supplem TAB therapy, 34

Janumet XR TAB 50-500MG, 26

Keppra XR TAB 750MG, 44

iron supplmt dro 15MG/ML, 34

Januvia TAB 100MG, 26

Keralac CRE 47%, 21

Iron TAB 18MG, 35

Januvia TAB 25MG, 26

Keralyt Gel 6%, 21

Iron TAB 18MG CR, 35

Januvia TAB 50MG, 26

Kerydin Sol 5%, 17

iron TAB 27MG, 34

Jardiance TAB 10MG, 26

Ketek TAB 300MG, 6

Iron TAB 28MG, 35

Jardiance TAB 25MG, 26

Ketek TAB 400MG, 6

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ketoconazole aer 2%, 17

lactic acid CRE /vit e, 20

Lancets Micr Mis Thin 33G, 63

ketoconazole CRE 2%, 17

lactic acid CRE e, 20

Lancets Mis, 63

ketoconazole sha 2%, 17

lactic acid lot 10%, 20

Lancets Mis 21G, 63

ketoconazole TAB 200MG, 3

lactulose sol 10gm/15, 29, 32

Lancets Mis 21G Colr, 63

ketodan aer 2%, 17

lactulose sol 20gm/30, 29

lancets mis 23G, 60

Ketoprofen CAP 200MG ER, 55

Lamictal Chw 25MG, 44

Lancets Mis 23G, 63

ketoprofen CAP 50MG, 54

Lamictal Chw 5MG, 44

Lancets Mis 26G, 63

ketoprofen CAP 75MG, 54

Lamictal Kit Start 35, 44

Lancets Mis 28G, 63

ketorolac inj 15MG/ML, 54

Lamictal Kit Start 49, 44

Lancets Mis 30G, 63

ketorolac inj 30MG/ML, 54

Lamictal Kit Start 98, 44

Lancets Mis 31G, 63

ketorolac inj 60MG/2ML, 54

Lamictal Odt Kit, 44

Lancets Mis 33G, 63

ketorolac sol 0.4%, 50

Lamictal Odt TAB 100MG, 44

Lancets Mis Colored, 63

ketorolac sol 0.5%, 50

Lamictal Odt TAB 200MG, 44

Lancets Mis Orange, 63

ketorolac TAB 10MG, 54

Lamictal Odt TAB 25MG, 44

Lancets Mis Original, 63

Keveyis TAB 50MG, 14

Lamictal Odt TAB 50MG, 44

Lancets Mis Thin, 63

Kevzara Inj 150/1.14, 54

Lamictal TAB 100MG, 44

Lancets Mis Thin 26G, 63

Kevzara Inj 200/1.14, 54

Lamictal TAB 150MG, 44

Lancets Mis Thin 30G, 63

Khedezla TAB 100MG ER, 38

Lamictal TAB 200MG, 44

Lancets Supr Mis Thin 28G, 63

Khedezla TAB 50MG ER, 38

Lamictal TAB 25MG, 44

Lancets Thin Mis, 63

kimidess TAB, 23

Lamictal XR Kit, 44

Lancets Thin Mis 26G, 63

Kineret Inj, 54

Lamictal XR TAB 100MG, 44

Lancets Thin Mis 30G, 63

Kinney Mis Lancets, 63

Lamictal XR TAB 200MG, 44

Lancets Ultr Mis Thin, 63

Kinney Thin Mis Lancets, 63

Lamictal XR TAB 250MG, 44

Lancets Ultr Mis Thin 28G, 63

Kinrix Inj, 58

Lamictal XR TAB 25MG, 44

Lancets Ultr Mis Thin 30G, 63

Kisqali 200 PAK Femara, 8

Lamictal XR TAB 300MG, 44

Lancing Devi Mis, 63

Kisqali 400 PAK Femara, 8

Lamictal XR TAB 50MG, 44

Lancing Devi Mis 25G, 63

Kisqali 600 PAK Femara, 8

Lamisil Gra 125MG, 3

Lancing Devi Mis 30G, 63

Kisqali TAB 200dose, 7

Lamisil Gra 187.5MG, 3

Lancing Devi Mis Adjust, 63

Kisqali TAB 400dose, 7

Lamisil TAB 250MG, 3

Lancing Mis Device, 63

Kisqali TAB 600dose, 7

lamivud/zido TAB 150-300, 3

Lancing Pen Mis, 63

Kitabis PAK Neb 300/5ML, 3

lamivudine sol 10MG/ML, 3

Lanoxin Inj 0.25MG/1, 8

Klaron Lot 10%, 17

lamivudine TAB 100MG, 3

Lanoxin PED Inj 0.1MG/ML, 8

klofensaid sol II, 18

lamivudine TAB 150MG, 3

Lanoxin TAB 0.0625MG, 8

Klonopin TAB 0.5MG, 44

lamivudine TAB 300MG, 3

Lanoxin TAB 0.125MG, 8

Klonopin TAB 1MG, 44

lamotrig odt kit 25/50MG, 43

Lanoxin TAB 0.1875MG, 8

Klonopin TAB 2MG, 44

lamotrig odt kit 50/100MG, 43

Lanoxin TAB 0.25MG, 8

kls aspirin TAB 325MG EC, 50

lamotrig odt TAB 100MG, 43

lansopr/amox mis /clarith, 30

kls aspirin TAB 81MG EC, 50

lamotrigine chw 25MG, 43

lansoprazole CAP 15MG DR, 30

kls quit2 gum 2MG, 46

lamotrigine chw 5MG, 43

lansoprazole CAP 30MG DR, 30

kls quit2 loz 2MG, 46

lamotrigine kit odt, 43

Lansoprazole Sus 3MG/ML, 31

kls quit4 gum 4MG, 46

lamotrigine kit start 35, 43

lanthanum chw 1000MG, 32

kls quit4 loz 4MG, 46

lamotrigine kit start 49, 43

lanthanum chw 500MG, 32

Kombiglyz XR TAB 2.5-1000, 26

lamotrigine kit start 98, 43

lanthanum chw 750MG, 32

Kombiglyz XR TAB 5-1000MG, 26

lamotrigine TAB 100MG, 43

Lantus Inj 100/ML, 25

Kombiglyz XR TAB 5-500MG, 26

lamotrigine TAB 100MG ER, 43

Lantus Inj Solostar, 25

Korlym TAB 300MG, 26

lamotrigine TAB 150MG, 43

Lanzo Mis Lancing, 63

kp aspirin TAB 81MG EC, 50

lamotrigine TAB 200MG, 43

larin 24 TAB FE 1/20, 23

kp bisacodyl TAB 5MG EC, 30

lamotrigine TAB 200MG ER, 43

larin FE TAB 1.5/30, 23

Kp Prenatal TAB Multivit, 60

lamotrigine TAB 250MG ER, 43

larin FE TAB 1/20, 23

Kristalose PAK 10gm, 30

lamotrigine TAB 25MG, 43

larin TAB 1.5/30, 23

Kristalose PAK 20gm, 30

lamotrigine TAB 25MG ER, 43

larin TAB 1/20, 23

Kroger Lance Mis, 63

lamotrigine TAB 25MG odt, 43

larissia TAB, 23

Kroger Lance Mis Thin, 63

lamotrigine TAB 300MG ER, 43

Lasix TAB 20MG, 14

Kroger Lance Mis Thin 30G, 63

lamotrigine TAB 50MG ER, 43

Lasix TAB 40MG, 14

kurvelo TAB 0.15/30, 23

lamotrigine TAB 50MG odt, 43

Lasix TAB 80MG, 14

Kuvan Pow 100MG, 28

Lancet Alter Mis Site 26G, 63

Lastacaft Sol 0.25%, 50

Kuvan Pow 500MG, 28

Lancet Auto Mis Injector, 63

latanoprost sol 0.005%, 49

Kuvan TAB 100MG, 28

lancet carry mis case, 60

Latuda TAB 120MG, 40

Kyleena Iud 19.5MG, 24

Lancet Carry Mis Case, 63

Latuda TAB 20MG, 40

Kynamro Inj 200MG/ML, 14

Lancet Devic Mis Adjust, 63

Latuda TAB 40MG, 40

L

Lancet Micro Mis Thin 33G, 63

Latuda TAB 60MG, 40

Lancet Stand Mis 21G, 63

Latuda TAB 80MG, 40

labetalol TAB 100MG, 9

Lancet Super Mis Thin 30G, 63

laxaclear pow, 30

labetalol TAB 200MG, 9

Lancet Ultra Mis 28G, 63

laxative pol pow glycol, 30

labetalol TAB 300MG, 9

Lancet Ultra Mis Fine, 63

laxative TAB 5MG EC, 30

Lac-hydrin CRE 12%, 21

Lancet Ultra Mis Thin 28G, 63

layolis FE chw, 23

Lac-hydrin Lot 12%, 21

Lancet Ultra Mis Thin 30G, 63

Lazanda Spr 100mcg, 52

lac-hydrin lot five, 20

Lancet With Mis Ejector, 63

Lazanda Spr 300mcg, 52

Lacrisert Mis 5MG Op, 48

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Lazanda Spr 400mcg, 52

levofloxacin sol 0.5%, 48

lidocaine sol 2% visc, 36

Lb Lancet Mis 28G, 63

levofloxacin sol 25MG/ML, 2

lidocaine sol 4%, 20

Lb Lancing Mis Device, 63

Levofloxacin Sol 25MG/ML, 2

Lidocaine Sol 4%, 36

Ldo Plus Gel 4%, 21

levofloxacin TAB 250MG, 2

lidocaine-pr CRE, 20

leena TAB, 23

levofloxacin TAB 500MG, 2

lidocaine/HC CRE 3%-0.5%, 32

leflunomide TAB 10MG, 54

levofloxacin TAB 750MG, 2

lidocaine/HC kit 3%-0.5%, 32

leflunomide TAB 20MG, 54

levonest TAB, 23

lidocaine/HC kit 3%-1%, 32

Lenvima CAP 10 MG, 7

levonor/ethi TAB, 23

Lidoderm Dis 5%, 21

Lenvima CAP 14 MG, 7

levonor/ethi TAB 0.1-0.02, 23

lidopin CRE 3%, 20

Lenvima CAP 18 MG, 7

levonor/ethi TAB estradio, 23

lidopril kit 2.5-2.5%, 20

Lenvima CAP 20 MG, 7

levonorgestr TAB 1.5MG, 23

lidopril XR kit 2.5-2.5%, 20

Lenvima CAP 24 MG, 7

levora-28 TAB 0.15/30, 23

Lidorx Gel 3%, 21

Lenvima CAP 8 MG, 7

Levorphanol TAB 2MG, 51

Lidothol Pad 4.5-5%, 21

Lescol XL TAB 80MG, 15

levothyroxin TAB 100mcg, 28

Lidotral CRE 3.88%, 21

lessina TAB, 23

levothyroxin TAB 112mcg, 28

Lidotrex Gel 2%, 21

Letairis TAB 10MG, 15

levothyroxin TAB 125mcg, 28

Lidovin CRE 3.95%, 21

Letairis TAB 5MG, 15

levothyroxin TAB 137mcg, 28

Lidozol CRE 3.75%, 21

letrozole TAB 2.5MG, 6

levothyroxin TAB 150mcg, 28

Lifescan Mis Unistik2, 63

Leucovor CA TAB 10MG, 8

levothyroxin TAB 175mcg, 28

Liletta Iud 52MG, 24

Leucovor CA TAB 15MG, 8

levothyroxin TAB 200mcg, 28

lillow TAB 0.15/30, 24

leucovor CA TAB 25MG, 8

levothyroxin TAB 25mcg, 28

Lincocin Inj 300MG/ML, 6

leucovor CA TAB 5MG, 8

levothyroxin TAB 300mcg, 28

lincomycin inj 300MG/ML, 5

Leukeran TAB 2MG, 6

levothyroxin TAB 50mcg, 28

lindane lot 1%, 20

leuprolide inj 1MG/0.2, 6

levothyroxin TAB 75mcg, 28

Lindane Lot 1%, 21

leva set kit, 20

levothyroxin TAB 88mcg, 28

lindane sha 1%, 20

leva set kit 2.5-2.5%, 20

levothyroxine TAB 0.075MG, 28

Lindane Sha 1%, 21

Levacet TAB, 51

levoxyl TAB 100mcg, 29

linezolid sus 100/5ML, 5

Levalbuterol Aer 45/Act, 57

levoxyl TAB 112mcg, 29

linezolid TAB 600MG, 5

levalbuterol neb 0.31MG, 57

levoxyl TAB 125mcg, 29

Linzess CAP 145mcg, 32

levalbuterol neb 0.63MG, 57

levoxyl TAB 137mcg, 29

Linzess CAP 290mcg, 32

levalbuterol neb 1.25/0.5, 57

levoxyl TAB 150mcg, 29

Linzess CAP 72mcg, 32

levalbuterol neb 1.25MG, 57

levoxyl TAB 175mcg, 29

liothyronine TAB 25mcg, 28

Levaquin TAB 250MG, 3

levoxyl TAB 200mcg, 29

liothyronine TAB 50mcg, 28

Levaquin TAB 500MG, 3

levoxyl TAB 25mcg, 29

liothyronine TAB 5mcg, 28

Levaquin TAB 750MG, 3

levoxyl TAB 50mcg, 29

Lipitor TAB 10MG, 15

Levatio Pad 0.3-5%, 21

levoxyl TAB 75mcg, 29

Lipitor TAB 20MG, 15

Levbid TAB 0.375 ER, 31

levoxyl TAB 88mcg, 29

Lipitor TAB 40MG, 15

Levemir Inj, 25

Levsin Inj 0.5MG/ML, 31

Lipitor TAB 80MG, 15

Levemir Inj Flextouc, 25

Levsin TAB 0.125MG, 31

Lipofen CAP 150MG, 15

levetiraceta sol 100MG/ML, 43

Levsin/SL Sub 0.125MG, 31

Lipofen CAP 50MG, 15

levetiraceta sol 500/5ML, 43

Lexapro Sol 5MG/5ML, 38

liprozonepak kit 2.5-2.5%, 20

levetiraceta TAB 1000MG, 43

Lexapro TAB 10MG, 38

lisinop/hctz TAB 10-12.5, 12

levetiraceta TAB 250MG, 43

Lexapro TAB 20MG, 38

lisinop/hctz TAB 20-12.5, 12

levetiraceta TAB 500MG, 43

Lexapro TAB 5MG, 38

lisinop/hctz TAB 20-25MG, 12

levetiraceta TAB 500MG ER, 43

Lexiva Sus 50MG/ML, 4

lisinopril TAB 10MG, 11

levetiraceta TAB 750MG, 43

Lexiva TAB 700MG, 4

lisinopril TAB 2.5MG, 11

levetiraceta TAB 750MG ER, 43

Lexuss 210 Liq 2-10/5ML, 56

lisinopril TAB 20MG, 11

Levo-ETH Est TAB 90-20mcg, 24

Lialda TAB 1.2gm, 32

lisinopril TAB 30MG, 11

levo-t TAB 100mcg, 28

Librax CAP 5-2.5MG, 30

lisinopril TAB 40MG, 11

levo-t TAB 112mcg, 28

lidenza pad 4-1%, 20

lisinopril TAB 5MG, 11

levo-t TAB 125mcg, 28

lido bdk kit, 20

Lite Touch Mis Lanc Dev, 63

levo-t TAB 137mcg, 28

Lido-hydro Gel 2.8-0.55, 32

Lite Touch Mis Lanc Pen, 63

levo-t TAB 150mcg, 28

Lido-k Lot 3%, 21

Lite Touch Mis Lancets, 63

levo-t TAB 175mcg, 28

lido-prilo kit 2.5-2.5%, 20

Liteaire Mis, 66

levo-t TAB 200 mcg, 29

lido/epi 1%- inj 1:100000, 56

Litetouch Mis 29GX12.7, 63

levo-t TAB 25mcg, 29

lido/prilocn CRE 2.5-2.5%, 20

Litetouch Mis 31GX8MM, 63

levo-t TAB 300 mcg, 29

lido/prilocn kit 2.5-2.5%, 20

Litetouch Mis Lancets, 63

levo-t TAB 50mcg, 29

Lidocain HCL Inj 10MG/ML, 56

lithium CARB CAP 150MG, 39

levo-t TAB 75mcg, 29

lidocaine CRE 3%, 20

Lithium CARB CAP 150MG, 39

levo-t TAB 88mcg, 29

lidocaine CRE 3.88%, 20

lithium CARB CAP 300MG, 39

levo/liothyr TAB 30MG, 29

lidocaine gel 2%, 20

lithium CARB CAP 600MG, 39

levo/liothyr TAB 60MG, 29

lidocaine gel 2% jelly, 20

Lithium CARB CAP 600MG, 39

levo/liothyr TAB 90MG, 29

lidocaine inj 1%, 56

lithium CARB TAB 300MG, 39

levobunolol sol 0.5% op, 49

lidocaine inj 2%, 56

lithium CARB TAB 300MG ER, 39

levocarnitin sol 1gm/10ML, 28

Lidocaine Lot 3%, 21

lithium CARB TAB 450MG ER, 39

levocarnitin TAB 330MG, 28

lidocaine oin 5%, 20

Lithium Sol 8meq/5ML, 39

levocetirizi sol 2.5/5ML, 56

lidocaine oin PAK 5%, 20

Lithobid TAB 300MG CR, 40

levocetirizi TAB 5MG, 56

lidocaine pad 5%, 20

Lithostat TAB 250MG, 34

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Livalo TAB 1MG, 15

Loseasonique TAB, 24

Lyrica Sol 20MG/ML, 44

Livalo TAB 2MG, 15

Lotemax Gel 0.5%, 49

Lysodren TAB 500MG, 6

Livalo TAB 4MG, 15

Lotemax Oin 0.5%, 49

Lysteda TAB 650MG, 36

livixil PAK kit 2.5-2.5%, 20

Lotemax Sus 0.5%, 49

lyza TAB 0.35MG, 24

LO Loestrin TAB, 24

Lotensin HCT TAB 10-12.5, 13

M

Locoid CRE 0.1%, 19

Lotensin HCT TAB 20-12.5, 13

M-m-r II Inj, 58

Locoid Lipo CRE 0.1%, 19

Lotensin HCT TAB 20-25MG, 13

Macrobid CAP 100MG, 33

Locoid Lot 0.1%, 19

Lotensin TAB 20MG, 11

Macrodantin CAP 100MG, 33

Locoid Oin 0.1%, 19

Lotensin TAB 40MG, 11

Macrodantin CAP 25MG, 33

Locoid Sol 0.1%, 19

Lotrel CAP 10-20MG, 13

Macrodantin CAP 50MG, 33

Locort PAK 11-day, 22

Lotrel CAP 10-40MG, 13

MAG citrate sol, 30

Locort PAK 7-day, 22

Lotrel CAP 2.5-10MG, 13

MAG citrate sol cherry, 30

Lodine TAB 400MG, 55

Lotrel CAP 5-10MG, 13

MAG citrate sol grape, 30

Lodosyn TAB 25MG, 45

Lotrel CAP 5-20MG, 13

MAG citrate sol lemon, 30

Loestrin 21 TAB 1.5/30, 24

Lotrisone CRE, 17

Malarone TAB 250-100, 5

Loestrin FE TAB 1.5/30, 24

Lotronex TAB 0.5MG, 32

Malarone TAB 62.5-25, 5

Loestrin FE TAB 1/20, 24

Lotronex TAB 1MG, 32

malathion lot 0.5%, 20

Loestrin TAB 1/20-21, 24

Loutrex CRE, 18

Maprotiline TAB 25MG, 38

Lofibra CAP 134MG, 15

lovastatin TAB 10MG, 14

Maprotiline TAB 50MG, 38

Lofibra CAP 200MG, 15

lovastatin TAB 20MG, 14

Maprotiline TAB 75MG, 38

Lofibra CAP 67MG, 15

lovastatin TAB 40MG, 14

margesic CAP, 51

Lofibra TAB 160MG, 15

Lovaza CAP 1gm, 15

Marinol CAP 10MG, 31

Lofibra TAB 54MG, 15

Lovenox Inj 100MG/ML, 36

Marinol CAP 2.5MG, 31

lokara lot 0.05%, 19

Lovenox Inj 120/0.8, 36

Marinol CAP 5MG, 31

lomedia 24 TAB FE, 24

Lovenox Inj 150MG/ML, 36

marlissa TAB 0.15/30, 24

Lomotil TAB 2.5MG, 30

Lovenox Inj 30/0.3ML, 36

Marplan TAB 10MG, 38

Lomustine CAP 100MG, 6

Lovenox Inj 300/3ML, 36

marten-TAB tab 50-325MG, 51

Lomustine CAP 10MG, 6

Lovenox Inj 40/0.4ML, 36

Mask Vortex/ Mis Baby Duc, 66

Lomustine CAP 40MG, 6

Lovenox Inj 60/0.6ML, 36

Mask Vortex/ Mis Duck, 66

Longs Lancet Mis Standard, 63

Lovenox Inj 80/0.8ML, 36

Mask Vortex/ Mis Frog, 66

Longs Lancet Mis Thin, 63

low-ogestrel TAB, 24

Mask Vortex/ Mis Lady Bug, 66

Longs Lancet Mis Ultra Th, 63

loxapine CAP 10MG, 39

Matulane CAP 50MG, 8

Lonsurf TAB 15-6.14, 8

loxapine CAP 25MG, 39

matzim LA TAB 180MG/24, 10

Lonsurf TAB 20-8.19, 8

loxapine CAP 50MG, 39

matzim LA TAB 240MG/24, 10

loperamide CAP 2MG, 30

loxapine CAP 5MG, 39

matzim LA TAB 300MG/24, 10

Lopid TAB 600MG, 15

LP lite PAK kit 2.5-2.5%, 20

matzim LA TAB 360MG/24, 10

lopin/riton sol 80-20/ML, 3

Lumigan Sol 0.01%, 49

matzim LA TAB 420MG/24, 10

lopreeza TAB 0.5-0.1, 22

Lumizyme Inj 50MG, 28

Mavik TAB 1MG, 11

lopreeza TAB 1-0.5MG, 22

Lunesta TAB 1MG, 41

Mavik TAB 2MG, 11

Lopress HCT TAB 50-25MG, 13

Lunesta TAB 2MG, 41

Mavik TAB 4MG, 11

Lopressor TAB 100MG, 9

Lunesta TAB 3MG, 41

Mavyret TAB 100-40MG, 4

Lopressor TAB 50MG, 9

Lupaneta Kit 11.25-5, 27

Maxalt TAB 10MG, 55

Loprox CRE 0.77%, 17

Lupaneta Kit 3.75-5, 27

Maxalt TAB 5MG, 55

Loprox Kit 0.77%, 17

Lupr Dep-PED Inj 11.25MG, 27

Maxalt-MLT TAB 10MG, 55

Loprox Sha 1%, 17

Lupr Dep-PED Inj 15MG, 27

Maxalt-MLT TAB 5MG, 55

Loprox Sus 0.77%, 17

Lupr Dep-PED Inj 3m 30MG, 27

Maxidex Sus 0.1% Op, 49

lorazepam CON 2MG/ML, 37

Lupr Dep-PED Inj 7.5MG, 27

Maxima Sol Control, 63

lorazepam inj 2MG/ML, 37

Lupron Depot Inj 11.25MG, 6

Maxipime Inj 1gm, 1

lorazepam TAB 0.5MG, 37

Lupron Depot Inj 22.5MG, 6

Maxitrol Oin 0.1% Op, 49

lorazepam TAB 1MG, 37

Lupron Depot Inj 3.75MG, 6

Maxitrol Sus 0.1% Op, 49

lorazepam TAB 2MG, 37

Lupron Depot Inj 30MG, 6

Maxzide TAB 75-50, 14

lorcet HD TAB 10-325MG, 51

Lupron Depot Inj 45MG, 6

Maxzide-25 TAB, 14

lorcet plus TAB 7.5-325, 51

Lupron Depot Inj 7.5MG, 6

me/naphos/mb TAB hyo 1, 33

lorcet TAB 5-325MG, 51

lutera TAB, 24

meclizine TAB 12.5MG, 31

lorenza pad 4-1%, 20

Luxiq Aer 0.12%, 19

meclizine TAB 25MG, 31

Lortab Elx 10-300MG, 53

Luzu CRE 1%, 17

Meclofen Sod CAP 100MG, 54

lortab TAB 10-325MG, 51

Lycelle Gel, 21

Meclofen Sod CAP 50MG, 54

lortab TAB 5-325MG, 51

Lynparza CAP 50MG, 8

Medi-patch Pad RX, 21

lortab TAB 7.5-325, 51

Lynparza TAB 100MG, 8

Medichoice Mis Lancet, 63

loryna TAB 3-0.02MG, 24

Lynparza TAB 150MG, 8

Medisense Liq Gluc-ket, 63

Lorzone TAB 375MG, 48

Lyrica CAP 100MG, 44

Medisense Liq Gluc/Ket, 63

Lorzone TAB 750MG, 48

Lyrica CAP 150MG, 44

Medlance Mis 30G Plus, 63

losartan pot TAB 100MG, 11

Lyrica CAP 200MG, 44

Medlance Mis Extr 21G, 63

losartan pot TAB 25MG, 11

Lyrica CAP 225MG, 44

Medlance Mis Lite 25G, 63

losartan pot TAB 50MG, 11

Lyrica CAP 25MG, 44

Medlance Mis Plus, 63

losartan/HCT TAB 100-12.5, 12

Lyrica CAP 300MG, 44

Medlance Mis Plus 30G, 63

losartan/HCT TAB 100-25, 12

Lyrica CAP 50MG, 44

Medlance Mis Unv 21G, 63

losartan/HCT TAB 50-12.5, 12

Lyrica CAP 75MG, 44

Medlance Pls Mis 0.8MM, 63

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Medlance Pls Mis Extr 21G, 63

