| 02546078 | (IRON) FERRIC CARBOXYMALTOSE | Ferinject 50mg/mL Inj Sol | VIR | 22.5000 | 22.5000 | NO | YES | NO |
| 02474026 | 5-AMINOSALICYLIC ACID | Mezera 1g/Actuation 14 Actuation-Foam Enema Canister Pk | AVP | 101.8220 | 101.8220 | NO | NO | NO |
| 02524481 | 5-AMINOSALICYLIC ACID | Mezera 500mg DR Tab | AVP | 0.6627 | 0.6627 | NO | NO | NO |
| 02099683 | 5-AMINOSALICYLIC ACID | Pentasa 500mg Del-Release Tab | FEI | 0.7544 | 0.7544 | NO | NO | NO |
| 02297558 | 5-AMINOSALICYLIC ACID | Mezavant 1.2g Delayed & ER Tab | TAK | 2.0020 | 2.0020 | NO | NO | NO |
| 02399466 | 5-AMINOSALICYLIC ACID | Pentasa 1g ER Tab | FEI | 1.5086 | 1.5086 | NO | NO | NO |
| 02153556 | 5-AMINOSALICYLIC ACID | Pentasa 4g/100mL Enema | FEI | 9.1942 | 9.1942 | NO | NO | NO |
| 02153521 | 5-AMINOSALICYLIC ACID | Pentasa 1g/100mL Enema | FEI | 6.6606 | 6.6606 | NO | NO | NO |
| 02112787 | 5-AMINOSALICYLIC ACID | Salofalk 500mg Ent Tab | BFI | 0.7050 | 0.7050 | NO | NO | NO |
| 02112809 | 5-AMINOSALICYLIC ACID | Salofalk 4g Rect Susp-Pk | BFI | 9.2100 | 9.2100 | NO | NO | NO |
| 02474018 | 5-AMINOSALICYLIC ACID | Mezera 1g Sup | AVP | 1.8702 | 1.8702 | NO | NO | NO |
| 02153564 | 5-AMINOSALICYLIC ACID | Pentasa 1g Sup | FEI | 2.6231 | 2.6231 | NO | NO | NO |
| 02112760 | 5-AMINOSALICYLIC ACID | Salofalk 500mg Sup | BFI | 1.7337 | 1.7337 | NO | NO | NO |
| 02242146 | 5-AMINOSALICYLIC ACID | Salofalk 1000mg Sup | BFI | 2.5463 | 2.5463 | NO | NO | NO |
| 01997580 | 5-AMINOSALICYLIC ACID | Asacol (Not a Benefit) 400mg Tab | WAR | N/A | N/A | YES | NO | NO |
| 02171929 | 5-AMINOSALICYLIC ACID | Teva-5-ASA 400mg Tab | TEV | 0.4758 | 0.4758 | YES | NO | NO |
| 02416255 | ABACAVIR & LAMIVUDINE & ZIDOVUDINE | Apo-Abacavir-Lamivudine-Zidovudine 300mg & 150mg & 300mg Tab | APX | 13.6425 | 13.6425 | YES | NO | NO |
| 02244757 | ABACAVIR & LAMIVUDINE & ZIDOVUDINE | Trizivir 300mg & 150mg & 300mg Tab | VIH | 19.0426 | 13.6425 | YES | NO | NO |
| 02240358 | ABACAVIR SULFATE | Ziagen 20mg/mL O/L | VIH | 0.6142 | 0.6142 | NO | NO | NO |
| 02396769 | ABACAVIR SULFATE | Apo-Abacavir 300mg Tab | APX | 3.4828 | 3.4828 | YES | NO | NO |
| 02480956 | ABACAVIR SULFATE | Mint-Abacavir 300mg Tab | MIN | 3.4828 | 3.4828 | YES | NO | NO |
| 02240357 | ABACAVIR SULFATE | Ziagen 300mg Tab | VIH | 8.6725 | 3.4828 | YES | NO | NO |
| 02399539 | ABACAVIR SULFATE & LAMIVUDINE | Apo-Abacavir-Lamivudine 600mg & 300mg Tab | APX | 5.9875 | 5.9875 | YES | NO | NO |
| 02454513 | ABACAVIR SULFATE & LAMIVUDINE | Auro-Abacavir/Lamivudine 600mg & 300mg Tab | AUR | 5.9875 | 5.9875 | YES | NO | NO |
| 02497654 | ABACAVIR SULFATE & LAMIVUDINE | Jamp Abacavir/Lamivudine 600mg & 300mg Tab | JPC | 5.9875 | 5.9875 | YES | NO | NO |
| 02269341 | ABACAVIR SULFATE & LAMIVUDINE | Kivexa 600mg & 300mg Tab | VIH | 28.3100 | 5.9875 | YES | NO | NO |
| 02450682 | ABACAVIR SULFATE & LAMIVUDINE | Mylan-Abacavir-Lamivudine 600mg & 300mg Tab | MYL | 5.9875 | 5.9875 | YES | NO | NO |
| 02458381 | ABACAVIR SULFATE & LAMIVUDINE | PMS-Abacavir-Lamivudine 600mg & 300mg Tab | PMS | 5.9875 | 5.9875 | YES | NO | NO |
| 02416662 | ABACAVIR SULFATE & LAMIVUDINE | Teva-Abacavir-Lamivudine 600mg & 300mg Tab | TEV | 5.9875 | 5.9875 | YES | NO | NO |
| 02525380 | ABIRATERONE ACETATE | Abiraterone 500mg Tab | JPC | 15.3125 | 15.3125 | YES | NO | NO |
| 02491397 | ABIRATERONE ACETATE | Apo-Abiraterone Film Coated Tablets 250mg Tab | APX | 7.6563 | 7.6563 | YES | NO | NO |
| 02491400 | ABIRATERONE ACETATE | Apo-Abiraterone Film Coated Tablets 500mg Tab | APX | 15.3125 | 15.3125 | YES | NO | NO |
| 02529629 | ABIRATERONE ACETATE | Jamp Abiraterone 500mg Tab | JPC | 15.3125 | 15.3125 | YES | NO | NO |
| 02502305 | ABIRATERONE ACETATE | Jamp Abiraterone 250mg Tab | JPC | 7.6563 | 7.6563 | YES | NO | NO |
| 02503999 | ABIRATERONE ACETATE | Mar-Abiraterone 500mg Tab | MAR | 15.3125 | 15.3125 | YES | NO | NO |
| 02503980 | ABIRATERONE ACETATE | Mar-Abiraterone 250mg Tab | MAR | 7.6563 | 7.6563 | YES | NO | NO |
| 02494132 | ABIRATERONE ACETATE | Nat-Abiraterone 250mg Tab | NAT | 7.6563 | 7.6563 | YES | NO | NO |
| 02492601 | ABIRATERONE ACETATE | PMS-Abiraterone 250mg Tab | PMS | 7.6563 | 7.6563 | YES | NO | NO |
| 02501503 | ABIRATERONE ACETATE | PMS-Abiraterone 500mg Tab | PMS | 15.3125 | 15.3125 | YES | NO | NO |
| 02540460 | ABIRATERONE ACETATE | PRZ-Abiraterone 500mg Tab | PRZ | 15.3125 | 15.3125 | YES | NO | NO |
| 02540452 | ABIRATERONE ACETATE | PRZ-Abiraterone 250mg Tab | PRZ | 7.6563 | 7.6563 | YES | NO | NO |
| 02477114 | ABIRATERONE ACETATE | Reddy-Abiraterone 250mg Tab | DRR | 7.6563 | 7.6563 | YES | NO | NO |
| 02533251 | ABIRATERONE ACETATE | Reddy-Abiraterone 500mg Tab | DRR | 15.3125 | 15.3125 | YES | NO | NO |
| 02486393 | ABIRATERONE ACETATE | Sandoz Abiraterone 250mg Tab | SDZ | 7.6563 | 7.6563 | YES | NO | NO |
| 02521644 | ABIRATERONE ACETATE | Sandoz Abiraterone 500mg Tab | SDZ | 15.3125 | 15.3125 | YES | NO | NO |
| 02371065 | ABIRATERONE ACETATE | Zytiga 250mg Tab | JAN | 35.5230 | 7.6563 | YES | NO | NO |
| 02457113 | ABIRATERONE ACETATE | Zytiga 500mg Tab | JAN | 71.0460 | 15.3125 | YES | NO | NO |
| 02460203 | ABOBOTULINUM TOXIN A | Dysport Therapeutic 300U/Vial Pd Inj-Vial Pk | IPS | 385.5600 | 385.5600 | NO | YES | NO |
| 02456117 | ABOBOTULINUM TOXIN A | Dysport Therapeutic 500U/Vial Pd Inj-Vial Pk | IPS | 642.6000 | 642.6000 | NO | YES | NO |
| 02293269 | ACAMPROSATE CALCIUM | Campral 333mg DR Tab | MYL | 0.9976 | 0.9976 | NO | YES | NO |
| 02190885 | ACARBOSE | Glucobay (Not a Benefit) 50mg Tab | BAY | N/A | N/A | YES | NO | NO |
| 02190893 | ACARBOSE | Glucobay (Not a Benefit) 100mg Tab | BAY | N/A | N/A | YES | NO | NO |
| 02494086 | ACARBOSE | Mar-Acarbose 100mg Tab | MAR | 0.2053 | 0.2053 | YES | YES | NO |
| 02494078 | ACARBOSE | Mar-Acarbose 50mg Tab | MAR | 0.1348 | 0.1348 | YES | YES | NO |
| 02147602 | ACEBUTOLOL HCL | Apo-Acebutolol 100mg Tab | APX | 0.1871 | 0.1871 | YES | NO | NO |
| 02147610 | ACEBUTOLOL HCL | Apo-Acebutolol 200mg Tab | APX | 0.2808 | 0.2808 | YES | NO | NO |
| 02147629 | ACEBUTOLOL HCL | Apo-Acebutolol 400mg Tab | APX | 0.5348 | 0.5348 | YES | NO | NO |
| 01926578 | ACEBUTOLOL HCL | Sectral (Not a Benefit) 400mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 01926551 | ACEBUTOLOL HCL | Sectral (Not a Benefit) 200mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 01926543 | ACEBUTOLOL HCL | Sectral (Not a Benefit) 100mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02204525 | ACEBUTOLOL HCL | Teva-Acebutolol 200mg Tab | TEV | 0.2808 | 0.2808 | YES | NO | NO |
| 02204517 | ACEBUTOLOL HCL | Teva-Acebutolol 100mg Tab | TEV | 0.1871 | 0.1871 | YES | NO | NO |
| 02204533 | ACEBUTOLOL HCL | Teva-Acebutolol 400mg Tab | TEV | 0.5348 | 0.5348 | YES | NO | NO |
| 02229977 | ACETAMINOPHEN | Apo-Acetaminophen Caplets 500mg | APX | 0.0149 | 0.0149 | YES | NO | NO |
| 02229873 | ACETAMINOPHEN | Apo-Acetaminophen Caplets 325mg | APX | 0.0114 | 0.0114 | YES | NO | NO |
| 00544981 | ACETAMINOPHEN | Apo-Acetaminophen Tab 325mg | APX | 0.0114 | 0.0114 | YES | NO | NO |
| 00545007 | ACETAMINOPHEN | Apo-Acetaminophen Tab 500mg | APX | 0.0149 | 0.0149 | YES | NO | NO |
| 00013668 | ACETAMINOPHEN | Atasol Forte Tab (Not a Benefit) 500mg | HOR | N/A | N/A | YES | NO | NO |
| 00293482 | ACETAMINOPHEN | Atasol Tab (Not a Benefit) 325mg | HOR | N/A | N/A | YES | NO | NO |
| 01938088 | ACETAMINOPHEN | Jamp Acetaminophen 325 Caplets 325mg | JPC | 0.0114 | 0.0114 | YES | NO | NO |
| 01939122 | ACETAMINOPHEN | Jamp Acetaminophen 500 Caplets 500mg | JPC | 0.0149 | 0.0149 | YES | NO | NO |
| 00482323 | ACETAMINOPHEN | Novo-Gesic Forte Tab 500mg | NOP | 0.0149 | 0.0149 | YES | NO | NO |
| 00389218 | ACETAMINOPHEN | Novo-Gesic Tab 325mg | NOP | 0.0114 | 0.0114 | YES | NO | NO |
| 00631353 | ACETAMINOPHEN | Atasol (Not a Benefit) 80mg/mL O/L | HOR | N/A | N/A | YES | NO | NO |
| 02027801 | ACETAMINOPHEN | Pediatrix 80mg/mL O/L | RPH | 0.1436 | 0.1436 | YES | NO | NO |
| 00642401 | ACETAMINOPHEN | Tempra (Not a Benefit) 80mg/mL O/L | MJS | N/A | N/A | YES | NO | NO |
| 02230434 | ACETAMINOPHEN | ACET 120 120mg Sup | PEN | 0.5367 | 0.5367 | YES | NO | NO |
| 02230436 | ACETAMINOPHEN | ACET 325 325mg Sup | PEN | 0.6625 | 0.6625 | YES | NO | NO |
| 02230437 | ACETAMINOPHEN | ACET 650 650mg Sup | PEN | 0.7608 | 0.7608 | YES | NO | NO |
| 01919407 | ACETAMINOPHEN | Abenol (Not a Benefit) 650mg Sup | PEN | N/A | N/A | YES | NO | NO |
| 01919393 | ACETAMINOPHEN | Abenol (Not a Benefit) 325mg Sup | PEN | N/A | N/A | YES | NO | NO |
| 01919385 | ACETAMINOPHEN | Abenol (Not a Benefit) 120mg Sup | PEN | N/A | N/A | YES | NO | NO |
| 00653241 | ACETAMINOPHEN & CAFFEINE & CODEINE PHOSPHATE | Teva-Lenoltec No.2 300mg & 15mg & 15mg Tab | TEV | 0.0933 | 0.0933 | YES | NO | YES |
| 00653276 | ACETAMINOPHEN & CAFFEINE & CODEINE PHOSPHATE | Teva-Lenoltec No.3 300mg & 15mg & 30mg Tab | TEV | 0.0980 | 0.0980 | YES | NO | YES |
| 02163934 | ACETAMINOPHEN & CAFFEINE & CODEINE PHOSPHATE | Tylenol with Codeine No. 2 (Not a Benefit) 300mg & 15mg & 15mg Tab | JAN | N/A | N/A | YES | NO | YES |
| 02163926 | ACETAMINOPHEN & CAFFEINE & CODEINE PHOSPHATE | Tylenol with Codeine No. 3 (Not a Benefit) 300mg & 15mg & 30mg Tab | JAN | N/A | N/A | YES | NO | YES |
| 00816027 | ACETAMINOPHEN & CODEINE PHOSPHATE | PMS-Acetaminophen With Codeine 160mg & 8mg/5mL O/L | PMS | 0.1370 | 0.1370 | YES | NO | YES |
| 02163942 | ACETAMINOPHEN & CODEINE PHOSPHATE | Tylenol With Codeine Elixir (Not a Benefit) 160mg & 8mg/5mL O/L | JAN | N/A | N/A | YES | NO | YES |
| 00666130 | ACETAMINOPHEN & CODEINE PHOSPHATE | Empracet-30 (Not a Benefit) 300mg & 30mg Tab | BWE | N/A | N/A | YES | NO | YES |
| 00608882 | ACETAMINOPHEN & CODEINE PHOSPHATE | Teva-Emtec-30 300mg & 30mg Tab | TEV | 0.1300 | 0.1300 | YES | NO | YES |
| 00621463 | ACETAMINOPHEN & CODEINE PHOSPHATE | Teva-Lenoltec No.4 300mg & 60mg Tab | TEV | 0.1685 | 0.1685 | YES | NO | YES |
| 02163918 | ACETAMINOPHEN & CODEINE PHOSPHATE | Tylenol with Codeine No. 4 (Not a Benefit) 300mg & 60mg Tab | JAN | N/A | N/A | YES | NO | YES |
| 00545015 | ACETAZOLAMIDE | Acetazolamide 250mg Tab | AAP | 0.1414 | 0.1414 | YES | NO | NO |
| 02238072 | ACETAZOLAMIDE | Diamox (Not a Benefit) 250mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02554690 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE | Apo-Butalbital-ASA-Caffeine (Off-Formulary Interchangeable) 330mg & 50mg & 40mg Cap | APX | 1.7939 | N/A | YES | NO | YES |
| 00226327 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE | Fiorinal (Off-Formulary Interchangeable) 330mg & 50mg & 40mg Cap | NOV | N/A | N/A | YES | NO | YES |
| 00608238 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE | Teva-Tecnal (Off-Formulary Interchangeable) 330mg & 50mg & 40mg Cap | TEV | 1.6192 | N/A | YES | NO | YES |
| 02554623 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATE | Apo-Butalbital-ASA-Caffeine-Codeine-C1/2 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 30mg Cap | APX | 2.1261 | N/A | YES | NO | YES |
| 02554615 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATE | Apo-Butalbital-ASA-Caffeine-Codeine-C1/4 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 15mg Cap | APX | 1.7363 | N/A | YES | NO | YES |
| 00176206 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATE | Fiorinal C1/2 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 30mg Cap | NOV | N/A | N/A | YES | NO | YES |
| 00176192 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATE | Fiorinal C1/4 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 15mg Cap | NOV | N/A | N/A | YES | NO | YES |
| 00608181 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATE | Teva-Tecnal C1/2 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 30mg Cap | TEV | 2.1261 | N/A | YES | NO | YES |
| 00608203 | ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATE | Teva-Tecnal C1/4 (Off-Formulary Interchangeable) 330mg & 50mg & 40mg & 15mg Cap | TEV | 1.7363 | N/A | YES | NO | YES |
| 02468840 | ACITRETIN | Mint-Acitretin 10mg Cap | MIN | 1.2965 | 1.2965 | YES | NO | YES |
| 02468859 | ACITRETIN | Mint-Acitretin 25mg Cap | MIN | 2.2770 | 2.2770 | YES | NO | YES |
| 02070863 | ACITRETIN | Soriatane 25mg Cap | ALL | 5.7557 | 2.2770 | YES | NO | YES |
| 02070847 | ACITRETIN | Soriatane 10mg Cap | ALL | 3.2773 | 1.2965 | YES | NO | YES |
| 02466082 | ACITRETIN | Taro-Acitretin 25mg Cap | TAR | 2.2770 | 2.2770 | YES | NO | YES |
| 02466074 | ACITRETIN | Taro-Acitretin 10mg Cap | TAR | 1.2965 | 1.2965 | YES | NO | YES |
| 02409720 | ACLIDINIUM BROMIDE | Tudorza Genuair 400mcg/actuation Pd Inh-60 Dose Pk | COP | 57.0467 | 57.0467 | NO | NO | NO |
| 02439530 | ACLIDINIUM BROMIDE & FORMOTEROL FUMARATE DIHYDRATE | Duaklir Genuair 400mcg & 12mcg Metered Dose Pd Inh-60 Dose Pk | COP | 65.1686 | 65.1686 | NO | YES | NO |
| 00886157 | ACYCLOVIR | Zovirax 200mg/5mL Oral Susp | GLW | 0.3142 | 0.3142 | NO | NO | NO |
| 02207648 | ACYCLOVIR | Apo-Acyclovir 400mg Tab | APX | 0.8890 | 0.8890 | YES | NO | NO |
| 02207656 | ACYCLOVIR | Apo-Acyclovir 800mg Tab | APX | 1.2673 | 1.2673 | YES | NO | NO |
| 02207621 | ACYCLOVIR | Apo-Acyclovir 200mg Tab | APX | 0.3511 | 0.3511 | YES | NO | NO |
| 02524724 | ACYCLOVIR | Mint-Acyclovir 800mg Tab | MIN | 1.2673 | 1.2673 | YES | NO | NO |
| 02524708 | ACYCLOVIR | Mint-Acyclovir 200mg Tab | MIN | 0.3511 | 0.3511 | YES | NO | NO |
| 02524716 | ACYCLOVIR | Mint-Acyclovir 400mg Tab | MIN | 0.8890 | 0.8890 | YES | NO | NO |
| 02242464 | ACYCLOVIR | Mylan-Acyclovir 800mg Tab | MYL | 1.2673 | 1.2673 | YES | NO | NO |
| 02242463 | ACYCLOVIR | Mylan-Acyclovir 400mg Tab | MYL | 0.8890 | 0.8890 | YES | NO | NO |
| 02242784 | ACYCLOVIR | Mylan-Acyclovir 200mg Tab | MYL | 0.3511 | 0.3511 | YES | NO | NO |
| 02285959 | ACYCLOVIR | Teva-Acyclovir 200mg Tab | TEV | 0.3511 | 0.3511 | YES | NO | NO |
| 02285967 | ACYCLOVIR | Teva-Acyclovir 400mg Tab | TEV | 0.8890 | 0.8890 | YES | NO | NO |
| 02285975 | ACYCLOVIR | Teva-Acyclovir 800mg Tab | TEV | 1.2673 | 1.2673 | YES | NO | NO |
| 01911627 | ACYCLOVIR | Zovirax (Not a Benefit) 400mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 01911635 | ACYCLOVIR | Zovirax 800mg Tab | GSK | 5.0692 | 1.2673 | YES | NO | NO |
| 00634506 | ACYCLOVIR | Zovirax (Not a Benefit) 200mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02477130 | ACYCLOVIR | Apo-Acyclovir Ointment (Off-Formulary Interchangeable) 5% Top Oint | APX | 12.3114 | N/A | YES | NO | NO |
| 02522306 | ACYCLOVIR | Taro-Acyclovir (Off-Formulary Interchangeable) 5% Top Oint | TAR | 12.3114 | N/A | YES | NO | NO |
| 00569771 | ACYCLOVIR | Zovirax (Off-Formulary Interchangeable) 5% Top Oint | VAL | N/A | N/A | YES | NO | NO |
| 02542315 | ADALIMUMAB | Hyrimoz 20mg/0.2mL Inj Sol-0.2mL Pref Syr (Preservative-Free) | SDZ | 235.6350 | 235.6350 | NO | YES | NO |
| 02533480 | ADALIMUMAB | Hadlima PushTouch 40mg/0.4mL Inj Sol-0.4mL Autoinj (Preservative-Free) | SAM | 471.2700 | 471.2700 | NO | YES | NO |
| 02523779 | ADALIMUMAB | Yuflyma 40mg/0.4mL Inj Sol-0.4mL Pref Autoinj Pen (Preservative-Free) | CEH | 471.2700 | 471.2700 | NO | YES | NO |
| 02523957 | ADALIMUMAB | Simlandi 40mg/0.4mL Inj Sol-0.4mL Pref Autoinj Syr (Preservative-Free) | JPC | 471.2700 | 471.2700 | NO | YES | NO |
| 02542331 | ADALIMUMAB | Hyrimoz 40mg/0.4mL Inj Sol-0.4mL Pref Pen (Preservative-Free) | SDZ | 471.2700 | 471.2700 | NO | YES | NO |
| 02511061 | ADALIMUMAB | Abrilada 20mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | PFI | 235.6300 | 235.6300 | NO | YES | NO |
| 02459310 | ADALIMUMAB | Amgevita 20mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | AMG | 235.6400 | 235.6400 | NO | YES | NO |
| 02533472 | ADALIMUMAB | Hadlima 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | SAM | 471.2700 | 471.2700 | NO | YES | NO |
| 02502380 | ADALIMUMAB | Hulio 20mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | BGP | 235.6350 | 235.6350 | NO | YES | NO |
| 02505258 | ADALIMUMAB | Hyrimoz 20mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | SDZ | 235.6350 | 235.6350 | NO | YES | NO |
| 02542323 | ADALIMUMAB | Hyrimoz 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | SDZ | 471.2700 | 471.2700 | NO | YES | NO |
| 02523949 | ADALIMUMAB | Simlandi 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | JPC | 471.2700 | 471.2700 | NO | YES | NO |
| 02523760 | ADALIMUMAB | Yuflyma 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | CEH | 471.2700 | 471.2700 | NO | YES | NO |
| 02459302 | ADALIMUMAB | Amgevita 40mg/0.8mL Inj Sol-0.8mL Pref Autoinj (Preservative-Free) | AMG | 471.2700 | 471.2700 | NO | YES | NO |