Metadate CD CAP 30MG, 42

methylphenid CAP 10MG, 41

Medlance Pls Mis Lite 25G, 63

Metadate CD CAP 40MG, 42

methylphenid CAP 20MG, 41

Medlance Pls Mis Univ 21G, 63

Metadate CD CAP 50MG, 42

methylphenid CAP 20MG ER, 41

medolor PAK kit 2.5-2.5%, 20

Metadate CD CAP 60MG, 42

methylphenid CAP 30MG, 41

Medrol TAB 16MG, 22

metadate TAB 20MG ER, 41

methylphenid CAP 30MG ER, 41

Medrol TAB 2MG, 21

Metaproteren Syp 10MG/5ML, 57

methylphenid CAP 40MG, 41

Medrol TAB 32MG, 22

Metaproteren TAB 10MG, 57

methylphenid CAP 40MG ER, 41

Medrol TAB 4MG, 22

Metaproteren TAB 20MG, 57

methylphenid CAP 50MG, 41

Medrol TAB 8MG, 22

metaxall TAB 800MG, 48

methylphenid CAP 60MG, 41

medroxypr ac inj 150MG/ML, 24

Metaxalone TAB 400MG, 48

Methylphenid CAP 60MG LA, 42

medroxypr ac TAB 10MG, 24

metaxalone TAB 800MG, 48

Methylphenid Chw 10MG, 42

medroxypr ac TAB 2.5MG, 25

metformin ER TAB 1000MG, 25

Methylphenid Chw 5MG, 42

medroxypr ac TAB 5MG, 25

metformin TAB 1000 ER, 25

methylphenid TAB 10MG, 41

mefenam acid CAP 250MG, 54

metformin TAB 1000MG, 25

methylphenid TAB 10MG ER, 41

mefloquine TAB 250MG, 5

metformin TAB 500MG, 25

methylphenid TAB 18MG ER, 41

Megace ES Sus 625/5ML, 25

metformin TAB 500MG ER, 25

Methylphenid TAB 18MG ER, 42

Megace Oral Sus 40MG/ML, 7

metformin TAB 750MG ER, 25

methylphenid TAB 20MG, 41

megestrol ac sus 400MG/10, 6

metformin TAB 850MG, 25

methylphenid TAB 20MG ER, 41

megestrol ac sus 40MG/ML, 6

methadone CON 10MG/ML, 51

methylphenid TAB 27MG ER, 41

megestrol ac TAB 20MG, 6

Methadone Inj 10MG/ML, 53

Methylphenid TAB 27MG ER, 42

megestrol ac TAB 40MG, 6

methadone sol 10MG/5ML, 51

methylphenid TAB 36MG ER, 41

megestrol sus 625MG/5m, 25

Methadone Sol 10MG/5ML, 51

Methylphenid TAB 36MG ER, 42

Meijer Lance Mis Color, 63

methadone sol 5MG/5ML, 51

methylphenid TAB 54MG ER, 41

Meijer Lance Mis Univ 21G, 63

Methadone Sol 5MG/5ML, 52

Methylphenid TAB 54MG ER, 42

Meijer Lance Mis Univ 30G, 63

methadone TAB 10MG, 51

methylphenid TAB 5MG, 41

Meijer Lance Mis Universa, 63

methadone TAB 40MG, 51

methylpr ace inj 40MG/ML, 21

Meijer Mis Lancets, 63

methadone TAB 5MG, 51

methylpr ace inj 80MG/ML, 21

Mekinist TAB 0.5MG, 8

Methadose CON 10MG/ML, 53

methylpr ss inj 125MG, 21

Mekinist TAB 2MG, 8

Methadose SF CON 10MG/ML, 53

methylpred TAB 16MG, 21

melodetta chw 24 FE, 24

methadose TAB 40MG, 51

methylpred TAB 32MG, 21

Meloxicam Sus 7.5/5ML, 55

methamphetam TAB 5MG, 42

methylpred TAB 4MG, 21

meloxicam TAB 15MG, 54

methazolamid TAB 25MG, 13

methylpred TAB 8MG, 21

meloxicam TAB 7.5MG, 54

methazolamid TAB 50MG, 14

methyltestos CAP 10MG, 22

melphalan TAB 2MG, 6

methenam hip TAB 1gm, 33

Metipranolol Sol 0.3% Oph, 49

memant titra PAK 5-10MG, 47

methenam man TAB 1000MG, 33

metoclopram inj 10MG/2ML, 32

memantine HC sol 2MG/ML, 47

methenam man TAB 1gm, 33

metoclopram inj 5MG/ML, 32

memantine TAB HCL 10MG, 45

Methenam Man TAB 500MG, 33

metoclopram sol 10/10ML, 32

memantine TAB HCL 5MG, 45

Methergine TAB 0.2MG, 50

metoclopram sol 5MG/5ML, 32

Menactra Inj, 58

methimazole TAB 10MG, 28

metoclopram TAB 10MG, 32

Menest TAB 0.3MG, 23

methimazole TAB 5MG, 28

metoclopram TAB 5MG, 32

Menest TAB 0.625MG, 23

Methitest TAB 10MG, 22

Metoclopram TAB 5MG Odt, 32

Menest TAB 1.25MG, 23

Methlphenida Chw 2.5MG, 42

Metocloprami TAB 10MG Odt, 32

Menest TAB 2.5MG, 23

methocarbam inj 1000MG, 48

metolazone TAB 10MG, 14

Menhibrix Inj, 58

methocarbam inj 100MG/ML, 48

metolazone TAB 2.5MG, 14

Menomune Inj A/C/Y/W, 58

methocarbam TAB 500MG, 48

metolazone TAB 5MG, 14

Menostar Dis 14mcg, 23

methocarbam TAB 750MG, 48

metoprl/hctz TAB 100-25MG, 12

Menthocin Pad Lidocain, 21

methotrexate inj 100/4ML, 6

metoprl/hctz TAB 100-50MG, 12

Mentholix Spr 4-1%, 21

methotrexate inj 1gm, 6

Metoprl/Hctz TAB 100-50MG, 12

Menveo Inj, 58

methotrexate inj 1gm/40ML, 6

metoprl/hctz TAB 50-25MG, 12

meperidine inj 100MG/ML, 51

methotrexate inj 200/8ML, 6

Metopro/Hctz TAB 100-12.5, 13

meperidine TAB 100MG, 52

methotrexate inj 250/10ML, 6

Metopro/Hctz TAB 25-12.5, 13

meperidine TAB 50MG, 52

methotrexate inj 25MG/ML, 6

Metopro/Hctz TAB 50-12.5, 13

Mephyton TAB 5MG, 59

Methotrexate Inj 25MG/ML, 6

metoprol suc TAB 100MG ER, 9

meprobamate TAB 200MG, 37

methotrexate inj 50MG/2ML, 6

metoprol suc TAB 200MG ER, 9

meprobamate TAB 400MG, 37

methotrexate TAB 2.5MG, 6

metoprol suc TAB 25MG ER, 9

Mepron Sus, 5

methoxsalen CAP 10MG, 18

metoprol suc TAB 50MG ER, 9

mercaptopur TAB 50MG, 6

methscopolam TAB 2.5MG, 30

metoprol TAR TAB 100MG, 9

mesalamine ene 4gm, 32

methscopolam TAB 5MG, 30

metoprol TAR TAB 25MG, 9

mesalamine kit 4gm, 32

Methyclothia TAB 5MG, 14

metoprol TAR TAB 50MG, 9

mesalamine TAB 1.2gm, 32

Methyld/Hctz TAB 250/15, 13

metoprolol TAB 100MG ER, 9

Mesalamine TAB 800MG DR, 32

Methyld/Hctz TAB 250/25, 13

metoprolol TAB 200MG ER, 9

mesna inj 1gm, 8

methyldopa TAB 250MG, 12

metoprolol TAB 25MG ER, 9

Mesnex TAB 400MG, 8

methyldopa TAB 500MG, 12

Metoprolol TAB 37.5MG, 9

Mestinon Syp 60MG/5ML, 48

methylergon inj 0.2MG/ML, 50

metoprolol TAB 50MG ER, 9

Mestinon TAB 60MG, 48

methylergon TAB 0.2MG, 50

Metoprolol TAB 75MG, 9

Mestinon TAB Timespan, 48

Methylin Chw 10MG, 42

Metozolv Odt TAB 5MG, 32

Metadate CD CAP 10MG, 42

Methylin Chw 2.5MG, 42

Metrocream CRE 0.75%, 17

Metadate CD CAP 20MG, 42

Methylin Chw 5MG, 42

Metrogel Gel 1%, 17

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Metrogel-vag Gel 0.75%, 33

Minivelle Dis 0.05MG, 23

moexipr/hctz TAB 7.5-12.5, 12

Metrolotion Lot 0.75%, 17

Minivelle Dis 0.075MG, 23

moexipril TAB 15MG, 11

metronidazol CAP 375MG, 6

Minivelle Dis 0.1MG, 23

moexipril TAB 7.5MG, 11

metronidazol CRE 0.75%, 17

Minocin CAP 100MG, 2

Molindone TAB HCL 10MG, 40

metronidazol gel 0.75%, 17

Minocin CAP 50MG, 2

Molindone TAB HCL 25MG, 40

metronidazol gel 0.75%vag, 33

Minocin CAP 75MG, 2

Molindone TAB HCL 5MG, 40

metronidazol gel 1%, 17

minocycline CAP 100MG, 2

mometasone CRE 0.1%, 19

metronidazol lot 0.75%, 17

minocycline CAP 50MG, 2

mometasone oin 0.1%, 19

metronidazol TAB 250MG, 5

minocycline CAP 75MG, 2

mometasone sol 0.1%, 19

metronidazol TAB 500MG, 5

minocycline TAB 100MG, 2

mometasone spr 50mcg, 56

Metronidazole 0.75% Jelly, 17

minocycline TAB 135MG ER, 2

mondoxyne nl CAP 100MG, 2

Mevacor TAB 40MG, 15

minocycline TAB 45MG ER, 2

mondoxyne nl CAP 50MG, 2

mexiletine CAP 150MG, 10

Minocycline TAB 45MG ER, 2

mondoxyne nl CAP 75MG, 2

mexiletine CAP 200MG, 10

minocycline TAB 50MG, 2

mono-linyah TAB 0.25-35, 24

mexiletine CAP 250MG, 10

minocycline TAB 75MG, 2

Monodox CAP 100MG, 2

Miacalcin Inj 200/ML, 27

minocycline TAB 90MG ER, 2

Monodox CAP 75MG, 2

Miacalcin Spr 200/Act, 27

minoxidil TAB 10MG, 12

Monojector Mis End CAPS, 63

mibelas 24 chw FE, 24

minoxidil TAB 2.5MG, 12

Monolet Mis Lancets, 63

Micardis HCT TAB 40/12.5, 13

Mirapex ER TAB 0.375MG, 45

Monolet Opd Mis Lancets, 63

Micardis HCT TAB 80-25MG, 13

Mirapex ER TAB 0.75MG, 45

Monolettor Mis Lancets, 63

Micardis HCT TAB 80/12.5, 13

Mirapex ER TAB 1.5MG, 45

mononessa TAB, 24

Micardis TAB 20MG, 12

Mirapex ER TAB 2.25MG, 45

montelukast chw 4MG, 57

Micardis TAB 40MG, 12

Mirapex ER TAB 3.75MG, 45

montelukast chw 5MG, 57

Micardis TAB 80MG, 12

Mirapex ER TAB 3MG, 45

montelukast gra 4MG, 57

Miconazole 3 Sup 200MG, 33

Mirapex ER TAB 4.5MG, 45

montelukast TAB 10MG, 57

Micort-HC CRE 2.5%, 19

Mirapex TAB 0.125MG, 45

Monurol PAK Granules, 33

micrgstin 24 TAB FE 1/20, 24

Mirapex TAB 0.25MG, 45

morgidox CAP 1X100MG, 2

Micro Thin Mis Lanc 33G, 63

Mirapex TAB 0.5MG, 45

morgidox CAP 1X50MG, 2

Microchamber Mis, 66

Mirapex TAB 0.75MG, 45

morgidox CAP 2X100MG, 2

Microdot CON Sol High/Low, 63

Mirapex TAB 1.5MG, 45

Morphabond TAB 100MG ER, 53

microgestin TAB 1.5/30, 24

Mirapex TAB 1MG, 45

Morphabond TAB 15MG ER, 53

microgestin TAB 1/20, 24

Mircera Inj 100mcg, 35

Morphabond TAB 30MG ER, 53

microgestin TAB FE 1/20, 24

Mircera Inj 200mcg, 35

Morphabond TAB 60MG ER, 53

microgestin TAB FE1.5/30, 24

Mircera Inj 50mcg, 35

morphine SUL CAP 100MG ER, 52

Microlet Mis Lancets, 63

Mircera Inj 75mcg, 35

morphine SUL CAP 10MG ER, 52

Microlet Mis Next, 63

Mircera Sol 150/0.3, 35

Morphine SUL CAP 120MG ER, 53

Microspacer Mis, 66

Mircera Sol 30/0.3ML, 35

morphine SUL CAP 20MG ER, 52

Microtainer Mis Lancet, 63

Mircette TAB 28 Day, 24

morphine SUL CAP 30MG ER, 52

Microzide CAP 12.5MG, 14

Mirena Iud System, 24

Morphine SUL CAP 30MG ER, 53

midazolam inj 10MG/2ML, 41

mirtazapine TAB 15MG, 37

Morphine SUL CAP 45MG ER, 53

midazolam inj 5MG/ML, 41

mirtazapine TAB 15MG odt, 37

morphine SUL CAP 50MG ER, 52

midazolam syp 2MG/ML, 41

mirtazapine TAB 30MG, 37

morphine SUL CAP 60MG ER, 52

midodrine TAB 10MG, 14

mirtazapine TAB 30MG odt, 37

Morphine SUL CAP 60MG ER, 53

midodrine TAB 2.5MG, 14

mirtazapine TAB 45MG, 37

Morphine SUL CAP 75MG ER, 53

midodrine TAB 5MG, 14

mirtazapine TAB 45MG odt, 37

morphine SUL CAP 80MG ER, 52

Mifeprex TAB 200MG, 28

mirtazapine TAB 7.5MG, 37

Morphine SUL CAP 90MG ER, 53

Migergot Sup 2/100, 55

Mirvaso Gel 0.33%, 17

Morphine SUL Inj 10/0.7ML, 52

miglitol TAB 100MG, 26

misoprostol TAB 100mcg, 30

morphine SUL sol 100/5ML, 51

miglitol TAB 25MG, 26

misoprostol TAB 200mcg, 30

morphine SUL sol 10MG/5ML, 51

miglitol TAB 50MG, 26

Mitigare CAP 0.6MG, 55

morphine SUL sol 20MG/5ML, 51

Migranal Spr 4MG/ML, 55

MM aspirin TAB 325MG, 51

Morphine SUL Sup 10MG, 52

migryl mis 0.0375-5, 20

MM Pentips Mis 29GX12MM, 63

Morphine SUL Sup 20MG, 52

Millipred DP PAK 5MG, 22

MM Pentips Mis 31GX5MM, 63

Morphine SUL Sup 30MG, 52

Millipred Sol 10MG/5ML, 22

MM Pentips Mis 31GX8MM, 63

Morphine SUL Sup 5MG, 52

Millipred TAB 5MG, 22

MM Pentips Mis 32GX4MM, 63

morphine SUL TAB 100MG ER, 51

mimvey LO TAB 0.5-0.1, 22

Mobic Sus 7.5/5ML, 55

Morphine SUL TAB 15MG, 52

mimvey TAB 1-0.5MG, 22

Mobic TAB 15MG, 55

morphine SUL TAB 15MG ER, 51

Mini Lancing Mis Device, 63

Mobic TAB 7.5MG, 55

morphine SUL TAB 200MG ER, 51

Minipress CAP 1MG, 12

modafinil TAB 100MG, 41

Morphine SUL TAB 30MG, 52

Minipress CAP 2MG, 12

modafinil TAB 200MG, 41

morphine SUL TAB 30MG ER, 51

Minipress CAP 5MG, 12

Moderiba PAK 1200/Day, 5

morphine SUL TAB 60MG ER, 51

miniprin low TAB 81MG EC, 51

Moderiba PAK 800/Day, 5

Motofen TAB 1-0.025, 30

minitran dis 0.1MG/HR, 8

Moderiba TAB 1000/Day, 5

Movantik TAB 12.5MG, 32

minitran dis 0.2MG/HR, 8

moderiba TAB 200MG, 3

Movantik TAB 25MG, 32

minitran dis 0.4MG/HR, 8

Moderiba TAB 600/Day, 5

Moviprep Sol, 30

minitran dis 0.6MG/HR, 8

Modicon TAB 0.5/35, 24

Moxatag TAB 775MG, 1

Minivelle Dis 0.025MG, 23

moexipr/hctz TAB 15-12.5, 12

Moxeza Sol 0.5%, 48

Minivelle Dis 0.0375MG, 23

moexipr/hctz TAB 15-25MG, 12

moxifloxacin sol 0.5%, 48

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moxifloxacin TAB 400MG, 2

Namenda XR CAP 21MG, 47

nefazodone TAB 250MG, 38

MS Contin TAB 100MG ER, 53

Namenda XR CAP 28MG, 47

nefazodone TAB 50MG, 38

MS Contin TAB 15MG ER, 53

Namenda XR CAP 7MG, 47

Nembutal Sod Inj 50MG/ML, 41

MS Contin TAB 200MG ER, 53

Namenda XR CAP Titratio, 47

neo-polycin oin HC 1%op, 49

MS Contin TAB 30MG ER, 53

Namzaric CAP, 47

neo-polycin oin op, 48

MS Contin TAB 60MG ER, 53

Namzaric CAP 14-10MG, 47

Neo-synalar CRE, 17

Multaq TAB 400MG, 11

Namzaric CAP 21-10MG, 47

neo/bac/poly oin op, 48

Multi Prenat TAB, 60

Namzaric CAP 28-10MG, 47

neo/poly GU sol 40/ML IR, 34

Multi-lancet Kit Device, 63

Namzaric CAP 7-10MG, 47

neo/poly/bac oin /HC 1%op, 49

Multi-lancet Mis Device, 63

Naphazoline Sol 0.1% Op, 49

neo/poly/dex oin 0.1% op, 49

mupirocin CA CRE 2%, 17

Naprelan TAB 375MG CR, 55

neo/poly/dex sus 0.1% op, 49

mupirocin CRE 2%, 17

Naprelan TAB 500MG CR, 55

neo/poly/gra sol op, 48

mupirocin oin 2%, 17

Naprelan TAB 750MG CR, 55

neo/poly/HC sol 1% otic, 50

my way TAB 1.5MG, 24

Naprosyn Sus 125/5ML, 55

neo/poly/HC sus 1% otic, 50

Myalept Inj 11.3MG, 28

Naprosyn TAB 500MG, 55

Neo/Poly/HC Sus Op, 49

Myambutol TAB 100MG, 3

naproxen DR TAB 375MG, 54

neomycin TAB 500MG, 3

Myambutol TAB 400MG, 3

naproxen DR TAB 500MG, 54

Neoral CAP 100MG, 7

Mycobutin CAP 150MG, 3

naproxen sod TAB 275MG, 54

Neoral CAP 25MG, 7

mycophenolat CAP 250MG, 7

naproxen sod TAB 375MG, 54

Neoral Sol 100MG/ML, 7

mycophenolat sus 200MG/ML, 7

naproxen sod TAB 375MG CR, 54

Neosalus Aer, 21

mycophenolat TAB 500MG, 7

naproxen sod TAB 500MG CR, 54

Neosalus CP CRE, 21

mycophenolic TAB 180MG DR, 7

naproxen sod TAB 550MG, 54

Neosalus CRE, 21

mycophenolic TAB 360MG DR, 7

naproxen sus 125/5ML, 54

Neosporin GU Sol 40/ML IR, 34

Mydayis CAP 12.5MG, 42

Naproxen Sus 125/5ML, 54

Neosporin Sol Op, 48

Mydayis CAP 25MG, 42

naproxen TAB 250MG, 54

Neptazane TAB 25MG, 14

Mydayis CAP 37.5MG, 42

naproxen TAB 375MG, 54

Neptazane TAB 50MG, 14

Mydayis CAP 50MG, 42

naproxen TAB 500MG, 54

Nerlynx TAB 40MG, 8

myferon 150 CAP 150MG, 34

naratriptan TAB 1MG, 55

Nesina TAB 12.5MG, 26

Myfortic TAB 180MG, 7

naratriptan TAB 2.5MG, 55

Nesina TAB 25MG, 26

Myfortic TAB 360MG, 7

Narcan Spr, 54

Nesina TAB 6.25MG, 26

Myglucohealt Mis Lanc 30G, 63

Nardil TAB 15MG, 38

neuac gel 1.2-5%, 16

Myglucohealt Sol LO/Nl/HI, 63

Nasonex Spr 50mcg/Ac, 56

Neulasta Inj 6MG/0.6m, 35

Mykidz Iron Sus 15/1.5ML, 35

nat-rul iron TAB 325MG, 34

Neulasta Kit 6MG/0.6m, 35

Myleran TAB 2MG, 6

Natacyn Sus 5% Op, 48

Neupogen Inj 300/0.5, 35

myorisan CAP 10MG, 16

Natazia TAB, 24

Neupogen Inj 300mcg, 35

myorisan CAP 20MG, 16

nateglinide TAB 120MG, 26

Neupogen Inj 480/0.8, 35

myorisan CAP 30MG, 16

nateglinide TAB 60MG, 26

Neupogen Inj 480mcg, 35

myorisan CAP 40MG, 16

Natesto Gel 5.5MG, 22

Neupro Dis 1MG/24HR, 45

Myrbetriq TAB 25MG, 33

Natpara Inj 100mcg, 27

Neupro Dis 2MG/24HR, 45

Myrbetriq TAB 50MG, 33

Natpara Inj 25mcg, 27

Neupro Dis 3MG/24HR, 45

Mysoline TAB 250MG, 43

Natpara Inj 50mcg, 27

Neupro Dis 4MG/24HR, 45

Mysoline TAB 50MG, 43

Natpara Inj 75mcg, 27

Neupro Dis 6MG/24HR, 45

Mytesi TAB 125MG, 30

Natroba Sus 0.9%, 21

Neupro Dis 8MG/24HR, 45

myzilra TAB, 24

natura-LAX pow 3350 NF, 30

Neurontin CAP 100MG, 44

N

Nature Throi TAB 162.5MG, 29

Neurontin CAP 300MG, 44

Nature-throi TAB 113.75MG, 29

Neurontin CAP 400MG, 44

nabumetone TAB 500MG, 54

Nature-throi TAB 130MG, 29

Neurontin Sol 250/5ML, 44

nabumetone TAB 750MG, 54

Nature-throi TAB 146.25MG, 29

Neurontin TAB 600MG, 44

nadolol TAB 20MG, 9

Nature-throi TAB 16.25MG, 29

Neurontin TAB 800MG, 44

nadolol TAB 40MG, 9

Nature-throi TAB 195MG, 29

Neutek 2tek Sol Control, 63

nadolol TAB 80MG, 9

Nature-throi TAB 260MG, 29

Neutrasal Pow, 36

nadolol/bend TAB 40-5MG, 13

Nature-throi TAB 32.5MG, 29

Neuvaxin Pad 0.0375-5, 21

nadolol/bend TAB 80-5MG, 13

Nature-throi TAB 325MG, 29

Nevanac Sus 0.1%, 50

naftifine CRE HCL 1%, 17

Nature-throi TAB 48.75MG, 29

Nevirapine Sus 50MG/5ML, 4

naftifine CRE HCL 2%, 17

Nature-throi TAB 65MG, 29

nevirapine TAB 100MG, 3

Naftin CRE 1%, 17

Nature-throi TAB 81.25MG, 29

nevirapine TAB 200MG, 3

Naftin CRE 2%, 17

Nature-throi TAB 97.5MG, 29

nevirapine TAB 400MG ER, 4

Naftin Gel 1%, 17

Nebupent Inh 300MG, 6

Nexavar TAB 200MG, 8

Naftin Gel 2%, 17

nebusal neb 3%, 56

Nexgen Tes Norm CON, 63

Nalfon CAP 400MG, 55

Nebusal Neb 6%, 56

Nexplanon Imp 68MG, 24

naloxone inj 0.4MG/ML, 54

necon TAB 0.5/35, 24

next choice TAB 1.5MG, 24

Naloxone Inj 0.4MG/ML, 54

necon TAB 1/35, 24

niacin ER TAB 1000MG, 15

Naloxone Inj 1MG/ML, 54

Necon TAB 1/50-28, 24

niacin ER TAB 500MG, 15

naltrexone TAB 50MG, 54

necon TAB 10/11-28, 24

niacin ER TAB 750MG, 15

Namenda Sol 10MG/5ML, 47

necon TAB 7/7/7, 24

Niacor TAB 500MG, 15

Namenda TAB 10MG, 47

Nefazodone TAB 100MG, 38

Niaspan TAB 1000 ER, 15

Namenda TAB 5-10MG, 47

Nefazodone TAB 150MG, 38

Niaspan TAB 500MG ER, 15

Namenda TAB 5MG, 47

Nefazodone TAB 200MG, 38

Niaspan TAB 750MG ER, 15

Namenda XR CAP 14MG, 47

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nicardipine CAP 20MG, 10

nicotine TD dis 7MG/24HR, 46

noreth/ethin chw FE 1/20, 24

nicardipine CAP 30MG, 10

Nicotrol Inh, 47

noreth/ethin TAB 0.5-2.5, 22

Nicoderm CQ Dis 14MG/24h, 47

Nicotrol Ns Spr 10MG/ML, 47

noreth/ethin TAB 1/20, 24

Nicoderm CQ Dis 21MG/24h, 47

nifedical XL TAB 30MG, 10

noreth/ethin TAB 1MG-5mcg, 22

Nicoderm CQ Dis 7MG/24HR, 47

nifedical XL TAB 60MG, 10

noreth/ethin TAB FE 1/20, 24

nicorelief gum 2MG mint, 46

nifedipine CAP 10MG, 10

norethin ace TAB 5MG, 25

nicorelief gum 2MG orig, 46

nifedipine CAP 20MG, 10

norethindron TAB 0.35MG, 24

nicorelief gum 4MG mint, 46

nifedipine TAB 30MG ER, 10

norgest/ethi TAB 0.25/35, 24

nicorelief gum 4MG orig, 46

nifedipine TAB 60MG ER, 10

norgest/ethi TAB estradio, 24

Nicorette Gum 2MG, 47

nifedipine TAB 90MG ER, 10

Norinyl TAB 1+50-28, 24

Nicorette Gum 2MG Cinn, 47

nikki TAB 3-0.02MG, 24

Norinyl TAB 1/35, 24

Nicorette Gum 2MG Mint, 47

Nilandron TAB 150MG, 6

Noritate CRE 1%, 17

Nicorette Gum 2MG Orig, 47

nilutamide TAB 150MG, 6

norlyda TAB 0.35MG, 24

Nicorette Gum 2mgfruit, 47

nimodipine CAP 30MG, 10

norlyroc TAB 0.35MG, 24

Nicorette Gum 4MG, 47

Ninlaro CAP 2.3MG, 8

Norpace CAP 100MG, 11

Nicorette Gum 4MG Cinn, 47

Ninlaro CAP 3MG, 8

Norpace CAP 100MG CR, 11

Nicorette Gum 4MG Mint, 47

Ninlaro CAP 4MG, 8

Norpace CAP 150MG, 11

Nicorette Gum 4MG Orig, 47

nisoldipine TAB 17MG ER, 10

Norpace CAP 150MG CR, 11

Nicorette Gum 4mgfruit, 47

Nisoldipine TAB 20MG ER, 10

Norpramin TAB 100MG, 38

Nicorette Loz 2MG Chry, 47

Nisoldipine TAB 25.5MG, 10

Norpramin TAB 10MG, 38

Nicorette Loz 2MG Mint, 47

Nisoldipine TAB 30MG ER, 10

Norpramin TAB 150MG, 38

Nicorette Loz 2MG Orig, 47

nisoldipine TAB 34MG ER, 10

Norpramin TAB 25MG, 38

Nicorette Loz 4MG Chry, 47

Nisoldipine TAB 40MG ER, 10

Norpramin TAB 50MG, 38

Nicorette Loz 4MG Mint, 47

nisoldipine TAB 8.5MG ER, 10

Norpramin TAB 75MG, 38

Nicorette Loz 4MG Orig, 47

Nitro-bid Oin 2%, 8

Northera CAP 100MG, 14

Nicorette ST Gum 2MG, 47

Nitro-dur Dis 0.1MG/HR, 9

Northera CAP 200MG, 14

Nicorette ST Gum 2MG Mint, 47

Nitro-dur Dis 0.2MG/HR, 9

Northera CAP 300MG, 14

Nicorette ST Gum 2MG Orig, 47

Nitro-dur Dis 0.3MG/HR, 8

nortrel TAB 0.5/35, 24

Nicorette ST Gum 4MG Mint, 47

Nitro-dur Dis 0.4MG/HR, 9

nortrel TAB 1/35, 24

Nicorette ST Gum 4MG Orig, 47

Nitro-dur Dis 0.6MG/HR, 9

nortrel TAB 7/7/7, 24

nicotine dis 14MG/24h, 46

Nitro-dur Dis 0.8MG/HR, 8

nortriptylin CAP 10MG, 37

nicotine dis 21MG/24h, 46

nitro-time CAP 9MG CR, 8

nortriptylin CAP 25MG, 37

nicotine dis 7MG/24HR, 46

nitrofur mac CAP 100MG, 33

nortriptylin CAP 50MG, 37

nicotine dis step 1, 46

nitrofur mac CAP 25MG, 33

nortriptylin CAP 75MG, 37

nicotine dis step 2, 46

nitrofur mac CAP 50MG, 33

Nortriptylin Sol 10MG/5ML, 38

nicotine dis step 3, 46

nitrofurantn CAP 100MG, 33

Nortuss-EX Liq 200-20/5, 57

nicotine gum 2MG, 46

nitrofurantn sus 25MG/5ML, 33

Norvasc TAB 10MG, 10

nicotine gum 2mgfruit, 46

Nitroglycer Aer 400mcg, 9

Norvasc TAB 2.5MG, 10

nicotine gum 4MG, 46

nitroglycer CAP 9MG ER, 8

Norvasc TAB 5MG, 10

nicotine loz 2MG chry, 46

nitroglycer dis 0.1MG/HR, 8

Norvir CAP 100MG, 4

nicotine loz 2MG mint, 46

nitroglycer dis 0.2MG/HR, 8

Norvir Sol 80MG/ML, 4

nicotine loz 4MG chry, 46

nitroglycer dis 0.4MG/HR, 8

Norvir TAB 100MG, 4

nicotine loz 4MG cinn, 46

nitroglycer dis 0.6MG/HR, 8

norwich asa TAB 325MG, 51

nicotine loz 4MG mint, 46

nitroglycrn spr 0.4MG, 8

Nova Max Glu Liq /Ket CON, 63

nicotine loz mini 2MG, 46

Nitrolingual Spr Pumpspra, 9

Nova Safety Mis Lanc 23G, 63

nicotine pol gum 2MG, 46

Nitromist Aer 400mcg, 9

Nova Safety Mis Lanc 28G, 63

nicotine pol gum 2MG cinn, 46

Nitrostat Sub 0.3MG, 9

Nova Sure Mis Lancets, 63

nicotine pol gum 2MG mint, 46

Nityr TAB 10MG, 28

Nova Sureflx Mis Lanc Dev, 63

nicotine pol gum 2MG orig, 46

Nityr TAB 2MG, 28

Novacort Gel, 19

nicotine pol gum 2MG ref, 46

Nityr TAB 5MG, 28

Novaferrum CAP 50MG, 35

nicotine pol gum 2MG strt, 46

Nivatopic CRE Plus, 21

Novaferrum Dro 15MG/ML, 35

nicotine pol gum 2mgfruit, 46

nizatidine CAP 150MG, 30

Novofine Aut Mis 30GX8MM, 63

nicotine pol gum 4MG, 46

nizatidine CAP 300MG, 30

Novofine Mis 30GX8MM, 63

nicotine pol gum 4MG cinn, 46

Nizatidine Sol 15MG/ML, 31

Novofine Mis 32GX6MM, 63

nicotine pol gum 4MG mint, 46

Nizoral Sha 2%, 17

Novofine Pls Mis 32GX4MM, 63

nicotine pol gum 4MG orig, 46

Noble Mystiq CRE Emu-lac, 21

Novolin Inj 70/30, 25

nicotine pol gum 4MG ref, 46

nolix lot 0.05%, 19

Novolin N Inj Relion, 25

nicotine pol gum 4MG strt, 46

Nor-QD TAB 0.35MG, 24

Novolin N Inj U-100, 25

nicotine pol gum 4mgfruit, 46

nora-be TAB 0.35MG, 24

Novolin R Inj Relion, 25

nicotine pol loz 2MG chry, 46

Norco TAB 10-325MG, 53

Novolin R Inj U-100, 25

nicotine pol loz 2MG cinn, 46

Norco TAB 5-325MG, 53

Novolin70/30 Inj Relion, 25

nicotine pol loz 2MG mint, 46

Norco TAB 7.5-325, 53

Novolog Inj 100/ML, 25

nicotine pol loz 4MG chry, 46

Norditropin Inj 10/1.5ML, 27

Novolog Inj Flexpen, 25

nicotine pol loz 4MG cinn, 46

Norditropin Inj 15/1.5ML, 27

Novolog Inj Penfill, 25

nicotine pol loz 4MG mint, 46

Norditropin Inj 30/3ML, 27

Novolog Mix Inj 70/30, 25

Nicotine SYS Kit Transder, 47

Norditropin Inj 5/1.5ML, 27

Novolog Mix Inj Flexpen, 25

nicotine TD dis 14MG/24h, 46

nore/ETH/fer chw 0.4MG-35, 24

Novotwist Mis 30GX8MM, 63

nicotine TD dis 21MG/24h, 46

noreth/ethin chw FE, 24

Novotwist Mis 32GX5MM, 64

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Noxafil Sus 40MG/ML, 3

olanza/fluox CAP 3-25MG, 47

Onetouch Mis Lancets, 64

Noxafil TAB 100MG, 3

olanza/fluox CAP 6-25MG, 47

Onetouch Sol Ult Cont, 64

NP thyroid TAB 120MG, 29

olanza/fluox CAP 6-50MG, 47

Onetouch Sol Verio, 64

NP thyroid TAB 15MG, 29

olanzapine inj 10MG, 40

Onetouch Sol Verio-HI, 64

NP thyroid TAB 30MG, 29

olanzapine TAB 10MG, 39

Onetouch Tes Ultra, 64

NP thyroid TAB 60MG, 29

olanzapine TAB 10MG odt, 40

Onetouch Tes Ultra BL, 64

NP thyroid TAB 90MG, 29

olanzapine TAB 15MG, 39

Onetouch Tes Verio, 64

nu-iron 150 CAP 150MG, 34

olanzapine TAB 15MG odt, 40

Onetouch Us Mis Lancets, 64

Nucort Lot 2%, 19

olanzapine TAB 2.5MG, 39

Onexton Gel 1.2-3.75, 17

Nucynta ER TAB 100MG, 53

olanzapine TAB 20MG, 39

Onfi Sus 2.5MG/ML, 43

Nucynta ER TAB 150MG, 53

olanzapine TAB 20MG odt, 40

Onfi TAB 10MG, 43

Nucynta ER TAB 200MG, 53

olanzapine TAB 5MG, 39

Onfi TAB 20MG, 43

Nucynta ER TAB 250MG, 53

olanzapine TAB 5MG odt, 40

Onglyza TAB 2.5MG, 26

Nucynta ER TAB 50MG, 53

olanzapine TAB 7.5MG, 39

Onglyza TAB 5MG, 26

Nucynta TAB 100MG, 53

olm MED/amlo TAB /hctz, 13

Onmel TAB 200MG, 3

Nucynta TAB 50MG, 53

olm MED/hctz TAB 20-12.5, 13

Opana ER TAB 10MG, 53

Nucynta TAB 75MG, 53

olm MED/hctz TAB 40-12.5, 13

Opana ER TAB 15MG, 53

Nuedexta CAP 20-10MG, 47

olm MED/hctz TAB 40-25MG, 13

Opana ER TAB 20MG, 53

nulev TAB 0.125MG, 30

olmesa medox TAB 20MG, 11

Opana ER TAB 30MG, 53

Nulytely Sol Flav Pks, 30

olmesa medox TAB 40MG, 11

Opana ER TAB 40MG, 53

Numbonex Lot 2.75%, 21

olmesa medox TAB 5MG, 11

Opana ER TAB 5MG, 53

Numoisyn Liq, 36

olopatadine dro 0.1%, 50

Opana ER TAB 7.5MG, 53

Numoisyn Loz, 36

olopatadine sol 0.2%, 50

Opana TAB 10MG, 53

Nuplazid TAB 17MG, 40

olopatadine spr 0.6%, 56

Opana TAB 5MG, 53

Nutropin AQ Inj 10MG/2ML, 27

Olux Aer 0.05%, 19

opcicon TAB 1.5MG, 24

Nutropin AQ Inj 20MG/2ML, 27

Olux-e Aer 0.05%, 19

opium tin 10MG/ML, 30

Nutropin AQ Inj Nuspin 5, 27

Olysio CAP 150MG, 4

Opsumit TAB 10MG, 15

Nuvaring Mis, 24

Omeclamox- Mis PAK, 31

Optichamber Mis Adv Lrg, 66

Nuvessa Gel 1.3%, 33

omega-3-acid CAP 1gm, 15

Optichamber Mis Adv MED, 66

Nuvigil TAB 150MG, 42

omeppi CAP 20-1100, 30

Optichamber Mis Adv Sm, 66

Nuvigil TAB 200MG, 42

omeppi CAP 40-1100, 30

Optichamber Mis Advantag, 66

Nuvigil TAB 250MG, 42

omepra/bicar CAP 20-1100, 31

Optichamber Mis Dia LG, 66

Nuvigil TAB 50MG, 42

omepra/bicar CAP 40-1100, 31

Optichamber Mis Dia MD, 66

nyamyc pow 100000, 17

omepra/bicar pow 20-1680, 30

Optichamber Mis Dia Sm, 66

nyata pow 100000, 17

omepra/bicar pow 40-1680, 30

Optichamber Mis Diamond, 66

Nymalize Sol 30/10ML, 10

Omeprazole + Sus Syrspend, 31

Optichamber Mis Face Mas, 66

Nymalize Sol 60/20ML, 10

omeprazole CAP 10MG, 30

Optihaler Mis, 66

nystat/triam CRE, 17

omeprazole CAP 20MG, 30

Optimal D3 M CAP, 59

nystat/triam oin, 17

omeprazole CAP 40MG, 30

optimal-d CAP 50000unt, 59

nystatin CRE 100000, 17

Omnaris Spr, 56

option 2 TAB 1.5MG, 24

nystatin oin 100000, 17

Omnipred Sus 1% Op, 49

Optumrx Cont Sol Level1/2, 64

nystatin pow, 3

Omnitrope Inj 10/1.5ML, 27

opurity vit chw d 5000un, 59

nystatin pow 100000, 17

Omnitrope Inj 5.8MG, 27

Oracea CAP 40MG, 17

nystatin sus 100000, 36

Omnitrope Inj 5/1.5ML, 27

Oracit Sol, 34

nystatin TAB 500000, 3

On Call Expr Sol Glucose, 64

oralone dent pst 0.1%, 36

nystop pow 100000, 17

On Call Lanc Mis Device, 64

Orap TAB 1MG, 47

O

On Call Mis Lancets, 64

Orap TAB 2MG, 47

On Call Plus Mis Lanc Dev, 64

Orapred Odt TAB 10MG, 22

Obredon Sol 2.5-200, 57

On Call Plus Mis Lancets, 64

Orapred Odt TAB 15MG, 22

Ocaliva TAB 10MG, 32

On Call Plus Sol Control, 64

Orapred Odt TAB 30MG, 22

Ocaliva TAB 5MG, 32

On Call Vivd Sol Control, 64

Oravig TAB 50MG, 36

ocella TAB 3-0.03MG, 24

On-the-go Mis Lanc 30G, 64

Orencia Clck Inj 125MG/ML, 54

octreotide inj 1000mcg, 27

ondansetron inj 40/20ML, 31

Orencia Inj 125MG/ML, 54

octreotide inj 100mcg, 27

ondansetron inj 4MG/2ML, 31

Orencia Inj 250MG, 54

octreotide inj 200mcg, 27

ondansetron sol 4MG/5ML, 31

Orencia Inj 50/0.4, 54

octreotide inj 500mcg, 27

ondansetron TAB 24MG, 31

Orencia Inj 87.5/0.7, 54

octreotide inj 50mcg/ML, 27

ondansetron TAB 4MG, 31

Orenitram TAB 0.125MG, 16

Ocufen Sol 0.03% Op, 50

ondansetron TAB 4MG odt, 31

Orenitram TAB 0.25MG, 15

Ocuflox Dro 0.3% Op, 48

ondansetron TAB 8MG, 31

Orenitram TAB 1MG, 15

Odefsey TAB, 4

ondansetron TAB 8MG odt, 31

Orenitram TAB 2.5MG, 15

Ofev CAP 100MG, 58

One A Day CAP Prenatal, 60

Orenitram TAB 5MG, 15

Ofev CAP 150MG, 58

One A Day Mis Prenatal, 60

Orfadin CAP 10MG, 28

ofloxacin dro 0.3% op, 48

One A Day PAK Prenatal, 60

Orfadin CAP 20MG, 28

ofloxacin dro 0.3%otic, 50

One-a-day PAK Prenatal, 60

Orfadin CAP 2MG, 28

Ofloxacin TAB 300MG, 3

Onetouch Fp Mis Lancets, 64

Orfadin CAP 5MG, 28

ofloxacin TAB 400MG, 3

Onetouch Mis 30G, 64

Orfadin Sus 4MG/ML, 28

Ogestrel TAB, 24

Onetouch Mis Combo, 64

Orkambi TAB 100-125, 58

olanza/fluox CAP 12-25MG, 47

Onetouch Mis Lanc Dev, 64

Orkambi TAB 200-125, 58

olanza/fluox CAP 12-50MG, 47

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orphenadrine inj 30MG/ML, 48