| 02473100 | ADALIMUMAB | Hadlima PushTouch 40mg/0.8mL Inj Sol-0.8mL Pref Autoinj (Preservative-Free) | SAM | 471.2700 | 471.2700 | NO | YES | NO |
| 02492156 | ADALIMUMAB | Hyrimoz 40mg/0.8mL Inj Sol-0.8mL Pref Autoinj (Preservative-Free) | SDZ | 471.2700 | 471.2700 | NO | YES | NO |
| 02511045 | ADALIMUMAB | Abrilada 40mg/0.8mL Inj Sol-0.8mL Pref Pen (Preservative-Free) | PFI | 471.2700 | 471.2700 | NO | YES | NO |
| 02502402 | ADALIMUMAB | Hulio 40mg/0.8mL Inj Sol-0.8mL Pref Pen (Preservative-Free) | BGP | 471.2700 | 471.2700 | NO | YES | NO |
| 02542366 | ADALIMUMAB | Hyrimoz 80mg/0.8mL Inj Sol-0.8mL Pref Pen (Preservative-Free) | SDZ | 942.5400 | 942.5400 | NO | YES | NO |
| 02502674 | ADALIMUMAB | Idacio 40mg/0.8mL Inj Sol-0.8mL Pref Pen (Preservative-Free) | FKC | 471.2700 | 471.2700 | NO | YES | NO |
| 02535084 | ADALIMUMAB | Yuflyma 80mg/0.8mL Inj Sol-0.8mL Pref Pen (Preservative-Free) | CEH | 942.5400 | 942.5400 | NO | YES | NO |
| 02511053 | ADALIMUMAB | Abrilada 40mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | PFI | 471.2700 | 471.2700 | NO | YES | NO |
| 02459299 | ADALIMUMAB | Amgevita 40mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | AMG | 471.2700 | 471.2700 | NO | YES | NO |
| 02473097 | ADALIMUMAB | Hadlima 40mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | SAM | 471.2700 | 471.2700 | NO | YES | NO |
| 02502399 | ADALIMUMAB | Hulio 40mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | BGP | 471.2700 | 471.2700 | NO | YES | NO |
| 02492164 | ADALIMUMAB | Hyrimoz 40mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | SDZ | 471.2700 | 471.2700 | NO | YES | NO |
| 02542358 | ADALIMUMAB | Hyrimoz 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | SDZ | 942.5400 | 942.5400 | NO | YES | NO |
| 02502682 | ADALIMUMAB | Idacio 40mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | FKC | 471.2700 | 471.2700 | NO | YES | NO |
| 02523965 | ADALIMUMAB | Simlandi 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | JPC | 942.5400 | 942.5400 | NO | YES | NO |
| 02535076 | ADALIMUMAB | Yuflyma 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | CEH | 942.5400 | 942.5400 | NO | YES | NO |
| 02489007 | ADAPALENE & BENZOYL PEROXIDE | Sandoz Adapalene/ Benzoyl Peroxide (Off-Formulary Interchangeable) 0.1%w/w & 2.5%w/w Top Gel | SDZ | 1.2718 | N/A | YES | NO | NO |
| 02517205 | ADAPALENE & BENZOYL PEROXIDE | Sandoz Adapalene/Benzoyl Peroxide (Off-Formulary Interchangeable) 0.3% w/w & 2.5% w/w Top Gel | SDZ | 2.1576 | N/A | YES | NO | NO |
| 02365871 | ADAPALENE & BENZOYL PEROXIDE | TactuPump (Off-Formulary Interchangeable) 0.1%w/w & 2.5%w/w Top Gel | GAC | N/A | N/A | YES | NO | NO |
| 02446235 | ADAPALENE & BENZOYL PEROXIDE | TactuPump Forte (Off-Formulary Interchangeable) 0.3% w/w & 2.5% w/w Top Gel | GAC | N/A | N/A | YES | NO | NO |
| 02456923 | ADAPALENE & BENZOYL PEROXIDE | Taro-Adapalene/Benzoyl Peroxide (Off-Formulary Interchangeable) 0.1%w/w & 2.5%w/w Top Gel | TAR | 1.2719 | N/A | YES | NO | NO |
| 02505053 | ADAPALENE & BENZOYL PEROXIDE | Taro-Adapalene/Benzoyl Peroxide Forte (Off-Formulary Interchangeable) 0.3% w/w & 2.5% w/w Top Gel | TAR | 2.1577 | N/A | YES | NO | NO |
| 02420333 | ADEFOVIR DIPIVOXIL | AA-Adefovir (Off-Formulary Interchangeable) 10mg Tab | AAP | 20.9130 | N/A | YES | NO | NO |
| 02247823 | ADEFOVIR DIPIVOXIL | Hepsera (Off-Formulary Interchangeable) 10mg Tab | GIL | N/A | N/A | YES | NO | NO |
| 02415682 | AFATINIB | Giotrif (Off-Formulary Interchangeable) 40mg Tab | BOE | 77.4784 | 38.7392 | YES | NO | NO |
| 02415674 | AFATINIB | Giotrif (Off-Formulary Interchangeable) 30mg Tab | BOE | 77.4784 | 38.7392 | YES | NO | NO |
| 02415666 | AFATINIB | Giotrif (Off-Formulary Interchangeable) 20mg Tab | BOE | 77.4784 | 38.7392 | YES | NO | NO |
| 02517035 | AFATINIB | Mar-Afatinib (Off-Formulary Interchangeable) 40mg Tab | MAR | 38.7392 | 38.7392 | YES | NO | NO |
| 02517019 | AFATINIB | Mar-Afatinib (Off-Formulary Interchangeable) 20mg Tab | MAR | 38.7392 | 38.7392 | YES | NO | NO |
| 02517027 | AFATINIB | Mar-Afatinib (Off-Formulary Interchangeable) 30mg Tab | MAR | 38.7392 | 38.7392 | YES | NO | NO |
| 02512793 | AFATINIB | Sandoz AFAtinib (Off-Formulary Interchangeable) 40mg Tab | SDZ | 38.7392 | 38.7392 | YES | NO | NO |
| 02512785 | AFATINIB | Sandoz AFAtinib (Off-Formulary Interchangeable) 30mg Tab | SDZ | 38.7392 | 38.7392 | YES | NO | NO |
| 02512777 | AFATINIB | Sandoz AFAtinib (Off-Formulary Interchangeable) 20mg Tab | SDZ | 38.7392 | 38.7392 | YES | NO | NO |
| 02554178 | AFLIBERCEPT | Aflivu 2mg/0.05mL Inj Sol-0.05mL Pref Syr (Preservative-Free) | APX | 850.8000 | 850.8000 | NO | YES | NO |
| 02505355 | AFLIBERCEPT | Eylea 40mg/mL Inj Sol-0.05mL Pref Syr (Preservative-Free) | BAH | 1418.0000 | 1418.0000 | NO | YES | NO |
| 02558238 | AFLIBERCEPT | Yesafili 2mg/0.05mL Inj Sol-0.05mL Pref Syr (Preservative-Free) | BCL | 850.8000 | 850.8000 | NO | YES | NO |
| 02554798 | AFLIBERCEPT | Eylea HD 8mg/0.07mL Inj Sol-0.07mL Pref Syr | BAH | 1250.0000 | 1250.0000 | NO | YES | NO |
| 02545004 | AFLIBERCEPT | Eylea HD 8mg/0.07mL Inj Sol-0.07mL Vial Pk | BAH | 1250.0000 | 1250.0000 | NO | YES | NO |
| 02554194 | AFLIBERCEPT | Aflivu 2mg/0.05mL Sol for Intravitreal Inj-0.05mL Vial Pk | APX | 850.8000 | 850.8000 | NO | YES | NO |
| 02415992 | AFLIBERCEPT | Eylea 40mg/mL Sol for Intravitreal Inj-0.05mL Vial Pk | BAH | 1418.0000 | 1418.0000 | NO | YES | NO |
| 02535858 | AFLIBERCEPT | Yesafili 2mg/0.05mL Sol for Intravitreal Inj-0.05mL Vial Pk | BCL | 850.8000 | 850.8000 | NO | YES | NO |
| 02485184 | ALENDRONATE | AG-Alendronate 70mg Tab | ANG | 1.7804 | 1.7804 | YES | NO | NO |
| 02299712 | ALENDRONATE | Alendronate 70mg Tab | SIV | 1.7804 | 1.7804 | YES | NO | NO |
| 02352966 | ALENDRONATE | Alendronate 70mg Tab | SAI | 1.7804 | 1.7804 | YES | NO | NO |
| 02381494 | ALENDRONATE | Alendronate Sodium Tablets 70mg Tab | ACH | 1.7804 | 1.7804 | YES | NO | NO |
| 02381478 | ALENDRONATE | Alendronate Sodium Tablets (Off-Formulary Interchangeable) 5mg Tab | ACH | 1.0370 | N/A | YES | NO | NO |
| 02381486 | ALENDRONATE | Alendronate Sodium Tablets 10mg Tab | ACH | 0.4987 | 0.4987 | YES | NO | NO |
| 02248730 | ALENDRONATE | Apo-Alendronate 70mg Tab | APX | 1.7804 | 1.7804 | YES | NO | NO |
| 02248727 | ALENDRONATE | Apo-Alendronate (Off-Formulary Interchangeable) 5mg Tab | APX | 1.0370 | N/A | YES | NO | NO |
| 02248728 | ALENDRONATE | Apo-Alendronate 10mg Tab | APX | 0.4987 | 0.4987 | YES | NO | NO |
| 02388545 | ALENDRONATE | Auro-Alendronate 10mg Tab | AUR | 0.4987 | 0.4987 | YES | NO | NO |
| 02388553 | ALENDRONATE | Auro-Alendronate 70mg Tab | AUR | 1.7804 | 1.7804 | YES | NO | NO |
| 02201011 | ALENDRONATE | Fosamax (Not a Benefit) 10mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 02245329 | ALENDRONATE | Fosamax 70mg Tab | OCI | 12.6250 | 1.7804 | YES | NO | NO |
| 02233055 | ALENDRONATE | Fosamax (Off-Formulary Interchangeable) 5mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 02500175 | ALENDRONATE | Jamp Alendronate Sodium 70mg Tab | JPC | 1.7804 | 1.7804 | YES | NO | NO |
| 02385031 | ALENDRONATE | Jamp-Alendronate 70mg Tab | JPC | 1.7804 | 1.7804 | YES | NO | NO |
| 02529394 | ALENDRONATE | M-Alendronate 70mg Tab | MAT | 1.7804 | 1.7804 | YES | NO | NO |
| 02394871 | ALENDRONATE | Mint-Alendronate 70mg Tab | MIN | 1.7804 | 1.7804 | YES | NO | NO |
| 02394863 | ALENDRONATE | Mint-Alendronate 10mg Tab | MIN | 0.4987 | 0.4987 | YES | NO | NO |
| 02523116 | ALENDRONATE | NRA-Alendronate 70mg Tab | NRA | 1.7804 | 1.7804 | YES | NO | NO |
| 02284006 | ALENDRONATE | PMS-Alendronate-FC 70mg Tab | PMS | 1.7804 | 1.7804 | YES | NO | NO |
| 02384701 | ALENDRONATE | Ran-Alendronate 10mg Tab | RAN | 0.4987 | 0.4987 | YES | NO | NO |
| 02270889 | ALENDRONATE | Riva-Alendronate 70mg Tab | RIA | 1.7804 | 1.7804 | YES | NO | NO |
| 02288109 | ALENDRONATE | Sandoz Alendronate 70mg Tab | SDZ | 1.7804 | 1.7804 | YES | NO | NO |
| 02288087 | ALENDRONATE | Sandoz Alendronate 10mg Tab | SDZ | 0.4987 | 0.4987 | YES | NO | NO |
| 02261715 | ALENDRONATE | Teva-Alendronate 70mg Tab | TEV | 1.7804 | 1.7804 | YES | NO | NO |
| 02247373 | ALENDRONATE | Teva-Alendronate 10mg Tab | TEV | 0.4987 | 0.4987 | YES | NO | NO |
| 02248251 | ALENDRONATE | Teva-Alendronate (Off-Formulary Interchangeable) 5mg Tab | TEV | 1.0370 | N/A | YES | NO | NO |
| 02454467 | ALENDRONATE & CHOLECALCIFEROL | Apo-Alendronate/Vitamin D3 70mg & 70mcg Tab | APX | 2.4348 | 2.4348 | YES | NO | YES |
| 02454475 | ALENDRONATE & CHOLECALCIFEROL | Apo-Alendronate/Vitamin D3 70mg & 140mcg Tab | APX | 2.4348 | 2.4348 | YES | NO | NO |
| 02276429 | ALENDRONATE & CHOLECALCIFEROL | Fosavance 70mg & 70mcg Tab | OCI | 5.5335 | 2.4348 | YES | NO | YES |
| 02314940 | ALENDRONATE & CHOLECALCIFEROL | Fosavance 70mg & 140mcg Tab | OCI | 5.4250 | 2.4348 | YES | NO | NO |
| 02519828 | ALENDRONATE & CHOLECALCIFEROL | Jamp Alendronate/Vitamin D3 70mg & 70mcg Tab | JPC | 2.4348 | 2.4348 | YES | NO | NO |
| 02519836 | ALENDRONATE & CHOLECALCIFEROL | Jamp Alendronate/Vitamin D3 70mg & 140mcg Tab | JPC | 2.4348 | 2.4348 | YES | NO | NO |
| 00474517 | ALFACALCIDOL | One-Alpha 0.25mcg Cap | LEO | 0.6289 | 0.4313 | YES | NO | NO |
| 00474525 | ALFACALCIDOL | One-Alpha 1mcg Cap | LEO | 1.8827 | 1.2911 | YES | NO | NO |
| 02533316 | ALFACALCIDOL | Sandoz Alfacalcidol 0.25mcg Cap | SDZ | 0.4313 | 0.4313 | YES | NO | NO |
| 02533324 | ALFACALCIDOL | Sandoz Alfacalcidol 1mcg Cap | SDZ | 1.2911 | 1.2911 | YES | NO | NO |
| 02240329 | ALFACALCIDOL | One-Alpha Drops 2mcg/mL Oral Drops | LEO | 7.5526 | 7.5526 | NO | NO | NO |
| 02519844 | ALFUZOSIN HYDROCHLORIDE | Alfuzosin 10mg Prolong-Rel Tab | SAI | 0.2601 | 0.2601 | YES | YES | NO |
| 02447576 | ALFUZOSIN HYDROCHLORIDE | Alfuzosin 10mg Prolong-Rel Tab | SIV | 0.2601 | 0.2601 | YES | YES | NO |
| 02315866 | ALFUZOSIN HYDROCHLORIDE | Apo-Alfuzosin 10mg Prolong-Rel Tab | APX | 0.2601 | 0.2601 | YES | YES | NO |
| 02443201 | ALFUZOSIN HYDROCHLORIDE | Auro-Alfuzosin 10mg Prolong-Rel Tab | AUR | 0.2601 | 0.2601 | YES | YES | NO |
| 02304678 | ALFUZOSIN HYDROCHLORIDE | Sandoz Alfuzosin 10mg Prolong-Rel Tab | SDZ | 0.2601 | 0.2601 | YES | YES | NO |
| 02245565 | ALFUZOSIN HYDROCHLORIDE | Xatral 10mg Prolong-Rel Tab | SAV | 1.0900 | 0.2601 | YES | YES | NO |
| 02453819 | ALIROCUMAB | Praluent 75mg/mL Inj Sol-Pref Pen | SAC | 267.8300 | 267.8300 | NO | YES | NO |
| 02453835 | ALIROCUMAB | Praluent 150mg/mL Inj Sol-Pref Pen | SAC | 267.8300 | 267.8300 | NO | YES | NO |
| 02547732 | ALIROCUMAB | Praluent 300mg/2mL Inj Sol-Pref Pen 2mL Pk (Preservative-Free) | SAC | 535.6600 | 535.6600 | NO | YES | NO |
| 02477440 | ALITRETINOIN | Hanzema 30mg Cap | DRR | 16.9868 | 16.9868 | YES | YES | YES |
| 02477432 | ALITRETINOIN | Hanzema 10mg Cap | DRR | 16.9868 | 16.9868 | YES | YES | YES |
| 02337649 | ALITRETINOIN | Toctino (Not a Benefit) 30mg Cap | GSK | N/A | N/A | YES | NO | YES |
| 02337630 | ALITRETINOIN | Toctino (Not a Benefit) 10mg Cap | GSK | N/A | N/A | YES | NO | YES |
| 02402769 | ALLOPURINOL | Apo-Allopurinol (Not a Benefit) 100mg Tab | APX | N/A | N/A | YES | NO | YES |
| 02402785 | ALLOPURINOL | Apo-Allopurinol (Not a Benefit) 300mg Tab | APX | N/A | N/A | YES | NO | YES |
| 02402777 | ALLOPURINOL | Apo-Allopurinol (Not a Benefit) 200mg Tab | APX | N/A | N/A | YES | NO | YES |
| 00402796 | ALLOPURINOL | Apo-Allopurinol Tablets 300mg Tab | APX | 0.2125 | 0.2125 | YES | NO | YES |
| 00402818 | ALLOPURINOL | Apo-Allopurinol Tablets 100mg Tab | APX | 0.0780 | 0.0780 | YES | NO | YES |
| 00479799 | ALLOPURINOL | Apo-Allopurinol Tablets 200mg Tab | APX | 0.1300 | 0.1300 | YES | NO | YES |
| 02396327 | ALLOPURINOL | Mar-Allopurinol 100mg Tab | MAR | 0.0780 | 0.0780 | YES | NO | YES |
| 02396335 | ALLOPURINOL | Mar-Allopurinol 200mg Tab | MAR | 0.1300 | 0.1300 | YES | NO | YES |
| 02396343 | ALLOPURINOL | Mar-Allopurinol 300mg Tab | MAR | 0.2125 | 0.2125 | YES | NO | YES |
| 00294322 | ALLOPURINOL | Zyloprim (Not a Benefit) 300mg Tab | BWE | N/A | N/A | YES | NO | YES |
| 02466821 | ALMOTRIPTAN | Almotriptan (Off-Formulary Interchangeable) 12.5mg Tab | SAI | 9.7833 | 9.7833 | YES | NO | NO |
| 02405806 | ALMOTRIPTAN | Apo-Almotriptan (Off-Formulary Interchangeable) 12.5mg Tab | APX | 9.7833 | 9.7833 | YES | NO | NO |
| 02405792 | ALMOTRIPTAN | Apo-Almotriptan (Off-Formulary Interchangeable) 6.25mg Tab | APX | 9.7833 | 9.7833 | YES | NO | NO |
| 02248128 | ALMOTRIPTAN | Axert (Off-Formulary Interchangeable) 6.25mg Tab | JNO | N/A | N/A | YES | NO | NO |
| 02248129 | ALMOTRIPTAN | Axert (Off-Formulary Interchangeable) 12.5mg Tab | JNO | N/A | N/A | YES | NO | NO |
| 02398435 | ALMOTRIPTAN | Mylan-Almotriptan (Off-Formulary Interchangeable) 6.25mg Tab | MYL | 9.7833 | 9.7833 | YES | NO | NO |
| 02398443 | ALMOTRIPTAN | Mylan-Almotriptan (Off-Formulary Interchangeable) 12.5mg Tab | MYL | 9.7833 | 9.7833 | YES | NO | NO |
| 02405334 | ALMOTRIPTAN | Sandoz Almotriptan (Off-Formulary Interchangeable) 12.5mg Tab | SDZ | 9.7825 | 9.7825 | YES | NO | NO |
| 02434849 | ALMOTRIPTAN | Teva-Almotriptan (Off-Formulary Interchangeable) 12.5mg Tab | TEV | 9.7833 | 9.7833 | YES | NO | NO |
| 00865397 | ALPRAZOLAM | Apo-Alpraz 0.25mg Tab | APX | 0.0633 | 0.0633 | YES | NO | NO |
| 02243611 | ALPRAZOLAM | Apo-Alpraz (Off-Formulary Interchangeable) 1mg Tab | APX | 0.6585 | N/A | YES | NO | NO |
| 00865400 | ALPRAZOLAM | Apo-Alpraz 0.5mg Tab | APX | 0.0757 | 0.0757 | YES | NO | NO |
| 02243612 | ALPRAZOLAM | Apo-Alpraz TS (Off-Formulary Interchangeable) 2mg Tab | APX | 1.1704 | N/A | YES | NO | NO |
| 02397064 | ALPRAZOLAM | Jamp Alprazolam (Off-Formulary Interchangeable) 2mg Tab | JPC | 0.9271 | N/A | YES | NO | NO |
| 02397056 | ALPRAZOLAM | Jamp Alprazolam (Off-Formulary Interchangeable) 1mg Tab | JPC | 0.4603 | N/A | YES | NO | NO |
| 02417669 | ALPRAZOLAM | Nat-Alprazolam (Off-Formulary Interchangeable) 2mg Tab | NAT | 0.5508 | N/A | YES | NO | NO |
| 02417634 | ALPRAZOLAM | Nat-Alprazolam 0.25mg Tab | NAT | 0.0633 | 0.0633 | YES | NO | NO |
| 02417650 | ALPRAZOLAM | Nat-Alprazolam (Off-Formulary Interchangeable) 1mg Tab | NAT | 0.3099 | N/A | YES | NO | NO |
| 02417642 | ALPRAZOLAM | Nat-Alprazolam 0.5mg Tab | NAT | 0.0757 | 0.0757 | YES | NO | NO |
| 01913484 | ALPRAZOLAM | Teva-Alprazolam 0.25mg Tab | TEV | 0.0633 | 0.0633 | YES | NO | NO |
| 01913492 | ALPRAZOLAM | Teva-Alprazolam 0.5mg Tab | TEV | 0.0757 | 0.0757 | YES | NO | NO |
| 00548367 | ALPRAZOLAM | Xanax 0.5mg Tab | UJC | 0.4304 | 0.0757 | YES | NO | NO |
| 00548359 | ALPRAZOLAM | Xanax 0.25mg Tab | UJC | 0.3599 | 0.0633 | YES | NO | NO |
| 00723770 | ALPRAZOLAM | Xanax (Off-Formulary Interchangeable) 1mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 00813958 | ALPRAZOLAM | Xanax TS (Off-Formulary Interchangeable) 2mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02126230 | ALTRETAMINE | Hexalen 50mg Cap | LIL | 3.3600 | 3.3600 | NO | NO | NO |
| 00491217 | ALUMINUM HYDROXIDE & MAGNESIUM HYDROXIDE | Diovol EX (Not a Benefit) 120mg & 60mg/mL O/L | HOR | N/A | N/A | YES | NO | NO |
| 02163136 | ALUMINUM HYDROXIDE & MAGNESIUM HYDROXIDE | Maalox (Not a Benefit) 40mg & 40mg/mL O/L | NOV | N/A | N/A | YES | NO | NO |
| 02162369 | ALUMINUM HYDROXIDE & MAGNESIUM HYDROXIDE | Maalox TC (Not a Benefit) 120mg & 60mg/mL O/L | NOV | N/A | N/A | YES | NO | NO |
| 00261173 | ALUMINUM HYDROXIDE & MAGNESIUM HYDROXIDE | Neutralca-S (Not a Benefit) 40mg & 40mg/mL O/L | DES | N/A | N/A | YES | NO | NO |
| 00483605 | ALUMINUM HYDROXIDE & MAGNESIUM HYDROXIDE | Gelusil Extra Strength (Not a Benefit) 400mg & 400mg Tab | PDA | N/A | N/A | YES | NO | NO |
| 02208253 | ALUMINUM HYDROXIDE & MAGNESIUM HYDROXIDE | Maalox (Not a Benefit) 400mg & 400mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 01990403 | AMANTADINE HCL | PDP-Amantadine Hydrochloride Capsules 100mg Cap | PEN | 0.5662 | 0.5662 | YES | NO | YES |
| 01914006 | AMANTADINE HCL | Symmetrel (Not a Benefit) 100mg Cap | BQU | N/A | N/A | YES | NO | YES |
| 02538601 | AMANTADINE HCL | Odan-Amantadine Syrup 10mg/mL O/L | ODN | 0.0988 | 0.0988 | YES | NO | YES |
| 02022826 | AMANTADINE HCL | PDP-Amantadine Hydrochloride Syrup 10mg/mL O/L | PEN | 0.0988 | 0.0988 | YES | NO | YES |
| 01913999 | AMANTADINE HCL | Symmetrel (Not a Benefit) 10mg/mL O/L | BQU | N/A | N/A | YES | NO | YES |
| 02475383 | AMBRISENTAN | Apo-Ambrisentan (Off-Formulary Interchangeable) 10mg Tab | APX | 106.3288 | 106.3288 | YES | NO | NO |
| 02475375 | AMBRISENTAN | Apo-Ambrisentan (Off-Formulary Interchangeable) 5mg Tab | APX | 106.3288 | 106.3288 | YES | NO | NO |