oxybutynin TAB 5MG, 33

Pancreaze CAP, 31

orphenadrine TAB 100MG ER, 48

oxybutynin TAB 5MG ER, 33

Pancreaze CAP 10500unt, 31

orsythia TAB, 24

oxycod/apap TAB 10-325MG, 51

Pancreaze CAP 16800unt, 31

Ortho Micron TAB 0.35MG, 24

oxycod/apap TAB 2.5-325, 51

Pancreaze CAP 21000unt, 32

Ortho Tri- TAB Cyclen, 24

oxycod/apap TAB 5-325MG, 51

Pancreaze CAP 4200unit, 32

Ortho Tri- TAB Cycln LO, 24

oxycod/apap TAB 7.5-325, 51

Pancrelipase CAP 5000unit, 31

Ortho-cyclen TAB 0.25/35, 24

oxycod/asa TAB, 51

Panda Mask Mis Large, 66

Ortho-novum TAB 1/35, 24

Oxycod/Ibu TAB 5-400MG, 53

Panda Mask Mis Medium, 66

Ortho-novum TAB 7/7/7, 24

oxycodone CAP 5MG, 52

Panda Mask Mis Pediatri, 66

oscimin SR TAB 0.375MG, 31

oxycodone CON 100/5ML, 51

Panda Mask Mis Small, 66

oscimin sub 0.125MG, 31

oxycodone CON 20MG/ML, 51

Pandel CRE 0.1%, 19

oscimin TAB 0.125MG, 31

oxycodone sol 5MG/5ML, 51

pantoprazole TAB 20MG, 30

oscion clnsr lot 6%, 16

oxycodone TAB 10MG, 51

pantoprazole TAB 40MG, 30

oseltamivir CAP 30MG, 4

Oxycodone TAB 10MG ER, 52

papaverine inj 30MG/ML, 15

oseltamivir CAP 45MG, 4

oxycodone TAB 15MG, 51

Papaverine Sol 30MG/ML, 15

oseltamivir CAP 75MG, 4

Oxycodone TAB 15MG ER, 53

Parafon Fort TAB 500MG, 48

Oseni TAB 12.5-15, 26

oxycodone TAB 20MG, 51

Paragard Iud T380a, 24

Oseni TAB 12.5-30, 26

Oxycodone TAB 20MG ER, 52

Paregoric Tin 2MG/5ML, 30

Oseni TAB 12.5-45, 26

oxycodone TAB 30MG, 51

paricalcitol CAP 1 mcg, 28

Oseni TAB 25-15MG, 26

Oxycodone TAB 30MG ER, 53

paricalcitol CAP 2 mcg, 28

Oseni TAB 25-30MG, 26

Oxycodone TAB 40MG ER, 52

paricalcitol CAP 4 mcg, 28

Oseni TAB 25-45MG, 26

oxycodone TAB 5MG, 51

Parlodel CAP 5MG, 45

Osmoprep TAB 1.5gm, 30

Oxycodone TAB 60MG ER, 52

Parlodel TAB 2.5MG, 45

Osphena TAB 60MG, 27

Oxycodone TAB 80MG ER, 52

Parnate TAB 10MG, 38

Otezla TAB 10/20/30, 54

Oxycodone/ Sol Apap, 53

paroex sol 0.12%, 36

Otezla TAB 30MG, 54

Oxycontin TAB 10MG CR, 52

paromomycin CAP 250MG, 3

Otovel Dro, 50

Oxycontin TAB 15MG CR, 52

paroxetin ER TAB 12.5MG, 38

Otrexup Inj 10MG, 55

Oxycontin TAB 20MG CR, 52

paroxetin ER TAB 37.5MG, 38

Otrexup Inj 12.5/0.4, 55

Oxycontin TAB 30MG CR, 52

paroxetine CAP 7.5MG, 47

Otrexup Inj 15MG, 55

Oxycontin TAB 40MG CR, 52

paroxetine TAB 10MG, 38

Otrexup Inj 17.5/0.4, 55

Oxycontin TAB 60MG CR, 52

paroxetine TAB 20MG, 38

Otrexup Inj 20MG, 55

Oxycontin TAB 80MG CR, 52

paroxetine TAB 25MG ER, 38

Otrexup Inj 22.5/0.4, 55

oxymorphone TAB 10MG ER, 52

paroxetine TAB 30MG, 38

Otrexup Inj 25MG, 55

Oxymorphone TAB 10MG ER, 53

paroxetine TAB 40MG, 38

Otrexup Inj 7.5/0.4, 55

oxymorphone TAB 15MG ER, 52

Paser Gra 4gm, 3

Ovace Plus Aer 9.8%, 18

Oxymorphone TAB 15MG ER, 53

Pataday Sol 0.2%, 50

Ovace Plus CRE 10%, 18

oxymorphone TAB 20MG ER, 52

Patanase Spr 0.6%, 56

Ovace Plus Gel 10% Wash, 18

Oxymorphone TAB 20MG ER, 53

Patanol Sol 0.1% Op, 50

Ovace Plus Liq 10% Wash, 18

oxymorphone TAB 30MG ER, 52

Paxil CR TAB 12.5MG, 38

Ovace Plus Sha 10%, 18

Oxymorphone TAB 30MG ER, 53

Paxil CR TAB 25MG, 38

Ovace Wash Liq 10%, 18

oxymorphone TAB 40MG ER, 52

Paxil CR TAB 37.5MG, 38

Ovcon-35 TAB, 24

Oxymorphone TAB 40MG ER, 53

Paxil Sus 10MG/5ML, 38

Ovide Lot 0.5%, 21

oxymorphone TAB 5MG ER, 52

Paxil TAB 10MG, 38

Oxandrin TAB 10MG, 22

Oxymorphone TAB 5MG ER, 53

Paxil TAB 20MG, 38

Oxandrin TAB 2.5MG, 22

oxymorphone TAB 7.5MG ER, 52

Paxil TAB 30MG, 38

oxandrolone TAB 10MG, 22

Oxymorphone TAB 7.5MG ER, 53

Paxil TAB 40MG, 38

oxandrolone TAB 2.5MG, 22

oxymorphone TAB HCL 10MG, 52

Pazeo Dro 0.7%, 50

oxaprozin TAB 600MG, 54

oxymorphone TAB HCL 5MG, 52

PC Lancets Mis 30G, 64

Oxaydo TAB 5MG, 53

Oxytrol Dis 3.9MG/24, 33

PCE TAB 333MG EC, 2

Oxaydo TAB 7.5MG, 53

P

PCE TAB 500MG EC, 2

oxazepam CAP 10MG, 37

PE/Guaifenes Dro 1.5-20MG, 57

PA vitamin CAP 2000unit, 59

oxazepam CAP 15MG, 37

pedia d-vite dro 400unit, 59

pacerone TAB 100MG, 11

oxazepam CAP 30MG, 37

pedia iron dro 15MG/ML, 35

pacerone TAB 200MG, 10

oxcarbazepin sus 300MG/5m, 43

Pediaderm HC Kit, 19

pacerone TAB 400MG, 11

oxcarbazepin TAB 150MG, 43

Pediapred Sol 6.7/5ML, 22

Pain Ease Aer MD Strm, 21

oxcarbazepin TAB 300MG, 43

Pediarix Inj 0.5ML, 58

Pain Ease Aer Mist, 21

oxcarbazepin TAB 600MG, 43

Pedvax HIB Inj, 58

Pain Relief Pad Patch, 21

oxiconazole CRE nitrate, 17

peg 3350 pow, 30

paliperidone TAB ER 1.5MG, 40

Oxistat CRE 1%, 17

peg 3350 sol electrol, 30

paliperidone TAB ER 3MG, 40

Oxistat Lot 1%, 18

peg-3350 sol electrol, 30

paliperidone TAB ER 6MG, 40

Oxsoralen Lot 1%, 21

peg-3350/KCL sol /sodium, 30

paliperidone TAB ER 9MG, 40

Oxsoralen-ul CAP 10MG, 18

Peg-intron Kit 120 Rp, 4

Pamelor CAP 10MG, 38

Oxtellar XR TAB 150MG, 44

Peg-intron Kit 120mcg, 4

Pamelor CAP 25MG, 38

Oxtellar XR TAB 300MG, 44

Peg-intron Kit 150 Rp, 4

Pamelor CAP 50MG, 38

Oxtellar XR TAB 600MG, 44

Peg-intron Kit 150mcg, 4

Pamelor CAP 75MG, 38

oxybutynin syp 5MG/5ML, 33

Peg-intron Kit 50mcg, 4

Pamine Forte TAB 5MG, 31

oxybutynin TAB 10MG ER, 33

Peg-intron Kit 50mcg Rp, 4

Pamine TAB 2.5MG, 31

oxybutynin TAB 15MG ER, 33

Peg-intron Kit 80mcg Rp, 4

Panatuss Dxp Liq, 57

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peg-prep kit, 30

perindopril TAB 8MG, 11

Picato Gel 0.015%, 8

peg3350 pow, 30

periogard sol 0.12%, 36

Picato Gel 0.05%, 8

Peganone TAB 250MG, 44

Permavan Pad, 21

pilocarpine sol 1% op, 49

Pegasys Inj, 4

permethrin CRE 5%, 20

pilocarpine sol 2% op, 49

Pegasys Inj 180mcg/M, 4

Perphen/Amit TAB 2-10MG, 45

pilocarpine sol 4% op, 49

Pegasys Inj Proclick, 4

Perphen/Amit TAB 2-25MG, 45

pilocarpine TAB 5MG, 36

Pegintron Kit 120mcg, 4

Perphen/Amit TAB 4-10MG, 45

pilocarpine TAB 7.5MG, 36

Pegintron Kit 150mcg, 4

Perphen/Amit TAB 4-25MG, 45

pimozide TAB 1MG, 45

Pegintron Kit 50mcg, 4

Perphen/Amit TAB 4-50MG, 45

pimozide TAB 2MG, 45

Pegintron Kit 80mcg, 4

perphenazine TAB 16MG, 39

pimtrea TAB, 24

pegylax pow, 30

perphenazine TAB 2MG, 39

pindolol TAB 10MG, 9

Pen Needle Mis 29GX1/2", 64

perphenazine TAB 4MG, 39

pindolol TAB 5MG, 9

Pen Needle Mis 32GX4MM, 64

perphenazine TAB 8MG, 39

pioglit/glim TAB 30-2MG, 26

Pen Needles Mis 29GX1/2", 64

Perry Prenat CAP, 60

pioglit/glim TAB 30-4MG, 26

Pen Needles Mis 29GX10MM, 64

Persantine TAB 25MG, 36

pioglita/met TAB 15-500MG, 26

Pen Needles Mis 29GX12.7, 64

Persantine TAB 50MG, 36

pioglita/met TAB 15-850MG, 26

Pen Needles Mis 29GX12MM, 64

Persantine TAB 75MG, 36

pioglitazone TAB 15MG, 26

Pen Needles Mis 30GX5/16, 64

Pertzye CAP, 32

pioglitazone TAB 30MG, 26

Pen Needles Mis 30GX5MM, 64

Pexeva TAB 10MG, 38

pioglitazone TAB 45MG, 26

Pen Needles Mis 30GX8MM, 64

Pexeva TAB 20MG, 38

pirmella TAB 1/35, 24

Pen Needles Mis 31GX1/4", 64

Pexeva TAB 30MG, 38

pirmella TAB 7/7/7, 24

Pen Needles Mis 31GX3/16, 64

Pexeva TAB 40MG, 38

piroxicam CAP 10MG, 54

Pen Needles Mis 31GX5/16, 64

pharbedryl CAP 50MG, 56

piroxicam CAP 20MG, 54

Pen Needles Mis 31GX5MM, 64

Pharmacy Cou Mis Lancets, 64

Plan B TAB 1.5MG, 24

Pen Needles Mis 31GX6MM, 64

phenadoz sup 12.5MG, 56

Plaquenil TAB 200MG, 5

Pen Needles Mis 31GX8MM, 64

phenadoz sup 25MG, 56

Plavix TAB 300MG, 36

Pen Needles Mis 32GX4MM, 64

phenazo TAB 200MG, 34

Plavix TAB 75MG, 36

Pen Needles Mis 32GX5/32, 64

phenazopyrid TAB 100MG, 34

Plegridy Inj, 47

Pen Needles Mis 32GX5MM, 64

phenazopyrid TAB 200MG, 34

Plegridy Inj Pen, 47

Pen Needles Mis 32GX6MM, 64

phenelzine TAB 15MG, 38

Plegridy Inj Starter, 47

Pen Needles Mis 32GX8MM, 64

Phener Fort Syp 25MG/5ML, 56

Plegridy Pen Inj Starter, 47

Pen Needles Mis 33GX4MM, 64

Phenergan Inj 25MG/ML, 56

Pletal TAB 100MG, 36

penicilln vk sol 125/5ML, 1

Phenergan Inj 50MG/ML, 56

Pletal TAB 50MG, 36

Penicilln Vk Sol 125/5ML, 1

phenergan sup 12.5MG, 56

Plexion Clth Pad 9.8-4.8%, 17

penicilln vk sol 250/5ML, 1

phenergan sup 25MG, 56

Plexion CRE 9.8-4.8%, 17

Penicilln Vk Sol 250/5ML, 1

phenergan sup 50MG, 56

Plexion Liq 9.8-4.8%, 17

penicilln vk TAB 250MG, 1

phenobarb elx 20MG/5ML, 41

Plexion Lot 9.8-4.8%, 17

penicilln vk TAB 500MG, 1

Phenobarb Inj 130MG/ML, 41

Pneumovax 23 Inj 25/0.5, 58

Penlac Sol 8%, 18

phenobarb sol 20MG/5ML, 41

Pocket Chamb Mis, 66

Penlet II Kit Blood, 64

Phenobarb TAB 100MG, 41

Pocket Space Mis, 66

Penlet II Mis Repl CAP, 64

Phenobarb TAB 15MG, 41

Pocketchem Sol EZ, 64

Pennsaid Sol 2%, 18

phenobarb TAB 16.2MG, 41

Podocon Sol 25%, 21

Pentacel Inj, 58

Phenobarb TAB 30MG, 41

podofilox sol 0.5%, 20

Pentam 300 Inj 300MG, 6

phenobarb TAB 32.4MG, 41

poly-iron CAP 150MG, 35

Pentasa CAP 250MG CR, 32

Phenobarb TAB 60MG, 41

polycin oin op, 48

Pentasa CAP 500MG CR, 32

phenobarb TAB 64.8MG, 41

polyeth GLYC pow 3350 NF, 30

pentaz/nalox TAB 50-0.5MG, 52

phenobarb TAB 97.2MG, 41

polyeth GLYC pow 3350-grx, 30

Pentips Mis 29GX12MM, 64

phenoxybenza CAP 10MG, 12

polymyxin b/ sol trimethp, 48

Pentips Mis 31GX5MM, 64

Phentolamine Inj 5MG, 12

Polytrim Sol Op, 48

Pentips Mis 31GX6MM, 64

phenylbutyra pow sodium, 28

Pomalyst CAP 1MG, 7

Pentips Mis 31GX8MM, 64

phenylephrin sol 10% op, 49

Pomalyst CAP 2MG, 7

Pentips Mis 32GX4MM, 64

phenylephrin sol 2.5% op, 49

Pomalyst CAP 3MG, 7

pentobarb inj 1000/20, 41

Phenytek CAP 200MG, 44

Pomalyst CAP 4MG, 7

pentoxifylli TAB 400MG ER, 36

Phenytek CAP 300MG, 44

Ponstel CAP 250MG, 55

Pepcid Sus 40MG/5ML, 31

phenytoin chw 50MG, 43

portia-28 TAB, 24

Pepcid TAB 20MG, 31

phenytoin EX CAP 100MG, 43

pot citrate TAB 1080MG, 34

Pepcid TAB 40MG, 31

phenytoin EX CAP 200MG, 43

pot citrate TAB 1620MG, 34

Pepsin Pow, 31

phenytoin EX CAP 300MG, 43

pot citrate TAB 540MG ER, 34

Percocet TAB 10-325MG, 53

phenytoin inj 50MG/ML, 43

pot citrate- PAK CIT acid, 34

Percocet TAB 2.5-325, 53

phenytoin sus 125/5ML, 43

Potiga TAB 200MG, 44

Percocet TAB 5-325MG, 53

philith TAB 0.4-35, 24

Potiga TAB 300MG, 44

Percocet TAB 7.5-325, 53

Phlag Spr, 21

Potiga TAB 400MG, 44

Perfect 28G Mis Lancets, 64

Phoslyra Sol, 32

Potiga TAB 50MG, 44

Perfect 30G Mis Lancets, 64

phosphasal TAB, 33

powderlax pow, 30

Perfect Iron TAB 25MG, 35

Phospholine Sol 0.125%op, 49

Pradaxa CAP 110MG, 36

Perforomist Neb 20mcg, 57

phrenilin CAP forte, 51

Pradaxa CAP 150MG, 36

perindopril TAB 2MG, 11

phytonadione inj 1MG/0.5, 59

Pradaxa CAP 75MG, 36

perindopril TAB 4MG, 11

Pic 200 CAP, 35

Praluent Inj 150MG/ML, 14

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Praluent Inj 75MG/ML, 14

Prednisone PAK 5MG, 21

Prilosec CAP 20MG, 31

pramipexole TAB 0.125MG, 44

Prednisone Sol 5MG/5ML, 21

Prilosec CAP 40MG, 31

pramipexole TAB 0.25MG, 44

prednisone TAB 10MG, 21

Prilosec Pow 10MG, 31

pramipexole TAB 0.375 ER, 45

prednisone TAB 1MG, 21

Prilosec Pow 2.5MG, 31

pramipexole TAB 0.5MG, 44

prednisone TAB 2.5MG, 21

priloxx LP kit 2.5-2.5%, 20

pramipexole TAB 0.75 ER, 45

prednisone TAB 20MG, 21

Primaquine TAB 26.3MG, 5

pramipexole TAB 0.75MG, 44

Prednisone TAB 50MG, 21

primidone TAB 250MG, 43

pramipexole TAB 1.5MG, 44

prednisone TAB 5MG, 21

primidone TAB 50MG, 43

pramipexole TAB 1.5MG ER, 45

Prefest TAB, 23

Primlev TAB 10-300MG, 53

pramipexole TAB 1MG, 44

Premarin TAB 0.3MG, 23

Primlev TAB 5-300MG, 53

pramipexole TAB 2.25 ER, 45

Premarin TAB 0.45MG, 23

Primlev TAB 7.5-300, 53

pramipexole TAB 3.75 ER, 45

Premarin TAB 0.625MG, 23

Primsol Sol 50MG/5ML, 5

pramipexole TAB 3MG ER, 45

Premarin TAB 0.9MG, 23

Prinivil TAB 10MG, 11

pramipexole TAB 4.5MG ER, 45

Premarin TAB 1.25MG, 23

Prinivil TAB 20MG, 11

Pramosone CRE 1-1%, 19

Premarin Vag CRE 0.625MG, 33

Prinivil TAB 5MG, 11

Pramosone CRE 1-2.5%, 19

Premphase TAB, 23

Pristiq TAB 100MG, 38

Pramosone Lot 1%, 19

Prempro TAB .625-2.5, 23

Pristiq TAB 25MG, 38

Pramosone Lot 2.5%, 19

Prempro TAB 0.3-1.5, 23

Pristiq TAB 50MG, 38

Pramotic Dro 1-0.1%, 50

Prempro TAB 0.45-1.5, 23

Pro Comfort Mis 31G, 64

pramox gel 1%, 20

Prempro TAB 0.625-5, 23

Pro Comfort Mis 31GX8MM, 64

Prandimet TAB 1-500MG, 26

Prenat Multi CAP +dha, 60

Pro Comfort Mis 32GX4MM, 64

Prandimet TAB 2-500MG, 26

Prenatal CAP Formula, 60

Pro Comfort Mis 32GX5MM, 64

Prandin TAB 0.5MG, 26

Prenatal CAP Omega-3, 60

Pro Comfort Mis 32GX6MM, 64

Prandin TAB 1MG, 26

Prenatal Mul CAP +dha, 60

Pro Comfort Mis Lancets, 64

Prandin TAB 2MG, 26

Prenatal MV Mis + DHA, 60

Pro:12 Aer Mousse, 21

prasugrel TAB 10MG, 36

Prenatal One TAB Daily, 60

Proair HFA Aer, 57

prasugrel TAB 5MG, 36

Prenatal TAB, 60

Proair Respi Aer, 57

Pravachol TAB 20MG, 15

Prenatal TAB 27-0.8MG, 60

proben/colch TAB 500-0.5, 55

Pravachol TAB 40MG, 15

Prenatal TAB 28-0.8MG, 60

probenecid TAB 500MG, 55

Pravachol TAB 80MG, 15

Prenatal TAB Complete, 60

Procainamide Inj 100MG/ML, 11

pravastatin TAB 10MG, 14

Prenatal TAB Formula, 60

Procainamide Inj 500MG/ML, 11

pravastatin TAB 20MG, 14

Prenatal TAB Forte, 60

Procardia CAP 10MG, 10

pravastatin TAB 40MG, 14

Prenatal TAB Iron, 60

Procardia XL TAB 30MG CR, 10

pravastatin TAB 80MG, 14

Prenatal TAB Low Iron, 60

Procardia XL TAB 60MG CR, 10

prazosin HCL CAP 1MG, 12

Prenatal TAB Multivit, 60

Procardia XL TAB 90MG CR, 10

prazosin HCL CAP 2MG, 12

Prenatal TAB Plus DHA, 60

Procentra Sol 5MG/5ML, 42

prazosin HCL CAP 5MG, 12

Prenatal TAB Vitamins, 60

prochlorper inj 10MG/2ML, 39

Pre-natal TAB Formula, 60

Prenatal Vit TAB 28-0.8MG, 60

prochlorper sup 25MG, 39

Precision Liq Control, 64

Prenatal Vit TAB Minerals, 60

prochlorper TAB 10MG, 39

Precision Liq Gluc/Ket, 64

Prenatal/FE TAB, 60

prochlorper TAB 5MG, 39

Precision Liq Nrml/Mid, 64

Prenatl Mult CAP + DHA, 60

Procort CRE, 32

Precision Mis 28G, 64

Prentat Mult CAP Plus DHA, 60

Procrit Inj 10000/ML, 34

Precision Mis 28g(t), 64

Prepidil Gel 0.5MG/3G, 50

Procrit Inj 2000/ML, 34

Precose TAB 100MG, 26

Prepopik PAK, 30

Procrit Inj 20000/ML, 34

Precose TAB 25MG, 26

Presera Aer, 21

Procrit Inj 3000/ML, 34

Precose TAB 50MG, 26

Pressure Act Mis Lancet, 64

Procrit Inj 4000/ML, 34

Pred Forte Sus 1% Op, 49

Pressure Act Mis Lancets, 64

Procrit Inj 40000/ML, 34

Pred Mild Sus 0.12% Op, 49

Prestalia TAB 14-10MG, 13

procto-MED CRE HC 2.5%, 32

Pred Sod PHO Sol 1% Op, 49

Prestalia TAB 3.5-2.5, 13

procto-PAK CRE 1%, 32

pred sod PHO sol 5MG/5ML, 21

Prestalia TAB 7-5MG, 13

Proctocort CRE 1%, 32

Pred-G S.o.p Oin Op, 49

Prevacid CAP 15MG DR, 31

Proctocort Sup 30MG, 32

Pred-G Sus Op, 49

Prevacid CAP 30MG DR, 31

Proctofoam Aer HC 1%, 32

Predni/Moxi/ Sol Bromfena, 49

Prevacid TAB 15MG Stb, 31

proctosol HC CRE 2.5%, 32

Predni/Moxi/ Sol Ketorola, 49

Prevacid TAB 30MG Stb, 31

proctozone CRE -HC 2.5%, 32

prednicarbat CRE 0.1%, 19

prevalite pow 4gm, 14

Procysbi CAP 25MG, 34

prednicarbat oin 0.1%, 19

prevalite pow 4gm pk, 14

Procysbi CAP 75MG, 34

prednisolone sol 10MG/5ML, 21

previfem TAB, 24

Prodigy Mis 26G, 64

prednisolone sol 15MG/5ML, 21

Prevnar 13 Inj, 58

Prodigy Mis 28G, 64

prednisolone sol 20MG/5ML, 21

Prevpac Mis, 31

Prodigy Mis Lanc Dev, 64

Prednisolone Sol 25MG/5ML, 21

Prezcobix TAB 800-150, 4

Prodigy NO Tes Coding, 64

Prednisolone Sol Moxiflox, 49

Prezista Sus 100MG/ML, 4

Prodigy Sol High, 64

prednisolone sus 1% op, 49

Prezista TAB 150MG, 4

Prodigy Sol Low, 64

prednisolone syp 15MG/5ML, 21

Prezista TAB 600MG, 4

Profe CAP 180MG, 35

prednisolone TAB 10MG odt, 22

Prezista TAB 75MG, 4

profeno TAB 600MG, 54

prednisolone TAB 15MG odt, 22

Prezista TAB 800MG, 4

Proferrin ES TAB 12 MG, 35

prednisolone TAB 30MG odt, 22

Priftin TAB 150MG, 3

progesterone CAP 100MG, 25

Prednisone CON 5MG/ML, 22

prilolid kit 2.5-2.5%, 20

progesterone CAP 200MG, 25

Prednisone PAK 10MG, 21

Prilosec CAP 10MG, 31

progesterone inj 50MG/ML, 25

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Progesterone Sup VGS 100, 34