| 02521938 | AMBRISENTAN | Jamp Ambrisentan (Off-Formulary Interchangeable) 5mg Tab | JPC | 106.3288 | 106.3288 | YES | NO | NO |
| 02521946 | AMBRISENTAN | Jamp Ambrisentan (Off-Formulary Interchangeable) 10mg Tab | JPC | 106.3288 | 106.3288 | YES | NO | NO |
| 02526875 | AMBRISENTAN | Sandoz Ambrisentan Tablets (Off-Formulary Interchangeable) 5mg Tab | SDZ | 106.3288 | 106.3288 | YES | NO | NO |
| 02307065 | AMBRISENTAN | Volibris (Off-Formulary Interchangeable) 5mg Tab | GSK | 133.9247 | 106.3288 | YES | NO | NO |
| 02307073 | AMBRISENTAN | Volibris (Off-Formulary Interchangeable) 10mg Tab | GSK | 133.9247 | 106.3288 | YES | NO | NO |
| 02192284 | AMCINONIDE | Cyclocort (Not a Benefit) 0.1% Cr | STI | N/A | N/A | YES | NO | NO |
| 02246714 | AMCINONIDE | Taro-Amcinonide 0.1% Cr | TAR | 0.4522 | 0.4522 | YES | NO | NO |
| 02249510 | AMILORIDE HCL | Midamor 5mg Tab | AAP | 0.3297 | 0.3297 | NO | NO | NO |
| 00784400 | AMILORIDE HCL & HYDROCHLOROTHIAZIDE | AA-Amilzide 5mg & 50mg Tab | AAP | 0.0881 | 0.0881 | YES | NO | NO |
| 00487813 | AMILORIDE HCL & HYDROCHLOROTHIAZIDE | Moduret (Not a Benefit) 5mg & 50mg Tab | PRE | N/A | N/A | YES | NO | NO |
| 02385465 | AMIODARONE HCL | Amiodarone 200mg Tab | SIV | 0.3706 | 0.3706 | YES | NO | YES |
| 02364336 | AMIODARONE HCL | Amiodarone 200mg Tab | SAI | 0.3706 | 0.3706 | YES | NO | YES |
| 02246194 | AMIODARONE HCL | Apo-Amiodarone 200mg Tab | APX | 0.3706 | 0.3706 | YES | NO | YES |
| 02036282 | AMIODARONE HCL | Cordarone (Not a Benefit) 200mg Tab | PFI | N/A | N/A | YES | NO | YES |
| 02531844 | AMIODARONE HCL | Jamp Amiodarone 200mg Tab | JPC | 0.3706 | 0.3706 | YES | NO | NO |
| 02242472 | AMIODARONE HCL | PMS-Amiodarone 200mg Tab | PMS | 0.3706 | 0.3706 | YES | NO | YES |
| 02247217 | AMIODARONE HCL | Riva-Amiodarone 200mg Tab | RIA | 0.3706 | 0.3706 | YES | NO | NO |
| 02243836 | AMIODARONE HCL | Sandoz Amiodarone 200mg Tab | SDZ | 0.3706 | 0.3706 | YES | NO | YES |
| 02239835 | AMIODARONE HCL | Teva-Amiodarone 200mg Tab | TEV | 0.3706 | 0.3706 | YES | NO | YES |
| 00335053 | AMITRIPTYLINE | Elavil 10mg Tab | AAP | 0.0664 | 0.0305 | YES | NO | NO |
| 00335088 | AMITRIPTYLINE | Elavil 50mg Tab | AAP | 0.2347 | 0.1078 | YES | NO | NO |
| 00335061 | AMITRIPTYLINE | Elavil 25mg Tab | AAP | 0.1211 | 0.0580 | YES | NO | NO |
| 02457687 | AMITRIPTYLINE | Jamp-Amitriptyline 50mg Tab | JPC | 0.1078 | 0.1078 | YES | NO | NO |
| 02457695 | AMITRIPTYLINE | Jamp-Amitriptyline 25mg Tab | JPC | 0.0580 | 0.0580 | YES | NO | NO |
| 02457679 | AMITRIPTYLINE | Jamp-Amitriptyline 10mg Tab | JPC | 0.0305 | 0.0305 | YES | NO | NO |
| 02429888 | AMITRIPTYLINE | Mar-Amitriptyline 25mg Tab | MAR | 0.0580 | 0.0580 | YES | NO | NO |
| 02429861 | AMITRIPTYLINE | Mar-Amitriptyline 10mg Tab | MAR | 0.0305 | 0.0305 | YES | NO | NO |
| 02429896 | AMITRIPTYLINE | Mar-Amitriptyline 50mg Tab | MAR | 0.1078 | 0.1078 | YES | NO | NO |
| 00654507 | AMITRIPTYLINE | PMS-Amitriptyline 50mg Tab | PMS | 0.1078 | 0.1078 | YES | NO | NO |
| 00654515 | AMITRIPTYLINE | PMS-Amitriptyline 25mg Tab | PMS | 0.0580 | 0.0580 | YES | NO | NO |
| 00654523 | AMITRIPTYLINE | PMS-Amitriptyline 10mg Tab | PMS | 0.0305 | 0.0305 | YES | NO | NO |
| 02484706 | AMLODIPINE | PDP-Amlodipine 1mg/mL Oral Sol | PEN | 1.1667 | 1.1667 | NO | YES | NO |
| 02419556 | AMLODIPINE | Ach-Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | ACH | 0.3328 | N/A | YES | NO | NO |
| 02419564 | AMLODIPINE | Ach-Amlodipine 5mg Tab | ACH | 0.1343 | 0.1343 | YES | NO | NO |
| 02419572 | AMLODIPINE | Ach-Amlodipine 10mg Tab | ACH | 0.1993 | 0.1993 | YES | NO | NO |
| 02297493 | AMLODIPINE | Act Amlodipine 10mg Tab | TEV | 0.1993 | 0.1993 | YES | NO | NO |
| 02297485 | AMLODIPINE | Act Amlodipine 5mg Tab | TEV | 0.1343 | 0.1343 | YES | NO | NO |
| 02429217 | AMLODIPINE | Amlodipine 5mg Tab | JPC | 0.1343 | 0.1343 | YES | NO | NO |
| 02385791 | AMLODIPINE | Amlodipine 5mg Tab | SIV | 0.1343 | 0.1343 | YES | NO | NO |
| 02331284 | AMLODIPINE | Amlodipine 5mg Tab | SAI | 0.1343 | 0.1343 | YES | NO | NO |
| 02478587 | AMLODIPINE | Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | SAI | 0.3328 | N/A | YES | NO | NO |
| 02385783 | AMLODIPINE | Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | SIV | 0.3328 | N/A | YES | NO | NO |
| 02429225 | AMLODIPINE | Amlodipine 10mg Tab | JPC | 0.1993 | 0.1993 | YES | NO | NO |
| 02385805 | AMLODIPINE | Amlodipine 10mg Tab | SIV | 0.1993 | 0.1993 | YES | NO | NO |
| 02331292 | AMLODIPINE | Amlodipine 10mg Tab | SAI | 0.1993 | 0.1993 | YES | NO | NO |
| 02273373 | AMLODIPINE | Apo-Amlodipine 5mg Tab | APX | 0.1343 | 0.1343 | YES | NO | NO |
| 02273381 | AMLODIPINE | Apo-Amlodipine 10mg Tab | APX | 0.1993 | 0.1993 | YES | NO | NO |
| 02397080 | AMLODIPINE | Auro-Amlodipine 10mg Tab | AUR | 0.1993 | 0.1993 | YES | NO | NO |
| 02397072 | AMLODIPINE | Auro-Amlodipine 5mg Tab | AUR | 0.1343 | 0.1343 | YES | NO | NO |
| 02280132 | AMLODIPINE | Gd-Amlodipine 5mg Tab | GEM | 0.1343 | 0.1343 | YES | NO | NO |
| 02280140 | AMLODIPINE | Gd-Amlodipine 10mg Tab | GEM | 0.1993 | 0.1993 | YES | NO | NO |
| 02357186 | AMLODIPINE | Jamp-Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | JPC | 0.3328 | N/A | YES | NO | NO |
| 02357208 | AMLODIPINE | Jamp-Amlodipine 10mg Tab | JPC | 0.1993 | 0.1993 | YES | NO | NO |
| 02357194 | AMLODIPINE | Jamp-Amlodipine 5mg Tab | JPC | 0.1343 | 0.1343 | YES | NO | NO |
| 02468034 | AMLODIPINE | M-Amlodipine 10mg Tab | MAT | 0.1993 | 0.1993 | YES | NO | NO |
| 02468018 | AMLODIPINE | M-Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | MAT | 0.3328 | N/A | YES | NO | NO |
| 02468026 | AMLODIPINE | M-Amlodipine 5mg Tab | MAT | 0.1343 | 0.1343 | YES | NO | NO |
| 02371707 | AMLODIPINE | Mar-Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | MAR | 0.3328 | N/A | YES | NO | NO |
| 02371723 | AMLODIPINE | Mar-Amlodipine Tablets 10mg Tab | MAR | 0.1993 | 0.1993 | YES | NO | NO |
| 02371715 | AMLODIPINE | Mar-Amlodipine Tablets 5mg Tab | MAR | 0.1343 | 0.1343 | YES | NO | NO |
| 02362651 | AMLODIPINE | Mint-Amlodipine 5mg Tab | MIN | 0.1343 | 0.1343 | YES | NO | NO |
| 02362678 | AMLODIPINE | Mint-Amlodipine 10mg Tab | MIN | 0.1993 | 0.1993 | YES | NO | NO |
| 02272113 | AMLODIPINE | Mylan-Amlodipine 5mg Tab | MYL | 0.1343 | 0.1343 | YES | NO | NO |
| 02272121 | AMLODIPINE | Mylan-Amlodipine 10mg Tab | MYL | 0.1993 | 0.1993 | YES | NO | NO |
| 02476460 | AMLODIPINE | NRA-Amlodipine 5mg Tab | NRA | 0.1343 | 0.1343 | YES | NO | NO |
| 02476479 | AMLODIPINE | NRA-Amlodipine 10mg Tab | NRA | 0.1993 | 0.1993 | YES | NO | NO |
| 00878936 | AMLODIPINE | Norvasc 10mg Tab | UJC | 2.5378 | 0.1993 | YES | NO | NO |
| 00878901 | AMLODIPINE | Norvasc (Off-Formulary Interchangeable) 2.5mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 00878928 | AMLODIPINE | Norvasc 5mg Tab | UJC | 1.7387 | 0.1343 | YES | NO | NO |
| 02295148 | AMLODIPINE | PMS-Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | PMS | 0.3328 | N/A | YES | NO | NO |
| 02284065 | AMLODIPINE | PMS-Amlodipine 5mg Tab | PMS | 0.1343 | 0.1343 | YES | NO | NO |
| 02284073 | AMLODIPINE | PMS-Amlodipine 10mg Tab | PMS | 0.1993 | 0.1993 | YES | NO | NO |
| 02522519 | AMLODIPINE | PRZ-Amlodipine 5mg Tab | PRZ | 0.1343 | 0.1343 | YES | NO | NO |
| 02522527 | AMLODIPINE | PRZ-Amlodipine 10mg Tab | PRZ | 0.1993 | 0.1993 | YES | NO | NO |
| 02321858 | AMLODIPINE | Ran-Amlodipine 5mg Tab | RAN | 0.1343 | 0.1343 | YES | NO | NO |
| 02321866 | AMLODIPINE | Ran-Amlodipine 10mg Tab | RAN | 0.1993 | 0.1993 | YES | NO | NO |
| 02259605 | AMLODIPINE | Ratio-Amlodipine 5mg Tab | RPH | 0.1343 | 0.1343 | YES | NO | NO |
| 02259613 | AMLODIPINE | Ratio-Amlodipine 10mg Tab | RPH | 0.1993 | 0.1993 | YES | NO | NO |
| 02284391 | AMLODIPINE | Sandoz Amlodipine 10mg Tab | SDZ | 0.1993 | 0.1993 | YES | NO | NO |
| 02284383 | AMLODIPINE | Sandoz Amlodipine 5mg Tab | SDZ | 0.1343 | 0.1343 | YES | NO | NO |
| 02330474 | AMLODIPINE | Sandoz Amlodipine (Off-Formulary Interchangeable) 2.5mg Tab | SDZ | 0.3328 | N/A | YES | NO | NO |
| 02357712 | AMLODIPINE | Septa-Amlodipine 5mg Tab | SET | 0.1343 | 0.1343 | YES | NO | NO |
| 02357720 | AMLODIPINE | Septa-Amlodipine 10mg Tab | SET | 0.1993 | 0.1993 | YES | NO | NO |
| 02250497 | AMLODIPINE | Teva-Amlodipine 5mg Tab | TEV | 0.1343 | 0.1343 | YES | NO | NO |
| 02250500 | AMLODIPINE | Teva-Amlodipine 10mg Tab | TEV | 0.1993 | 0.1993 | YES | NO | NO |
| 02411318 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 10mg & 10mg Tab | APX | 1.2250 | 1.2250 | YES | NO | YES |
| 02411296 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 5mg & 80mg Tab | APX | 0.7232 | 0.7232 | YES | NO | YES |
| 02411288 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 5mg & 40mg Tab | APX | 0.7232 | 0.7232 | YES | NO | YES |
| 02411261 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 5mg & 20mg Tab | APX | 1.3683 | 1.3683 | YES | NO | YES |
| 02411342 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 10mg & 80mg Tab | APX | 0.8000 | 0.8000 | YES | NO | YES |
| 02411253 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 5mg & 10mg Tab | APX | 1.1603 | 1.1603 | YES | NO | YES |
| 02411334 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 10mg & 40mg Tab | APX | 0.8000 | 0.8000 | YES | NO | YES |
| 02411326 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Apo-Amlodipine-Atorvastatin 10mg & 20mg Tab | APX | 1.5272 | 1.5272 | YES | NO | YES |
| 02273284 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 10mg & 10mg Tab | UJC | 2.9480 | 1.2250 | YES | NO | YES |
| 02273276 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 5mg & 80mg Tab | UJC | 3.4805 | 0.7232 | YES | NO | YES |
| 02273233 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 5mg & 10mg Tab | UJC | 2.7922 | 1.1603 | YES | NO | YES |
| 02273314 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 10mg & 80mg Tab | UJC | 3.8504 | 0.8000 | YES | NO | YES |
| 02273268 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 5mg & 40mg Tab | UJC | 3.4805 | 0.7232 | YES | NO | YES |
| 02273306 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 10mg & 40mg Tab | UJC | 3.8504 | 0.8000 | YES | NO | YES |
| 02273241 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 5mg & 20mg Tab | UJC | 3.2927 | 1.3683 | YES | NO | YES |
| 02273292 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Caduet 10mg & 20mg Tab | UJC | 3.6752 | 1.5272 | YES | NO | YES |
| 02362821 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 10mg & 80mg Tab | UJC | 0.8000 | 0.8000 | YES | NO | YES |
| 02362759 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 5mg & 10mg Tab | UJC | 1.1603 | 1.1603 | YES | NO | YES |
| 02362767 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 5mg & 20mg Tab | UJC | 1.3683 | 1.3683 | YES | NO | YES |
| 02362775 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 5mg & 40mg Tab | UJC | 0.7232 | 0.7232 | YES | NO | YES |
| 02362783 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 5mg & 80mg Tab | UJC | 0.7232 | 0.7232 | YES | NO | YES |
| 02362791 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 10mg & 10mg Tab | UJC | 1.2250 | 1.2250 | YES | NO | YES |
| 02362805 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 10mg & 20mg Tab | UJC | 1.5272 | 1.5272 | YES | NO | YES |
| 02362813 | AMLODIPINE BESYLATE & ATORVASTATIN CALCIUM | Gd-Amlodipine/Atorvastatin 10mg & 40mg Tab | UJC | 0.8000 | 0.8000 | YES | NO | YES |
| 02477726 | AMOXICILLIN | AG-Amoxicillin 500mg Cap | ANG | 0.1308 | 0.1308 | YES | NO | NO |
| 02401509 | AMOXICILLIN | Amoxicillin 500mg Cap | SIV | 0.1308 | 0.1308 | YES | NO | NO |
| 02525356 | AMOXICILLIN | Amoxicillin Capsules BP 500mg Cap | SAI | 0.1308 | 0.1308 | YES | NO | NO |
| 02525348 | AMOXICILLIN | Amoxicillin Capsules BP 250mg Cap | SAI | 0.0672 | 0.0672 | YES | NO | NO |
| 02041294 | AMOXICILLIN | Amoxil (Not a Benefit) 250mg Cap | WAY | N/A | N/A | YES | NO | NO |
| 02041308 | AMOXICILLIN | Amoxil (Not a Benefit) 500mg Cap | WAY | N/A | N/A | YES | NO | NO |
| 00628123 | AMOXICILLIN | Apo-Amoxi 500mg Cap | APX | 0.1308 | 0.1308 | YES | NO | NO |
| 00628115 | AMOXICILLIN | Apo-Amoxi 250mg Cap | APX | 0.0672 | 0.0672 | YES | NO | NO |
| 02388081 | AMOXICILLIN | Auro-Amoxicillin 500mg Cap | AUR | 0.1308 | 0.1308 | YES | NO | NO |
| 02388073 | AMOXICILLIN | Auro-Amoxicillin 250mg Cap | AUR | 0.0672 | 0.0672 | YES | NO | NO |
| 02433060 | AMOXICILLIN | Jamp-Amoxicillin 250mg Cap | JPC | 0.0672 | 0.0672 | YES | NO | NO |
| 02433079 | AMOXICILLIN | Jamp-Amoxicillin 500mg Cap | JPC | 0.1308 | 0.1308 | YES | NO | NO |
| 00406716 | AMOXICILLIN | Novamoxin 500mg Cap | TEV | 0.1308 | 0.1308 | YES | NO | NO |
| 00406724 | AMOXICILLIN | Novamoxin 250mg Cap | TEV | 0.0672 | 0.0672 | YES | NO | NO |
| 02532050 | AMOXICILLIN | PRZ-Amoxicillin 500mg Cap | PRZ | 0.1308 | 0.1308 | YES | NO | NO |
| 02532042 | AMOXICILLIN | PRZ-Amoxicillin 250mg Cap | PRZ | 0.0672 | 0.0672 | YES | NO | NO |
| 02041685 | AMOXICILLIN | Amoxil Chewable (Off-Formulary Interchangeable) 125mg Chew Tab | AYE | N/A | N/A | YES | NO | NO |
| 02041286 | AMOXICILLIN | Amoxil Chewable (Off-Formulary Interchangeable) 250mg Chew Tab | AYE | N/A | N/A | YES | NO | NO |
| 02036347 | AMOXICILLIN | Novamoxin Chewable (Off-Formulary Interchangeable) 125mg Chew Tab | TEV | 0.5099 | N/A | YES | NO | NO |
| 02036355 | AMOXICILLIN | Novamoxin Chewable (Off-Formulary Interchangeable) 250mg Chew Tab | TEV | 0.8282 | N/A | YES | NO | NO |
| 02401541 | AMOXICILLIN | Amoxicillin 50mg/mL O/L | SIV | 0.0540 | 0.0540 | YES | NO | NO |
| 02352753 | AMOXICILLIN | Amoxicillin 50mg/mL O/L | SAI | 0.0540 | 0.0540 | YES | NO | NO |
| 02352788 | AMOXICILLIN | Amoxicillin (Sugar Reduced) 50mg/mL O/L | SAI | 0.0540 | 0.0540 | YES | NO | NO |
| 02042592 | AMOXICILLIN | Amoxil (Not a Benefit) 50mg/mL O/L | WAY | N/A | N/A | YES | NO | NO |
| 02041316 | AMOXICILLIN | Amoxil (Not a Benefit) 25mg/mL O/L | WAY | N/A | N/A | YES | NO | NO |
| 00628158 | AMOXICILLIN | Apo-Amoxi 50mg/mL O/L | APX | 0.0540 | 0.0540 | YES | NO | NO |
| 00628131 | AMOXICILLIN | Apo-Amoxi 25mg/mL O/L | APX | 0.0247 | 0.0247 | YES | NO | NO |
| 02458594 | AMOXICILLIN | Auro-Amoxicillin 50mg/mL O/L | AUR | 0.0540 | 0.0540 | YES | NO | NO |
| 02535793 | AMOXICILLIN | Jamp-Amoxicillin 25mg/mL O/L | JPC | 0.0247 | 0.0247 | YES | NO | NO |
| 02535815 | AMOXICILLIN | Jamp-Amoxicillin 50mg/mL O/L | JPC | 0.0540 | 0.0540 | YES | NO | NO |
| 00452130 | AMOXICILLIN | Novamoxin 50mg/mL O/L | TEV | 0.0540 | 0.0540 | YES | NO | NO |
| 01934163 | AMOXICILLIN | Novamoxin (Sugar Reduced) 50mg/mL O/L | TEV | 0.0540 | 0.0540 | YES | NO | NO |
| 02495864 | AMOXICILLIN | Sandoz Amoxicillin 50mg/mL O/L | SDZ | 0.0540 | 0.0540 | YES | NO | NO |
| 09858237 | AMOXICILLIN | Moxilen Forte 250mg/5mL (Temporary Benefit) 50mg/mL Pd for Oral Susp | JUN | 0.0810 | 0.0810 | NO | NO | NO |
| 01916874 | AMOXICILLIN & CLAVULANIC ACID | Clavulin 50mg & 12.5mg/mL O/L | GSK | 0.2702 | 0.1216 | YES | NO | YES |
| 01916882 | AMOXICILLIN & CLAVULANIC ACID | Clavulin 25mg & 6.25mg/mL O/L | GSK | 0.1241 | 0.1241 | NO | NO | YES |
| 02539438 | AMOXICILLIN & CLAVULANIC ACID | Jamp Amoxi Clav Suspension 50mg & 12.5mg/mL O/L | JPC | 0.1216 | 0.1216 | YES | NO | YES |
| 02542226 | AMOXICILLIN & CLAVULANIC ACID | M-Amoxi Clav 50mg & 12.5mg/mL O/L | MAT | 0.1216 | 0.1216 | YES | NO | YES |
| 02238830 | AMOXICILLIN & CLAVULANIC ACID | Clavulin (BID) 400mg & 57mg/5mL Susp | GSK | 0.3779 | 0.1591 | YES | NO | YES |
| 02238831 | AMOXICILLIN & CLAVULANIC ACID | Clavulin (BID) 200mg & 28.5mg/5mL Susp | GSK | 0.1937 | 0.1007 | YES | NO | YES |
| 02539446 | AMOXICILLIN & CLAVULANIC ACID | Jamp Amoxi Clav Suspension 400mg & 57mg/5mL Susp | JPC | 0.1591 | 0.1591 | YES | NO | YES |
| 02539411 | AMOXICILLIN & CLAVULANIC ACID | Jamp Amoxi Clav Suspension 200mg & 28.5mg/5mL Susp | JPC | 0.1007 | 0.1007 | YES | NO | YES |
| 02530694 | AMOXICILLIN & CLAVULANIC ACID | M-Amoxi Clav 400mg & 57mg/5mL Susp | MAT | 0.1591 | 0.1591 | YES | NO | YES |
| 02536048 | AMOXICILLIN & CLAVULANIC ACID | Amoxicillin/Clav 875mg & 125mg Tab | SAI | 0.5551 | 0.5551 | YES | NO | YES |
| 02536021 | AMOXICILLIN & CLAVULANIC ACID | Amoxicillin/Clav 500mg & 125mg Tab | SAI | 0.3778 | 0.3778 | YES | NO | YES |
| 02243350 | AMOXICILLIN & CLAVULANIC ACID | Apo-Amoxi Clav 250mg & 125mg Tab | APX | 0.2467 | 0.2467 | YES | NO | YES |
| 02243351 | AMOXICILLIN & CLAVULANIC ACID | Apo-Amoxi Clav 500mg & 125mg Tab | APX | 0.3778 | 0.3778 | YES | NO | YES |
| 02245623 | AMOXICILLIN & CLAVULANIC ACID | Apo-Amoxi Clav 875mg & 125mg Tab | APX | 0.5551 | 0.5551 | YES | NO | YES |