protriptylin TAB 5MG, 38

Questran Pow 4gm, 15

Progesterone Sup VGS 200, 34

Proventil Aer HFA, 57

Questran Pow 4gm Lite, 15

Progesterone Sup VGS 25, 34

Provera TAB 10MG, 25

quetiapine TAB 100MG, 39

Progesterone Sup VGS 400, 34

Provera TAB 2.5MG, 25

quetiapine TAB 150MG ER, 40

Progesterone Sup VGS 50, 34

Provera TAB 5MG, 25

quetiapine TAB 200MG, 39

Proglycem Sus 50MG/ML, 26

Provigil TAB 100MG, 42

quetiapine TAB 200MG ER, 40

Prograf CAP 0.5MG, 7

Provigil TAB 200MG, 42

quetiapine TAB 25MG, 39

Prograf CAP 1MG, 7

Prozac CAP 10MG, 38

quetiapine TAB 300MG, 39

Prograf CAP 5MG, 7

Prozac CAP 20MG, 38

quetiapine TAB 300MG ER, 40

Prolensa Sol 0.07%, 50

Prozac CAP 40MG, 38

quetiapine TAB 400MG, 39

Prolia Sol 60MG/ML, 27

Prozac Weekl CAP 90MG, 38

quetiapine TAB 400MG ER, 40

Promacta TAB 12.5MG, 35

Pruclair CRE, 21

quetiapine TAB 50MG, 39

Promacta TAB 25MG, 35

Prudoxin CRE 5%, 18

quetiapine TAB 50MG ER, 40

Promacta TAB 50MG, 35

Prumyx CRE, 21

Quicktek Liq Solution, 64

Promacta TAB 75MG, 35

Psorcon CRE 0.05%, 19

Quillichew Chw 20MG ER, 42

prometh VC sol plain, 56

Pss Safe Lan Mis, 64

Quillichew Chw 30MG ER, 42

prometh VC/ syp codeine, 56

Pss Sel Lanc Mis, 64

Quillichew Chw 40MG ER, 42

prometh/cod syp 6.25-10, 56

Pss Sel Plat Mis, 64

Quillivant Sus 25MG/5ML, 42

prometh/PE syp 6.25-5/5, 56

Pulmicort Inh 180mcg, 57

quinapril TAB 10MG, 11

prometh/PE/ syp codeine, 56

Pulmicort Inh 90mcg, 57

quinapril TAB 20MG, 11

promethazine inj 25MG/ML, 56

Pulmicort Sus 0.25MG/2, 57

quinapril TAB 40MG, 11

promethazine inj 50MG/ML, 56

Pulmicort Sus 0.5MG/2, 57

quinapril TAB 5MG, 11

promethazine sol 6.25/5ML, 56

Pulmicort Sus 1MG/2ML, 57

Quinidine Gl Inj 80MG/ML, 11

promethazine sup 12.5MG, 56

pulmosal neb 7%, 56

quinidine gl TAB 324MG CR, 10

promethazine sup 25MG, 56

Pulmozyme Sol 1MG/ML, 58

quinidine gl TAB 324MG ER, 11

promethazine sup 50MG, 56

Purixan Sus 20MG/ML, 6

Quinidine SU TAB 200MG, 11

promethazine syp 6.25/5ML, 56

px aspirin chw 81MG, 51

quinidine SU TAB 300MG, 11

promethazine syp DM, 56

px aspirin TAB 325MG, 51

Quinidine SU TAB 300MG, 11

promethazine TAB 12.5MG, 56

px aspirin TAB 325MG EC, 51

Quinidine SU TAB 300MG ER, 11

promethazine TAB 25MG, 56

px aspirin TAB 81MG EC, 51

quinine sulf CAP 324MG, 5

promethazine TAB 50MG, 56

px iron TAB 200MG, 35

Quintet Cont Sol Hgh/Norm, 64

promethegan sup 12.5MG, 56

px iron TAB 27MG, 35

Qvar Aer 40mcg, 57

promethegan sup 25MG, 56

Px Lancets Mis 28G, 64

Qvar Aer 80mcg, 57

promethegan sup 50MG, 56

Px Lancets Mis Ult Thin, 64

R

Prometrium CAP 100MG, 25

Px Prenatal TAB Multivit, 60

ra aspirin chw 81MG, 51

Prometrium CAP 200MG, 25

Pylera CAP, 30

ra aspirin TAB 325MG, 51

Promiseb CRE, 18

pyrazinamide TAB 500MG, 3

ra aspirin TAB 325MG EC, 51

propafenone CAP 225MG ER, 11

Pyridium TAB 100MG, 34

ra aspirin TAB 81MG EC, 51

propafenone CAP 325MG ER, 11

Pyridium TAB 200MG, 34

ra child asa chw 81MG, 51

propafenone CAP 425MG SR, 11

pyridostigm TAB 60MG, 48

Ra E-ZJECT Mis 28G, 64

propafenone TAB 150MG, 10

pyridostigmi TAB ER 180MG, 48

Ra E-ZJECT Mis 33G, 64

propafenone TAB 225MG, 10

Pyrogall Acd Oin, 21

Ra E-ZJECT Mis Thin 26G, 64

propafenone TAB 300MG, 10

Q

Ra E-ZJECT Mis Thin 28G, 64

Propanthelin TAB 15MG, 30

Qbrelis Sol 1MG/ML, 11

Ra E-ZJECT Mis Ult Thin, 64

proparacaine sol 0.5% op, 50

qc aspirin TAB 325MG, 51

ra iron TAB 27MG, 35

Propran/Hctz TAB 40/25, 12

qc aspirin TAB 325MG EC, 51

ra iron TAB 325MG, 35

Propran/Hctz TAB 80/25, 12

qc child asa chw 81MG, 51

ra iron TAB 65MG, 35

propranolol CAP 120MG ER, 9

Qc Lancets Mis 28G, 64

ra laxative pow, 30

propranolol CAP 160MG ER, 9

Qc Lancets Mis 30G, 64

ra laxative TAB 5MG EC, 30

propranolol CAP 60MG ER, 9

Qc Lancing Mis Device, 64

ra nicotine dis 14MG/24h, 46

propranolol CAP 80MG ER, 9

qc laxative TAB 5MG EC, 30

ra nicotine dis 21MG/24h, 46

Propranolol Sol 20MG/5ML, 9

qc nicotine gum 4MG, 46

ra nicotine dis 7MG/24HR, 46

Propranolol Sol 40MG/5ML, 9

Qc Prenatal TAB 28-0.8MG, 60

ra nicotine gum 2MG, 46

propranolol TAB 10MG, 9

qnapril/hctz TAB 10-12.5, 12

ra nicotine gum 2MG cinn, 46

propranolol TAB 20MG, 9

qnapril/hctz TAB 20-12.5, 12

ra nicotine gum 2MG mint, 46

propranolol TAB 40MG, 9

qnapril/hctz TAB 20-25MG, 12

ra nicotine gum 2mgfruit, 46

propranolol TAB 60MG, 9

Qnasl Aer 80mcg, 56

ra nicotine gum 4MG, 46

propranolol TAB 80MG, 9

Qnasl Child Spr 40mcg, 56

ra nicotine gum 4MG frut, 46

propylthiour TAB 50MG, 28

Quadracel Inj, 58

ra nicotine gum 4MG mint, 46

Proquad Inj, 58

Qualaquin CAP 324MG, 5

ra nicotine loz 2MG mint, 46

Proscar TAB 5MG, 34

Quartette TAB, 24

ra nicotine loz 4MG mint, 46

Prostin E2 Sup 20MG, 50

quasense TAB, 24

Ra One Daily Mis, 60

Protonix PAK, 31

Quazepam TAB 15MG, 41

Ra Pen Needl Mis 31GX3/16, 64

Protonix TAB 20MG, 31

Qudexy XR CAP 100/24HR, 44

Ra Prenatal TAB 28-0.8MG, 60

Protonix TAB 40MG, 31

Qudexy XR CAP 150/24HR, 44

Ra Prenatal TAB Formula, 60

Protopic Oin 0.03%, 20

Qudexy XR CAP 200/24HR, 44

ra vitamin CAP 2000unit, 59

Protopic Oin 0.1%, 20

Qudexy XR CAP 25/24HR, 44

rabeprazole TAB 20MG, 30

protriptylin TAB 10MG, 38

Qudexy XR CAP 50/24HR, 44

rajani TAB, 24

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raloxifene TAB 60MG, 27

Reglan TAB 10MG, 32

Requip XL TAB 4MG, 45

ramipril CAP 1.25MG, 11

Reglan TAB 5MG, 32

Requip XL TAB 6MG, 45

ramipril CAP 10MG, 11

relador PAK kit 2.5-2.5%, 20

Requip XL TAB 8MG, 45

ramipril CAP 2.5MG, 11

relador PAK kit plus, 20

Rescriptor TAB 100 MG, 4

ramipril CAP 5MG, 11

Relagard Gel, 34

Rescriptor TAB 200MG, 4

Ranexa TAB 1000MG, 9

Releevia Mc Pad .0375-5%, 21

Rescula Sol 0.15%, 49

Ranexa TAB 500MG, 9

releevia ML pad 4-1%, 20

Reserpine TAB 0.1MG, 12

ranitidine CAP 150MG, 31

Releevia Pad .0375-5%, 21

Reserpine TAB 0.25MG, 12

ranitidine CAP 300MG, 31

Relenza Mis Diskhale, 4

Respa-BR TAB 11MG, 56

ranitidine syp 150/10ML, 30

Relhist Chw, 57

Restasis Emu 0.05%, 49

ranitidine syp 15MG/ML, 30

Relion Kit Lancing, 64

Restasis Mul Emu 0.05%, 49

ranitidine syp 75MG/5ML, 30

Relion Lance Mis Stnd 21G, 64

Restoril CAP 15MG, 41

ranitidine TAB 150MG, 30

Relion Lance Mis Thin 26G, 64

Restoril CAP 22.5MG, 41

ranitidine TAB 300MG, 30

Relion Lance Mis Thin 30G, 64

Restoril CAP 30MG, 41

Rapaflo CAP 4MG, 34

Relion Lanci Mis Device, 64

Restoril CAP 7.5MG, 41

Rapaflo CAP 8MG, 34

Relion Micro Mis Thin 33G, 64

Retin-a CRE 0.025%, 16

Rapamune Sol 1MG/ML, 7

Relion Pen Mis 29GX12MM, 64

Retin-a CRE 0.05%, 16

Rapamune TAB 0.5MG, 7

Relion Pen Mis 31GX6MM, 64

Retin-a CRE 0.1%, 16

Rapamune TAB 1MG, 7

Relion Pen Mis 31GX8MM, 64

Retin-a Gel 0.01%, 16

Rapamune TAB 2MG, 7

Relion Pen Mis 32GX4MM, 64

Retin-a Gel 0.025%, 16

Rapid-safe Mis Lancing, 64

Relion Thin Mis Lancets, 64

Retin-a Micr Gel 0.04%, 16

rasagiline TAB 0.5MG, 44

Relion Ultra Mis Thin, 64

Retin-a Micr Gel 0.04%pmp, 16

rasagiline TAB 1MG, 44

Relion Ultra Mis Thin 32G, 64

Retin-a Micr Gel 0.08%, 17

Rasuvo Inj 10MG, 54

Relion Ultra Mis Thin Pls, 64

Retin-a Micr Gel 0.1%, 16

Rasuvo Inj 12.5MG, 54

Relistor Inj 12/0.6ML, 32

Retin-a Micr Gel 0.1%P.M., 16

Rasuvo Inj 15MG, 54

Relistor Inj 8/0.4ML, 32

Retrovir CAP 100MG, 5

Rasuvo Inj 17.5MG, 54

Relistor TAB 150MG, 32

Retrovir Syp 50MG/5ML, 5

Rasuvo Inj 20MG, 54

Relpax TAB 20MG, 55

Revatio Sus 10MG/ML, 15

Rasuvo Inj 22.5MG, 54

Relpax TAB 40MG, 55

Revatio TAB 20MG, 15

Rasuvo Inj 25MG, 54

Remaxazon Pad, 21

Revia TAB 50MG, 54

Rasuvo Inj 27.5MG, 54

Remeron Sltb TAB 15MG, 38

Revlimid CAP 10MG, 7

Rasuvo Inj 30MG, 54

Remeron Sltb TAB 30MG, 38

Revlimid CAP 15MG, 7

Rasuvo Inj 7.5MG, 54

Remeron Sltb TAB 45MG, 38

Revlimid CAP 2.5MG, 7

Ravicti Liq 1.1gm/ML, 28

Remeron TAB 15MG, 38

Revlimid CAP 20MG, 7

Rayaldee CAP 30mcg, 28

Remeron TAB 30MG, 38

Revlimid CAP 25MG, 7

Rayos TAB 1MG, 22

Remeron TAB 45MG, 38

Revlimid CAP 5MG, 7

Rayos TAB 2MG, 22

remeven CRE 50%, 20

Rexaphenac CRE 1%, 18

Rayos TAB 5MG, 22

Remicade Inj 100MG, 32

Rexulti TAB 0.25MG, 40

Razadyne ER CAP 16MG, 47

Renacidin Sol, 34

Rexulti TAB 0.5MG, 40

Razadyne ER CAP 24MG, 47

Renacidin Sol Irr, 34

Rexulti TAB 1MG, 40

Razadyne ER CAP 8MG, 47

Renagel TAB 400MG, 32

Rexulti TAB 2MG, 40

Razadyne TAB 12MG, 47

Renagel TAB 800MG, 32

Rexulti TAB 3MG, 40

Razadyne TAB 4MG, 47

Renovo Pad 0.0375-5, 21

Rexulti TAB 4MG, 40

Razadyne TAB 8MG, 47

Renvela PAK 0.8gm, 32

Reyataz CAP 150MG, 4

rea LO 39 CRE 39%, 20

Renvela PAK 2.4gm, 32

Reyataz CAP 200MG, 4

rea LO 40 CRE 40%, 20

Renvela TAB 800MG, 32

Reyataz CAP 300MG, 4

react TAB 1.5MG, 24

repaglinide TAB 0.5MG, 26

Reyataz Pow 50MG, 5

Readylance Mis 21G, 64

Repaglinide TAB 1-500MG, 26

Rezira Sol 60-5/5ML, 57

Readylance Mis 23G, 64

repaglinide TAB 1MG, 26

Rheumatrex TAB 2.5MG, 55

Readylance Mis 26G, 64

Repaglinide TAB 2-500MG, 26

Rhinocort Sus Aqua, 56

Readylance Mis 28G, 64

repaglinide TAB 2MG, 26

Rhofade CRE 1%, 17

Readylance Mis 30G, 64

Repatha Inj 140MG/ML, 14

Ribapak PAK 1200/Day, 5

Reality Mis Lancets, 64

Repatha Push Inj 420/3.5, 14

Ribapak PAK 800/Day, 5

Reality Trig Mis Lancets, 64

Repatha Sure Inj 140MG/ML, 14

Ribapak TAB 1000/Day, 5

Rebetol CAP 200MG, 5

Replesta Nx Waf 14000unt, 59

Ribapak TAB 600/Day, 5

Rebetol Sol 40MG/ML, 4

Replesta Waf 14000unt, 59

ribasphere CAP 200MG, 4

Rebif Inj 22/0.5, 47

Replesta Waf 50000unt, 59

ribasphere TAB 200MG, 4

Rebif Inj 44/0.5, 47

reprexain TAB 10-200MG, 52

Ribasphere TAB 400MG, 5

Rebif Rebido Inj 22/0.5, 47

Reprexain TAB 5-200MG, 53

Ribasphere TAB 600MG, 5

Rebif Rebido Inj 44/0.5, 47

Requip TAB 0.25MG, 45

Ribatab TAB 1000/Day, 5

Rebif Rebido Inj Titratn, 47

Requip TAB 0.5MG, 45

Ribatab TAB 1200/Day, 5

Rebif Titrtn Inj Pack, 47

Requip TAB 1MG, 45

Ribatab TAB 800/Day, 5

reclipsen TAB, 24

Requip TAB 2MG, 45

ribavirin CAP 200MG, 4

Recombiva HB Inj 10mcg/ML, 58

Requip TAB 3MG, 45

ribavirin inh 6gm, 5

Recombiva HB Inj 5mcg/0.5, 58

Requip TAB 4MG, 45

ribavirin TAB 200MG, 4

Recombiva-HB Inj 40mcg/ML, 58

Requip TAB 5MG, 45

Ridaura CAP 3MG, 54

Rectiv Oin 0.4%, 32

Requip XL TAB 12MG, 45

rifabutin CAP 150MG, 3

Refuah Plus Sol Control, 64

Requip XL TAB 2MG, 45

Rifadin CAP 150MG, 3

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Rifadin CAP 300MG, 3

rivastigmine dis 9.5MG/24, 47

Safe-t-lance Mis HI Flow, 64

Rifamate CAP, 3

rivelsa TAB, 24

Safe-t-lance Mis Low Flow, 64

rifampin CAP 150MG, 3

rizatriptan TAB 10MG, 55

Safe-t-lance Mis Nor Flow, 64

rifampin CAP 300MG, 3

rizatriptan TAB 10MG odt, 55

Safe-t-pro Mis Lancets, 64

Rifater TAB, 3

rizatriptan TAB 5MG, 55

Safe-t-pro Mis Plus, 64

Right Step TAB Prenatal, 60

rizatriptan TAB 5MG odt, 55

Safety 21G Mis Lancets, 64

Rightest Alt Mis Adaptor, 64

Robaxin Inj 100MG/ML, 48

Safety 28G Mis Lancets, 64

Rightest Liq High CON, 64

Robaxin TAB 500MG, 48

Safety Let Mis Lancets, 64

Rightest Liq Norm CON, 64

Robaxin-750 TAB 750MG, 48

Safety Mis Lancets, 64

Rightest Mis GD500, 64

Robinul Fort TAB 2MG, 31

Safety Seal Mis 28G, 64

Rightest Mis Gl300, 64

Robinul Inj 0.2MG/ML, 31

Safety Seal Mis 30G, 64

Rilutek TAB 50MG, 48

Robinul TAB 1MG, 31

Safyral TAB, 24

riluzole TAB 50MG, 48

Rocaltrol CAP 0.25mcg, 28

Saizen Inj 5MG, 27

rimantadine TAB 100MG, 4

Rocaltrol CAP 0.5mcg, 28

Saizen Inj 8.8MG, 27

Rimso-50 Sol 50%, 34

Rocaltrol Sol 1mcg/ML, 28

Saizenprep Inj 8.8MG, 27

Riomet Sol, 25

ropinirole TAB 0.25MG, 44

salacyn CRE 6%, 20

Riomet Sol 500/5ML, 25

ropinirole TAB 0.5MG, 44

salacyn lot 6%, 20

risedron sod TAB 35MG DR, 27

ropinirole TAB 12MG ER, 45

Salagen TAB 5MG, 36

risedronate TAB 150MG, 27

ropinirole TAB 1MG, 44

Salagen TAB 7.5MG, 36

risedronate TAB 30MG, 27

ropinirole TAB 2MG, 44

Salex Sha 6%, 21

risedronate TAB 35MG, 27

ropinirole TAB 2MG ER, 45

salicylic ac CRE 6%, 20

risedronate TAB 5MG, 27

ropinirole TAB 3MG, 44

salicylic ac gel 6%, 20

Risperdal Inj 12.5MG, 39

ropinirole TAB 4MG, 45

salicylic ac liq 26%, 20

Risperdal Inj 25MG, 39

ropinirole TAB 4MG ER, 45

salicylic ac liq 27.5%, 20

Risperdal Inj 37.5MG, 39

ropinirole TAB 5MG, 45

salicylic ac lot 6%, 20

Risperdal Inj 50MG, 39

ropinirole TAB 6MG ER, 45

salicylic ac sha 6%, 20

Risperdal M TAB 0.5MG, 40

ropinirole TAB 8MG ER, 45

salicylic aer 6%, 20

Risperdal M TAB 1MG, 40

rosadan CRE 0.75%, 17

salisol fort sol 26%, 20

Risperdal M TAB 2MG, 40

rosadan gel 0.75%, 17

Salitech Lot 5%, 21

Risperdal M TAB 3MG, 40

Rosadan Kit 0.75%, 17

salitech lot forte, 20

Risperdal M TAB 4MG, 40

rosanil emu cleanser, 16

Salivamax Pow, 36

Risperdal Sol 1MG/ML, 40

Rosula Liq 10-4.5%, 17

Salivate RX Pow, 36

Risperdal TAB 0.25MG, 40

Rosula Pad 10-5%, 17

salsalate TAB 500MG, 50

Risperdal TAB 0.5MG, 40

rosuvastatin TAB 10MG, 14

salsalate TAB 750MG, 50

Risperdal TAB 1MG, 40

rosuvastatin TAB 20MG, 14

Salvax Aer 6%, 21

Risperdal TAB 2MG, 40

rosuvastatin TAB 40MG, 14

Samsca TAB 15MG, 28

Risperdal TAB 3MG, 40

rosuvastatin TAB 5MG, 14

Samsca TAB 30MG, 28

Risperdal TAB 4MG, 40

Rotarix Sus, 58

Sancuso Dis 3.1MG, 31

risperidone sol 1MG/ML, 39

Rotateq Sol, 58

Sandimmune CAP 100MG, 7

risperidone TAB 0.25 odt, 40

Rowasa Kit 4gm, 32

Sandimmune CAP 25MG, 7

risperidone TAB 0.25MG, 39

roweepra TAB 1000MG, 43

Sandimmune Sol 100MG/ML, 7

risperidone TAB 0.5MG, 39

roweepra TAB 500MG, 43

Sandostatin Inj 1000mcg, 28

risperidone TAB 0.5MG od, 40

roweepra TAB 750MG, 43

Sandostatin Inj 100mcg, 28

risperidone TAB 1MG, 39

Roxicodone TAB 15MG, 53

Sandostatin Inj 200mcg, 28

risperidone TAB 1MG odt, 40

Roxicodone TAB 30MG, 53

Sandostatin Inj 500mcg, 28

risperidone TAB 2MG, 39

Roxicodone TAB 5MG, 53

Sandostatin Inj 50mcg/ML, 28

risperidone TAB 2MG odt, 40

Rozerem TAB 8MG, 41

Sandostatin Kit Lar 10MG, 27

risperidone TAB 3MG, 39

Rubraca TAB 200MG, 8

Sandostatin Kit Lar 20MG, 27

risperidone TAB 3MG odt, 40

Rubraca TAB 250MG, 8

Sandostatin Kit Lar 30MG, 27

risperidone TAB 4MG, 39

Rubraca TAB 300MG, 8

Saphris Sub 10MG, 40

risperidone TAB 4MG odt, 40

Ruconest Inj 2100unit, 36

Saphris Sub 2.5MG, 40

Ritalin LA CAP 10MG, 42

Rydapt CAP 25MG, 8

Saphris Sub 5MG, 40

Ritalin LA CAP 20MG, 42

Rynoderm CRE 37.5%, 21

Saps Health Mis Twist, 64

Ritalin LA CAP 30MG, 42

Rytary CAP 145MG, 45

Sapscare Mis Twist, 64

Ritalin LA CAP 40MG, 42

Rytary CAP 195MG, 45

Sarafem TAB 10MG, 47

Ritalin LA CAP 60MG, 42

Rytary CAP 245MG, 45

Sarafem TAB 20MG, 48

Ritalin TAB 10MG, 42

Rytary CAP 95MG, 45

Savaysa TAB 15MG, 36

Ritalin TAB 20MG, 42

Rythmol SR CAP 225MG, 11

Savaysa TAB 30MG, 36

Ritalin TAB 5MG, 42

Rythmol SR CAP 325MG, 11

Savaysa TAB 60MG, 36

Riteflo Mis, 66

Rythmol SR CAP 425MG, 11

Savella Mis Titr PAK, 48

Rituxan Inj 100MG, 6

Rythmol TAB 150MG, 11

Savella TAB 100MG, 48

Rituxan Inj 500MG, 6

Rythmol TAB 225MG, 11

Savella TAB 12.5MG, 48

rivastigmine CAP 1.5MG, 45

Ryvent TAB 6MG, 56

Savella TAB 25MG, 48

rivastigmine CAP 3MG, 45

S

Savella TAB 50MG, 48

rivastigmine CAP 4.5MG, 45

SB aspirin TAB 325MG, 51

Sabril Pow 500MG, 43

rivastigmine CAP 6MG, 45

SB aspirin TAB 325MG EC, 51

Sabril TAB 500MG, 43

rivastigmine dis 13.3/24, 47

SB bisacodyl TAB 5MG EC, 30

Safe-t-lance Mis 21G, 64

rivastigmine dis 4.6MG/24, 47

SB child asa chw 81MG, 51

Safe-t-lance Mis 25G, 64

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SB Lancets Mis Thin, 65

Simbrinza Sus 1-0.2%, 49

sm nicotine gum 2MG mint, 46

SB Lancets Mis Ultr Thn, 65

Simcor TAB 1000-20, 15

sm nicotine gum 4MG, 46

scalacort lot 2%, 19

Simcor TAB 1000-40, 15

sm nicotine gum 4MG mint, 46