| 02471701 | AMOXICILLIN & CLAVULANIC ACID | Auro-Amoxiclav 875mg & 125mg Tab | AUR | 0.5551 | 0.5551 | YES | NO | YES |
| 02471671 | AMOXICILLIN & CLAVULANIC ACID | Auro-Amoxiclav 250mg & 125mg Tab | AUR | 0.2467 | 0.2467 | YES | NO | YES |
| 02471698 | AMOXICILLIN & CLAVULANIC ACID | Auro-Amoxiclav 500mg & 125mg Tab | AUR | 0.3778 | 0.3778 | YES | NO | YES |
| 01916866 | AMOXICILLIN & CLAVULANIC ACID | Clavulin (Not a Benefit) 250mg & 125mg Tab | GSK | N/A | N/A | YES | NO | YES |
| 01916858 | AMOXICILLIN & CLAVULANIC ACID | Clavulin 500mg & 125mg Tab | GSK | 1.8875 | 0.3778 | YES | NO | YES |
| 02238829 | AMOXICILLIN & CLAVULANIC ACID | Clavulin (BID) 875mg & 125mg Tab | GSK | 2.7515 | 0.5551 | YES | NO | YES |
| 02508257 | AMOXICILLIN & CLAVULANIC ACID | Jamp Amoxi Clav 500mg & 125mg Tab | JPC | 0.3778 | 0.3778 | YES | NO | YES |
| 02508265 | AMOXICILLIN & CLAVULANIC ACID | Jamp Amoxi Clav 875mg & 125mg Tab | JPC | 0.5551 | 0.5551 | YES | NO | YES |
| 02508249 | AMOXICILLIN & CLAVULANIC ACID | Jamp Amoxi Clav 250mg & 125mg Tab | JPC | 0.2467 | 0.2467 | YES | NO | YES |
| 02482584 | AMOXICILLIN & CLAVULANIC ACID | Sandoz Amoxi-Clav Tablets 875mg & 125mg Tab | SDZ | 0.5551 | 0.5551 | YES | NO | YES |
| 02482576 | AMOXICILLIN & CLAVULANIC ACID | Sandoz Amoxi-Clav Tablets 500mg & 125mg Tab | SDZ | 0.3778 | 0.3778 | YES | NO | YES |
| 00029149 | AMPHOTERICIN B | Fungizone Inj Pd-50mg Pk | CHE | 102.0109 | 102.0109 | NO | NO | NO |
| 00020877 | AMPICILLIN | Novo-Ampicillin 250mg Cap | NOP | 0.4223 | 0.4223 | YES | NO | YES |
| 00020885 | AMPICILLIN | Novo-Ampicillin 500mg Cap | NOP | 0.8006 | 0.8006 | YES | NO | YES |
| 00002011 | AMPICILLIN | Penbritin (Not a Benefit) 500mg Cap | AYE | N/A | N/A | YES | NO | YES |
| 00002003 | AMPICILLIN | Penbritin (Not a Benefit) 250mg Cap | AYE | N/A | N/A | YES | NO | YES |
| 02236859 | ANAGRELIDE HCL | Agrylin (Not a Benefit) 0.5mg Cap | TAK | N/A | N/A | YES | NO | NO |
| 09858363 | ANAGRELIDE HCL | Anagride (Temporary Benefit) 0.5mg Cap | SET | 5.9696 | 5.9696 | NO | NO | NO |
| 02274949 | ANAGRELIDE HCL | PMS-Anagrelide 0.5mg Cap | PMS | 4.6997 | 4.6997 | YES | YES | NO |
| 02529904 | ANASTROZOLE | Anastrozole 1mg Tab | SIV | 0.9522 | 0.9522 | YES | NO | NO |
| 02351218 | ANASTROZOLE | Anastrozole 1mg Tab | ACH | 0.9522 | 0.9522 | YES | NO | NO |
| 02442736 | ANASTROZOLE | Anastrozole 1mg Tab | SAI | 0.9522 | 0.9522 | YES | NO | NO |
| 02374420 | ANASTROZOLE | Apo-Anastrozole 1mg Tab | APX | 0.9522 | 0.9522 | YES | NO | NO |
| 02224135 | ANASTROZOLE | Arimidex 1mg Tab | AZC | 6.2371 | 0.9522 | YES | NO | NO |
| 02458799 | ANASTROZOLE | CCP-Anastrozole 1mg Tab | CCP | 0.9522 | 0.9522 | YES | NO | NO |
| 02394898 | ANASTROZOLE | Co Anastrozole 1mg Tab | COB | 0.9522 | 0.9522 | YES | NO | NO |
| 02339080 | ANASTROZOLE | Jamp-Anastrozole 1mg Tab | JPC | 0.9522 | 0.9522 | YES | NO | NO |
| 02379562 | ANASTROZOLE | Mar-Anastrozole 1mg Tab | MAR | 0.9522 | 0.9522 | YES | NO | NO |
| 02379104 | ANASTROZOLE | Med-Anastrozole 1mg Tab | GMP | 0.9522 | 0.9522 | YES | NO | NO |
| 02393573 | ANASTROZOLE | Mint-Anastrozole 1mg Tab | MIN | 0.9522 | 0.9522 | YES | NO | NO |
| 02417855 | ANASTROZOLE | Nat-Anastrozole 1mg Tab | NAT | 0.9522 | 0.9522 | YES | NO | NO |
| 02320738 | ANASTROZOLE | PMS-Anastrozole 1mg Tab | PMS | 0.9522 | 0.9522 | YES | NO | NO |
| 02328690 | ANASTROZOLE | Ran-Anastrozole 1mg Tab | RAN | 0.9522 | 0.9522 | YES | NO | NO |
| 02392259 | ANASTROZOLE | Riva-Anastrozole 1mg Tab | RIA | 0.9522 | 0.9522 | YES | NO | NO |
| 02338467 | ANASTROZOLE | Sandoz Anastrozole 1mg Tab | SDZ | 0.9522 | 0.9522 | YES | NO | NO |
| 02365650 | ANASTROZOLE | Taro-Anastrozole 1mg Tab | TAR | 0.9522 | 0.9522 | YES | NO | NO |
| 02487721 | APIXABAN | Ach-Apixaban 5mg Tab | ACH | 0.4084 | 0.4084 | YES | NO | NO |
| 02487713 | APIXABAN | Ach-Apixaban 2.5mg Tab | ACH | 0.4084 | 0.4084 | YES | NO | NO |
| 02548887 | APIXABAN | Apixaban 5mg Tab | SAI | 0.4084 | 0.4084 | YES | NO | NO |
| 02530716 | APIXABAN | Apixaban 5mg Tab | SIV | 0.4084 | 0.4084 | YES | NO | NO |
| 02548879 | APIXABAN | Apixaban 2.5mg Tab | SAI | 0.4084 | 0.4084 | YES | NO | NO |
| 02530708 | APIXABAN | Apixaban 2.5mg Tab | SIV | 0.4084 | 0.4084 | YES | NO | NO |
| 02487403 | APIXABAN | Apo-Apixaban 5mg Tab | APX | 0.4084 | 0.4084 | YES | NO | NO |
| 02487381 | APIXABAN | Apo-Apixaban 2.5mg Tab | APX | 0.4084 | 0.4084 | YES | NO | NO |
| 02486806 | APIXABAN | Auro-Apixaban 2.5mg Tab | AUR | 0.4084 | 0.4084 | YES | NO | NO |
| 02486814 | APIXABAN | Auro-Apixaban 5mg Tab | AUR | 0.4084 | 0.4084 | YES | NO | NO |
| 02377233 | APIXABAN | Eliquis 2.5mg Tab | BQU | 1.6336 | 0.4084 | YES | NO | NO |
| 02397714 | APIXABAN | Eliquis 5mg Tab | BQU | 1.6336 | 0.4084 | YES | NO | NO |
| 02528932 | APIXABAN | Jamp Apixaban 5mg Tab | JPC | 0.4084 | 0.4084 | YES | NO | NO |
| 02528924 | APIXABAN | Jamp Apixaban 2.5mg Tab | JPC | 0.4084 | 0.4084 | YES | NO | NO |
| 02529017 | APIXABAN | M-Apixaban 5mg Tab | MAT | 0.4084 | 0.4084 | YES | NO | NO |
| 02529009 | APIXABAN | M-Apixaban 2.5mg Tab | MAT | 0.4084 | 0.4084 | YES | NO | NO |
| 02492377 | APIXABAN | Mar-Apixaban 5mg Tab | MAR | 0.4084 | 0.4084 | YES | NO | NO |
| 02492369 | APIXABAN | Mar-Apixaban 2.5mg Tab | MAR | 0.4084 | 0.4084 | YES | NO | NO |
| 02495449 | APIXABAN | Mint-Apixaban 5mg Tab | MIN | 0.4084 | 0.4084 | YES | NO | NO |
| 02495430 | APIXABAN | Mint-Apixaban 2.5mg Tab | MIN | 0.4084 | 0.4084 | YES | NO | NO |
| 02526069 | APIXABAN | NRA-Apixaban 5mg Tab | NRA | 0.4084 | 0.4084 | YES | NO | NO |
| 02526050 | APIXABAN | NRA-Apixaban 2.5mg Tab | NRA | 0.4084 | 0.4084 | YES | NO | NO |
| 02546884 | APIXABAN | NRA-Apixaban Tablets 2.5mg Tab | NRA | 0.4084 | 0.4084 | YES | NO | NO |
| 02546892 | APIXABAN | NRA-Apixaban Tablets 5mg Tab | NRA | 0.4084 | 0.4084 | YES | NO | NO |
| 02492814 | APIXABAN | Nat-Apixaban 2.5mg Tab | NAT | 0.4084 | 0.4084 | YES | NO | NO |
| 02492822 | APIXABAN | Nat-Apixaban 5mg Tab | NAT | 0.4084 | 0.4084 | YES | NO | NO |
| 02525518 | APIXABAN | Riva-Apixaban 2.5mg Tab | RIA | 0.4084 | 0.4084 | YES | NO | NO |
| 02525526 | APIXABAN | Riva-Apixaban 5mg Tab | RIA | 0.4084 | 0.4084 | YES | NO | NO |
| 02489236 | APIXABAN | Sandoz Apixaban SDZ 5mg Tab | SDZ | 0.4084 | 0.4084 | YES | NO | NO |
| 02489228 | APIXABAN | Sandoz Apixaban SDZ 2.5mg Tab | SDZ | 0.4084 | 0.4084 | YES | NO | NO |
| 02510464 | APIXABAN | Taro-Apixaban 2.5mg Tab | TAR | 0.4084 | 0.4084 | YES | NO | NO |
| 02510472 | APIXABAN | Taro-Apixaban 5mg Tab | TAR | 0.4084 | 0.4084 | YES | NO | NO |
| 02485001 | APIXABAN | Teva-Apixaban 5mg Tab | TEV | 0.4084 | 0.4084 | YES | NO | NO |
| 02484994 | APIXABAN | Teva-Apixaban 2.5mg Tab | TEV | 0.4084 | 0.4084 | YES | NO | NO |
| 02538180 | APREMILAST | Apo-Apremilast (Off-Formulary Interchangeable) 30mg Tab | APX | 18.7238 | N/A | YES | NO | NO |
| 02524104 | APREMILAST | Auro-Apremilast (Off-Formulary Interchangeable) 30mg Tab | AUR | 18.7237 | N/A | YES | NO | NO |
| 02518910 | APREMILAST | GLN-Apremilast (Off-Formulary Interchangeable) 30mg Tab | GLP | 18.7238 | N/A | YES | NO | NO |
| 02528959 | APREMILAST | Jamp Apremilast (Off-Formulary Interchangeable) 30mg Tab | JPC | 18.7238 | N/A | YES | NO | NO |
| 02525747 | APREMILAST | Mint-Apremilast (Off-Formulary Interchangeable) 30mg Tab | MIN | 18.7238 | N/A | YES | NO | NO |
| 02434334 | APREMILAST | Otezla (Off-Formulary Interchangeable) 30mg Tab | AMG | N/A | N/A | YES | NO | NO |
| 02521733 | APREMILAST | PMS-Apremilast (Off-Formulary Interchangeable) 30mg Tab | PMS | 18.7238 | N/A | YES | NO | NO |
| 02529084 | APREMILAST | Sandoz Apremilast (Off-Formulary Interchangeable) 30mg Tab | SDZ | 18.7238 | N/A | YES | NO | NO |
| 02524120 | APREMILAST | Auro-Apremilast (Off-Formulary Interchangeable) 10mg & 20mg & 30mg Tab-27 Blister Starter Pk | AUR | 505.5426 | N/A | YES | NO | NO |
| 02528967 | APREMILAST | Jamp Apremilast (Off-Formulary Interchangeable) 10mg & 20mg & 30mg Tab-27 Blister Starter Pk | JPC | 505.5426 | N/A | YES | NO | NO |
| 02434318 | APREMILAST | Otezla (Off-Formulary Interchangeable) 10mg & 20mg & 30mg Tab-27 Blister Starter Pk | AMG | N/A | N/A | YES | NO | NO |
| 02529092 | APREMILAST | Sandoz Apremilast (Off-Formulary Interchangeable) 10mg & 20mg & 30mg Tab-27 Blister Starter Pk | SDZ | 505.5426 | N/A | YES | NO | NO |
| 02298813 | APREPITANT | Emend Tri-Pack 125mg & 80mg Cap | MEK | 106.9839 | 106.9839 | NO | YES | NO |
| 02554569 | ARIPIPRAZOLE | Abilify Asimtufii 720mg/2.4mL Inj Sol-Pref Syr | OTS | 912.3600 | 912.3600 | NO | NO | YES |
| 02554577 | ARIPIPRAZOLE | Abilify Asimtufii 960mg/3.2mL Inj Sol-Pref Syr | OTS | 912.3600 | 912.3600 | NO | NO | YES |
| 02420864 | ARIPIPRAZOLE | Abilify Maintena 300mg/Vial Prolong-Rel Inj Pd-Vial Pk | OTS | 487.2002 | 487.2002 | NO | NO | YES |
| 02420872 | ARIPIPRAZOLE | Abilify Maintena 400mg/Vial Prolong-Rel Inj Pd-Vial Pk | OTS | 487.2002 | 487.2002 | NO | NO | YES |
| 02322390 | ARIPIPRAZOLE | Abilify 10mg Tab | OTS | 4.4049 | 1.0754 | YES | NO | YES |
| 02322455 | ARIPIPRAZOLE | Abilify 30mg Tab | OTS | 4.1028 | 1.0017 | YES | NO | YES |
| 02322382 | ARIPIPRAZOLE | Abilify 5mg Tab | OTS | 3.7052 | 0.9046 | YES | NO | YES |
| 02322374 | ARIPIPRAZOLE | Abilify 2mg Tab | OTS | 3.3143 | 0.8092 | YES | NO | YES |
| 02322412 | ARIPIPRAZOLE | Abilify 20mg Tab | OTS | 4.1028 | 1.0017 | YES | NO | YES |
| 02322404 | ARIPIPRAZOLE | Abilify 15mg Tab | OTS | 5.1985 | 1.2692 | YES | NO | YES |
| 02471116 | ARIPIPRAZOLE | Apo-Aripiprazole 15mg Tab | APX | 1.2692 | 1.2692 | YES | NO | YES |
| 02471108 | ARIPIPRAZOLE | Apo-Aripiprazole 10mg Tab | APX | 1.0754 | 1.0754 | YES | NO | YES |
| 02471086 | ARIPIPRAZOLE | Apo-Aripiprazole 2mg Tab | APX | 0.8092 | 0.8092 | YES | NO | YES |
| 02471124 | ARIPIPRAZOLE | Apo-Aripiprazole 20mg Tab | APX | 1.0017 | 1.0017 | YES | NO | YES |
| 02471094 | ARIPIPRAZOLE | Apo-Aripiprazole 5mg Tab | APX | 0.9046 | 0.9046 | YES | NO | YES |
| 02471132 | ARIPIPRAZOLE | Apo-Aripiprazole 30mg Tab | APX | 1.0017 | 1.0017 | YES | NO | YES |
| 02534371 | ARIPIPRAZOLE | Aripiprazole 30mg Tab | SIV | 1.0017 | 1.0017 | YES | NO | YES |
| 02506726 | ARIPIPRAZOLE | Aripiprazole 10mg Tab | SAI | 1.0754 | 1.0754 | YES | NO | YES |
| 02534347 | ARIPIPRAZOLE | Aripiprazole 10mg Tab | SIV | 1.0754 | 1.0754 | YES | NO | YES |
| 02506750 | ARIPIPRAZOLE | Aripiprazole 20mg Tab | SAI | 1.0017 | 1.0017 | YES | NO | YES |
| 02534363 | ARIPIPRAZOLE | Aripiprazole 20mg Tab | SIV | 1.0017 | 1.0017 | YES | NO | YES |
| 02534320 | ARIPIPRAZOLE | Aripiprazole 2mg Tab | SIV | 0.8092 | 0.8092 | YES | NO | YES |
| 02506718 | ARIPIPRAZOLE | Aripiprazole 5mg Tab | SAI | 0.9046 | 0.9046 | YES | NO | YES |
| 02534355 | ARIPIPRAZOLE | Aripiprazole 15mg Tab | SIV | 1.2692 | 1.2692 | YES | NO | YES |
| 02506734 | ARIPIPRAZOLE | Aripiprazole 15mg Tab | SAI | 1.2692 | 1.2692 | YES | NO | YES |
| 02534339 | ARIPIPRAZOLE | Aripiprazole 5mg Tab | SIV | 0.9046 | 0.9046 | YES | NO | YES |
| 02506688 | ARIPIPRAZOLE | Aripiprazole 2mg Tab | SAI | 0.8092 | 0.8092 | YES | NO | YES |
| 02506785 | ARIPIPRAZOLE | Aripiprazole 30mg Tab | SAI | 1.0017 | 1.0017 | YES | NO | YES |
| 02460084 | ARIPIPRAZOLE | Auro-Aripiprazole 30mg Tab | AUR | 1.0017 | 1.0017 | YES | NO | YES |
| 02460041 | ARIPIPRAZOLE | Auro-Aripiprazole 10mg Tab | AUR | 1.0754 | 1.0754 | YES | NO | YES |
| 02460033 | ARIPIPRAZOLE | Auro-Aripiprazole 5mg Tab | AUR | 0.9046 | 0.9046 | YES | NO | YES |
| 02460076 | ARIPIPRAZOLE | Auro-Aripiprazole 20mg Tab | AUR | 1.0017 | 1.0017 | YES | NO | YES |
| 02460068 | ARIPIPRAZOLE | Auro-Aripiprazole 15mg Tab | AUR | 1.2692 | 1.2692 | YES | NO | YES |
| 02460025 | ARIPIPRAZOLE | Auro-Aripiprazole 2mg Tab | AUR | 0.8092 | 0.8092 | YES | NO | YES |
| 02483556 | ARIPIPRAZOLE | Mint-Aripiprazole 2mg Tab | MIN | 0.8092 | 0.8092 | YES | NO | YES |
| 02483599 | ARIPIPRAZOLE | Mint-Aripiprazole 20mg Tab | MIN | 1.0017 | 1.0017 | YES | NO | YES |
| 02483580 | ARIPIPRAZOLE | Mint-Aripiprazole 15mg Tab | MIN | 1.2692 | 1.2692 | YES | NO | YES |
| 02483564 | ARIPIPRAZOLE | Mint-Aripiprazole 5mg Tab | MIN | 0.9046 | 0.9046 | YES | NO | YES |
| 02483572 | ARIPIPRAZOLE | Mint-Aripiprazole 10mg Tab | MIN | 1.0754 | 1.0754 | YES | NO | YES |
| 02483602 | ARIPIPRAZOLE | Mint-Aripiprazole 30mg Tab | MIN | 1.0017 | 1.0017 | YES | NO | YES |
| 02472279 | ARIPIPRAZOLE | NRA-Aripiprazole 30mg Tab | NRA | 1.0017 | 1.0017 | YES | NO | YES |
| 02472260 | ARIPIPRAZOLE | NRA-Aripiprazole 20mg Tab | NRA | 1.0017 | 1.0017 | YES | NO | YES |
| 02472252 | ARIPIPRAZOLE | NRA-Aripiprazole 15mg Tab | NRA | 1.2692 | 1.2692 | YES | NO | YES |
| 02472244 | ARIPIPRAZOLE | NRA-Aripiprazole 10mg Tab | NRA | 1.0754 | 1.0754 | YES | NO | YES |
| 02472228 | ARIPIPRAZOLE | NRA-Aripiprazole 5mg Tab | NRA | 0.9046 | 0.9046 | YES | NO | YES |
| 02472201 | ARIPIPRAZOLE | NRA-Aripiprazole 2mg Tab | NRA | 0.8092 | 0.8092 | YES | NO | YES |
| 02466686 | ARIPIPRAZOLE | PMS-Aripiprazole 20mg Tab | PMS | 1.0017 | 1.0017 | YES | NO | YES |
| 02466694 | ARIPIPRAZOLE | PMS-Aripiprazole 30mg Tab | PMS | 1.0017 | 1.0017 | YES | NO | YES |
| 02466635 | ARIPIPRAZOLE | PMS-Aripiprazole 2mg Tab | PMS | 0.8092 | 0.8092 | YES | NO | YES |
| 02466643 | ARIPIPRAZOLE | PMS-Aripiprazole 5mg Tab | PMS | 0.9046 | 0.9046 | YES | NO | YES |
| 02466678 | ARIPIPRAZOLE | PMS-Aripiprazole 15mg Tab | PMS | 1.2692 | 1.2692 | YES | NO | YES |
| 02466651 | ARIPIPRAZOLE | PMS-Aripiprazole 10mg Tab | PMS | 1.0754 | 1.0754 | YES | NO | YES |
| 02473682 | ARIPIPRAZOLE | Sandoz Aripiprazole 15mg Tab | SDZ | 1.2692 | 1.2692 | YES | NO | YES |
| 02473666 | ARIPIPRAZOLE | Sandoz Aripiprazole 5mg Tab | SDZ | 0.9046 | 0.9046 | YES | NO | YES |
| 02473658 | ARIPIPRAZOLE | Sandoz Aripiprazole 2mg Tab | SDZ | 0.8092 | 0.8092 | YES | NO | YES |
| 02473674 | ARIPIPRAZOLE | Sandoz Aripiprazole 10mg Tab | SDZ | 1.0754 | 1.0754 | YES | NO | YES |
| 02473704 | ARIPIPRAZOLE | Sandoz Aripiprazole 30mg Tab | SDZ | 1.0017 | 1.0017 | YES | NO | YES |
| 02473690 | ARIPIPRAZOLE | Sandoz Aripiprazole 20mg Tab | SDZ | 1.0017 | 1.0017 | YES | NO | YES |
| 02464144 | ARIPIPRAZOLE | Teva-Aripiprazole 2mg Tab | TEV | 0.8092 | 0.8092 | YES | NO | YES |
| 02464179 | ARIPIPRAZOLE | Teva-Aripiprazole 15mg Tab | TEV | 1.2692 | 1.2692 | YES | NO | YES |
| 02464160 | ARIPIPRAZOLE | Teva-Aripiprazole 10mg Tab | TEV | 1.0754 | 1.0754 | YES | NO | YES |
| 02464152 | ARIPIPRAZOLE | Teva-Aripiprazole 5mg Tab | TEV | 0.9046 | 0.9046 | YES | NO | YES |
| 02464195 | ARIPIPRAZOLE | Teva-Aripiprazole 30mg Tab | TEV | 1.0017 | 1.0017 | YES | NO | YES |
| 02464187 | ARIPIPRAZOLE | Teva-Aripiprazole 20mg Tab | TEV | 1.0017 | 1.0017 | YES | NO | YES |
| 00466611 | ASCORBIC ACID | Apo-C (Not a Benefit) 500mg Tab | APX | N/A | N/A | YES | NO | NO |
| 00021997 | ASCORBIC ACID | Novo-C (Not a Benefit) 500mg Tab | NOP | N/A | N/A | YES | NO | NO |
| 00036188 | ASCORBIC ACID | Vitamin C (Not a Benefit) 500mg Tab | RPR | N/A | N/A | YES | NO | NO |
| 02374811 | ASENAPINE | Saphris 10mg SL Tab | OCI | 1.5910 | 1.5910 | NO | NO | YES |
| 02374803 | ASENAPINE | Saphris 5mg SL Tab | OCI | 1.5910 | 1.5910 | NO | NO | YES |
| 02513129 | ATAZANAVIR SULFATE | Jamp Atazanavir (Off-Formulary Interchangeable) 300mg Cap | JPC | 19.0681 | N/A | YES | NO | NO |
| 02513102 | ATAZANAVIR SULFATE | Jamp Atazanavir 150mg Cap | JPC | 2.8386 | 2.8386 | YES | NO | NO |
| 02513110 | ATAZANAVIR SULFATE | Jamp Atazanavir 200mg Cap | JPC | 2.8552 | 2.8552 | YES | NO | NO |
| 02456885 | ATAZANAVIR SULFATE | Mylan-Atazanavir 200mg Cap | MYL | 2.8552 | 2.8552 | YES | NO | NO |
| 02456893 | ATAZANAVIR SULFATE | Mylan-Atazanavir (Off-Formulary Interchangeable) 300mg Cap | MYL | 19.0681 | N/A | YES | NO | NO |
| 02456877 | ATAZANAVIR SULFATE | Mylan-Atazanavir 150mg Cap | MYL | 2.8386 | 2.8386 | YES | NO | NO |
| 02294176 | ATAZANAVIR SULFATE | Reyataz (Off-Formulary Interchangeable) 300mg Cap | BQU | N/A | N/A | YES | NO | NO |
| 02248610 | ATAZANAVIR SULFATE | Reyataz 150mg Cap | BQU | 11.6950 | 2.8386 | YES | NO | NO |
| 02248611 | ATAZANAVIR SULFATE | Reyataz 200mg Cap | BQU | 11.7633 | 2.8552 | YES | NO | NO |
| 02443791 | ATAZANAVIR SULFATE | Teva-Atazanavir 150mg Cap | TEV | 2.8386 | 2.8386 | YES | NO | NO |
| 02443813 | ATAZANAVIR SULFATE | Teva-Atazanavir 200mg Cap | TEV | 2.8552 | 2.8552 | YES | NO | NO |
| 02443821 | ATAZANAVIR SULFATE | Teva-Atazanavir (Off-Formulary Interchangeable) 300mg Cap | TEV | 19.0681 | N/A | YES | NO | NO |
| 02369192 | ATENOLOL | AG-Atenolol 100mg Tab | ANG | 0.1543 | 0.1543 | YES | NO | NO |
| 02369184 | ATENOLOL | AG-Atenolol 50mg Tab | ANG | 0.0938 | 0.0938 | YES | NO | NO |