scopolamine dis 1MG/3day, 31

Simcor TAB 500-20MG, 15

sm nicotine loz 2MG mint, 46

Seasonique TAB, 24

Simcor TAB 500-40MG, 15

sm nicotine loz 4MG mint, 46

seb-prev liq wash, 18

Simcor TAB 750-20MG, 15

Sm One Daily Mis Prenatal, 60

Seconal CAP 100MG, 41

Similac Pren PAK Early Sh, 60

sm prenatal TAB vitamins, 59

Seconal Sod CAP 100MG, 41

Simple Diag Mis Lancing, 64

Sm Prenatal TAB Vitamins, 60

Sectral CAP 200MG, 9

Simponi Inj 100MG/ML, 54

Sm Truedraw Mis Lanc Dev, 65

Sectral CAP 400MG, 9

Simponi Inj 50/0.5ML, 54

sm vitamin d TAB 400unit, 59

Seebri Neoha CAP 15.6mcg, 57

simvastatin TAB 10MG, 14

Smart Sense Mis Lanc 21G, 65

Select-lite Kit Dev/Lanc, 64

simvastatin TAB 20MG, 14

Smart Sense Mis Lanc 26G, 65

Select-lite Mis Lanc Dev, 64

simvastatin TAB 40MG, 14

Smart Sense Mis Lanc 30G, 65

selegiline CAP 5MG, 45

simvastatin TAB 5MG, 14

Smart Sense Mis Lanc 33G, 65

selegiline TAB 5MG, 45

simvastatin TAB 80MG, 14

Smartest Mis Lancets, 65

selenium SUL lot 2.5%, 18

Sinemet CR TAB 25-100MG, 45

Smartest Sol Control, 65

Selenium SUL Sha 2.25%, 18

Sinemet CR TAB 50-200MG, 45

smooth LAX pow, 30

selenium SUL sha 2.25%, 18

Sinemet TAB 10-100MG, 45

smz-tmp DS TAB 800-160, 5

Selrx Sha 2.3%, 18

Sinemet TAB 25-100MG, 45

smz-tmp sus 200-40/5, 5

Selzentry Sol 20MG/ML, 4

Sinemet TAB 25-250MG, 45

smz-tmp TAB 400-80MG, 5

Selzentry TAB 150MG, 4

Single-let Mis 23G, 64

smz/tmp DS TAB 800-160, 5

Selzentry TAB 25MG, 4

Singulair Chw 4MG, 57

sod chloride neb 0.9%, 56

Selzentry TAB 300MG, 4

Singulair Chw 5MG, 58

sod citrate sol citr acd, 34

Selzentry TAB 75MG, 4

Singulair Gra 4MG, 58

sod SUL/sulf CRE 10-2%, 16

Semprex-d CAP 8-60MG, 57

Singulair TAB 10MG, 58

sod SUL/sulf CRE 10-5%, 16

Sensipar TAB 30MG, 28

sirolimus TAB 0.5MG, 7

sod SUL/sulf CRE 9.8-4.8%, 16

Sensipar TAB 60MG, 28

sirolimus TAB 1MG, 7

sod SUL/sulf emu 10-5%, 16

Sensipar TAB 90MG, 28

sirolimus TAB 2MG, 7

Sod SUL/Sulf Emu 10-5%, 16

Serevent Dis Aer 50mcg, 57

Sirturo TAB 100MG, 3

Sod SUL/Sulf Gel 10-5%, 17

Sernivo Spr, 19

Sitavig TAB 50MG, 5

sod SUL/sulf liq 10-2%, 16

Seroquel TAB 100MG, 40

Sivextro TAB 200MG, 5

sod SUL/sulf liq 9-4.5%, 16

Seroquel TAB 200MG, 40

Skelaxin TAB 800MG, 48

sod SUL/sulf liq 9.8-4.8%, 16

Seroquel TAB 25MG, 40

Sklice Lot 0.5%, 21

sod SUL/sulf liq wash, 16

Seroquel TAB 300MG, 40

Skyla Iud 13.5MG, 24

sod SUL/sulf lot 10-5%, 16

Seroquel TAB 400MG, 40

Slow FE TAB 142MG, 35

Sod SUL/Sulf Lot 10-5%, 16

Seroquel TAB 50MG, 40

slow FE TAB 45MG, 35

sod SUL/sulf lot 9.8-4.8%, 16

Seroquel XR TAB 150MG, 40

Slow FE TAB 45MG, 35

sod SUL/sulf pad 10-4%, 16

Seroquel XR TAB 200MG, 40

slow iron TAB 160MG CR, 35

Sod SUL/Sulf Sus 10-5%, 17

Seroquel XR TAB 300MG, 40

slow iron TAB 50MG, 35

sod SUL/sulf sus 8-4%, 16

Seroquel XR TAB 400MG, 40

Slow Rel FE TAB 143MG CR, 35

sod sulfacet gel 10%, 18

Seroquel XR TAB 50MG, 40

slow rel FE TAB 160MG CR, 35

sod sulfacet sha 10%, 18

Serostim Inj 4MG, 27

slow release TAB 143MG, 35

sod sulfacet sol 10% op, 48

Serostim Inj 5MG, 27

slow release TAB 45MG, 35

sodium chlor neb 10%, 56

Serostim Inj 6MG, 27

slow release TAB 47.5MG, 35

sodium chlor neb 3%, 56

sertraline CON 20MG/ML, 38

slow release TAB iron 45, 35

sodium chlor neb 7%, 56

sertraline TAB 100MG, 38

slow-release TAB FE 45MG, 35

sodium chlor sol 0.9% irr, 34

sertraline TAB 25MG, 38

sm aspirin chw 81MG, 51

sodium pheny TAB 500MG, 28

sertraline TAB 50MG, 38

sm aspirin TAB 325MG, 51

sodium SULFA liq 10% wash, 18

setlakin TAB, 24

sm aspirin TAB 325MG EC, 51

Sodium SULFA Liq 10% Wash, 18

sevelamer pow 0.8gm, 32

sm aspirin TAB 81MG EC, 51

Soft Touch Mis Lancets, 65

sevelamer pow 2.4gm, 32

sm child asa chw 81MG, 51

Softclix Mis Lancets, 65

sevelamer TAB 800MG, 32

sm clearlax pow, 30

Soliqua Inj 100/33, 26

Sfrowasa Ene 4gm, 32

sm folic acd TAB 400mcg, 35

Solodyn TAB 105MG, 2

sharobel TAB 0.35MG, 24

sm gentle TAB laxative, 30

Solodyn TAB 115MG, 2

Shohls Sol Modified, 34

sm iron slow TAB 160MG CR, 35

Solodyn TAB 55MG, 2

Shopko Lanc Mis Device, 64

sm iron TAB, 35

Solodyn TAB 65MG, 2

Shur-seal Gel 2%, 33

sm iron TAB 325MG, 35

Solodyn TAB 80MG, 2

Side Button Mis Safety, 64

sm iron TAB 45MG, 35

Soltamox Sol 10MG/5ML, 6

Signifor Inj 0.3MG/ML, 27

Sm Lancets Mis 21G, 65

Solu-cortef Inj 100MG, 21

Signifor Inj 0.6MG/ML, 27

Sm Lancets Mis 33G, 65

Solu-medrol Inj 125MG, 22

Signifor Inj 0.9MG/ML, 27

Sm Lancets Mis Thin 26G, 64

Solus V2 Mis Lanc 28G, 65

Signifor Lar Inj 20MG, 28

Sm Lancets Mis Thin 30G, 65

Solus V2 Mis Lanc 30G, 65

Signifor Lar Inj 40MG, 28

sm laxative TAB 5MG EC, 30

Solus V2 Mis Lanc Dev, 65

Signifor Lar Inj 60MG, 28

sm nicotine dis 14MG/24h, 46

Solus V2 Sol High, 65

sildenafil TAB 20MG, 15

sm nicotine dis 21MG, 46

Solus V2 Sol Low, 65

Silenor TAB 3MG, 41

sm nicotine dis 21MG/24h, 46

Soma TAB 250MG, 48

Silenor TAB 6MG, 41

sm nicotine dis 7MG/24HR, 46

Soma TAB 350MG, 48

Siliq Inj 210/1.5, 18

sm nicotine gum 2MG, 46

Somatuline Inj 120/.5ML, 27

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Somatuline Inj 60/0.2ML, 27

stavudine CAP 40MG, 4

Sumatriptan Inj 6MG/0.5, 55

Somatuline Inj 90/0.3ML, 27

stavudine sol 1MG/ML, 4

sumatriptan spr 20MG/act, 55

Somavert Inj 10MG, 28

Stelara Inj 45MG/0.5, 18

sumatriptan spr 5MG/act, 55

Somavert Inj 15MG, 28

Stelara Inj 90MG/ML, 18

sumatriptan TAB 100MG, 55

Somavert Inj 20MG, 28

Sterilance Mis 1.8MM, 65

sumatriptan TAB 25MG, 55

Somavert Inj 25MG, 28

Sterilance Mis TL 28G, 65

sumatriptan TAB 50MG, 55

Somavert Inj 30MG, 28

Sterilance Mis TL 30G, 65

Sumavel Dose Inj 4MG/0.5, 55

Sonata CAP 10MG, 41

Sterilance Mis TL 32G, 65

Sumavel Dose Inj 6MG/0.5, 55

Sonata CAP 5MG, 41

stim laxat TAB 5MG EC, 30

Sumaxin Pad 10-4%, 17

Soolantra CRE 1%, 17

Stimate Sol 1.5MG/ML, 28

Sumaxin Ts Sus 8-4%, 17

Soothee Pad, 21

Stiolto Aer 2.5-2.5, 57

Sumaxin Wash Liq 9-4%, 17

Soriatane CAP 10MG, 18

Stivarga TAB 40MG, 8

Super Daily Dro D3, 59

Soriatane CAP 17.5MG, 18

stop smoking gum 2MG mint, 46

Super Thin Mis Lanc 28G, 65

Soriatane CAP 25MG, 18

stop smoking gum 2MG orig, 46

Super Thin Mis Lancet, 65

Sorilux Aer 0.005%, 18

stop smoking gum 4MG, 46

Super Thin Mis Lancets, 65

sorine TAB 120MG, 9

stop smoking loz 2MG, 46

Suprax CAP 400MG, 1

sorine TAB 160MG, 9

stop smoking loz 2MG mint, 46

Suprax Chw 100MG, 1

sorine TAB 240MG, 9

stop smoking loz 4MG mint, 46

Suprax Chw 200MG, 1

sorine TAB 80MG, 9

Strattera CAP 100MG, 42

Suprax Sus 100/5ML, 1

sotalol AF TAB 120MG, 9

Strattera CAP 10MG, 42

Suprax Sus 200/5ML, 1

sotalol AF TAB 160MG, 9

Strattera CAP 18MG, 42

Suprax Sus 500/5ML, 1

sotalol AF TAB 80MG, 9

Strattera CAP 25MG, 42

Supreme II Liq High/Low, 65

sotalol HCL TAB 120MG, 9

Strattera CAP 40MG, 42

Suprep Bowel Sol Prep Kit, 30

sotalol HCL TAB 160MG, 9

Strattera CAP 60MG, 42

Sure Comfort Mis 0.5/31G, 65

sotalol HCL TAB 240MG, 9

Strattera CAP 80MG, 42

Sure Comfort Mis 29GX1/2", 65

sotalol HCL TAB 80MG, 9

Strensiq Inj 18/0.45, 28

Sure Comfort Mis 30GX5/16, 65

Sotylize Sol 5MG/ML, 9

Strensiq Inj 28/0.7ML, 28

Sure Comfort Mis 31GX3/16, 65

Sovaldi TAB 400MG, 4

Strensiq Inj 40MG/ML, 28

Sure Comfort Mis 31GX5/16, 65

Spectracef TAB 400MG, 1

Strensiq Inj 80/0.8ML, 28

Sure Comfort Mis 31GX6MM, 65

Spinosad Sus 0.9%, 21

Streptomycin Inj 1gm, 3

Sure Comfort Mis 32GX5/32, 65

Spiriva Aer 1.25mcg, 57

Striant Mis 30MG, 22

Sure Comfort Mis 32GX6MM, 65

Spiriva CAP Handihlr, 57

Stribild TAB, 4

Sure Comfort Mis Lanc 18G, 65

Spiriva Spr 2.5mcg, 57

Striverdi Aer 2.5mcg, 57

Sure Comfort Mis Lanc 21G, 65

spirono/hctz TAB 25/25, 14

Stromectol TAB 3MG, 5

Sure Comfort Mis Lanc 23G, 65

spironolact TAB 100MG, 14

Stuart One CAP, 60

Sure Comfort Mis Lanc 30G, 65

spironolact TAB 25MG, 14

Suboxone Mis 12-3MG, 53

Sure Comfort Mis Lanc Pen, 65

spironolact TAB 50MG, 14

Suboxone Mis 2-0.5MG, 53

Sure Comfort Mis Lancets, 65

Sporanox CAP 100MG, 3

Suboxone Mis 4-1MG, 53

Sure-fine Mis 29GX1/2", 65

Sporanox CAP Pulsepak, 3

Suboxone Mis 8-2MG, 53

Sure-fine Mis 31GX3/16, 65

Sporanox Sol 10MG/ML, 3

Subsys Spr 100mcg, 52

Sure-fine Mis 31GX5/16, 65

sprintec 28 TAB 28 day, 24

Subsys Spr 1200mcg, 52

Sure-lance Mis 26G, 65

Spritam TAB 1000MG, 44

Subsys Spr 1600mcg, 52

Sure-lance Mis Lancets, 65

Spritam TAB 250MG, 44

Subsys Spr 200mcg, 52

Sure-pen Mis, 65

Spritam TAB 500MG, 44

Subsys Spr 400mcg, 52

Sure-touch Mis Unv Lanc, 65

Spritam TAB 750MG, 44

Subsys Spr 600mcg, 52

Sureflex Mis Lancets, 65

Sprix Spr 15.75MG, 55

Subsys Spr 800mcg, 52

Surelite Mis Lancets, 65

Sprycel TAB 100MG, 8

Sucraid Sol 8500/ML, 31

Surestep Glu Sol, 65

Sprycel TAB 140MG, 8

sucralfate TAB 1gm, 30

Surestep Glu Sol High/Low, 65

Sprycel TAB 20MG, 8

SUL sod/sulf liq 10-2%, 17

Surestep Pro Tes High CON, 65

Sprycel TAB 50MG, 8

SUL sod/sulf pad 10-4%, 17

Surestep Pro Tes Low CON, 65

Sprycel TAB 70MG, 8

Sular TAB 17MG, 10

Surestep Pro Tes Norm CON, 65

Sprycel TAB 80MG, 8

Sular TAB 34MG, 10

Surestep Sol Control, 65

SR nicotine gum 2MG, 47

Sular TAB 8.5MG, 10

Surmontil CAP 100MG, 38

sronyx TAB, 24

sulf/pred NA sol op, 49

Surmontil CAP 25MG, 38

Sss 10-5 Aer 10-5%, 17

Sulfacet Sod Oin 10% Op, 48

Surmontil CAP 50MG, 38

sss CRE 10%-5%, 16

sulfacet sod sol 10% op, 48

Survanta Inh, 58

st joseph chw low 81MG, 51

sulfacetamid lot 10%, 16

Sustiva CAP 200MG, 4

Stalevo 100 TAB, 45

sulfacetamid sus 10%, 16

Sustiva CAP 50MG, 4

Stalevo 125 TAB, 45

sulfacleanse sus 8-4%, 16

Sustiva TAB 600MG, 4

Stalevo 150 TAB, 45

Sulfadiazine TAB 500MG, 3

Sutent CAP 12.5MG, 8

Stalevo 200 TAB, 45

sulfasalazin TAB 500MG, 32

Sutent CAP 25MG, 8

Stalevo 50 TAB, 45

sulfasalazin TAB 500MG DR, 32

Sutent CAP 37.5MG, 8

Stalevo 75 TAB, 45

sulfatrim PD sus 200-40/5, 5

Sutent CAP 50MG, 8

Starlix TAB 120MG, 26

sulindac TAB 150MG, 54

sw clearlax pow, 30

Starlix TAB 60MG, 26

sulindac TAB 200MG, 54

sw nicotine gum 2MG mint, 46

stavudine CAP 15MG, 4

Sumadan Wash Liq 9-4.5%, 17

sw nicotine gum 4MG, 46

stavudine CAP 20MG, 4

sumatriptan inj 4MG/0.5, 55

sw nicotine loz 2MG mint, 46

stavudine CAP 30MG, 4

sumatriptan inj 6MG/0.5, 55

sw nicotine loz 4MG mint, 46

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syeda TAB 3-0.03MG, 24

tamsulosin CAP 0.4MG, 34

Temodar CAP 20MG, 6

Sylatron Kit 200mcg, 8

Tanzeum Inj 30MG, 25

Temodar CAP 250MG, 6

Sylatron Kit 300mcg, 8

Tanzeum Inj 50MG, 25

Temodar CAP 5MG, 6

Sylatron Kit 600mcg, 8

Tapazole TAB 10MG, 29

Temovate CRE 0.05%, 19

Symax Duotab TAB, 31

Tapazole TAB 5MG, 29

Temovate E CRE 0.05%eml, 19

symax-SL sub 0.125MG, 31

Tarceva TAB 100MG, 8

Temovate Gel 0.05%, 19

symax-SR TAB 0.375MG, 31

Tarceva TAB 150MG, 8

Temovate Oin 0.05%, 19

Symbicort Aer 160-4.5, 58

Tarceva TAB 25MG, 8

Temovate Sol 0.05%, 19

Symbicort Aer 80-4.5, 58

Targadox TAB 50MG, 2

temozolomide CAP 100MG, 6

Symbyax CAP 12-25MG, 48

Targretin CAP 75MG, 8

temozolomide CAP 140MG, 6

Symbyax CAP 12-50MG, 48

tarina FE TAB 1/20, 24

temozolomide CAP 180MG, 6

Symbyax CAP 3-25MG, 48

Tarka TAB 1-240 CR, 13

temozolomide CAP 20MG, 6

Symbyax CAP 6-25MG, 48

Tarka TAB 2-180 CR, 13

temozolomide CAP 250MG, 6

Symbyax CAP 6-50MG, 48

Tarka TAB 2-240 CR, 13

temozolomide CAP 5MG, 6

Symlinpen 60 Inj 1000mcg, 25

Tarka TAB 4-240 CR, 13

Tencon TAB 50-325MG, 51

Symlnpen 120 Inj 1000mcg, 25

taron gra crystals, 34

Tenex TAB 1MG, 12

Synalar CRE 0.025%, 19

Tasigna CAP 150MG, 8

Tenex TAB 2MG, 12

Synalar Oin 0.025%, 19

Tasigna CAP 200MG, 8

Tenivac Inj 5-2LF, 58

Synalar Sol 0.01%, 19

Tasmar TAB 100MG, 45

Tenoretic TAB 100, 13

Synalgos-dc CAP, 53

Taytulla CAP, 24

Tenoretic TAB 50, 13

Synarel Sol 2MG/ML, 27

tazarotene CRE 0.1%, 18

Tenormin TAB 100MG, 9

Synera Dis 70-70MG, 21

tazicef inj 1gm, 1

Tenormin TAB 25MG, 9

Synerderm Emu, 21

Tazorac CRE 0.05%, 18

Tenormin TAB 50MG, 9

Synjardy TAB, 26

Tazorac CRE 0.1%, 18

Terazol 3 CRE 0.8%, 34

Synjardy TAB 12.5-500, 26

Tazorac Gel 0.05%, 18

Terazol 7 CRE 0.4%, 34

Synjardy TAB 5-1000MG, 26

Tazorac Gel 0.1%, 18

terazosin CAP 10MG, 12

Synjardy TAB 5-500MG, 26

taztia XT CAP 120MG/24, 10

terazosin CAP 1MG, 12

Synjardy XR TAB, 26

taztia XT CAP 180MG/24, 10

terazosin CAP 2MG, 12

Synjardy XR TAB 10-1000, 26

taztia XT CAP 240MG/24, 10

terazosin CAP 5MG, 12

Synjardy XR TAB 25-1000, 26

taztia XT CAP 300MG/24, 10

terbinafine TAB 250MG, 3

Synjardy XR TAB 5-1000MG, 26

taztia XT CAP 360MG/24, 10

terbutaline inj 1MG/ML, 57

Synthroid TAB 100mcg, 29

Tecfidera CAP 120MG, 47

terbutaline TAB 2.5MG, 57

Synthroid TAB 112mcg, 29

Tecfidera CAP 240MG, 47

terbutaline TAB 5MG, 57

Synthroid TAB 125mcg, 29

Tecfidera Mis Starter, 47

terconazole CRE 0.4%, 33

Synthroid TAB 137mcg, 29

Techlite AST Mis Lancets, 65

terconazole CRE 0.8%, 33

Synthroid TAB 150mcg, 29

Techlite Mis Lanc 30G, 65

terconazole sup 80MG, 33

Synthroid TAB 175mcg, 29

Techlite Mis Lancets, 65

Tersi Foam Aer 2.25%, 18

Synthroid TAB 200mcg, 29

Technivie TAB, 4

Tessalon Per CAP 100MG, 57

Synthroid TAB 25mcg, 29

Tegretol Sus 100/5ML, 44

Testim Gel 1%(50MG), 22

Synthroid TAB 300mcg, 29

Tegretol TAB 200MG, 44

Testone Cik Kit 200MG/ML, 22

Synthroid TAB 50mcg, 29

Tegretol-XR TAB 100MG, 44

testost cyp inj 100MG/ML, 22

Synthroid TAB 75mcg, 29

Tegretol-XR TAB 200MG, 44

testost cyp inj 200MG/ML, 22

Synthroid TAB 88mcg, 29

Tegretol-XR TAB 400MG, 44

testost enan inj 200MG/ML, 22

synvexia pad 4-1%, 20

Tekturna HCT TAB 150-12.5, 13

testosterone gel 1%(25MG), 22

Syringe 0.5 Mis 30G, 65

Tekturna HCT TAB 150-25MG, 13

Testosterone Gel 1%(25MG), 22

Syringe Mis 0.5/30G, 65

Tekturna HCT TAB 300-12.5, 13

testosterone gel 1%(50MG), 22

T

Tekturna HCT TAB 300-25MG, 13

Testosterone Gel 1%(50MG), 22

Tekturna TAB 150MG, 12

Testosterone Gel 10MG/Act, 22

Tabloid TAB 40MG, 6

Tekturna TAB 300MG, 12

testosterone gel P.M. 1%, 22

Taclonex Oin, 19

Telcare Sol Level1/2, 65

Testosterone Gel P.M. 1%, 22

Taclonex Sus, 19

telmis/amlod TAB 40-10MG, 13

testosterone sol 30MG/act, 22

tacrolimus CAP 0.5MG, 7

telmis/amlod TAB 40-5MG, 13

Testred CAP 10MG, 22

tacrolimus CAP 1MG, 7

telmis/amlod TAB 80-10MG, 13

Tet/Dip Tox Inj 2-2 LF, 58

tacrolimus CAP 5MG, 7

telmis/amlod TAB 80-5MG, 13

tetcaine sol 0.5% op, 50

tacrolimus oin 0.03%, 19

telmisa/hctz TAB 40-12.5, 13

tetrabenazin TAB 12.5MG, 47

tacrolimus oin 0.1%, 20

telmisa/hctz TAB 80-12.5, 13

tetrabenazin TAB 25MG, 47

Tafinlar CAP 50MG, 8

telmisa/hctz TAB 80-25MG, 13

tetracaine sol 0.5% op, 50

Tafinlar CAP 75MG, 8

telmisartan TAB 20MG, 11

tetracycline CAP 250MG, 2

Tagrisso TAB 40MG, 8

telmisartan TAB 40MG, 11

Tetracycline CAP 250MG, 2

Tagrisso TAB 80MG, 8

telmisartan TAB 80MG, 11

tetracycline CAP 500MG, 2

Tai Doc Sol Norm CON, 65

Temazepam 7.5MG CAPS, 41

Tetracycline CAP 500MG, 2

take action TAB 1.5MG, 24

temazepam CAP 15MG, 41

Tetramex Spr 2-1-3%, 21

Taltz Inj 80MG/ML, 18

temazepam CAP 22.5MG, 41

tetravisc sol 0.5% op, 50

Tamiflu CAP 30MG, 5

temazepam CAP 30MG, 41

tetravisc sol forte, 50

Tamiflu CAP 45MG, 5

temazepam CAP 7.5MG, 41

Tetrix CRE, 21

Tamiflu CAP 75MG, 5

Temodar CAP 100MG, 6

Texacort Sol 2.5%, 19

Tamiflu Sus 6MG/ML, 4

Temodar CAP 140MG, 6

tgt aspirin chw 81MG, 51

tamoxifen TAB 10MG, 6

Temodar CAP 180MG, 6

tgt aspirin chw child, 51

tamoxifen TAB 20MG, 6

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tgt aspirin TAB 325MG, 51

tiagabine TAB 4MG, 43

Tofranil-PM CAP 125MG, 39

tgt aspirin TAB 81MG, 51

Tiazac CAP 120MG/24, 10

Tofranil-PM CAP 150MG, 39

tgt aspirin TAB 81MG EC, 51