| 00773697 | ATENOLOL | Apo-Atenol 100mg Tab | APX | 0.1543 | 0.1543 | YES | NO | NO |
| 00773689 | ATENOLOL | Apo-Atenol 50mg Tab | APX | 0.0938 | 0.0938 | YES | NO | NO |
| 02466465 | ATENOLOL | Atenolol 50mg Tab | SAI | 0.0938 | 0.0938 | YES | NO | NO |
| 02238316 | ATENOLOL | Atenolol 50mg Tab | SIV | 0.0938 | 0.0938 | YES | NO | NO |
| 02466473 | ATENOLOL | Atenolol 100mg Tab | SAI | 0.1543 | 0.1543 | YES | NO | NO |
| 02238318 | ATENOLOL | Atenolol 100mg Tab | SIV | 0.1543 | 0.1543 | YES | NO | NO |
| 02367564 | ATENOLOL | Jamp-Atenolol 50mg Tab | JPC | 0.0938 | 0.0938 | YES | NO | NO |
| 02367572 | ATENOLOL | Jamp-Atenolol 100mg Tab | JPC | 0.1543 | 0.1543 | YES | NO | NO |
| 02371995 | ATENOLOL | Mar-Atenolol 100mg Tab | MAR | 0.1543 | 0.1543 | YES | NO | NO |
| 02371987 | ATENOLOL | Mar-Atenolol 50mg Tab | MAR | 0.0938 | 0.0938 | YES | NO | NO |
| 02368021 | ATENOLOL | Mint-Atenol 50mg Tab | MIN | 0.0938 | 0.0938 | YES | NO | NO |
| 02368048 | ATENOLOL | Mint-Atenol 100mg Tab | MIN | 0.1543 | 0.1543 | YES | NO | NO |
| 02237600 | ATENOLOL | PMS-Atenolol 50mg Tab | PMS | 0.0938 | 0.0938 | YES | NO | NO |
| 02237601 | ATENOLOL | PMS-Atenolol 100mg Tab | PMS | 0.1543 | 0.1543 | YES | NO | NO |
| 02267985 | ATENOLOL | Ran-Atenolol 50mg Tab | RAN | 0.0938 | 0.0938 | YES | NO | NO |
| 02267993 | ATENOLOL | Ran-Atenolol 100mg Tab | RAN | 0.1543 | 0.1543 | YES | NO | NO |
| 02171791 | ATENOLOL | Ratio-Atenolol 50mg Tab | TEV | 0.0938 | 0.0938 | YES | NO | NO |
| 02171805 | ATENOLOL | Ratio-Atenolol 100mg Tab | TEV | 0.1543 | 0.1543 | YES | NO | NO |
| 02368668 | ATENOLOL | Septa-Atenolol 100mg Tab | SET | 0.1543 | 0.1543 | YES | NO | NO |
| 02368641 | ATENOLOL | Septa-Atenolol 50mg Tab | SET | 0.0938 | 0.0938 | YES | NO | NO |
| 02039540 | ATENOLOL | Tenormin 100mg Tab | AZC | 1.0117 | 0.1543 | YES | NO | NO |
| 02039532 | ATENOLOL | Tenormin 50mg Tab | AZC | 0.6150 | 0.0938 | YES | NO | NO |
| 01912062 | ATENOLOL | Teva-Atenolol 50mg Tab | TEV | 0.0938 | 0.0938 | YES | NO | NO |
| 01912054 | ATENOLOL | Teva-Atenolol 100mg Tab | TEV | 0.1543 | 0.1543 | YES | NO | NO |
| 02248764 | ATENOLOL & CHLORTHALIDONE | AA-Atenidone 100 & 25mg Tab | AAP | 0.8755 | 0.8755 | YES | NO | NO |
| 02248763 | ATENOLOL & CHLORTHALIDONE | AA-Atenidone 50 & 25mg Tab | AAP | 0.5342 | 0.5342 | YES | NO | NO |
| 02049988 | ATENOLOL & CHLORTHALIDONE | Tenoretic 100/25 (Not a Benefit) 100 & 25mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02049961 | ATENOLOL & CHLORTHALIDONE | Tenoretic 50/25 (Not a Benefit) 50 & 25mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02318032 | ATOMOXETINE HCL | Apo-Atomoxetine 18mg Cap | APX | 0.5748 | 0.5748 | YES | NO | NO |
| 02318024 | ATOMOXETINE HCL | Apo-Atomoxetine 10mg Cap | APX | 0.5106 | 0.5106 | YES | NO | NO |
| 02318083 | ATOMOXETINE HCL | Apo-Atomoxetine (Off-Formulary Interchangeable) 100mg Cap | APX | 4.3521 | N/A | YES | NO | NO |
| 02318040 | ATOMOXETINE HCL | Apo-Atomoxetine 25mg Cap | APX | 0.6420 | 0.6420 | YES | NO | NO |
| 02318075 | ATOMOXETINE HCL | Apo-Atomoxetine (Off-Formulary Interchangeable) 80mg Cap | APX | 3.9961 | N/A | YES | NO | NO |
| 02318059 | ATOMOXETINE HCL | Apo-Atomoxetine 40mg Cap | APX | 0.7369 | 0.7369 | YES | NO | NO |
| 02318067 | ATOMOXETINE HCL | Apo-Atomoxetine 60mg Cap | APX | 0.8092 | 0.8092 | YES | NO | NO |
| 02445883 | ATOMOXETINE HCL | Atomoxetine 10mg Cap | SIV | 0.5106 | 0.5106 | YES | NO | NO |
| 02467747 | ATOMOXETINE HCL | Atomoxetine 10mg Cap | SAI | 0.5106 | 0.5106 | YES | NO | NO |
| 02467801 | ATOMOXETINE HCL | Atomoxetine (Off-Formulary Interchangeable) 80mg Cap | SAI | 3.9960 | N/A | YES | NO | NO |
| 02467763 | ATOMOXETINE HCL | Atomoxetine 25mg Cap | SAI | 0.6420 | 0.6420 | YES | NO | NO |
| 02445948 | ATOMOXETINE HCL | Atomoxetine 40mg Cap | SIV | 0.7369 | 0.7369 | YES | NO | NO |
| 02467771 | ATOMOXETINE HCL | Atomoxetine 40mg Cap | SAI | 0.7369 | 0.7369 | YES | NO | NO |
| 02467798 | ATOMOXETINE HCL | Atomoxetine 60mg Cap | SAI | 0.8092 | 0.8092 | YES | NO | NO |
| 02467828 | ATOMOXETINE HCL | Atomoxetine (Off-Formulary Interchangeable) 100mg Cap | SAI | 4.3520 | N/A | YES | NO | NO |
| 02445956 | ATOMOXETINE HCL | Atomoxetine 60mg Cap | SIV | 0.8092 | 0.8092 | YES | NO | NO |
| 02445913 | ATOMOXETINE HCL | Atomoxetine 25mg Cap | SIV | 0.6420 | 0.6420 | YES | NO | NO |
| 02467755 | ATOMOXETINE HCL | Atomoxetine 18mg Cap | SAI | 0.5748 | 0.5748 | YES | NO | NO |
| 02445905 | ATOMOXETINE HCL | Atomoxetine 18mg Cap | SIV | 0.5748 | 0.5748 | YES | NO | NO |
| 02471485 | ATOMOXETINE HCL | Auro-Atomoxetine 10mg Cap | AUR | 0.5106 | 0.5106 | YES | NO | NO |
| 02471558 | ATOMOXETINE HCL | Auro-Atomoxetine (Off-Formulary Interchangeable) 100mg Cap | AUR | 4.3520 | N/A | YES | NO | NO |
| 02471531 | ATOMOXETINE HCL | Auro-Atomoxetine (Off-Formulary Interchangeable) 80mg Cap | AUR | 3.9960 | N/A | YES | NO | NO |
| 02471493 | ATOMOXETINE HCL | Auro-Atomoxetine 18mg Cap | AUR | 0.5748 | 0.5748 | YES | NO | NO |
| 02471523 | ATOMOXETINE HCL | Auro-Atomoxetine 60mg Cap | AUR | 0.8092 | 0.8092 | YES | NO | NO |
| 02471515 | ATOMOXETINE HCL | Auro-Atomoxetine 40mg Cap | AUR | 0.7369 | 0.7369 | YES | NO | NO |
| 02471507 | ATOMOXETINE HCL | Auro-Atomoxetine 25mg Cap | AUR | 0.6420 | 0.6420 | YES | NO | NO |
| 02506874 | ATOMOXETINE HCL | Jamp Atomoxetine (Off-Formulary Interchangeable) 100mg Cap | JPC | 4.3520 | N/A | YES | NO | NO |
| 02506815 | ATOMOXETINE HCL | Jamp Atomoxetine 18mg Cap | JPC | 0.5748 | 0.5748 | YES | NO | NO |
| 02506831 | ATOMOXETINE HCL | Jamp Atomoxetine 40mg Cap | JPC | 0.7369 | 0.7369 | YES | NO | NO |
| 02506858 | ATOMOXETINE HCL | Jamp Atomoxetine 60mg Cap | JPC | 0.8092 | 0.8092 | YES | NO | NO |
| 02506823 | ATOMOXETINE HCL | Jamp Atomoxetine 25mg Cap | JPC | 0.6420 | 0.6420 | YES | NO | NO |
| 02506866 | ATOMOXETINE HCL | Jamp Atomoxetine (Off-Formulary Interchangeable) 80mg Cap | JPC | 3.9960 | N/A | YES | NO | NO |
| 02506807 | ATOMOXETINE HCL | Jamp Atomoxetine 10mg Cap | JPC | 0.5106 | 0.5106 | YES | NO | NO |
| 02381052 | ATOMOXETINE HCL | PMS-Atomoxetine 40mg Cap | PMS | 0.7369 | 0.7369 | YES | NO | NO |
| 02381036 | ATOMOXETINE HCL | PMS-Atomoxetine 18mg Cap | PMS | 0.5748 | 0.5748 | YES | NO | NO |
| 02381060 | ATOMOXETINE HCL | PMS-Atomoxetine 60mg Cap | PMS | 0.8092 | 0.8092 | YES | NO | NO |
| 02381044 | ATOMOXETINE HCL | PMS-Atomoxetine 25mg Cap | PMS | 0.6420 | 0.6420 | YES | NO | NO |
| 02381028 | ATOMOXETINE HCL | PMS-Atomoxetine 10mg Cap | PMS | 0.5106 | 0.5106 | YES | NO | NO |
| 02386437 | ATOMOXETINE HCL | Sandoz Atomoxetine 25mg Cap | SDZ | 0.6420 | 0.6420 | YES | NO | NO |
| 02386410 | ATOMOXETINE HCL | Sandoz Atomoxetine 10mg Cap | SDZ | 0.5106 | 0.5106 | YES | NO | NO |
| 02386429 | ATOMOXETINE HCL | Sandoz Atomoxetine 18mg Cap | SDZ | 0.5748 | 0.5748 | YES | NO | NO |
| 02386461 | ATOMOXETINE HCL | Sandoz Atomoxetine (Off-Formulary Interchangeable) 80mg Cap | SDZ | 3.9963 | N/A | YES | NO | NO |
| 02386488 | ATOMOXETINE HCL | Sandoz Atomoxetine (Off-Formulary Interchangeable) 100mg Cap | SDZ | 4.3524 | N/A | YES | NO | NO |
| 02386453 | ATOMOXETINE HCL | Sandoz Atomoxetine 60mg Cap | SDZ | 0.8092 | 0.8092 | YES | NO | NO |
| 02386445 | ATOMOXETINE HCL | Sandoz Atomoxetine 40mg Cap | SDZ | 0.7369 | 0.7369 | YES | NO | NO |
| 02279347 | ATOMOXETINE HCL | Strattera (Off-Formulary Interchangeable) 80mg Cap | LIL | N/A | N/A | YES | NO | NO |
| 02279355 | ATOMOXETINE HCL | Strattera (Off-Formulary Interchangeable) 100mg Cap | LIL | N/A | N/A | YES | NO | NO |
| 02262800 | ATOMOXETINE HCL | Strattera (Not a Benefit) 10mg Cap | LIL | N/A | N/A | YES | NO | NO |
| 02262819 | ATOMOXETINE HCL | Strattera (Not a Benefit) 18mg Cap | LIL | N/A | N/A | YES | NO | NO |
| 02262827 | ATOMOXETINE HCL | Strattera (Not a Benefit) 25mg Cap | LIL | N/A | N/A | YES | NO | NO |
| 02262835 | ATOMOXETINE HCL | Strattera (Not a Benefit) 40mg Cap | LIL | N/A | N/A | YES | NO | NO |
| 02262843 | ATOMOXETINE HCL | Strattera (Not a Benefit) 60mg Cap | LIL | N/A | N/A | YES | NO | NO |
| 02362511 | ATOMOXETINE HCL | Teva-Atomoxetin (Off-Formulary Interchangeable) 80mg Cap | TEV | 3.9960 | N/A | YES | NO | NO |
| 02362538 | ATOMOXETINE HCL | Teva-Atomoxetin (Off-Formulary Interchangeable) 100mg Cap | TEV | 4.3520 | N/A | YES | NO | NO |
| 02314568 | ATOMOXETINE HCL | Teva-Atomoxetine 18mg Cap | TEV | 0.5748 | 0.5748 | YES | NO | NO |
| 02314541 | ATOMOXETINE HCL | Teva-Atomoxetine 10mg Cap | TEV | 0.5106 | 0.5106 | YES | NO | NO |
| 02314576 | ATOMOXETINE HCL | Teva-Atomoxetine 25mg Cap | TEV | 0.6420 | 0.6420 | YES | NO | NO |
| 02314592 | ATOMOXETINE HCL | Teva-Atomoxetine 60mg Cap | TEV | 0.8092 | 0.8092 | YES | NO | NO |
| 02314584 | ATOMOXETINE HCL | Teva-Atomoxetine 40mg Cap | TEV | 0.7369 | 0.7369 | YES | NO | NO |
| 02478188 | ATORVASTATIN CALCIUM | AG-Atorvastatin 80mg Tab | ANG | 0.2342 | 0.2342 | YES | NO | NO |
| 02478145 | ATORVASTATIN CALCIUM | AG-Atorvastatin 10mg Tab | ANG | 0.1743 | 0.1743 | YES | NO | NO |
| 02478161 | ATORVASTATIN CALCIUM | AG-Atorvastatin 40mg Tab | ANG | 0.2342 | 0.2342 | YES | NO | NO |
| 02478153 | ATORVASTATIN CALCIUM | AG-Atorvastatin 20mg Tab | ANG | 0.2179 | 0.2179 | YES | NO | NO |
| 02457741 | ATORVASTATIN CALCIUM | Ach-Atorvastatin Calcium 10mg Tab | ACH | 0.1743 | 0.1743 | YES | NO | NO |
| 02457768 | ATORVASTATIN CALCIUM | Ach-Atorvastatin Calcium 20mg Tab | ACH | 0.2179 | 0.2179 | YES | NO | NO |
| 02457784 | ATORVASTATIN CALCIUM | Ach-Atorvastatin Calcium 80mg Tab | ACH | 0.2342 | 0.2342 | YES | NO | NO |
| 02457776 | ATORVASTATIN CALCIUM | Ach-Atorvastatin Calcium 40mg Tab | ACH | 0.2342 | 0.2342 | YES | NO | NO |
| 02295318 | ATORVASTATIN CALCIUM | Apo-Atorvastatin 80mg Tab | APX | 0.2342 | 0.2342 | YES | NO | NO |
| 02295296 | ATORVASTATIN CALCIUM | Apo-Atorvastatin 40mg Tab | APX | 0.2342 | 0.2342 | YES | NO | NO |
| 02295288 | ATORVASTATIN CALCIUM | Apo-Atorvastatin 20mg Tab | APX | 0.2179 | 0.2179 | YES | NO | NO |
| 02295261 | ATORVASTATIN CALCIUM | Apo-Atorvastatin 10mg Tab | APX | 0.1743 | 0.1743 | YES | NO | NO |
| 02475057 | ATORVASTATIN CALCIUM | Atorvastatin 80mg Tab | RIA | 0.2342 | 0.2342 | YES | NO | NO |
| 02348705 | ATORVASTATIN CALCIUM | Atorvastatin 10mg Tab | SAI | 0.1743 | 0.1743 | YES | NO | NO |
| 02475022 | ATORVASTATIN CALCIUM | Atorvastatin 10mg Tab | RIA | 0.1743 | 0.1743 | YES | NO | NO |
| 02348713 | ATORVASTATIN CALCIUM | Atorvastatin 20mg Tab | SAI | 0.2179 | 0.2179 | YES | NO | NO |
| 02475030 | ATORVASTATIN CALCIUM | Atorvastatin 20mg Tab | RIA | 0.2179 | 0.2179 | YES | NO | NO |
| 02348721 | ATORVASTATIN CALCIUM | Atorvastatin 40mg Tab | SAI | 0.2342 | 0.2342 | YES | NO | NO |
| 02475049 | ATORVASTATIN CALCIUM | Atorvastatin 40mg Tab | RIA | 0.2342 | 0.2342 | YES | NO | NO |
| 02348748 | ATORVASTATIN CALCIUM | Atorvastatin 80mg Tab | SAI | 0.2342 | 0.2342 | YES | NO | NO |
| 02411350 | ATORVASTATIN CALCIUM | Atorvastatin-10 10mg Tab | SIV | 0.1743 | 0.1743 | YES | NO | NO |
| 02411369 | ATORVASTATIN CALCIUM | Atorvastatin-20 20mg Tab | SIV | 0.2179 | 0.2179 | YES | NO | NO |
| 02411377 | ATORVASTATIN CALCIUM | Atorvastatin-40 40mg Tab | SIV | 0.2342 | 0.2342 | YES | NO | NO |
| 02411385 | ATORVASTATIN CALCIUM | Atorvastatin-80 80mg Tab | SIV | 0.2342 | 0.2342 | YES | NO | NO |
| 02407272 | ATORVASTATIN CALCIUM | Auro-Atorvastatin 40mg Tab | AUR | 0.2342 | 0.2342 | YES | NO | NO |
| 02407280 | ATORVASTATIN CALCIUM | Auro-Atorvastatin 80mg Tab | AUR | 0.2342 | 0.2342 | YES | NO | NO |
| 02407256 | ATORVASTATIN CALCIUM | Auro-Atorvastatin 10mg Tab | AUR | 0.1743 | 0.1743 | YES | NO | NO |
| 02407264 | ATORVASTATIN CALCIUM | Auro-Atorvastatin 20mg Tab | AUR | 0.2179 | 0.2179 | YES | NO | NO |
| 02504200 | ATORVASTATIN CALCIUM | Jamp Atorvastatin Calcium 20mg Tab | JPC | 0.2179 | 0.2179 | YES | NO | NO |
| 02504219 | ATORVASTATIN CALCIUM | Jamp Atorvastatin Calcium 40mg Tab | JPC | 0.2342 | 0.2342 | YES | NO | NO |
| 02504235 | ATORVASTATIN CALCIUM | Jamp Atorvastatin Calcium 80mg Tab | JPC | 0.2342 | 0.2342 | YES | NO | NO |
| 02504197 | ATORVASTATIN CALCIUM | Jamp Atorvastatin Calcium 10mg Tab | JPC | 0.1743 | 0.1743 | YES | NO | NO |
| 02391082 | ATORVASTATIN CALCIUM | Jamp-Atorvastatin 80mg Tab | JPC | 0.2342 | 0.2342 | YES | NO | NO |
| 02391058 | ATORVASTATIN CALCIUM | Jamp-Atorvastatin 10mg Tab | JPC | 0.1743 | 0.1743 | YES | NO | NO |
| 02391066 | ATORVASTATIN CALCIUM | Jamp-Atorvastatin 20mg Tab | JPC | 0.2179 | 0.2179 | YES | NO | NO |
| 02391074 | ATORVASTATIN CALCIUM | Jamp-Atorvastatin 40mg Tab | JPC | 0.2342 | 0.2342 | YES | NO | NO |
| 02230713 | ATORVASTATIN CALCIUM | Lipitor 20mg Tab | UJC | 2.6741 | 0.2179 | YES | NO | NO |
| 02230711 | ATORVASTATIN CALCIUM | Lipitor 10mg Tab | UJC | 2.1393 | 0.1743 | YES | NO | NO |
| 02230714 | ATORVASTATIN CALCIUM | Lipitor 40mg Tab | UJC | 2.8747 | 0.2342 | YES | NO | NO |
| 02243097 | ATORVASTATIN CALCIUM | Lipitor 80mg Tab | UJC | 2.8747 | 0.2342 | YES | NO | NO |
| 02471167 | ATORVASTATIN CALCIUM | M-Atorvastatin 10mg Tab | MAT | 0.1743 | 0.1743 | YES | NO | NO |
| 02471175 | ATORVASTATIN CALCIUM | M-Atorvastatin 20mg Tab | MAT | 0.2179 | 0.2179 | YES | NO | NO |
| 02471191 | ATORVASTATIN CALCIUM | M-Atorvastatin 80mg Tab | MAT | 0.2342 | 0.2342 | YES | NO | NO |
| 02471183 | ATORVASTATIN CALCIUM | M-Atorvastatin 40mg Tab | MAT | 0.2342 | 0.2342 | YES | NO | NO |
| 02454041 | ATORVASTATIN CALCIUM | Mar-Atorvastatin 80mg Tab | MAR | 0.2342 | 0.2342 | YES | NO | NO |
| 02454017 | ATORVASTATIN CALCIUM | Mar-Atorvastatin 10mg Tab | MAR | 0.1743 | 0.1743 | YES | NO | NO |
| 02454033 | ATORVASTATIN CALCIUM | Mar-Atorvastatin 40mg Tab | MAR | 0.2342 | 0.2342 | YES | NO | NO |
| 02454025 | ATORVASTATIN CALCIUM | Mar-Atorvastatin 20mg Tab | MAR | 0.2179 | 0.2179 | YES | NO | NO |
| 02479532 | ATORVASTATIN CALCIUM | Mint-Atorvastatin 80mg Tab | MIN | 0.2342 | 0.2342 | YES | NO | NO |
| 02479508 | ATORVASTATIN CALCIUM | Mint-Atorvastatin 10mg Tab | MIN | 0.1743 | 0.1743 | YES | NO | NO |
| 02479516 | ATORVASTATIN CALCIUM | Mint-Atorvastatin 20mg Tab | MIN | 0.2179 | 0.2179 | YES | NO | NO |
| 02479524 | ATORVASTATIN CALCIUM | Mint-Atorvastatin 40mg Tab | MIN | 0.2342 | 0.2342 | YES | NO | NO |
| 02392941 | ATORVASTATIN CALCIUM | Mylan-Atorvastatin 20mg Tab | MYL | 0.2179 | 0.2179 | YES | NO | NO |
| 02392976 | ATORVASTATIN CALCIUM | Mylan-Atorvastatin 80mg Tab | MYL | 0.2342 | 0.2342 | YES | NO | NO |
| 02392933 | ATORVASTATIN CALCIUM | Mylan-Atorvastatin 10mg Tab | MYL | 0.1743 | 0.1743 | YES | NO | NO |
| 02392968 | ATORVASTATIN CALCIUM | Mylan-Atorvastatin 40mg Tab | MYL | 0.2342 | 0.2342 | YES | NO | NO |
| 02476541 | ATORVASTATIN CALCIUM | NRA-Atorvastatin 80mg Tab | NRA | 0.2342 | 0.2342 | YES | NO | NO |
| 02476517 | ATORVASTATIN CALCIUM | NRA-Atorvastatin 10mg Tab | NRA | 0.1743 | 0.1743 | YES | NO | NO |
| 02476533 | ATORVASTATIN CALCIUM | NRA-Atorvastatin 40mg Tab | NRA | 0.2342 | 0.2342 | YES | NO | NO |
| 02476525 | ATORVASTATIN CALCIUM | NRA-Atorvastatin 20mg Tab | NRA | 0.2179 | 0.2179 | YES | NO | NO |
| 02477149 | ATORVASTATIN CALCIUM | PMS-Atorvastatin 10mg Tab | PMS | 0.1743 | 0.1743 | YES | NO | NO |
| 02477157 | ATORVASTATIN CALCIUM | PMS-Atorvastatin 20mg Tab | PMS | 0.2179 | 0.2179 | YES | NO | NO |
| 02477165 | ATORVASTATIN CALCIUM | PMS-Atorvastatin 40mg Tab | PMS | 0.2342 | 0.2342 | YES | NO | NO |
| 02507234 | ATORVASTATIN CALCIUM | PMSC-Atorvastatin 10mg Tab | PMS | 0.1743 | 0.1743 | YES | NO | NO |
| 02507269 | ATORVASTATIN CALCIUM | PMSC-Atorvastatin 80mg Tab | PMS | 0.2342 | 0.2342 | YES | NO | NO |
| 02507242 | ATORVASTATIN CALCIUM | PMSC-Atorvastatin 20mg Tab | PMS | 0.2179 | 0.2179 | YES | NO | NO |
| 02507250 | ATORVASTATIN CALCIUM | PMSC-Atorvastatin 40mg Tab | PMS | 0.2342 | 0.2342 | YES | NO | NO |
| 02521563 | ATORVASTATIN CALCIUM | PRZ-Atorvastatin 20mg Tab | PRZ | 0.2179 | 0.2179 | YES | NO | NO |
| 02521555 | ATORVASTATIN CALCIUM | PRZ-Atorvastatin 10mg Tab | PRZ | 0.1743 | 0.1743 | YES | NO | NO |
| 02521571 | ATORVASTATIN CALCIUM | PRZ-Atorvastatin 40mg Tab | PRZ | 0.2342 | 0.2342 | YES | NO | NO |
| 02521598 | ATORVASTATIN CALCIUM | PRZ-Atorvastatin 80mg Tab | PRZ | 0.2342 | 0.2342 | YES | NO | NO |
| 02350319 | ATORVASTATIN CALCIUM | Ratio-Atorvastatin 20mg Tab | RPH | 0.2179 | 0.2179 | YES | NO | NO |
| 02350327 | ATORVASTATIN CALCIUM | Ratio-Atorvastatin 40mg Tab | RPH | 0.2342 | 0.2342 | YES | NO | NO |
| 02350297 | ATORVASTATIN CALCIUM | Ratio-Atorvastatin 10mg Tab | RPH | 0.1743 | 0.1743 | YES | NO | NO |
| 02350335 | ATORVASTATIN CALCIUM | Ratio-Atorvastatin 80mg Tab | RPH | 0.2342 | 0.2342 | YES | NO | NO |
| 02417944 | ATORVASTATIN CALCIUM | Reddy-Atorvastatin 20mg Tab | DRR | 0.2179 | 0.2179 | YES | NO | NO |
| 02417936 | ATORVASTATIN CALCIUM | Reddy-Atorvastatin 10mg Tab | DRR | 0.1743 | 0.1743 | YES | NO | NO |
| 02417960 | ATORVASTATIN CALCIUM | Reddy-Atorvastatin 80mg Tab | DRR | 0.2342 | 0.2342 | YES | NO | NO |
| 02417952 | ATORVASTATIN CALCIUM | Reddy-Atorvastatin 40mg Tab | DRR | 0.2342 | 0.2342 | YES | NO | NO |
| 02324946 | ATORVASTATIN CALCIUM | Sandoz Atorvastatin 10mg Tab | SDZ | 0.1743 | 0.1743 | YES | NO | NO |
| 02324970 | ATORVASTATIN CALCIUM | Sandoz Atorvastatin 80mg Tab | SDZ | 0.2342 | 0.2342 | YES | NO | NO |
| 02324962 | ATORVASTATIN CALCIUM | Sandoz Atorvastatin 40mg Tab | SDZ | 0.2342 | 0.2342 | YES | NO | NO |
| 02324954 | ATORVASTATIN CALCIUM | Sandoz Atorvastatin 20mg Tab | SDZ | 0.2179 | 0.2179 | YES | NO | NO |
| 02313758 | ATORVASTATIN CALCIUM | Taro-Atorvastatin 80mg Tab | SPC | 0.2342 | 0.2342 | YES | NO | NO |
| 02313707 | ATORVASTATIN CALCIUM | Taro-Atorvastatin 10mg Tab | SPC | 0.1743 | 0.1743 | YES | NO | NO |
| 02313715 | ATORVASTATIN CALCIUM | Taro-Atorvastatin 20mg Tab | SPC | 0.2179 | 0.2179 | YES | NO | NO |
| 02313723 | ATORVASTATIN CALCIUM | Taro-Atorvastatin 40mg Tab | SPC | 0.2342 | 0.2342 | YES | NO | NO |
| 02310902 | ATORVASTATIN CALCIUM | Teva-Atorvastatin 20mg Tab | TEV | 0.2179 | 0.2179 | YES | NO | NO |
| 02310899 | ATORVASTATIN CALCIUM | Teva-Atorvastatin 10mg Tab | TEV | 0.1743 | 0.1743 | YES | NO | NO |
| 02310929 | ATORVASTATIN CALCIUM | Teva-Atorvastatin 80mg Tab | TEV | 0.2342 | 0.2342 | YES | NO | NO |
| 02310910 | ATORVASTATIN CALCIUM | Teva-Atorvastatin 40mg Tab | TEV | 0.2342 | 0.2342 | YES | NO | NO |
| 02528495 | ATOVAQUONE | GLN-Atovaquone 750mg/5mL O/L | GLP | 2.3785 | 2.3785 | YES | NO | NO |
| 02217422 | ATOVAQUONE | Mepron 750mg/5mL O/L | GSK | 3.7661 | 2.3785 | YES | NO | NO |
| 02421429 | ATOVAQUONE & PROGUANIL HCL | Atovaquone Proguanil (Off-Formulary Interchangeable) 250mg & 100mg Tab | SAI | 4.1308 | 4.1308 | YES | NO | NO |
| 02466783 | ATOVAQUONE & PROGUANIL HCL | Atovaquone and Proguanil Hydrochloride (Off-Formulary Interchangeable) 250mg & 100mg Tab | GLP | 4.1308 | 4.1308 | YES | NO | NO |
| 02238151 | ATOVAQUONE & PROGUANIL HCL | Malarone (Off-Formulary Interchangeable) 250mg & 100mg Tab | GSK | 6.3558 | 4.1308 | YES | NO | NO |
| 02402165 | ATOVAQUONE & PROGUANIL HCL | Mylan-Atovaquone/Proguanil (Off-Formulary Interchangeable) 250mg & 100mg Tab | MYL | 4.1308 | 4.1308 | YES | NO | NO |
| 02380927 | ATOVAQUONE & PROGUANIL HCL | Teva-Atovaquone Proguanil (Off-Formulary Interchangeable) 250mg & 100mg Tab | TEV | 4.1308 | 4.1308 | YES | NO | NO |
| 02023695 | ATROPINE SULFATE | Atropine 1% Oph Sol | PHS | 0.5490 | 0.5490 | YES | NO | NO |
| 00035017 | ATROPINE SULFATE | Isopto Atropine 1% Oph Sol | ALC | 0.8420 | 0.5490 | YES | NO | NO |
| 01916823 | AURANOFIN | Ridaura 3mg Cap | XED | 6.9127 | 6.9127 | NO | NO | NO |
| 02242907 | AZATHIOPRINE | Apo-Azathioprine 50mg Tab | APX | 0.5185 | 0.5185 | YES | NO | YES |
| 00004596 | AZATHIOPRINE | Imuran 50mg Tab | ASN | 1.3820 | 0.5185 | YES | NO | YES |
| 02236819 | AZATHIOPRINE | Teva-Azathioprine 50mg Tab | TEV | 0.5185 | 0.5185 | YES | NO | YES |
| 02270811 | AZELAIC ACID | Finacea 15% Top Gel | LEO | 0.8763 | 0.8763 | NO | NO | NO |
| 02540886 | AZELASTINE HCL & FLUTICASONE PROPIONATE | Apo-Azelastine/Fluticasone (Off-Formulary Interchangeable) 137mcg/Actuation&50mcg/Actuation Nas-Sp-120 Dose Pk | APX | 89.9215 | N/A | YES | NO | YES |
| 02432889 | AZELASTINE HCL & FLUTICASONE PROPIONATE | Dymista (Off-Formulary Interchangeable) 137mcg/Actuation&50mcg/Actuation Nas-Sp-120 Dose Pk | BGP | N/A | N/A | YES | NO | YES |
| 02530341 | AZELASTINE HCL & FLUTICASONE PROPIONATE | Mylan-Azelastine/Fluticasone (Off-Formulary Interchangeable) 137mcg/Actuation&50mcg/Actuation Nas-Sp-120 Dose Pk | MYL | 89.9215 | N/A | YES | NO | YES |
| 02547023 | AZILSARTAN MEDOXOMIL | Auro-Azilsartan Medoxomil (Off-Formulary Interchangeable) 80mg Tab | AUR | 1.1177 | N/A | YES | NO | NO |
| 02547015 | AZILSARTAN MEDOXOMIL | Auro-Azilsartan Medoxomil (Off-Formulary Interchangeable) 40mg Tab | AUR | 1.1177 | N/A | YES | NO | NO |
| 02381389 | AZILSARTAN MEDOXOMIL | Edarbi (Off-Formulary Interchangeable) 40mg Tab | BHC | N/A | N/A | YES | NO | NO |
| 02381397 | AZILSARTAN MEDOXOMIL | Edarbi (Off-Formulary Interchangeable) 80mg Tab | BHC | N/A | N/A | YES | NO | NO |
| 02482363 | AZITHROMYCIN | Auro-Azithromycin 100mg/5mL O/L-15mL Pk | AUR | 8.8208 | 8.8208 | YES | NO | YES |
| 02482371 | AZITHROMYCIN | Auro-Azithromycin 200mg/5mL O/L-15mL Pk | AUR | 12.4943 | 12.4943 | YES | NO | YES |
| 02332396 | AZITHROMYCIN | Sandoz Azithromycin 200mg/5mL O/L-15mL Pk | SDZ | 12.4943 | 12.4943 | YES | NO | YES |
| 02332388 | AZITHROMYCIN | Sandoz Azithromycin 100mg/5mL O/L-15mL Pk | SDZ | 8.8208 | 8.8208 | YES | NO | YES |
| 02223716 | AZITHROMYCIN | Zithromax 100mg/5mL O/L-15mL Pk | PFI | 17.6415 | 8.8208 | YES | NO | YES |
| 02223724 | AZITHROMYCIN | Zithromax 200mg/5mL O/L-15mL Pk | PFI | 24.9885 | 12.4943 | YES | NO | YES |
| 09857636 | AZITHROMYCIN | Auro-Azithromycin 200mg/5mL O/L-22.5mL Pk | AUR | 18.7425 | 18.7425 | YES | NO | YES |
| 09857351 | AZITHROMYCIN | Sandoz Azithromycin 200mg/5mL O/L-22.5mL Pk | SDZ | 18.7425 | 18.7425 | YES | NO | YES |
| 09857315 | AZITHROMYCIN | Zithromax 200mg/5mL O/L-22.5mL Pk | PFI | 37.4828 | 18.7425 | YES | NO | YES |
| 09857638 | AZITHROMYCIN | Auro-Azithromycin 200mg/5mL O/L-37.5mL Pk | AUR | 31.2375 | 31.2375 | YES | NO | YES |
| 09857637 | AZITHROMYCIN | Zithromax (Not a Benefit) 200mg/5mL O/L-37.5mL Pk | PFI | N/A | N/A | YES | NO | YES |
| 02480700 | AZITHROMYCIN | AG-Azithromycin 250mg Tab | ANG | 0.9410 | 0.9410 | YES | NO | YES |
| 02247423 | AZITHROMYCIN | Apo-Azithromycin 250mg Tab | APX | 0.9410 | 0.9410 | YES | NO | YES |
| 02415542 | AZITHROMYCIN | Apo-Azithromycin Z 250mg Tab | APX | 0.9410 | 0.9410 | YES | NO | YES |
| 02330881 | AZITHROMYCIN | Azithromycin 250mg Tab | SAI | 0.9410 | 0.9410 | YES | NO | YES |
| 02442434 | AZITHROMYCIN | Azithromycin 250mg Tab | SIV | 0.9410 | 0.9410 | YES | NO | YES |
| 02452308 | AZITHROMYCIN | Jamp-Azithromycin 250mg Tab | JPC | 0.9410 | 0.9410 | YES | NO | YES |
| 02502038 | AZITHROMYCIN | M-Azithromycin 250mg Tab | MAT | 0.9410 | 0.9410 | YES | NO | YES |
| 02452324 | AZITHROMYCIN | Mar-Azithromycin 250mg Tab | MAR | 0.9410 | 0.9410 | YES | NO | YES |
| 02479680 | AZITHROMYCIN | NRA-Azithromycin 250mg Tab | NRA | 0.9410 | 0.9410 | YES | NO | YES |
| 02267845 | AZITHROMYCIN | Novo-Azithromycin 250mg Tab | NOP | 0.9410 | 0.9410 | YES | NO | YES |
| 02261634 | AZITHROMYCIN | PMS-Azithromycin 250mg Tab | PMS | 0.9410 | 0.9410 | YES | NO | YES |
| 02261642 | AZITHROMYCIN | PMS-Azithromycin 600mg Tab | PMS | 10.6652 | 10.6652 | YES | YES | YES |
| 02275309 | AZITHROMYCIN | Riva-Azithromycin 250mg Tab | RIA | 0.9410 | 0.9410 | YES | NO | YES |
| 02265826 | AZITHROMYCIN | Sandoz Azithromycin 250mg Tab | SDZ | 0.9410 | 0.9410 | YES | NO | YES |
| 02231143 | AZITHROMYCIN | Zithromax (Not a Benefit) 600mg Tab | PFI | N/A | N/A | YES | NO | YES |
| 02212021 | AZITHROMYCIN | Zithromax 250mg Tab | PFI | 5.4382 | 0.9410 | YES | NO | YES |
| 02457075 | BACLOFEN | Baclofen Injection (Off-Formulary Interchangeable) 2mg/mL Inj Sol (Preservative-Free) | TEL | 35.4500 | 35.4500 | YES | NO | YES |
| 02553341 | BACLOFEN | Baclofen Injection USP (Off-Formulary Interchangeable) 2mg/mL Inj Sol (Preservative-Free) | JPC | 35.4500 | 35.4500 | YES | NO | YES |
| 02413647 | BACLOFEN | Baclofen Intrathecal (Off-Formulary Interchangeable) 2mg/mL Inj Sol (Preservative-Free) | STE | 35.4500 | 35.4500 | YES | NO | YES |
| 02485516 | BACLOFEN | Baclofen Intrathecal (Off-Formulary Interchangeable) 2mg/mL Inj Sol (Preservative-Free) | AVP | 35.4500 | 35.4500 | YES | NO | YES |
| 02131064 | BACLOFEN | Lioresal Intrathecal (Off-Formulary Interchangeable) 2mg/mL Inj Sol (Preservative-Free) | NOV | N/A | N/A | YES | NO | YES |
| 02413620 | BACLOFEN | Baclofen Injection (Off-Formulary Interchangeable) 0.05mg/mL Inj Sol-1mL Pk (Preservative-Free) | STE | 11.2500 | 11.2500 | YES | NO | YES |
| 02457059 | BACLOFEN | Baclofen Injection (Off-Formulary Interchangeable) 0.05mg/mL Inj Sol-1mL Pk (Preservative-Free) | TEL | 11.2500 | 11.2500 | YES | NO | YES |
| 02131048 | BACLOFEN | Lioresal Intrathecal (Off-Formulary Interchangeable) 0.05mg/mL Inj Sol-1mL Pk (Preservative-Free) | NOV | N/A | N/A | YES | NO | YES |
| 02457067 | BACLOFEN | Baclofen Injection (Off-Formulary Interchangeable) 0.5mg/mL Inj Sol-20mL Pk (Preservative-Free) | TEL | 177.2500 | 177.2500 | YES | NO | YES |
| 02413639 | BACLOFEN | Baclofen Intrathecal (Off-Formulary Interchangeable) 0.5mg/mL Inj Sol-20mL Pk (Preservative-Free) | STE | 177.2500 | 177.2500 | YES | NO | YES |
| 02485508 | BACLOFEN | Baclofen Intrathecal (Off-Formulary Interchangeable) 0.5mg/mL Inj Sol-20mL Pk (Preservative-Free) | AVP | 177.2500 | 177.2500 | YES | NO | YES |
| 02131056 | BACLOFEN | Lioresal Intrathecal (Off-Formulary Interchangeable) 0.5mg/mL Inj Sol-20mL Pk (Preservative-Free) | NOV | N/A | N/A | YES | NO | YES |
| 02139332 | BACLOFEN | Apo-Baclofen 10mg Tab | APX | 0.1595 | 0.1595 | YES | NO | YES |
| 02139391 | BACLOFEN | Apo-Baclofen 20mg Tab | APX | 0.3104 | 0.3104 | YES | NO | YES |
| 02544679 | BACLOFEN | Baclofen 20mg Tab | SIV | 0.3104 | 0.3104 | YES | NO | YES |
| 02544660 | BACLOFEN | Baclofen 10mg Tab | SIV | 0.1595 | 0.1595 | YES | NO | YES |
| 02287021 | BACLOFEN | Baclofen 10mg Tab | SAI | 0.1595 | 0.1595 | YES | NO | YES |
| 02287048 | BACLOFEN | Baclofen 20mg Tab | SAI | 0.3104 | 0.3104 | YES | NO | YES |
| 00455881 | BACLOFEN | Lioresal 10mg Tab | NOV | 0.8795 | 0.1595 | YES | NO | YES |
| 00636576 | BACLOFEN | Lioresal DS 20mg Tab | NOV | 1.7122 | 0.3104 | YES | NO | YES |
| 02088401 | BACLOFEN | Mylan-Baclofen 20mg Tab | MYL | 0.3104 | 0.3104 | YES | NO | YES |
| 02088398 | BACLOFEN | Mylan-Baclofen 10mg Tab | MYL | 0.1595 | 0.1595 | YES | NO | YES |
| 02063743 | BACLOFEN | PMS-Baclofen 20mg Tab | PMS | 0.3104 | 0.3104 | YES | NO | YES |
| 02063735 | BACLOFEN | PMS-Baclofen 10mg Tab | PMS | 0.1595 | 0.1595 | YES | NO | YES |
| 02236507 | BACLOFEN | Ratio-Baclofen 10mg Tab | RPH | 0.1595 | 0.1595 | YES | NO | YES |
| 02236508 | BACLOFEN | Ratio-Baclofen 20mg Tab | RPH | 0.3104 | 0.3104 | YES | NO | YES |
| 02544768 | BARICITINIB | Olumiant 4mg Tab | LIL | 59.4367 | 59.4367 | NO | YES | NO |
| 02480018 | BARICITINIB | Olumiant 2mg Tab | LIL | 59.4367 | 59.4367 | NO | YES | NO |
| 02242030 | BECLOMETHASONE DIPROPIONATE | QVAR 100mcg/Metered Dose Aero Inh-200 Dose Pk | GRA | 85.8405 | 85.8405 | NO | NO | NO |
| 02242029 | BECLOMETHASONE DIPROPIONATE | QVAR 50mcg/Metered Dose Aero Inh-200 Dose Pk | GRA | 43.0469 | 43.0469 | NO | NO | NO |
| 02089602 | BECLOMETHASONE DIPROPIONATE | Propaderm 0.025% Cr | VAL | 0.5969 | 0.5969 | NO | NO | NO |
| 02238796 | BECLOMETHASONE DIPROPIONATE | Apo-Beclomethasone Nasal Spray 50mcg Nas-Sp-200 Dose Pk | APX | 12.2600 | 12.2600 | YES | NO | YES |
| 02213702 | BECLOMETHASONE DIPROPIONATE | Beconase Aqueous (Not a Benefit) 50mcg Nas-Sp-200 Dose Pk | GLW | N/A | N/A | YES | NO | YES |
| 02172712 | BECLOMETHASONE DIPROPIONATE | Mylan-Beclo AQ 50mcg Nas-Sp-200 Dose Pk | MYL | 12.2600 | 12.2600 | YES | NO | YES |
| 01927957 | BECLOMETHASONE DIPROPIONATE | Propaderm 0.025% Oint | GLA | 0.4038 | 0.4038 | NO | NO | NO |
| 02290340 | BENAZEPRIL | Benazepril 10mg Tab | AAP | 0.9938 | 0.9938 | YES | NO | NO |
| 02273918 | BENAZEPRIL | Benazepril 20mg Tab | AAP | 1.2875 | 1.2875 | YES | NO | NO |
| 02290332 | BENAZEPRIL | Benazepril 5mg Tab | AAP | 0.9485 | 0.9485 | YES | NO | NO |
| 00885851 | BENAZEPRIL | Lotensin (Not a Benefit) 20mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00885843 | BENAZEPRIL | Lotensin (Not a Benefit) 10mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00885835 | BENAZEPRIL | Lotensin (Not a Benefit) 5mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00706531 | BENZTROPINE MESYLATE | PDP-Benztropine 1mg Tab | PEN | 0.0563 | 0.0563 | NO | NO | NO |
| 02463105 | BENZYDAMINE HCL | Odan-Benzydamine (Off-Formulary Interchangeable) 0.15% Oral Rinse | ODN | 0.0960 | N/A | YES | NO | NO |
| 02239537 | BENZYDAMINE HCL | PMS-Benzydamine (Off-Formulary Interchangeable) 0.15% Oral Rinse | PMS | 0.0960 | N/A | YES | NO | NO |
| 02229777 | BENZYDAMINE HCL | Pharixia (Not a Benefit) 0.15% Oral Rinse | PEN | N/A | N/A | YES | NO | NO |
| 01966065 | BENZYDAMINE HCL | Tantum (Not a Benefit) 0.15% Oral Rinse | GRA | N/A | N/A | YES | NO | NO |
| 02449153 | BETAHISTINE DIHYDROCHLORIDE | Auro-Betahistine (Off-Formulary Interchangeable) 16mg Tab | AUR | 0.3557 | 0.3557 | YES | NO | NO |
| 02449145 | BETAHISTINE DIHYDROCHLORIDE | Auro-Betahistine (Off-Formulary Interchangeable) 8mg Tab | AUR | 0.2070 | 0.2070 | YES | NO | NO |
| 02449161 | BETAHISTINE DIHYDROCHLORIDE | Auro-Betahistine (Off-Formulary Interchangeable) 24mg Tab | AUR | 0.4983 | N/A | YES | NO | NO |
| 02466457 | BETAHISTINE DIHYDROCHLORIDE | Betahistine (Off-Formulary Interchangeable) 24mg Tab | SAI | 0.4983 | N/A | YES | NO | NO |
| 02466449 | BETAHISTINE DIHYDROCHLORIDE | Betahistine (Off-Formulary Interchangeable) 16mg Tab | SAI | 0.3557 | 0.3557 | YES | NO | NO |
| 02374757 | BETAHISTINE DIHYDROCHLORIDE | Co Betahistine (Off-Formulary Interchangeable) 16mg Tab | COB | 0.3557 | 0.3557 | YES | NO | NO |
| 02374765 | BETAHISTINE DIHYDROCHLORIDE | Co Betahistine (Off-Formulary Interchangeable) 24mg Tab | COB | 0.4983 | N/A | YES | NO | NO |
| 02519690 | BETAHISTINE DIHYDROCHLORIDE | M-Betahistine (Off-Formulary Interchangeable) 16mg Tab | MAT | 0.3557 | 0.3557 | YES | NO | NO |
| 02519682 | BETAHISTINE DIHYDROCHLORIDE | M-Betahistine (Off-Formulary Interchangeable) 8mg Tab | MAT | 0.2259 | 0.2259 | YES | NO | NO |
| 02519704 | BETAHISTINE DIHYDROCHLORIDE | M-Betahistine (Off-Formulary Interchangeable) 24mg Tab | MAT | 0.4983 | N/A | YES | NO | NO |
| 02538148 | BETAHISTINE DIHYDROCHLORIDE | Mint-Betahistine (Off-Formulary Interchangeable) 16mg Tab | MIN | 0.3557 | 0.3557 | YES | NO | NO |
| 02538121 | BETAHISTINE DIHYDROCHLORIDE | Mint-Betahistine (Off-Formulary Interchangeable) 8mg Tab | MIN | 0.2259 | 0.2259 | YES | NO | NO |
| 02538156 | BETAHISTINE DIHYDROCHLORIDE | Mint-Betahistine (Off-Formulary Interchangeable) 24mg Tab | MIN | 0.4983 | N/A | YES | NO | NO |
| 02544946 | BETAHISTINE DIHYDROCHLORIDE | NRA-Betahistine (Off-Formulary Interchangeable) 24mg Tab | NRA | 0.4983 | N/A | YES | NO | NO |
| 02544911 | BETAHISTINE DIHYDROCHLORIDE | NRA-Betahistine (Off-Formulary Interchangeable) 8mg Tab | NRA | 0.2259 | 0.2259 | YES | NO | NO |
| 02544938 | BETAHISTINE DIHYDROCHLORIDE | NRA-Betahistine (Off-Formulary Interchangeable) 16mg Tab | NRA | 0.3557 | 0.3557 | YES | NO | NO |
| 02330210 | BETAHISTINE DIHYDROCHLORIDE | PMS-Betahistine (Off-Formulary Interchangeable) 16mg Tab | PMS | 0.3557 | 0.3557 | YES | NO | NO |
| 02330237 | BETAHISTINE DIHYDROCHLORIDE | PMS-Betahistine (Off-Formulary Interchangeable) 24mg Tab | PMS | 0.4983 | N/A | YES | NO | NO |
| 02247998 | BETAHISTINE DIHYDROCHLORIDE | Serc (Off-Formulary Interchangeable) 24mg Tab | BGP | N/A | N/A | YES | NO | NO |
| 02243878 | BETAHISTINE DIHYDROCHLORIDE | Serc (Off-Formulary Interchangeable) 16mg Tab | BGP | N/A | N/A | YES | NO | NO |
| 02240601 | BETAHISTINE DIHYDROCHLORIDE | Serc (Off-Formulary Interchangeable) 8mg Tab | SPH | N/A | N/A | YES | NO | NO |
| 02280205 | BETAHISTINE DIHYDROCHLORIDE | Teva-Betahistine (Off-Formulary Interchangeable) 24mg Tab | TEV | 0.4983 | N/A | YES | NO | NO |
| 02280183 | BETAHISTINE DIHYDROCHLORIDE | Teva-Betahistine (Off-Formulary Interchangeable) 8mg Tab | TEV | 0.2259 | 0.2259 | YES | NO | NO |
| 02280191 | BETAHISTINE DIHYDROCHLORIDE | Teva-Betahistine (Off-Formulary Interchangeable) 16mg Tab | TEV | 0.3557 | 0.3557 | YES | NO | NO |
| 00323071 | BETAMETHASONE DIPROPIONATE | Diprosone 0.05% Cr | OCI | 0.2174 | 0.2048 | YES | NO | NO |
| 01925350 | BETAMETHASONE DIPROPIONATE | Taro-Sone 0.05% Cr | TAR | 0.2048 | 0.2048 | YES | NO | NO |
| 00417246 | BETAMETHASONE DIPROPIONATE | Diprosone 0.05% Lot | OCI | 0.2100 | 0.1980 | YES | NO | NO |
| 00809187 | BETAMETHASONE DIPROPIONATE | Ratio-Topisone 0.05% Lot | RPH | 0.1980 | 0.1980 | YES | NO | NO |
| 00344923 | BETAMETHASONE DIPROPIONATE | Diprosone 0.05% Oint | OCI | 0.2284 | 0.2152 | YES | NO | NO |
| 00805009 | BETAMETHASONE DIPROPIONATE | Ratio-Topisone 0.05% Oint | RPH | 0.2152 | 0.2152 | YES | NO | NO |