Tiazac CAP 180MG/24, 10

Tofranil-PM CAP 75MG, 39

Tgt Lancet Mis 23G, 65

Tiazac CAP 240MG/24, 10

Tolak CRE 4%, 6

Tgt Lancet Mis 26G, 65

Tiazac CAP 300MG/24, 10

Tolazamide TAB 250MG, 25

Tgt Lancet Mis 28G, 65

Tiazac CAP 360MG/24, 10

Tolazamide TAB 500MG, 25

Tgt Lancet Mis 30G, 65

Tiazac CAP 420MG/24, 10

Tolbutamide TAB 500MG, 25

Tgt Lancet Mis 33G, 65

Ticalast Kit 137/50, 56

tolcapone TAB 100MG, 45

Tgt Lancet Mis Alternat, 65

Tier Uni Pls Mis 31GX8MM, 65

tolmetin sod CAP 400MG, 54

Tgt Lancing Mis Adv Dev, 65

Tigan CAP 300MG, 31

Tolmetin Sod CAP 400MG, 54

Tgt Lancing Mis Device, 65

Tigan Inj 100MG/ML, 31

Tolmetin Sod TAB 200MG, 54

tgt nicotine dis 14MG/24h, 46

Tikosyn CAP 125mcg, 11

Tolmetin Sod TAB 600MG, 55

tgt nicotine dis 21MG/24h, 46

Tikosyn CAP 250mcg, 11

tolterodine CAP 2MG ER, 33

tgt nicotine dis 7MG/24HR, 46

Tikosyn CAP 500mcg, 11

tolterodine CAP 4MG ER, 33

tgt nicotine gum 2MG mint, 46

tilia FE TAB, 24

tolterodine TAB 1MG, 33

tgt nicotine gum 2MG orig, 46

timolol gel sol 0.25% op, 49

tolterodine TAB 2MG, 33

tgt nicotine gum 2mgfruit, 46

timolol gel sol 0.5% op, 49

Topamax Spr CAP 15MG, 44

tgt nicotine gum 4MG, 46

timolol mal sol 0.25% op, 49

Topamax Spr CAP 25MG, 44

tgt nicotine gum 4MG mint, 46

timolol mal sol 0.5% op, 49

Topamax TAB 100MG, 44

tgt nicotine gum 4MG orig, 46

Timolol Mal TAB 10MG, 9

Topamax TAB 200MG, 44

tgt nicotine loz 2MG chry, 46

Timolol Mal TAB 20MG, 9

Topamax TAB 25MG, 44

tgt nicotine loz 2MG mint, 46

Timolol Mal TAB 5MG, 9

Topamax TAB 50MG, 44

tgt nicotine loz 4MG chry, 46

Timoptic Ocu Sol 0.25% Op, 49

Topcare Mis Lanc 33G, 65

tgt nicotine loz 4MG mint, 46

Timoptic Ocu Sol 0.5% Op, 49

Topicort CRE 0.05%, 19

Thalomid CAP 100MG, 7

Timoptic Sol 0.25% Op, 49

Topicort CRE 0.25%, 19

Thalomid CAP 150MG, 7

Timoptic Sol 0.5% Op, 49

Topicort Gel 0.05%, 19

Thalomid CAP 200MG, 7

Timoptic-xe Sol 0.25% Op, 49

Topicort Oin 0.05%, 19

Thalomid CAP 50MG, 7

Timoptic-xe Sol 0.5% Op, 49

Topicort Oin 0.25%, 19

Theo-24 CAP 100MG CR, 58

Tindamax TAB 250MG, 6

Topicort Spr 0.25%, 19

Theo-24 CAP 200MG CR, 58

Tindamax TAB 500MG, 6

topiramate CAP 15MG, 43

Theo-24 CAP 300MG CR, 58

tinidazole TAB 250MG, 6

topiramate CAP 25MG, 43

Theo-24 CAP 400MG ER, 58

tinidazole TAB 500MG, 6

Topiramate CAP ER 100MG, 44

theochron TAB 100MG CR, 57

Tirosint CAP 100mcg, 29

Topiramate CAP ER 150MG, 44

theochron TAB 200MG CR, 57

Tirosint CAP 112mcg, 29

Topiramate CAP ER 200MG, 44

theochron TAB 300MG CR, 57

Tirosint CAP 125mcg, 29

Topiramate CAP ER 25MG, 44

theophylline sol 80/15ML, 57

Tirosint CAP 137mcg, 29

Topiramate CAP ER 50MG, 44

theophylline TAB 100MG CR, 57

Tirosint CAP 13mcg, 29

topiramate TAB 100MG, 43

theophylline TAB 100MG ER, 57

Tirosint CAP 150mcg, 29

topiramate TAB 200MG, 43

theophylline TAB 200MG CR, 57

Tirosint CAP 25mcg, 29

topiramate TAB 25MG, 43

theophylline TAB 200MG ER, 57

Tirosint CAP 50mcg, 29

topiramate TAB 50MG, 43

theophylline TAB 300MG ER, 57

Tirosint CAP 75mcg, 29

Toprol XL TAB 100MG, 9

theophylline TAB 400MG ER, 57

Tirosint CAP 88mcg, 29

Toprol XL TAB 200MG, 9

theophylline TAB 450MG ER, 57

Tivicay TAB 10MG, 4

Toprol XL TAB 25MG, 9

theophylline TAB 600MG ER, 57

Tivicay TAB 25MG, 4

Toprol XL TAB 50MG, 9

thera-d sprt TAB 2000unit, 59

Tivicay TAB 50MG, 4

torsemide TAB 100MG, 14

thera-d TAB 2000unit, 59

Tivorbex CAP 20MG, 55

torsemide TAB 10MG, 14

Thera-d TAB 4000unit, 59

Tivorbex CAP 40MG, 55

torsemide TAB 20MG, 14

Thin Lancets Mis, 65

tizanidine CAP 2MG, 48

torsemide TAB 5MG, 14

Thin Lancets Mis 26G, 65

tizanidine CAP 4MG, 48

Toujeo Solo Inj 300iu/ML, 25

Thin Lancets Mis 30G, 65

tizanidine CAP 6MG, 48

Toviaz TAB 4MG, 33

Thinlets GP Mis 26G, 65

tizanidine TAB 2MG, 48

Toviaz TAB 8MG, 33

Thinlets Mis 28g(t), 65

tizanidine TAB 4MG, 48

Tracleer TAB 125MG, 15

Thiola TAB 100MG, 34

Tobi Neb 300/5ML, 3

Tracleer TAB 62.5MG, 15

thioridazine TAB 100MG, 40

Tobi Podhalr CAP 28MG, 3

Tradjenta TAB 5MG, 26

thioridazine TAB 10MG, 40

tobra/dexame sus 0.3-0.1%, 49

tramadl/apap TAB 37.5-325, 51

thioridazine TAB 25MG, 40

Tobradex Oin 0.3-0.1%, 49

Tramadol HCL CAP 150MG ER, 53

thioridazine TAB 50MG, 40

Tobradex ST Sus 0.3-0.05, 49

Tramadol HCL CAP ER 100MG, 53

thiothixene CAP 10MG, 39

Tobradex Sus 0.3-0.1%, 49

Tramadol HCL CAP ER 200MG, 53

thiothixene CAP 1MG, 39

tobramycin neb 300/5ML, 3

Tramadol HCL CAP ER 300MG, 53

thiothixene CAP 2MG, 39

Tobramycin Neb 300/5ML, 3

tramadol HCL TAB 100MG ER, 52

thiothixene CAP 5MG, 39

tobramycin sol 0.3% op, 48

tramadol HCL TAB 200MG ER, 52

thrive gum 2MG mint, 46

Tobrex Oin 0.3% Op, 48

tramadol HCL TAB 300MG ER, 52

Thyrolar-1 TAB 60MG, 29

Tobrex Sol 0.3% Op, 48

tramadol HCL TAB 50MG, 51

Thyrolar-1/2 TAB 30MG, 29

Today Sponge Mis, 33

trando/verap TAB 1-240 ER, 13

Thyrolar-1/4 TAB 15MG, 29

Tofranil TAB 10MG, 38

trando/verap TAB 2-180 ER, 13

Thyrolar-2 TAB 120MG, 29

Tofranil TAB 25MG, 39

trando/verap TAB 2-240 ER, 13

Thyrolar-3 TAB 180MG, 29

Tofranil TAB 50MG, 39

trando/verap TAB 4-240 ER, 13

tiagabine TAB 2MG, 43

Tofranil-PM CAP 100MG, 39

trandolapril TAB 1MG, 11

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trandolapril TAB 2MG, 11

Tribenzor40- TAB 10-12.5, 13

Truvada TAB 167-250, 4

trandolapril TAB 4MG, 11

Tribenzor40- TAB 10-25MG, 13

Truvada TAB 200-300, 4

tranex acid TAB 650MG, 36

Tribenzor40- TAB 5-12.5MG, 13

Tudorza Pres Aer 400/Act, 58

Transderm-sc Dis 1.5MG, 31

Tribenzor40- TAB 5-25MG, 13

Tussicaps CAP 10-8MG, 57

Tranxene T TAB 3.75MG, 37

tricitrates sol, 34

Tussicaps CAP 5-4MG, 57

Tranxene T TAB 7.5MG, 37

Tricor TAB 145MG, 15

tussigon TAB 5-1.5MG, 56

tranylcyprom TAB 10MG, 38

Tricor TAB 48MG, 15

Tussionex Sus 10-8/5ML, 57

Tranzarel Gel 4%, 21

triderm CRE 0.1%, 19

Tuzistra XR Sus, 57

Travatan Z Dro 0.004%, 49

triderm CRE 0.5%, 19

Twinrix Inj, 58

Travel Lance Mis 30G, 65

Tridesilon CRE 0.05%, 19

Twynsta TAB 40-10MG, 13

Travel Lance Mis Adv 28G, 65

trifluoperaz TAB 10MG, 39

Twynsta TAB 40-5MG, 13

Travoprost Dro 0.004%, 49

trifluoperaz TAB 1MG, 39

Twynsta TAB 80-10MG, 13

trazodone TAB 100MG, 38

trifluoperaz TAB 2MG, 39

Twynsta TAB 80-5MG, 13

trazodone TAB 150MG, 38

trifluoperaz TAB 5MG, 39

Tybost TAB 150MG, 4

trazodone TAB 300MG, 38

trifluridine sol 1% op, 48

Tykerb TAB 250MG, 8

trazodone TAB 50MG, 38

Triglide TAB 160MG, 15

Tylenol/Cod TAB #3, 53

Trecator TAB 250MG, 3

trihexyphen elx 0.4MG/ML, 45

Tylenol/Cod TAB #4, 53

Tremfya Inj 100MG/ML, 18

trihexyphen TAB 2MG, 45

Tymlos Inj, 27

Tresiba Flex Inj 100unit, 25

trihexyphen TAB 5MG, 45

Tysabri Inj 300/15ML, 47

Tresiba Flex Inj 200unit, 25

triklo CAP 1gm, 15

Tyvaso Refil Sol 0.6MG/ML, 15

Tretin-x CRE 0.0375%, 17

Trileptal Sus 300MG/5m, 44

Tyvaso Sol 0.6MG/ML, 15

Tretin-x CRE 0.075%, 17

Trileptal TAB 150MG, 44

Tyvaso Start Sol 0.6MG/ML, 15

tretinoin CAP 10MG, 8

Trileptal TAB 300MG, 44

Tyzeka TAB 600MG, 4

tretinoin CRE 0.025%, 16

Trileptal TAB 600MG, 44

Tyzine PED Dro 0.05%, 56

tretinoin CRE 0.05%, 16

Trilipix CAP 135MG, 15

U

tretinoin CRE 0.1%, 16

Trilipix CAP 45MG, 15

Uceris Aer 2MG/Act, 32

tretinoin gel 0.01%, 16

trilyte sol, 30

Uceris TAB 9MG, 21

tretinoin gel 0.025%, 16

trimethobenz CAP 300MG, 31

Ulesfia Lot 5%, 20

tretinoin gel 0.04%, 16

trimethoprim sol polymyxn, 48

Uloric TAB 40MG, 55

tretinoin gel 0.04%pmp, 16

trimethoprim TAB 100MG, 5

Uloric TAB 80MG, 55

tretinoin gel 0.05%, 16

trimipramine CAP 100MG, 38

Ulti-lance Mis CLR Tip, 65

tretinoin gel 0.1%, 16

trimipramine CAP 25MG, 38

Ulticare Pen Mis 31GX5MM, 65

tretinoin gel 0.1%P.M., 16

trimipramine CAP 50MG, 38

Ultilet Insu Mis 30X12.7, 65

Trexall TAB 10MG, 6

Trimpex Sol 50MG/5ML, 5

Ultilet Insu Mis 31GX6MM, 65

Trexall TAB 15MG, 6

trinessa LO TAB, 24

Ultilet Mis 26G, 65

Trexall TAB 5MG, 6

trinessa TAB, 24

Ultilet Mis 28G, 65

Trexall TAB 7.5MG, 6

Trintellix TAB 10MG, 39

Ultilet Mis 30G, 65

Treximet TAB 10-60MG, 55

Trintellix TAB 20MG, 39

Ultilet Mis 33G, 65

Treximet TAB 85-500MG, 55

Trintellix TAB 5MG, 39

Ultilet Mis Lancets, 65

tri femynor TAB, 24

Triumeq TAB, 4

Ultilet Mis Safety, 65

tri-estaryll TAB, 24

trivora-28 TAB, 24

Ultilet Pen Mis 29GX12.7, 65

tri-legest TAB FE, 24

Trizivir TAB, 4

Ultilet Pen Mis 31GX5MM, 65

tri-linyah TAB, 24

Trokendi XR CAP 100MG, 44

Ultilet Pen Mis 31GX8MM, 65

tri-LO TAB estaryll, 24

Trokendi XR CAP 200MG, 44

Ultilet Pen Mis 32GX4MM, 65

tri-LO- TAB marzia, 24

Trokendi XR CAP 25MG, 44

Ultilet Safe Mis 21G, 65

tri-LO- TAB sprintec, 24

Trokendi XR CAP 50MG, 44

Ultra Thin Mis 28G, 65

Tri-norinyl TAB 28, 24

trospium chl CAP 60MG ER, 33

Ultra Thin Mis 30G, 65

tri-previfem TAB, 24

trospium CL TAB 20MG, 33

Ultra Thin Mis 31G, 65

tri-sprintec TAB, 24

True Metrix Sol Level 1, 65

Ultra Thin Mis 33G, 65

triamcinolon aer 55mcg/ac, 56

True Metrix Sol Level 2, 65

Ultra Thin Mis Lanc 26G, 65

triamcinolon aer spray, 19

True Metrix Sol Level 3, 65

Ultra Thin Mis Lanc 28G, 65

triamcinolon CRE 0.025%, 19

Truecontrol Liq Level 0, 65

Ultra Thin Mis Lanc 30G, 65

triamcinolon CRE 0.1%, 19

Truecontrol Liq Level 1, 65

Ultra Thin Mis Lancets, 65

triamcinolon CRE 0.5%, 19

Truedraw Mis Lanc Dev, 65

Ultracet TAB 37.5-325, 53

triamcinolon lot 0.025%, 19

Truetest Liq Level 1, 65

Ultralance Mis 1.8MM, 65

triamcinolon lot 0.1%, 19

Truetest Liq Level 2, 65

Ultram ER TAB 100MG, 53

triamcinolon oin 0.025%, 19

Truetest Liq Level 3, 65

Ultram ER TAB 200MG, 53

triamcinolon oin 0.1%, 19

Trulance TAB 3MG, 32

Ultram ER TAB 300MG, 53

triamcinolon oin 0.5%, 19

Trulicity Inj 0.75/0.5, 25

Ultram TAB 50MG, 53

triamcinolon pst den 0.1%, 36

Trulicity Inj 1.5/0.5, 25

Ultratrk Pro Sol, 65

triamt/hctz CAP 37.5-25, 14

Trumenba Inj, 58

Ultratrk Pro Sol High/Low, 65

Triamt/Hctz CAP 50-25MG, 14

Truplus Lanc Mis 26G, 65

Ultratrk Ult Sol High/Low, 65

triamt/hctz TAB 37.5-25, 14

Truplus Lanc Mis 28G, 65

Ultravate CRE 0.05%, 19

triamt/hctz TAB 75-50MG, 14

Truplus Lanc Mis 30G, 65

Ultravate Lot 0.05%, 19

Trianex Oin 0.05%, 19

Truplus Lanc Mis 33G, 65

Ultravate Oin 0.05%, 19

Triazolam TAB 0.125MG, 41

Trusopt Sol 2% Op, 50

Ultresa CAP 13800unt, 32

triazolam TAB 0.25MG, 41

Truvada TAB 100-150, 4

Ultresa CAP 20700unt, 32

Tribenzor20- TAB 5-12.5MG, 13

Truvada TAB 133-200, 4

Ultresa CAP 23000unt, 32

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Umecta Emu, 21

unithroid TAB 100mcg, 29

ursodiol TAB 250MG, 32

umecta mouss aer 40%, 20

unithroid TAB 112mcg, 29

ursodiol TAB 500MG, 32

Umecta Nail Sus Film, 21

unithroid TAB 125mcg, 29

uryl TAB, 33

Umecta PD Emu 40-0.3%, 21

unithroid TAB 137mcg, 29

ustell CAP, 33

Unfine Pntp Mis 32GX4MM, 65

unithroid TAB 150mcg, 29

uta CAP 120MG, 33

Unifine Pntp Mis 29GX1/2", 65

unithroid TAB 175mcg, 29

Utibron CAP Neohaler, 58

Unifine Pntp Mis 29GX12MM, 65

unithroid TAB 200mcg, 29

uticap CAP, 33

Unifine Pntp Mis 31GX3/16, 65

unithroid TAB 25mcg, 29

utira-c TAB, 33

Unifine Pntp Mis 31GX5/16, 65

unithroid TAB 300mcg, 29

Utopic CRE 41%, 21

Unifine Pntp Mis 31GX5MM, 65

unithroid TAB 50mcg, 29

utrona-c TAB, 33

Unifine Pntp Mis 31GX6MM, 65

unithroid TAB 75mcg, 29

V

Unifine Pntp Mis 31GX8MM, 65

unithroid TAB 88mcg, 29

Vagifem TAB 10mcg, 34

Unifine Pntp Mis 32GX4MM, 65

Universal 1 Mis 33G, 66

valacyclovir TAB 1gm, 4

Unifine Pntp Mis 32GX5/32, 65

Universal 1 Mis Lanc 26G, 66

valacyclovir TAB 500MG, 4

Unilet Cmfr Mis Tch 28G, 65

Universal 1 Mis Lanc 30G, 66

Valchlor Gel 0.016%, 6

Unilet Cmfr Mis Tch 30G, 65

Upspringbaby Dro Vit D3, 59

Valcyte Sol 50MG/ML, 4

Unilet EX II Mis 28G, 65

Uptravi TAB 1000mcg, 15

Valcyte TAB 450MG, 4

Unilet Excel Mis 23G, 65

Uptravi TAB 1200mcg, 15

valganciclov sol 50MG/ML, 4

Unilet G.p Mis Supr 23G, 65

Uptravi TAB 1400mcg, 15

valganciclov TAB 450MG, 4

Unilet G.p. Mis 21G, 65

Uptravi TAB 1600mcg, 15

Valium TAB 10MG, 37

Unilet GP 28 Mis Ult Thin, 65

Uptravi TAB 200/800, 15

Valium TAB 2MG, 37

Unilet Lanc Mis 33G, 65

Uptravi TAB 200mcg, 15

Valium TAB 5MG, 37

Unilet Lance Mis 21G, 65

Uptravi TAB 400mcg, 15

valproic acd CAP 250MG, 43

Unilet Lance Mis 28G, 65

Uptravi TAB 600mcg, 15

valproic acd sol 250/5ML, 43

Unilet Lance Mis 33G, 66

Uptravi TAB 800mcg, 15

valsart/hctz TAB 160-12.5, 12

Unilet Lanct Mis 28G, 66

ur n-c TAB, 33

valsart/hctz TAB 160-25MG, 12

Unilet Lanct Mis 30G, 66

Uramaxin CRE 45%, 21

valsart/hctz TAB 320-12.5, 12

Unilet Lanct Mis 33G, 66

Uramaxin Gel 45%, 21

valsart/hctz TAB 320-25MG, 12

Unilet Mis 21G, 66

Uramaxin GT Gel 45%, 21

valsart/hctz TAB 80-12.5, 12

Unilet Super Mis 23G, 66

uramit mb CAP 118MG, 33

valsartan TAB 160MG, 11

Unilet Super Mis G.p. 23G, 66

ure-39 CRE 39%, 20

valsartan TAB 320MG, 11

Unistik 1 Mis 2.4MM, 66

ure-k CRE 50%, 20

valsartan TAB 40MG, 11

Unistik 1 Mis 3.0MM, 66

urea 40% sus nail, 20

valsartan TAB 80MG, 11

Unistik 2 Mis, 66

urea CRE 39%, 20

Valtrex TAB 1gm, 5

Unistik 2 Mis 1.8MM, 66

urea CRE 40%, 20

Valtrex TAB 500MG, 5

Unistik 2 Mis 2.4MM, 66

urea CRE 45%, 20

Valvd Holdng Mis Chamber, 66

Unistik 2 Mis Comfort, 66

urea CRE 47%, 20

Vanatol LQ Sol, 51

Unistik 2 Mis Extra, 66

urea CRE 50%, 20

Vanatol S Sol, 51

Unistik 2 Mis Neonatal, 66

urea gel 40%, 20

Vancocin HCL CAP 125MG, 5

Unistik 2 Mis Normal, 66

urea hydrati aer 35%, 20

Vancocin HCL CAP 250MG, 5

Unistik 2 Mis Super, 66

urea nail gel 45%, 20

vancomycin 250/5ML, 5

Unistik 3 Mis 1.8MM, 66

Urea Topical Sus 40%, 21

vancomycin CAP 125MG, 5

Unistik 3 Mis Comfort, 66

Urecholine TAB 10MG, 33

vancomycin CAP 250MG, 5

Unistik 3 Mis Extra, 66

Urecholine TAB 25MG, 33

Vancomycn 25 Sol 25MG/ML, 6

Unistik 3 Mis Gent 30G, 66

Urecholine TAB 50MG, 33

Vancomycn 50 Sol 50MG/ML, 6

Unistik 3 Mis Neonatal, 66

Urecholine TAB 5MG, 33

vandazole gel 0.75%, 33

Unistik 3 Mis Normal, 66

urelle TAB, 33

Vanos CRE 0.1%, 19

Unistik 3 Mis Xtr 21G, 66

uretron d/s TAB, 33

Vanoxide-HC Lot 5-0.5%, 17

Unistik CZT Mis Comfort, 66

Urevaz CRE 44%, 21

Vantage Lanc Mis Device, 66

Unistik CZT Mis Normal, 66

uribel CAP 118MG, 33

Vaqta Inj 25/0.5ML, 58

Unistik II Mis Lancets, 66

Urimar-t TAB, 33

Vaqta Inj 50unt/ML, 58

Unistik Safe Mis Lanc 28G, 66

urin d/s TAB, 33

Varivax Inj, 58

Unistik Safe Mis Lanc 30G, 66

uro-458 TAB, 33

Varubi TAB 90MG, 31

Unistik Touc Mis Lanc 21G, 66

uro-blue TAB 81.6MG, 33

Vascepa CAP 0.5gm, 15

Unistik Touc Mis Lanc 23G, 66

uro-l TAB 81MG, 33

Vascepa CAP 1gm, 15

Unistik Touc Mis Lanc 28G, 66

uro-mp CAP 118MG, 33

Vaseretic TAB 10-25MG, 13

Unistik Touc Mis Lanc 30G, 66

uroav-81 TAB, 33

Vasotec TAB 10MG, 11

unith direct TAB 100mcg, 29

uroav-b CAP, 33

Vasotec TAB 2.5MG, 11

unith direct TAB 112mcg, 29

Urocit-k 10 TAB, 34

Vasotec TAB 20MG, 11

unith direct TAB 125mcg, 29

Urocit-k 15 TAB, 34

Vasotec TAB 5MG, 11

unith direct TAB 150mcg, 29

Urocit-k 5 TAB, 34

vcf vaginal aer contracp, 33

unith direct TAB 175mcg, 29

Urogesic- TAB Blue, 33

Vcf Vaginal Aer Contracp, 33

unith direct TAB 200mcg, 29

urolet mb TAB, 33

vcf vaginal gel contrace, 33

unith direct TAB 25mcg, 29

urophen mb TAB 81.6MG, 33

Vcf Vaginal Mis Contracp, 33

unith direct TAB 300mcg, 29

Uroxatral TAB 10MG, 34

Vecamyl TAB 2.5MG, 12

unith direct TAB 50mcg, 29

Urso 250 TAB 250MG, 32

Vectical Oin 3mcg/Gm, 18

unith direct TAB 75mcg, 29

Urso Forte TAB 500MG, 32

velivet PAK, 24

unith direct TAB 88mcg, 29

ursodiol CAP 300MG, 32

Velphoro Chw 500MG, 32

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Veltin Gel, 17

Victory Sol Control, 66

vitamin d-3 CAP 2000unit, 59