| 00629367 | BETAMETHASONE DIPROPIONATE IN A BASE CONTAINING PROPYLENE GLYCOL | Diprolene 0.05% Oint | OCI | 0.5186 | 0.5186 | YES | NO | NO |
| 00849669 | BETAMETHASONE DIPROPIONATE IN A BASE CONTAINING PROPYLENE GLYCOL | Ratio-Topilene 0.05% Oint | RPH | 0.5186 | 0.5186 | YES | NO | YES |
| 00688622 | BETAMETHASONE DIPROPIONATE IN PROPYLENE GLYCOL BASE | Diprolene Glycol 0.05% Cr | SCH | 0.5186 | 0.5186 | YES | NO | YES |
| 00849650 | BETAMETHASONE DIPROPIONATE IN PROPYLENE GLYCOL BASE | Ratio-Topilene 0.05% Cr | RPH | 0.5186 | 0.5186 | YES | NO | YES |
| 00716618 | BETAMETHASONE VALERATE | Betaderm 0.05% Cr | TAR | 0.0596 | 0.0596 | YES | NO | NO |
| 00716626 | BETAMETHASONE VALERATE | Betaderm 0.1% Cr | TAR | 0.0889 | 0.0889 | YES | NO | NO |
| 00011924 | BETAMETHASONE VALERATE | Betnovate (Not a Benefit) 0.1% Cr | GLA | N/A | N/A | YES | NO | NO |
| 00011916 | BETAMETHASONE VALERATE | Betnovate-1/2 (Not a Benefit) 0.05% Cr | GLA | N/A | N/A | YES | NO | NO |
| 02357844 | BETAMETHASONE VALERATE | Celestoderm-V 0.1% Cr | VAE | 0.0889 | 0.0889 | YES | NO | NO |
| 00535427 | BETAMETHASONE VALERATE | Ratio-Ectosone Mild 0.05% Cr | RPH | 0.0611 | 0.0596 | YES | NO | NO |
| 00535435 | BETAMETHASONE VALERATE | Ratio-Ectosone Regular 0.1% Cr | RPH | 0.0911 | 0.0889 | YES | NO | NO |
| 02100193 | BETAMETHASONE VALERATE | Betnovate (Not a Benefit) 0.1% Lot | SHI | N/A | N/A | YES | NO | NO |
| 02100185 | BETAMETHASONE VALERATE | Betnovate-1/2 (Not a Benefit) 0.05% Lot | RBT | N/A | N/A | YES | NO | NO |
| 00653209 | BETAMETHASONE VALERATE | Ratio-Ectosone Mild 0.05% Lot | RPH | 0.2847 | 0.2847 | YES | NO | NO |
| 00750050 | BETAMETHASONE VALERATE | Ratio-Ectosone Regular 0.1% Lot | RPH | 0.3125 | 0.3125 | YES | NO | NO |
| 00716642 | BETAMETHASONE VALERATE | Betaderm 0.05% Oint | TAR | 0.0596 | 0.0596 | YES | NO | NO |
| 00716650 | BETAMETHASONE VALERATE | Betaderm 0.1% Oint | TAR | 0.0889 | 0.0889 | YES | NO | NO |
| 00012386 | BETAMETHASONE VALERATE | Betnovate (Not a Benefit) 0.1% Oint | GLA | N/A | N/A | YES | NO | NO |
| 00012378 | BETAMETHASONE VALERATE | Betnovate-1/2 (Not a Benefit) 0.05% Oint | GLA | N/A | N/A | YES | NO | NO |
| 02357852 | BETAMETHASONE VALERATE | Celestoderm-V 0.1% Oint | VAE | 0.0889 | 0.0889 | YES | NO | NO |
| 02357879 | BETAMETHASONE VALERATE | Celestoderm-V/2 0.05% Oint | VAE | 0.0596 | 0.0596 | YES | NO | NO |
| 00716634 | BETAMETHASONE VALERATE | Betaderm 0.1% Scalp Lot | TAR | 0.1271 | 0.1271 | YES | NO | NO |
| 00027944 | BETAMETHASONE VALERATE | Valisone (Not a Benefit) 0.1% Scalp Lot | VAE | N/A | N/A | YES | NO | NO |
| 01908448 | BETAXOLOL HCL | Betoptic S 0.25% Oph Susp | NOV | 2.5580 | 2.5580 | NO | NO | NO |
| 01947958 | BETHANECHOL CHLORIDE | Duvoid 10mg Tab | PPI | 0.5025 | 0.5025 | NO | NO | NO |
| 01947931 | BETHANECHOL CHLORIDE | Duvoid 25mg Tab | PPI | 0.8137 | 0.8137 | NO | NO | NO |
| 01947923 | BETHANECHOL CHLORIDE | Duvoid 50mg Tab | PPI | 0.9921 | 0.9921 | NO | NO | NO |
| 02083523 | BEZAFIBRATE | Bezalip 400mg SR Tab | ALL | 2.9427 | 1.7460 | YES | NO | NO |
| 02453312 | BEZAFIBRATE | Jamp-Bezafibrate SR 400mg SR Tab | JPC | 1.7460 | 1.7460 | YES | NO | NO |
| 02296063 | BICALUTAMIDE | Apo-Bicalutamide 50mg Tab | APX | 1.2690 | 1.2690 | YES | NO | NO |
| 02519178 | BICALUTAMIDE | Bicalutamide 50mg Tab | SAI | 1.2690 | 1.2690 | YES | NO | NO |
| 02325985 | BICALUTAMIDE | Bicalutamide Tablets 50mg Tab | ACH | 1.2690 | 1.2690 | YES | NO | NO |
| 02184478 | BICALUTAMIDE | Casodex (Not a Benefit) 50mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02274337 | BICALUTAMIDE | Co Bicalutamide 50mg Tab | COB | 1.2690 | 1.2690 | YES | NO | NO |
| 02357216 | BICALUTAMIDE | Jamp-Bicalutamide 50mg Tab | JPC | 1.2690 | 1.2690 | YES | NO | NO |
| 02275589 | BICALUTAMIDE | PMS-Bicalutamide 50mg Tab | PMS | 1.2690 | 1.2690 | YES | NO | NO |
| 02371324 | BICALUTAMIDE | Ran-Bicalutamide 50mg Tab | RAN | 1.2690 | 1.2690 | YES | NO | NO |
| 02270226 | BICALUTAMIDE | Teva-Bicalutamide 50mg Tab | TEV | 1.2690 | 1.2690 | YES | NO | NO |
| 02478579 | BICTEGRAVIR SODIUM/EMTRICITABINE/TENOFOVIR ALAFENAMIDE HEMIFUMARATE | Biktarvy 50mg & 200mg & 25mg Tab | GIL | 39.2227 | 39.2227 | NO | NO | NO |
| 02549883 | BILASTINE | Apo-Bilastine Tablets (Off-Formulary Interchangeable) 20mg Tab | APX | 1.1240 | N/A | YES | NO | NO |
| 02541556 | BILASTINE | Auro-Bilastine (Off-Formulary Interchangeable) 20mg Tab | AUR | 1.1229 | N/A | YES | NO | NO |
| 02454130 | BILASTINE | Blexten (Off-Formulary Interchangeable) 20mg Tab | ARZ | N/A | N/A | YES | NO | NO |
| 02544369 | BILASTINE | GLN-Bilastine (Off-Formulary Interchangeable) 20mg Tab | GLP | 1.1243 | N/A | YES | NO | NO |
| 02546795 | BILASTINE | Jamp-Bilastine (Off-Formulary Interchangeable) 20mg Tab | JPC | 1.1240 | N/A | YES | NO | NO |
| 02548410 | BILASTINE | M-Bilastine (Off-Formulary Interchangeable) 20mg Tab | MAT | 1.1240 | N/A | YES | NO | NO |
| 02547279 | BILASTINE | Mar-Bilastine (Off-Formulary Interchangeable) 20mg Tab | MAR | 1.1240 | N/A | YES | NO | NO |
| 02551934 | BILASTINE | NRA-Bilastine (Off-Formulary Interchangeable) 20mg Tab | NRA | 1.1243 | N/A | YES | NO | NO |
| 02536269 | BILASTINE | Sandoz Bilastine (Off-Formulary Interchangeable) 20mg Tab | SDZ | 1.1240 | N/A | YES | NO | NO |
| 02245860 | BIMATOPROST | Lumigan (Not a Benefit) 0.03% Oph Sol | ALL | N/A | N/A | YES | NO | NO |
| 02429063 | BIMATOPROST | Vistitan 0.03% Oph Sol | SDZ | 9.1936 | 9.1936 | YES | YES | NO |
| 09857368 | BIMATOPROST | Lumigan RC 0.01% Oph Sol-5mL Pk | ALL | 60.1892 | 60.1892 | NO | YES | NO |
| 09857398 | BIMATOPROST | Lumigan RC 0.01% Oph Sol-7.5mL Pk | ALL | 90.2838 | 90.2838 | NO | YES | NO |
| 02525275 | BIMEKIZUMAB | Bimzelx 160mg/mL Inj Sol-1mL Pref Autoinj (Preservative-Free) | UCB | 1625.0000 | 1625.0000 | NO | YES | NO |
| 02525267 | BIMEKIZUMAB | Bimzelx 160mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | UCB | 1625.0000 | 1625.0000 | NO | YES | NO |
| 02553627 | BIMEKIZUMAB | Bimzelx 320mg/2mL Inj Sol-2mL Pref Autoinj (Preservative-Free) | UCB | 3250.0000 | 3250.0000 | NO | YES | NO |
| 02553619 | BIMEKIZUMAB | Bimzelx 320mg/2mL Inj Sol-2mL Pref Syr (Preservative-Free) | UCB | 3250.0000 | 3250.0000 | NO | YES | NO |
| 00254142 | BISACODYL | Dulcolax 5mg Ent Tab | SCO | 0.2009 | 0.2009 | NO | NO | NO |
| 02520478 | BISACODYL | AMB-Bisacodyl 10mg Sup | AMB | 0.4206 | 0.4206 | YES | NO | NO |
| 02458853 | BISACODYL | Bisacodyl 10mg 10mg Sup | CCP | 0.4206 | 0.4206 | YES | NO | NO |
| 02361450 | BISACODYL | Bisacodyl Suppository 10mg Sup | JPC | 0.4206 | 0.4206 | YES | NO | NO |
| 00003875 | BISACODYL | Dulcolax 10mg Sup | SCO | 1.2267 | 0.4206 | YES | NO | NO |
| 02256177 | BISOPROLOL FUMARATE | Apo-Bisoprolol 10mg Tab | APX | 0.0885 | 0.0885 | YES | NO | NO |
| 02256134 | BISOPROLOL FUMARATE | Apo-Bisoprolol 5mg Tab | APX | 0.0606 | 0.0606 | YES | NO | NO |
| 02391589 | BISOPROLOL FUMARATE | Bisoprolol 5mg Tab | SAI | 0.0606 | 0.0606 | YES | NO | NO |
| 02391597 | BISOPROLOL FUMARATE | Bisoprolol 10mg Tab | SAI | 0.0885 | 0.0885 | YES | NO | NO |
| 02495562 | BISOPROLOL FUMARATE | Bisoprolol Tablets 5mg Tab | SIV | 0.0606 | 0.0606 | YES | NO | NO |
| 02495570 | BISOPROLOL FUMARATE | Bisoprolol Tablets 10mg Tab | SIV | 0.0885 | 0.0885 | YES | NO | NO |
| 02518805 | BISOPROLOL FUMARATE | Jamp Bisoprolol 5mg Tab | JPC | 0.0606 | 0.0606 | YES | NO | NO |
| 02518791 | BISOPROLOL FUMARATE | Jamp Bisoprolol 10mg Tab | JPC | 0.0885 | 0.0885 | YES | NO | NO |
| 02465612 | BISOPROLOL FUMARATE | Mint-Bisoprolol 5mg Tab | MIN | 0.0606 | 0.0606 | YES | NO | NO |
| 02465620 | BISOPROLOL FUMARATE | Mint-Bisoprolol 10mg Tab | MIN | 0.0885 | 0.0885 | YES | NO | NO |
| 02241148 | BISOPROLOL FUMARATE | Monocor (Not a Benefit) 5mg Tab | BIO | N/A | N/A | YES | NO | NO |
| 02241149 | BISOPROLOL FUMARATE | Monocor (Not a Benefit) 10mg Tab | CRY | N/A | N/A | YES | NO | NO |
| 02544253 | BISOPROLOL FUMARATE | Sandoz Bisoprolol Tablets 2.5mg Tab | SDZ | 0.0303 | 0.0303 | NO | NO | NO |
| 02494043 | BISOPROLOL FUMARATE | Sandoz Bisoprolol Tablets 10mg Tab | SDZ | 0.0885 | 0.0885 | YES | NO | NO |
| 02494035 | BISOPROLOL FUMARATE | Sandoz Bisoprolol Tablets 5mg Tab | SDZ | 0.0606 | 0.0606 | YES | NO | NO |
| 02544245 | BISOPROLOL FUMARATE | Sandoz Bisoprolol Tablets 1.25mg Tab | SDZ | 0.0152 | 0.0152 | NO | NO | NO |
| 02267470 | BISOPROLOL FUMARATE | Teva-Bisoprolol 5mg Tab | TEV | 0.0606 | 0.0606 | YES | NO | NO |
| 02267489 | BISOPROLOL FUMARATE | Teva-Bisoprolol 10mg Tab | TEV | 0.0885 | 0.0885 | YES | NO | NO |
| 02399202 | BOSENTAN MONOHYDRATE | Apo-Bosentan (Off-Formulary Interchangeable) 62.5mg Tab | APX | 32.0893 | 32.0893 | YES | NO | NO |
| 02399210 | BOSENTAN MONOHYDRATE | Apo-Bosentan (Off-Formulary Interchangeable) 125mg Tab | APX | 32.0893 | 32.0893 | YES | NO | NO |
| 02386208 | BOSENTAN MONOHYDRATE | Co Bosentan (Off-Formulary Interchangeable) 125mg Tab | COB | 32.0893 | 32.0893 | YES | NO | NO |
| 02386194 | BOSENTAN MONOHYDRATE | Co Bosentan (Off-Formulary Interchangeable) 62.5mg Tab | COB | 32.0893 | 32.0893 | YES | NO | NO |
| 02467992 | BOSENTAN MONOHYDRATE | Nat-Bosentan (Off-Formulary Interchangeable) 125mg Tab | NAT | 32.0893 | 32.0893 | YES | NO | NO |
| 02467984 | BOSENTAN MONOHYDRATE | Nat-Bosentan (Off-Formulary Interchangeable) 62.5mg Tab | NAT | 32.0893 | 32.0893 | YES | NO | NO |
| 02383012 | BOSENTAN MONOHYDRATE | PMS-Bosentan (Off-Formulary Interchangeable) 62.5mg Tab | PMS | 32.0893 | 32.0893 | YES | NO | NO |
| 02383020 | BOSENTAN MONOHYDRATE | PMS-Bosentan (Off-Formulary Interchangeable) 125mg Tab | PMS | 32.0893 | 32.0893 | YES | NO | NO |
| 02386283 | BOSENTAN MONOHYDRATE | Sandoz Bosentan (Off-Formulary Interchangeable) 125mg Tab | SDZ | 32.0893 | 32.0893 | YES | NO | NO |
| 02386275 | BOSENTAN MONOHYDRATE | Sandoz Bosentan (Off-Formulary Interchangeable) 62.5mg Tab | SDZ | 32.0893 | 32.0893 | YES | NO | NO |
| 02483149 | BOSENTAN MONOHYDRATE | Taro-Bosentan (Off-Formulary Interchangeable) 125mg Tab | TAR | 32.0893 | 32.0893 | YES | NO | NO |
| 02483130 | BOSENTAN MONOHYDRATE | Taro-Bosentan (Off-Formulary Interchangeable) 62.5mg Tab | TAR | 32.0893 | 32.0893 | YES | NO | NO |
| 02244981 | BOSENTAN MONOHYDRATE | Tracleer (Off-Formulary Interchangeable) 62.5mg Tab | JAN | 87.5600 | 32.0893 | YES | NO | NO |
| 02244982 | BOSENTAN MONOHYDRATE | Tracleer (Off-Formulary Interchangeable) 125mg Tab | JAN | 87.5600 | 32.0893 | YES | NO | NO |
| 02419149 | BOSUTINIB | Bosulif (Off-Formulary Interchangeable) 100mg Tab | PFI | 38.9787 | 29.2340 | YES | NO | NO |
| 02419157 | BOSUTINIB | Bosulif (Off-Formulary Interchangeable) 500mg Tab | PFI | 152.2403 | 114.1802 | YES | NO | NO |
| 02560046 | BOSUTINIB | Reddy-Bosutinib (Off-Formulary Interchangeable) 500mg Tab | DRR | 114.1802 | 114.1802 | YES | NO | NO |
| 02560038 | BOSUTINIB | Reddy-Bosutinib (Off-Formulary Interchangeable) 100mg Tab | DRR | 29.2340 | 29.2340 | YES | NO | NO |
| 01981501 | BOTULINUM TOXIN TYPE A | Botox 100U/Vial Pd Inj-100U Vial Pk | ABV | 374.8500 | 374.8500 | NO | YES | NO |
| 09857387 | BOTULINUM TOXIN TYPE A | Botox 200U/Vial Pd Inj-200U Vial Pk | ABV | 749.7000 | 749.7000 | NO | YES | NO |
| 02531585 | BOTULINUM TOXIN TYPE A | Botox 200U/Vial Pd Inj-200U Vial Pk | ABV | 749.7000 | 749.7000 | NO | YES | NO |
| 09857386 | BOTULINUM TOXIN TYPE A | Botox 50U/Vial Pd Inj-50U Vial Pk | ABV | 187.4300 | 187.4300 | NO | YES | NO |
| 02531577 | BOTULINUM TOXIN TYPE A | Botox 50U/Vial Pd Inj-50U Vial Pk | ABV | 187.4300 | 187.4300 | NO | YES | NO |
| 02461749 | BREXPIPRAZOLE | Rexulti 0.25mg Tab | OTS | 3.5000 | 3.5000 | NO | NO | NO |
| 02461757 | BREXPIPRAZOLE | Rexulti 0.5mg Tab | OTS | 3.5000 | 3.5000 | NO | NO | NO |
| 02461765 | BREXPIPRAZOLE | Rexulti 1mg Tab | OTS | 3.5000 | 3.5000 | NO | NO | NO |
| 02461773 | BREXPIPRAZOLE | Rexulti 2mg Tab | OTS | 3.5000 | 3.5000 | NO | NO | NO |
| 02461781 | BREXPIPRAZOLE | Rexulti 3mg Tab | OTS | 3.5000 | 3.5000 | NO | NO | NO |
| 02461803 | BREXPIPRAZOLE | Rexulti 4mg Tab | OTS | 3.5000 | 3.5000 | NO | NO | NO |
| 02236876 | BRIMONIDINE | Alphagan 0.2% Oph Sol | ALL | 3.7970 | 1.1550 | YES | YES | NO |
| 02248151 | BRIMONIDINE | Alphagan P 0.15% Oph Sol | ALL | 2.6017 | 2.0305 | YES | YES | NO |
| 02301334 | BRIMONIDINE | Brimonidine P 0.15% Oph Sol | AAP | 2.0305 | 2.0305 | YES | YES | NO |
| 02515377 | BRIMONIDINE | Brimonidine Tartrate Ophthalmic Solution 0.2% Oph Sol | TCI | 1.1550 | 1.1550 | YES | YES | NO |
| 02449226 | BRIMONIDINE | Jamp-Brimonidine 0.2% Oph Sol | JPC | 1.1550 | 1.1550 | YES | YES | NO |
| 02507811 | BRIMONIDINE | Med-Brimonidine 0.2% Oph Sol | GMP | 1.1550 | 1.1550 | YES | YES | NO |
| 02305429 | BRIMONIDINE | Sandoz Brimonidine 0.2% Oph Sol | SDZ | 1.1550 | 1.1550 | YES | YES | NO |
| 02375311 | BRIMONIDINE TARTRATE & TIMOLOL MALEATE | Apo-Brimonidine-Timop 0.2% & 0.5% Oph Sol-10mL Pk | APX | 23.2900 | 23.2900 | YES | YES | NO |
| 09857298 | BRIMONIDINE TARTRATE & TIMOLOL MALEATE | Combigan 0.2% & 0.5% Oph Sol-10mL Pk | ALL | 46.5800 | 23.2900 | YES | YES | NO |
| 02531704 | BRIMONIDINE TARTRATE & TIMOLOL MALEATE | Jamp Brimonidine/Timolol 0.2% & 0.5% Oph Sol-10mL Pk | JPC | 23.2900 | 23.2900 | YES | YES | NO |
| 02238873 | BRINZOLAMIDE | Azopt 1% Oph Susp | NOV | 3.5560 | 3.5560 | NO | YES | NO |
| 02435411 | BRINZOLAMIDE & BRIMONIDINE TARTRATE | Simbrinza 1.0% & 0.2% Oph Susp-10mL Pk | NOV | 50.6900 | 50.6900 | NO | YES | NO |
| 02331624 | BRINZOLAMIDE & TIMOLOL MALEATE | Azarga 1% & 0.5% Oph Susp-5mL Pk | NOV | 20.4000 | 20.4000 | NO | YES | NO |
| 02538695 | BRIVARACETAM | Apo-Brivaracetam 50mg Tab | APX | 2.1600 | 2.1600 | YES | YES | NO |
| 02538687 | BRIVARACETAM | Apo-Brivaracetam 25mg Tab | APX | 2.3760 | 2.3760 | YES | YES | NO |
| 02538709 | BRIVARACETAM | Apo-Brivaracetam 75mg Tab | APX | 2.3760 | 2.3760 | YES | YES | NO |
| 02538679 | BRIVARACETAM | Apo-Brivaracetam 10mg Tab | APX | 2.3760 | 2.3760 | YES | YES | NO |
| 02538717 | BRIVARACETAM | Apo-Brivaracetam 100mg Tab | APX | 2.1600 | 2.1600 | YES | YES | NO |
| 02539306 | BRIVARACETAM | Auro-Brivaracetam 100mg Tab | AUR | 2.1600 | 2.1600 | YES | YES | NO |
| 02539292 | BRIVARACETAM | Auro-Brivaracetam 50mg Tab | AUR | 2.1600 | 2.1600 | YES | YES | NO |
| 02452952 | BRIVARACETAM | Brivlera 50mg Tab | UCB | 4.3200 | 2.1600 | YES | YES | NO |
| 02452944 | BRIVARACETAM | Brivlera 25mg Tab | UCB | 4.3200 | 2.3760 | YES | YES | NO |
| 02452936 | BRIVARACETAM | Brivlera 10mg Tab | UCB | 4.3200 | 2.3760 | YES | YES | NO |
| 02452979 | BRIVARACETAM | Brivlera 100mg Tab | UCB | 4.3200 | 2.1600 | YES | YES | NO |
| 02452960 | BRIVARACETAM | Brivlera 75mg Tab | UCB | 4.3200 | 2.3760 | YES | YES | NO |
| 02473623 | BRODALUMAB | Siliq 210mg/1.5mL Inj Sol-Pref Syr | VAL | 645.0000 | 645.0000 | NO | YES | NO |
| 02496976 | BROLUCIZUMAB | Beovu 6mg/0.05mL Inj Sol-0.05mL Pref Syr (Preservative-Free) | NOV | 1390.0000 | 1390.0000 | NO | YES | NO |
| 02177188 | BROMAZEPAM | Apo-Bromazepam 6mg Tab | APX | 0.1310 | 0.1310 | YES | NO | NO |
| 02177161 | BROMAZEPAM | Apo-Bromazepam 3mg Tab | APX | 0.0897 | 0.0897 | YES | NO | NO |
| 02177153 | BROMAZEPAM | Apo-Bromazepam 1.5mg Tab | APX | 0.1028 | 0.1028 | YES | NO | NO |
| 00518131 | BROMAZEPAM | Lectopam (Not a Benefit) 6mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 00682314 | BROMAZEPAM | Lectopam (Not a Benefit) 1.5mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 00518123 | BROMAZEPAM | Lectopam (Not a Benefit) 3mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02230584 | BROMAZEPAM | Teva-Bromazepam 3mg Tab | TEV | 0.0897 | 0.0897 | YES | NO | NO |
| 02230585 | BROMAZEPAM | Teva-Bromazepam 6mg Tab | TEV | 0.1310 | 0.1310 | YES | NO | NO |
| 02537788 | BROMFENAC | Apo-Bromfenac (Off-Formulary Interchangeable) 0.07% w/v Oph Sol (With Preservative) | APX | 8.5000 | N/A | YES | NO | YES |
| 02439123 | BROMFENAC | Prolensa (Off-Formulary Interchangeable) 0.07% w/v Oph Sol (With Preservative) | BSH | N/A | N/A | YES | NO | YES |
| 02230454 | BROMOCRIPTINE | Bromocriptine 5mg Cap | AAP | 1.7097 | 1.7097 | YES | NO | NO |
| 00568643 | BROMOCRIPTINE | Parlodel (Not a Benefit) 5mg Cap | NOV | N/A | N/A | YES | NO | NO |
| 02087324 | BROMOCRIPTINE | Bromocriptine 2.5mg Tab | AAP | 1.0800 | 1.0800 | YES | NO | NO |
| 00371033 | BROMOCRIPTINE | Parlodel (Not a Benefit) 2.5mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02229099 | BUDESONIDE | Pulmicort Nebuamp 0.125mg/mL Inh Susp | AZC | 0.2724 | 0.1143 | YES | YES | NO |
| 01978918 | BUDESONIDE | Pulmicort Nebuamp 0.25mg/mL Inh Susp | AZC | 0.5458 | 0.3593 | YES | YES | NO |