Vemlidy TAB 25MG, 4

Victoza Inj 18MG/3ML, 25

vitamin d-3 TAB 1000unit, 59

venlafaxine CAP 150MG ER, 38

Victrelis CAP 200MG, 4

vitamin d-3 TAB 2000unit, 59

venlafaxine CAP 37.5 ER, 38

Videx EC CAP 125MG, 5

vitamin d-3 TAB 5000unit, 59

venlafaxine CAP 75MG ER, 38

Videx EC CAP 200MG, 5

vitamin d3 CAP 10000unt, 59

venlafaxine TAB 100MG, 38

Videx EC CAP 250MG, 5

vitamin d3 CAP 1000unit, 59

venlafaxine TAB 150MG ER, 38

Videx EC CAP 400MG, 5

vitamin d3 CAP 2000unit, 59

Venlafaxine TAB 150MG ER, 39

Videx Sol 2gm, 4

Vitamin D3 CAP 4000unit, 59

venlafaxine TAB 225MG ER, 38

Videx Sol 4gm, 4

vitamin d3 CAP 400unit, 59

Venlafaxine TAB 225MG ER, 39

Viekira PAK TAB, 4

vitamin d3 CAP 50000unt, 59

venlafaxine TAB 25MG, 38

Viekira XR TAB, 4

vitamin d3 CAP 5000unit, 59

venlafaxine TAB 37.5 ER, 38

vienva TAB 0.1-20, 24

vitamin d3 chw 1000unit, 59

Venlafaxine TAB 37.5 ER, 39

vigabatrin PAK 500MG, 43

vitamin d3 chw 2000unit, 59

venlafaxine TAB 37.5MG, 38

Vigamox Dro 0.5%, 48

vitamin d3 chw 400unit, 59

venlafaxine TAB 50MG, 38

Viibryd Kit Starter, 39

vitamin d3 chw 5000unit, 59

venlafaxine TAB 75MG, 38

Viibryd TAB 10MG, 39

Vitamin D3 Chw 5000unit, 59

venlafaxine TAB 75MG ER, 38

Viibryd TAB 20MG, 39

vitamin d3 dro 400unit, 59

Venlafaxine TAB 75MG ER, 39

Viibryd TAB 40MG, 39

vitamin d3 dro 5000unit, 59

Ventavis Sol 10mcg/ML, 15

Vimovo TAB 375-20MG, 54

Vitamin D3 Liq 1000unit, 59

Ventavis Sol 20mcg/ML, 15

Vimovo TAB 500-20MG, 54

Vitamin D3 Liq 1200unit, 59

Ventolin HFA Aer, 57

Vimpat Sol 10MG/ML, 44

Vitamin D3 Spr 1000unit, 59

Veramyst Spr 27.5mcg, 56

Vimpat TAB 100MG, 43

Vitamin D3 TAB 10000unt, 59

verapamil CAP 100MG ER, 10

Vimpat TAB 150MG, 43

vitamin d3 TAB 1000unit, 59

verapamil CAP 120MG ER, 10

Vimpat TAB 200MG, 43

vitamin d3 TAB 2000unit, 59

verapamil CAP 120MG SR, 10

Vimpat TAB 50MG, 43

Vitamin D3 TAB 3000unit, 59

verapamil CAP 180MG ER, 10

Viokace TAB, 32

vitamin d3 TAB 400unit, 59

verapamil CAP 180MG SR, 10

Viokace TAB 20880, 32

vitamin d3 TAB 50000uni, 59

verapamil CAP 200MG ER, 10

viorele TAB, 24

vitamin d3 TAB 50000unt, 59

verapamil CAP 240MG ER, 10

Viracept TAB 250MG, 4

vitamin d3 TAB 5000unit, 59

verapamil CAP 240MG SR, 10

Viracept TAB 625MG, 4

Vitamin D3 TAB 5000unit, 59

verapamil CAP 300MG ER, 10

Viramune Sus 50MG/5ML, 5

Vitamin K1 Inj 10MG/ML, 59

verapamil CAP 360MG SR, 10

Viramune TAB 200MG, 5

vitamin k1 inj 1MG/0.5, 59

verapamil TAB 120MG, 10

Viramune XR TAB 100MG, 5

Vitekta TAB 150MG, 4

verapamil TAB 120MG ER, 10

Viramune XR TAB 400MG, 5

Vitekta TAB 85MG, 4

verapamil TAB 180MG ER, 10

Virasal Liq 27.5%, 21

Vituz Sol 5-4MG, 57

verapamil TAB 240MG ER, 10

Virazole Inh 6gm, 5

Vivelle-dot Dis 0.025MG, 23

verapamil TAB 40MG, 10

Viread Pow 40MG/Gm, 4

Vivelle-dot Dis 0.0375MG, 23

verapamil TAB 80MG, 10

Viread TAB 150MG, 4

Vivelle-dot Dis 0.05MG, 23

Verasens Liq Level 1, 66

Viread TAB 200MG, 4

Vivelle-dot Dis 0.075MG, 23

vercolate TAB 5MG EC, 30

Viread TAB 250MG, 4

Vivelle-dot Dis 0.1MG, 23

Verdeso Aer 0.05%, 19

Viread TAB 300MG, 4

Vivitrol Inj 380MG, 54

verdrocet TAB 2.5-325, 52

Viroptic Sol 1% Op, 48

Vivlodex CAP 10MG, 55

Veregen Oin 15%, 21

virtrate-2 sol, 34

Vivlodex CAP 5MG, 55

Verelan CAP 120MG SR, 10

virtrate-2 sol 500-334, 34

Vogelxo Gel 1%(50MG), 22

Verelan CAP 180MG SR, 10

virtrate-3 sol, 34

Vogelxo Gel P.M. 1%, 22

Verelan CAP 240MG SR, 10

virtrate-k sol 1100-334, 34

Voltaren Gel 1%, 18

Verelan CAP 360MG SR, 10

Vistaril CAP 25MG, 37

voriconazole sus 40MG/ML, 3

Verelan PM CAP 100MG ER, 10

Vistaril CAP 50MG, 37

voriconazole TAB 200MG, 3

Verelan PM CAP 200MG ER, 10

vit d child chw 1000unit, 59

voriconazole TAB 50MG, 3

Verelan PM CAP 300MG ER, 10

vit d gummie chw 400unit, 59

Vortex Valve Mis Chamber, 66

Veripred 20 Sol 20MG/5ML, 22

Vit D3 Drops Liq 400unit, 59

Vosevi TAB, 4

Versacloz Sus 50MG/ML, 40

vit d3 gumm chw 1000unit, 59

Vospire ER TAB 4MG, 58

Vesicare TAB 10MG, 33

vitajoy daly chw d 1000iu, 59

Vospire ER TAB 8MG, 58

Vesicare TAB 5MG, 33

Vitalet Pro Mis, 66

Votrient TAB 200MG, 8

vestura TAB 3-0.02MG, 24

Vitalet Pro Mis Plus, 66

Vpriv Inj 400unit, 35

Vexol Sus 1% Op, 49

Vitamelts D TAB 1000 Iu, 59

Vraylar CAP 1.5-3MG, 40

Vfend Sus 40MG/ML, 3

vitamin d CAP 1000unit, 59

Vraylar CAP 1.5MG, 40

Vfend TAB 200MG, 3

vitamin d CAP 2000unit, 59

Vraylar CAP 3MG, 40

Vfend TAB 50MG, 3

vitamin d CAP 400unit, 59

Vraylar CAP 4.5MG, 40

Viberzi TAB 100MG, 32

vitamin d CAP 50000unt, 59

Vraylar CAP 6MG, 40

Viberzi TAB 75MG, 32

vitamin d chw 1000unit, 59

Vusion Oin, 18

Vibramycin CAP 100MG, 2

vitamin d chw 400unit, 59

vyfemla TAB 0.4-35, 24

Vibramycin Sus 25MG/5ML, 2

vitamin d dro 400unit, 59

Vytorin TAB 10-10MG, 15

Vibramycin Syp 50MG/5ML, 2

vitamin d TAB 1000unit, 59

Vytorin TAB 10-20MG, 15

vicodin ES TAB 7.5-300, 52

vitamin d TAB 2000unit, 59

Vytorin TAB 10-40MG, 15

vicodin HP TAB 10-300MG, 52

vitamin d TAB 400unit, 59

Vytorin TAB 10-80MG, 15

vicodin TAB 5-300MG, 52

vitamin d TAB 5000iu, 59

Vyvanse CAP 10MG, 42

Vicoprofen TAB 7.5-200, 53

vitamin d-3 CAP 1000unit, 59

Vyvanse CAP 20MG, 42

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Vyvanse CAP 30MG, 42

Xarelto TAB 10MG, 36

Zanaflex TAB 4MG, 48

Vyvanse CAP 40MG, 42

Xarelto TAB 15MG, 36

Zantac TAB 150MG, 31

Vyvanse CAP 50MG, 42

Xarelto TAB 20MG, 36

Zantac TAB 300MG, 31

Vyvanse CAP 60MG, 42

Xartemis XR TAB 7.5-325, 53

zarah TAB 3-0.03MG, 24

Vyvanse CAP 70MG, 42

Xatmep Sol 2.5MG/ML, 6

Zarontin CAP 250MG, 44

Vyvanse Chw 10MG, 42

Xeljanz TAB 5MG, 54

Zarontin Sol 250/5ML, 44

Vyvanse Chw 20MG, 42

Xeljanz XR TAB 11MG, 54

Zarxio Inj 300/0.5, 35

Vyvanse Chw 30MG, 42

Xeloda TAB 150MG, 6

Zarxio Inj 480/0.8, 35

Vyvanse Chw 40MG, 42

Xeloda TAB 500MG, 6

Zavesca CAP 100MG, 35

Vyvanse Chw 50MG, 42

Xenazine TAB 12.5MG, 47

zazole CRE 0.8%, 33

Vyvanse Chw 60MG, 42

Xenazine TAB 25MG, 47

zazole sup 80MG, 33

W

Xeralux CRE, 21

Zebeta TAB 10MG, 9

Xerese CRE 5-1%, 18

Zebeta TAB 5MG, 9

W&f Lancets Mis 21G, 66

Xermelo TAB 250MG, 32

zebutal CAP, 51

W&f Lancets Mis 26G, 66

Xgeva Inj, 27

Zecuity Pad 6.5MG/4h, 55

warfarin TAB 10MG, 35

Xifaxan TAB 200MG, 5

Zegerid CAP 20-1100, 31

warfarin TAB 1MG, 35

Xifaxan TAB 550MG, 5

Zegerid CAP 40-1100, 31

warfarin TAB 2.5MG, 35

Xigduo XR TAB 10-1000, 26

Zegerid Pow 20-1680, 31

warfarin TAB 2MG, 35

Xigduo XR TAB 10-500MG, 27

Zegerid Pow 40-1680, 31

warfarin TAB 3MG, 35

Xigduo XR TAB 5-1000MG, 27

Zejula CAP 100MG, 8

warfarin TAB 4MG, 35

Xigduo XR TAB 5-500MG, 27

Zelapar TAB 1.25MG, 45

warfarin TAB 5MG, 35

Xiidra Dro 5%, 50

Zelboraf TAB 240MG, 8

warfarin TAB 6MG, 35

Xodol TAB 10-300MG, 53

Zembrace Sym Inj 3/0.5ML, 55

warfarin TAB 7.5MG, 35

Xodol TAB 5-300MG, 53

Zemplar CAP 1mcg, 28

Watchhaler Mis, 66

Xodol TAB 7.5-300, 53

Zemplar CAP 2mcg, 28

wee care sus 15/1.25, 35

Xolegel Gel 2%, 18

zenatane CAP 10MG, 16

Welchol PAK 3.75gm, 15

Xopenex CONC Neb 1.25/0.5, 58

zenatane CAP 20MG, 16

Welchol TAB 625MG, 15

Xopenex HFA Aer, 58

zenatane CAP 30MG, 16

Wellbutrin TAB 100MG, 39

Xopenex Neb 0.31MG, 58

zenatane CAP 40MG, 16

Wellbutrin TAB 100MG SR, 39

Xopenex Neb 0.63MG, 58

zenchent FE chw 0.4MG-35, 24

Wellbutrin TAB 150MG SR, 39

Xopenex Neb 1.25/3ML, 58

zenchent TAB, 24

Wellbutrin TAB 200MG SR, 39

Xtampza ER CAP 13.5MG, 52

zencia liq 9-4%, 16

Wellbutrin TAB 75MG, 39

Xtampza ER CAP 18MG, 52

Zenpep CAP 10000unt, 31

Wellbutrin TAB XL 150MG, 39

Xtampza ER CAP 27MG, 52

Zenpep CAP 15000unt, 31

Wellbutrin TAB XL 300MG, 39

Xtampza ER CAP 36MG, 52

Zenpep CAP 20000unt, 31

wera TAB 0.5/35, 24

Xtampza ER CAP 9MG, 52

Zenpep CAP 25000unt, 31

Westcort Oin 0.2%, 19

Xtandi CAP 40MG, 6

Zenpep CAP 3000unit, 31

Westhroid TAB 130MG, 29

Xulane Dis 150-35, 24

Zenpep CAP 40000unt, 31

Westhroid TAB 195MG, 29

Xultophy Inj 100/3.6, 27

Zenpep CAP 5000unit, 31

Westhroid TAB 32.5MG, 29

Xylo/Epi 1%- Inj 1:100000, 56

zenzedi TAB 10MG, 41

Westhroid TAB 65MG, 29

Xylocaine Inj -mpf 2%, 56

Zenzedi TAB 15MG, 42

Westhroid TAB 97.5MG, 29

Xylocaine Inj 1%, 56

Zenzedi TAB 2.5MG, 42

womans laxat TAB 5MG EC, 30

Xylocaine Inj 2%, 56

Zenzedi TAB 20MG, 42

womens laxat TAB 5MG EC, 30

Xylocaine Sol 4%, 21

Zenzedi TAB 30MG, 42

Wp Thyroid TAB 113.75MG, 29

xylon TAB 10-200MG, 52

zenzedi TAB 5MG, 41

Wp Thyroid TAB 130MG, 29

xyphex mis, 20

Zenzedi TAB 7.5MG, 42

Wp Thyroid TAB 16.25MG, 29

Xyrem Sol 500MG/ML, 47

Zepatier TAB 50-100MG, 5

Wp Thyroid TAB 32.5MG, 29

Xyzal Sol, 56

Zerit CAP 15MG, 5

Wp Thyroid TAB 48.75MG, 29

Xyzal Sol 2.5/5ML, 56

Zerit CAP 20MG, 5

Wp Thyroid TAB 65MG, 29

Xyzal TAB 5MG, 56

Zerit CAP 30MG, 5

Wp Thyroid TAB 81.25MG, 29

Y

Zerit CAP 40MG, 5

Wp Thyroid TAB 97.5MG, 29

Zerit Sol 1MG/ML, 5

wymzya FE chw 0.4MG-35, 24

Yasmin 28 TAB 3-0.03MG, 24

zeruvia pad 4-1%, 20

X

Yaz TAB 3-0.02MG, 24

Zestoretic TAB 10-12.5, 13

yl folic aci TAB 400mcg, 35

Zestoretic TAB 20-12.5, 13

Xadago TAB 100MG, 45

Yosprala TAB 325-40MG, 36

Zestoretic TAB 20-25MG, 13

Xadago TAB 50MG, 45

Yosprala TAB 81-40MG, 36

Zestril TAB 10MG, 11

Xalatan Sol 0.005%, 49

Your Life CAP Prenatal, 60

Zestril TAB 2.5MG, 11

Xalkori CAP 200MG, 8

yuvafem TAB 10mcg, 33

Zestril TAB 20MG, 11

Xalkori CAP 250MG, 8

Z

Zestril TAB 30MG, 11

Xanax TAB 0.25MG, 37

Zestril TAB 40MG, 11

Xanax TAB 0.5MG, 37

Zaclir Lot 8%, 17

Zestril TAB 5MG, 11

Xanax TAB 1MG, 37

zafirlukast TAB 10MG, 57

Zetia TAB 10MG, 15

Xanax TAB 2MG, 37

zafirlukast TAB 20MG, 57

Zetonna Aer 37mcg, 56

Xanax XR TAB 0.5MG, 37

zaleplon CAP 10MG, 41

Ziac TAB 10/6.25, 13

Xanax XR TAB 1MG, 37

zaleplon CAP 5MG, 41

Ziac TAB 2.5/6.25, 13

Xanax XR TAB 2MG, 37

Zanaflex CAP 2MG, 48

Ziac TAB 5-6.25MG, 13

Xanax XR TAB 3MG, 37

Zanaflex CAP 4MG, 48

Ziagen Sol 20MG/ML, 4

Xarelto Star TAB 15/20MG, 36

Zanaflex CAP 6MG, 48

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Ziagen TAB 300MG, 5

Zonacort PAK 11 Day, 22

1ST Choice Mis Lancets, 66

Ziana Gel, 17

Zonacort PAK 7 Day, 22

1ST Tier Uni Mis 29GX12MM, 66

zidovudine CAP 100MG, 4

Zonalon CRE 5%, 18

1ST Tier Uni Mis 31GX5MM, 66

zidovudine syp 50MG/5ML, 4

Zonatuss CAP 150MG, 57

1ST Tier Uni Mis 31GX6MM, 66

zidovudine TAB 300MG, 4

Zonegran CAP 100MG, 44

1ST Tier Uni Mis 31GX8MM, 66

zileuton ER TAB 600MG, 57

Zonegran CAP 25MG, 44

1ST Tier Uni Mis 32GX4MM, 66

Zinbryta Inj 150MG/ML, 47

zonisamide CAP 100MG, 43

8

Zioptan Dro 0.0015%, 49

zonisamide CAP 25MG, 43

8-mop CAP 10MG, 18

ziprasidone CAP 20MG, 39

zonisamide CAP 50MG, 43

ziprasidone CAP 40MG, 39

Zontivity TAB 2.08MG, 36

ziprasidone CAP 60MG, 39

Zorbtive Inj 8.8MG, 27

ziprasidone CAP 80MG, 39

Zortress TAB 0.25MG, 7

Zipsor CAP 25MG, 55

Zortress TAB 0.5MG, 7

Zirgan Gel 0.15%, 48

Zortress TAB 0.75MG, 7

Zithranol Sha 1%, 18

Zorvolex CAP 18MG, 55

Zithranol-rr CRE 1.2%, 18

Zorvolex CAP 35MG, 55

Zithromax Pow 1gm PAK, 2

Zostavax Inj, 58

Zithromax Sus 100/5ML, 2

zovia 1/35e TAB, 24

Zithromax Sus 200/5ML, 2

zovia 1/50e TAB, 24

Zithromax TAB 250MG, 2

Zovirax CAP 200MG, 5

Zithromax TAB 500MG, 2

Zovirax CRE 5%, 18

Zithromax TAB 600MG, 2

Zovirax Sus 200/5ML, 5

Zithromax TAB Tri-PAK, 2

Zovirax TAB 400MG, 5

Zithromax TAB Z-PAK, 2

Zovirax TAB 800MG, 5

Zmax Sus 2gm, 2

Zubsolv Sub 0.7-0.18, 54

Zocor TAB 10MG, 15

Zubsolv Sub 1.4-0.36, 54

Zocor TAB 20MG, 15

Zubsolv Sub 11.4-2.9, 54

Zocor TAB 40MG, 15

Zubsolv Sub 2.9-0.71, 54

Zocor TAB 5MG, 15

Zubsolv Sub 5.7-1.4, 54

Zocor TAB 80MG, 15

Zubsolv Sub 8.6-2.1, 54

Zodex PAK 12-day, 22

Zuplenz Mis 4MG, 31

Zodex PAK 6 Day, 22

Zuplenz Mis 8MG, 31

Zofran Sol 4MG/5ML, 31

Zurampic TAB 200MG, 55

Zofran TAB 4MG, 31

Zutripro Liq 60-4-5MG, 57

Zofran TAB 4MG Odt, 31

Zyban TAB 150MG SR, 48

Zofran TAB 8MG, 31

Zyclara CRE 3.75%, 20

Zofran TAB 8MG Odt, 31

Zyclara P.M. CRE 2.5%, 20

Zohydro ER CAP 10MG, 53

Zyclara P.M. CRE 3.75%, 20

Zohydro ER CAP 15MG, 53

Zydelig TAB 100MG, 8

Zohydro ER CAP 20MG, 53

Zydelig TAB 150MG, 8

Zohydro ER CAP 30MG, 53

Zyflo CR TAB 600MG, 57

Zohydro ER CAP 40MG, 54

Zyflo TAB 600MG, 57

Zohydro ER CAP 50MG, 54

Zykadia CAP 150MG, 8

Zoledronic Inj 4MG, 27

Zylet Sus 0.5-0.3%, 49

zoledronic inj 4MG/5ML, 27

Zyloprim TAB 100MG, 55

Zolinza CAP 100MG, 8

Zyloprim TAB 300MG, 55

zolmitriptan TAB 2.5 MG, 55

Zymaxid Sol 0.5%, 48

zolmitriptan TAB 2.5MG, 55

Zyprexa Inj 10MG, 40

zolmitriptan TAB 5MG, 55

Zyprexa Relp Inj 210MG, 40

Zoloft CON 20MG/ML, 39

Zyprexa Relp Inj 300MG, 40

Zoloft TAB 100MG, 39

Zyprexa Relp Inj 405MG, 40

Zoloft TAB 25MG, 39

Zyprexa TAB 10MG, 40

Zoloft TAB 50MG, 39

Zyprexa TAB 15MG, 40

zolpidem ER TAB 12.5MG, 41

Zyprexa TAB 2.5MG, 40

zolpidem ER TAB 6.25MG, 41

Zyprexa TAB 20MG, 40

zolpidem TAB 10MG, 41

Zyprexa TAB 5MG, 40

zolpidem TAB 5MG, 41

Zyprexa TAB 7.5MG, 40

zolpidem TAR sub 1.75MG, 41

Zyprexa Zydi TAB 10MG, 40

zolpidem TAR sub 3.5MG, 41

Zyprexa Zydi TAB 15MG, 40

Zolpimist Spr 5MG, 41

Zyprexa Zydi TAB 20MG, 40

Zomacton Inj 10MG, 27

Zyprexa Zydi TAB 5MG, 40

Zomacton Inj 5MG, 27

Zytiga TAB 250MG, 6

Zomig Spr 2.5MG, 55

Zytiga TAB 500MG, 6

Zomig Spr 5MG, 55

Zyvox Sus 100MG/5m, 5

Zomig TAB 2.5MG, 55

Zyvox TAB 600MG, 5

Zomig TAB 5MG, 55

1

Zomig ZMT TAB 2.5 MG, 55

1ML Syringe Mis 29G, 66

Zomig ZMT TAB 5MG, 55

1ML Syringe Mis 30G, 66

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Українська (Ukrainian): УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером 1-888-901-4636 (телетайп: 1-800-833-6388 / 711).

ភាសាខ្មែរ (Khmer)៖ របយ័ត៖ េ េបើសិនអកនិខ្យមរ, េ សជំនួខ្យផក េ យមិនគិតល គឺចនសំប់បំេ រអក។ ចូរទូ រស័ព 1-888-901-4636 (TTY: 1-800-833-6388 / 711)។ 日本語 (Japanese): 注意事項:日本語を話される場 合、無料の言語支援をご利用いただけます。 1-888-901-4636 (TTY: 1-800-833-6388 / 711) まで、 お電話にてご連絡ください。

አማርኛ (Amharic) ፥ ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-888-901-4636 (መስማት ለተሳናቸው: 1-800-833-6388 / 711).

Oromiffa (Oromo): XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-888-901-4636 (TTY: 1-800-833-6388 / 711).

ਪੰਜਾਬੀ (Punjabi) ਧਿਆਨ ਧਿਓ: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਿ ੇਹੋ, ਤਾਂ ਭਾਸਾ ਧ ਿੱ ਚ ਸਹਾਇਤਾ ਸੇ ਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਿ ਹੈ। 1-888-901-4636 (TTY: 1-800-833-6388 / 711) ‘ਤੇ ਕਾਲ ਕਰੋ।

تتوافر اللغوية المساعدة خدمات فإن اللغة، اذكر تتحدث كنت إذا :ملحوظة في ومعلومات مساعدة على الحصول حق لديكم :(Arabic) العربية : (6388-833-800-1 / 711) .والبكم الصم هاتف رقم 4636-901-888-1 برقم اتصل .بالمجان لك

Deutsch (German): ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-901-4636 (TTY: 1-800-833-6388 / 711).

ພາສາລາວ (Lao): ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວ ້ າພາສາລາວ, ການບໍ ລິ ການຊ່ວຍເຫ ຼື ອດ້ານພາສາ, ໂດຍບໍ່ ເສັຽຄ່າ, ແມ່ນມີ ພ້ອມ ໃຫ້ທ່ານ. ໂທຣ 1-888-901-4636 (TTY: 1-800-833-6388 / 711).

Srpsko-hrvatski (Serbo-Croatian): OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite 1-888-901-4636 (TTY- Telefon za osobe sa oštećenim govorom ili sluhom: 1-800-833-6388 / 711).

Français (French): ATTENTION: Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-888-901-4636 (ATS: 1-800-833-6388 / 711).

Română (Romanian): ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit. Sunați la 1-888-901-4636 (TTY: 1-800-833-6388 / 711).

Adamawa (Fulfulde): MAANDO: To a waawi Adamawa, e woodi ballooji-ma to ekkitaaki wolde caahu. Noddu 1-888-901-4636 (TTY: 1-800-833-6388 / 711).

می فراهم شما برای رايگان بصورت زبانی تسهيالت کنيد، می گفتگو فارسی زبان به اگر :توجه :(Farsi) فارسی .بگيريد تماس (TTY: 1-800-833-6388 / 711) 4636-901-888-1 با .باشد

XB0001444-55-17


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