| 01978926 | BUDESONIDE | Pulmicort Nebuamp 0.5mg/mL Inh Susp | AZC | 1.0888 | 0.4559 | YES | YES | NO |
| 02494272 | BUDESONIDE | Taro-Budesonide 0.25mg/mL Inh Susp | TAR | 0.3593 | 0.3593 | YES | YES | NO |
| 02494280 | BUDESONIDE | Taro-Budesonide 0.5mg/mL Inh Susp | TAR | 0.4559 | 0.4559 | YES | YES | NO |
| 02494264 | BUDESONIDE | Taro-Budesonide 0.125mg/mL Inh Susp | TAR | 0.1143 | 0.1143 | YES | YES | NO |
| 02465957 | BUDESONIDE | Teva-Budesonide 0.5mg/mL Inh Susp | TEV | 0.4559 | 0.4559 | YES | YES | NO |
| 02465949 | BUDESONIDE | Teva-Budesonide 0.125mg/mL Inh Susp | TEV | 0.1143 | 0.1143 | YES | YES | NO |
| 02231923 | BUDESONIDE | Rhinocort Aqua 64mcg/Metered Dose Nas Sp-120 Dose Pk | MCL | 11.0400 | 11.0400 | NO | NO | YES |
| 02230648 | BUDESONIDE | Mylan-Budesonide AQ 100mcg/Metered Dose Nas Sp-165 Dose Pk | MYL | 12.7400 | 12.7400 | YES | NO | YES |
| 01974432 | BUDESONIDE | Rhinocort Aqua (Not a Benefit) 100mcg/Metered Dose Nas Sp-165 Dose Pk | AST | N/A | N/A | YES | NO | YES |
| 00851752 | BUDESONIDE | Pulmicort Turbuhaler 200mcg/Metered Dose Pd Inh-200 Dose Pk | AZC | 78.2690 | 78.2690 | NO | NO | NO |
| 00851760 | BUDESONIDE | Pulmicort Turbuhaler 400mcg/Metered Dose Pd Inh-200 Dose Pk | AZC | 114.2465 | 114.2465 | NO | NO | NO |
| 00852074 | BUDESONIDE | Pulmicort Turbuhaler 100mcg/Metered Dose Pd Inh-200 Dose Pk | AZC | 38.2735 | 38.2735 | NO | NO | NO |
| 02498057 | BUDESONIDE | Uceris 2mg/Act Rectal Foam-14 Act Canister | BHC | 99.9600 | 99.9600 | NO | NO | NO |
| 02245385 | BUDESONIDE & FORMOTEROL FUMARATE DIHYDRATE | Symbicort 100 Turbuhaler 100mcg/6mcg Pd Inh-120 Dose Pk | AZC | 78.3613 | 78.3613 | NO | YES | NO |
| 02245386 | BUDESONIDE & FORMOTEROL FUMARATE DIHYDRATE | Symbicort 200 Turbuhaler 200mcg/6mcg Pd Inh-120 Dose Pk | AZC | 101.8235 | 101.8235 | NO | YES | NO |
| 02518058 | BUDESONIDE&GLYCOPYRRONIUM (GLYCOPYRRONIUM BROMIDE)&FORMOTEROL FUMARATE DIHYDRATE | Breztri Aerosphere 160mcg & 7.2mcg & 5mcg/Act Metered Dose Inh-120 Dose Pk | AZC | 127.0000 | 127.0000 | NO | YES | NO |
| 02483084 | BUPRENORPHINE | Sublocade 100mg/0.5mL Inj Sol- 0.5mL Pref Syr | IND | 550.0000 | 550.0000 | NO | NO | NO |
| 02483092 | BUPRENORPHINE | Sublocade 300mg/1.5mL Inj Sol- 1.5mL Pref Syr | IND | 550.0000 | 550.0000 | NO | NO | NO |
| 02453916 | BUPRENORPHINE & NALOXONE | Act Buprenorphine/Naloxone 8mg & 2mg SL Tab | ACV | 2.3650 | 2.3650 | YES | NO | NO |
| 02453908 | BUPRENORPHINE & NALOXONE | Act Buprenorphine/Naloxone 2mg & 0.5mg SL Tab | ACV | 1.3350 | 1.3350 | YES | NO | NO |
| 02424851 | BUPRENORPHINE & NALOXONE | PMS-Buprenorphine-Naloxone 2mg & 0.5mg SL Tab | PMS | 1.3350 | 1.3350 | YES | NO | NO |
| 02424878 | BUPRENORPHINE & NALOXONE | PMS-Buprenorphine-Naloxone 8mg & 2mg SL Tab | PMS | 2.3650 | 2.3650 | YES | NO | NO |
| 02295695 | BUPRENORPHINE & NALOXONE | Suboxone 2mg & 0.5mg SL Tab | IND | 2.7261 | 1.3350 | YES | NO | NO |
| 02295709 | BUPRENORPHINE & NALOXONE | Suboxone 8mg & 2mg SL Tab | IND | 4.8293 | 2.3650 | YES | NO | NO |
| 02502356 | BUPRENORPHINE & NALOXONE | Suboxone 12mg & 3mg Soluble Film | IND | 7.0950 | 7.0950 | NO | NO | NO |
| 02502348 | BUPRENORPHINE & NALOXONE | Suboxone 8mg & 2mg Soluble Film | IND | 4.7300 | 4.7300 | NO | NO | NO |
| 02502313 | BUPRENORPHINE & NALOXONE | Suboxone 2mg & 0.5mg Soluble Film | IND | 2.6700 | 2.6700 | NO | NO | NO |
| 02474921 | BUPRENORPHINE HYDROCHLORIDE | Probuphine 80mg Subdermal Implant-Kit Pk | KNT | 1495.0000 | 1495.0000 | NO | YES | NO |
| 02439654 | BUPROPION HCL | Act Bupropion XL 150mg ER Tab | ACV | 0.2926 | 0.2926 | YES | YES | NO |
| 02439662 | BUPROPION HCL | Act Bupropion XL 300mg ER Tab | ACV | 0.5853 | 0.5853 | YES | YES | NO |
| 02475804 | BUPROPION HCL | Taro-Bupropion XL 150mg ER Tab | SPC | 0.2926 | 0.2926 | YES | YES | NO |
| 02475812 | BUPROPION HCL | Taro-Bupropion XL 300mg ER Tab | SPC | 0.5853 | 0.5853 | YES | YES | NO |
| 02275090 | BUPROPION HCL | Wellbutrin XL 150mg ER Tab | VAL | 0.6211 | 0.2926 | YES | YES | NO |
| 02275104 | BUPROPION HCL | Wellbutrin XL 300mg ER Tab | VAL | 1.2425 | 0.5853 | YES | YES | NO |
| 02238441 | BUPROPION HCL | Zyban 150mg SR Tab | VAL | 1.3275 | 1.3275 | NO | YES | NO |
| 02275082 | BUPROPION HCL | Odan Bupropion SR 150mg Tab | ODN | 0.9169 | 0.9169 | YES | YES | NO |
| 02275074 | BUPROPION HCL | Odan Bupropion SR 100mg Tab | ODN | 0.5260 | 0.5260 | YES | YES | NO |
| 02237824 | BUPROPION HCL | Wellbutrin SR (Not a Benefit) 100mg Tab | BIO | N/A | N/A | YES | NO | NO |
| 02237825 | BUPROPION HCL | Wellbutrin SR (Not a Benefit) 150mg Tab | VAL | N/A | N/A | YES | NO | NO |
| 02228955 | BUSERELIN ACETATE | Suprefact Depot 2 Months 6.3mg Implant Kit | CHE | 929.2348 | 929.2348 | NO | NO | NO |
| 02240749 | BUSERELIN ACETATE | Suprefact Depot 3 Months 9.45mg Implant Kit | CHE | 1376.9938 | 1376.9938 | NO | NO | NO |
| 02225166 | BUSERELIN ACETATE | Suprefact 1mg/mL Inj Sol-5.5mL Pk | CHE | 77.0464 | 77.0464 | NO | NO | NO |
| 02225158 | BUSERELIN ACETATE | Suprefact 1mg/mL Nas Sp-10mL Pk | CHE | 85.5300 | 85.5300 | NO | NO | NO |
| 02550555 | BUSPIRONE HYDROCHLORIDE | AMB-Buspirone 10mg Tab | AMB | 0.2713 | 0.2713 | YES | NO | NO |
| 02211076 | BUSPIRONE HYDROCHLORIDE | Apo-Buspirone 10mg Tab | APX | 0.2713 | 0.2713 | YES | NO | NO |
| 02500213 | BUSPIRONE HYDROCHLORIDE | Auro-Buspirone 10mg Tab | AUR | 0.2713 | 0.2713 | YES | NO | NO |
| 00603821 | BUSPIRONE HYDROCHLORIDE | Buspar (Not a Benefit) 10mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02447851 | BUSPIRONE HYDROCHLORIDE | Buspirone 10mg Tab | SAI | 0.2713 | 0.2713 | YES | NO | NO |
| 02509911 | BUSPIRONE HYDROCHLORIDE | Jamp Buspirone 10mg Tab | JPC | 0.2713 | 0.2713 | YES | NO | NO |
| 02519054 | BUSPIRONE HYDROCHLORIDE | Mint-Buspirone 10mg Tab | MIN | 0.2713 | 0.2713 | YES | NO | NO |
| 02230942 | BUSPIRONE HYDROCHLORIDE | PMS-Buspirone 10mg Tab | PMS | 0.2713 | 0.2713 | YES | NO | NO |
| 02231492 | BUSPIRONE HYDROCHLORIDE | Teva-Buspirone 10mg Tab | TEV | 0.2713 | 0.2713 | YES | NO | NO |
| 00004618 | BUSULFAN | Myleran 2mg Tab | ASN | 2.2656 | 2.2656 | NO | NO | NO |
| 02242504 | BUTORPHANOL TARTRATE | Butorphanol Nasal Spray (Off-Formulary Interchangeable) 10mg/mL Nas Sp-2.5mL Pk | AAP | 64.0200 | 64.0200 | YES | NO | NO |
| 02113031 | BUTORPHANOL TARTRATE | Stadol NS (Off-Formulary Interchangeable) 10mg/mL Nas Sp-2.5mL Pk | BQU | N/A | N/A | YES | NO | NO |
| 02455897 | CABERGOLINE | Apo-Cabergoline 0.5mg Tab | APX | 7.2907 | 7.2907 | YES | YES | NO |
| 02242471 | CABERGOLINE | Dostinex 0.5mg Tab | PMJ | 23.0588 | 7.2907 | YES | YES | NO |
| 02549611 | CABERGOLINE | Jamp Cabergoline 0.5mg Tab | JPC | 7.2907 | 7.2907 | YES | YES | NO |
| 02547473 | CABOTEGRAVIR | Apretude 200mg/mL Inj Sol-ER Susp 3mL Vial Kit Pk | VIH | 1710.0000 | 1710.0000 | NO | NO | NO |
| 02547465 | CABOTEGRAVIR | Apretude 30mg Tab | VIH | 30.0750 | 30.0750 | NO | NO | NO |
| 02497204 | CABOTEGRAVIR | Vocabria 30mg Tab | VIH | 30.8270 | 30.8270 | NO | NO | NO |
| 02497220 | CABOTEGRAVIR & RILPIVIRINE | Cabenuva 200mg/mL & 300mg/mL Inj Sol-2mL Kit | VIH | 1316.4700 | 1316.4700 | NO | NO | NO |
| 02497247 | CABOTEGRAVIR & RILPIVIRINE | Cabenuva 200mg/mL & 300mg/mL Inj Sol-3mL Kit | VIH | 2568.7100 | 2568.7100 | NO | NO | NO |
| 01976133 | CALCIPOTRIOL | Dovonex 50mcg/g Oint | LEO | 1.2489 | 1.2489 | NO | YES | NO |
| 02244126 | CALCIPOTRIOL & BETAMETHASONE DIPROPIONATE | Dovobet 50mcg/g & 0.5mg/g Oint | LEO | 2.1918 | 1.2545 | YES | NO | YES |
| 02427419 | CALCIPOTRIOL & BETAMETHASONE DIPROPIONATE | Teva-Betamethasone/Calcipotriol 50mcg/g & 0.5mg/g Oint | TEV | 1.2545 | 1.2545 | YES | NO | YES |
| 02457393 | CALCIPOTRIOL & BETAMETHASONE DIPROPIONATE | Enstilar 50mcg/g & 0.5mg/g Top Aero Foam | LEO | 1.6412 | 1.6412 | NO | NO | YES |
| 02319012 | CALCIPOTRIOL & BETAMETHASONE DIPROPIONATE | Dovobet Gel 50mcg/g & 0.5mg/g Top Gel | LEO | 2.1867 | 1.3142 | YES | NO | YES |
| 02525178 | CALCIPOTRIOL & BETAMETHASONE DIPROPIONATE | Taro-Calcipotriol / Betamethasone Gel 50mcg/g & 0.5mg/g Top Gel | TAR | 1.3142 | 1.3142 | YES | NO | YES |
| 02007134 | CALCITONIN (SALMON SYNTHETIC) | Caltine 100 100IU/mL Inj Sol-1mL Pk | FEI | 7.8200 | 7.8200 | NO | NO | NO |
| 01926691 | CALCITONIN (SALMON SYNTHETIC) | Calcimar 400IU/2mL Inj Sol-2mL Pk | SAV | 65.4400 | 65.4400 | NO | NO | NO |
| 02431637 | CALCITRIOL | Calcitriol-Odan 0.25mcg Cap | ODN | 0.2341 | 0.2341 | YES | NO | NO |
| 02431645 | CALCITRIOL | Calcitriol-Odan 0.5mcg Cap | ODN | 0.3723 | 0.3723 | YES | NO | NO |
| 02495899 | CALCITRIOL | PMS-Calcitriol 0.25mcg Cap | PMS | 0.2341 | 0.2341 | YES | NO | NO |
| 02495902 | CALCITRIOL | PMS-Calcitriol 0.5mcg Cap | PMS | 0.3723 | 0.3723 | YES | NO | NO |
| 00481815 | CALCITRIOL | Rocaltrol 0.5mcg Cap | HLR | 1.1246 | 0.3723 | YES | NO | NO |
| 00481823 | CALCITRIOL | Rocaltrol 0.25mcg Cap | HLR | 0.7071 | 0.2341 | YES | NO | NO |
| 02485729 | CALCITRIOL | Taro-Calcitriol 0.5mcg Cap | TAR | 0.3723 | 0.3723 | YES | NO | NO |
| 02485710 | CALCITRIOL | Taro-Calcitriol 0.25mcg Cap | TAR | 0.2341 | 0.2341 | YES | NO | NO |
| 00891738 | CALCITRIOL | Calcijex (Off-Formulary Interchangeable) 1mcg/mL Inj Sol Amp-1mL Pk | ABV | N/A | N/A | YES | NO | NO |
| 02399334 | CALCITRIOL | Calcitriol Injection USP (Off-Formulary Interchangeable) 1mcg/mL Inj Sol Amp-1mL Pk | STE | 9.5132 | 9.5132 | YES | NO | NO |
| 02338572 | CALCITRIOL | Silkis 3mcg/g Oint | GAC | 1.3625 | 1.3625 | NO | YES | NO |
| 02425483 | CANAGLIFLOZIN | Invokana 100mg Tab | JAN | 2.8910 | 2.8910 | NO | NO | YES |
| 02425491 | CANAGLIFLOZIN | Invokana 300mg Tab | JAN | 3.0060 | 3.0060 | NO | NO | YES |
| 02365367 | CANDESARTAN CILEXETIL | Apo-Candesartan 16mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02399105 | CANDESARTAN CILEXETIL | Apo-Candesartan 32mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02365340 | CANDESARTAN CILEXETIL | Apo-Candesartan 4mg Tab | APX | 0.1700 | 0.1700 | YES | NO | NO |
| 02365359 | CANDESARTAN CILEXETIL | Apo-Candesartan 8mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02541289 | CANDESARTAN CILEXETIL | Apo-Candesartan Tablets 4mg Tab | APX | 0.1700 | 0.1700 | YES | NO | NO |
| 02541300 | CANDESARTAN CILEXETIL | Apo-Candesartan Tablets 16mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02541297 | CANDESARTAN CILEXETIL | Apo-Candesartan Tablets 8mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02541319 | CANDESARTAN CILEXETIL | Apo-Candesartan Tablets 32mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02239091 | CANDESARTAN CILEXETIL | Atacand 8mg Tab | CHE | 1.5845 | 0.2281 | YES | NO | NO |
| 02239090 | CANDESARTAN CILEXETIL | Atacand 4mg Tab | CHE | 0.9527 | 0.1700 | YES | NO | NO |
| 02311658 | CANDESARTAN CILEXETIL | Atacand 32mg Tab | CHE | 1.5845 | 0.2281 | YES | NO | NO |
| 02239092 | CANDESARTAN CILEXETIL | Atacand 16mg Tab | CHE | 1.5845 | 0.2281 | YES | NO | NO |
| 02445786 | CANDESARTAN CILEXETIL | Auro-Candesartan 4mg Tab | AUR | 0.1700 | 0.1700 | YES | NO | NO |
| 02445816 | CANDESARTAN CILEXETIL | Auro-Candesartan 32mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02445808 | CANDESARTAN CILEXETIL | Auro-Candesartan 16mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02445794 | CANDESARTAN CILEXETIL | Auro-Candesartan 8mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02388901 | CANDESARTAN CILEXETIL | Candesartan 4mg Tab | SAI | 0.1700 | 0.1700 | YES | NO | NO |
| 02388715 | CANDESARTAN CILEXETIL | Candesartan 16mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02388936 | CANDESARTAN CILEXETIL | Candesartan 16mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02528266 | CANDESARTAN CILEXETIL | Candesartan 32mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02435845 | CANDESARTAN CILEXETIL | Candesartan 32mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02528258 | CANDESARTAN CILEXETIL | Candesartan 4mg Tab | SIV | 0.1700 | 0.1700 | YES | NO | NO |
| 02388707 | CANDESARTAN CILEXETIL | Candesartan 8mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02388928 | CANDESARTAN CILEXETIL | Candesartan 8mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02379260 | CANDESARTAN CILEXETIL | Candesartan Cilexetil Tablets 4mg Tab | ACH | 0.1700 | 0.1700 | YES | NO | NO |
| 02379279 | CANDESARTAN CILEXETIL | Candesartan Cilexetil Tablets 8mg Tab | ACH | 0.2281 | 0.2281 | YES | NO | NO |
| 02379287 | CANDESARTAN CILEXETIL | Candesartan Cilexetil Tablets 16mg Tab | ACH | 0.2281 | 0.2281 | YES | NO | NO |
| 02379295 | CANDESARTAN CILEXETIL | Candesartan Cilexetil Tablets 32mg Tab | ACH | 0.2281 | 0.2281 | YES | NO | NO |
| 02376555 | CANDESARTAN CILEXETIL | Co Candesartan 32mg Tab | COB | 0.2281 | 0.2281 | YES | NO | NO |
| 02376547 | CANDESARTAN CILEXETIL | Co Candesartan 16mg Tab | COB | 0.2281 | 0.2281 | YES | NO | NO |
| 02376539 | CANDESARTAN CILEXETIL | Co Candesartan 8mg Tab | COB | 0.2281 | 0.2281 | YES | NO | NO |
| 02376520 | CANDESARTAN CILEXETIL | Co Candesartan 4mg Tab | COB | 0.1700 | 0.1700 | YES | NO | NO |
| 02386534 | CANDESARTAN CILEXETIL | Jamp-Candesartan 32mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02386526 | CANDESARTAN CILEXETIL | Jamp-Candesartan 16mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02386518 | CANDESARTAN CILEXETIL | Jamp-Candesartan 8mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02386496 | CANDESARTAN CILEXETIL | Jamp-Candesartan 4mg Tab | JPC | 0.1700 | 0.1700 | YES | NO | NO |
| 02476908 | CANDESARTAN CILEXETIL | Mint-Candesartan 4mg Tab | MIN | 0.1700 | 0.1700 | YES | NO | NO |
| 02476924 | CANDESARTAN CILEXETIL | Mint-Candesartan 16mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02476932 | CANDESARTAN CILEXETIL | Mint-Candesartan 32mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02476916 | CANDESARTAN CILEXETIL | Mint-Candesartan 8mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02527014 | CANDESARTAN CILEXETIL | NRA-Candesartan 8mg Tab | NRA | 0.2281 | 0.2281 | YES | NO | NO |
| 02527022 | CANDESARTAN CILEXETIL | NRA-Candesartan 16mg Tab | NRA | 0.2281 | 0.2281 | YES | NO | NO |
| 02527030 | CANDESARTAN CILEXETIL | NRA-Candesartan 32mg Tab | NRA | 0.2281 | 0.2281 | YES | NO | NO |
| 02527006 | CANDESARTAN CILEXETIL | NRA-Candesartan 4mg Tab | NRA | 0.1700 | 0.1700 | YES | NO | NO |
| 02391198 | CANDESARTAN CILEXETIL | PMS-Candesartan 8mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02391228 | CANDESARTAN CILEXETIL | PMS-Candesartan 32mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02391201 | CANDESARTAN CILEXETIL | PMS-Candesartan 16mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02391171 | CANDESARTAN CILEXETIL | PMS-Candesartan 4mg Tab | PMS | 0.1700 | 0.1700 | YES | NO | NO |
| 02380692 | CANDESARTAN CILEXETIL | Ran-Candesartan 8mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02380714 | CANDESARTAN CILEXETIL | Ran-Candesartan 32mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02380706 | CANDESARTAN CILEXETIL | Ran-Candesartan 16mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02380684 | CANDESARTAN CILEXETIL | Ran-Candesartan 4mg Tab | RAN | 0.1700 | 0.1700 | YES | NO | NO |
| 02326973 | CANDESARTAN CILEXETIL | Sandoz Candesartan 16mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02326957 | CANDESARTAN CILEXETIL | Sandoz Candesartan 4mg Tab | SDZ | 0.1700 | 0.1700 | YES | NO | NO |
| 02326965 | CANDESARTAN CILEXETIL | Sandoz Candesartan 8mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02417340 | CANDESARTAN CILEXETIL | Sandoz Candesartan 32mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02366312 | CANDESARTAN CILEXETIL | Teva-Candesartan 8mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02366339 | CANDESARTAN CILEXETIL | Teva-Candesartan 32mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02366320 | CANDESARTAN CILEXETIL | Teva-Candesartan 16mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02244021 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Atacand Plus 16mg & 12.5mg Tab | CHE | 1.5845 | 0.2156 | YES | NO | NO |
| 02332922 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Atacand Plus 32mg & 12.5mg Tab | CHE | 1.5845 | 0.2156 | YES | NO | NO |
| 02332957 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Atacand Plus 32mg & 25mg Tab | CHE | 1.5845 | 0.3008 | YES | NO | NO |
| 02421038 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Auro-Candesartan HCT 16mg & 12.5mg Tab | AUR | 0.2156 | 0.2156 | YES | NO | NO |
| 02421046 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Auro-Candesartan HCT 32mg & 12.5mg Tab | AUR | 0.2156 | 0.2156 | YES | NO | NO |
| 02421054 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Auro-Candesartan HCT 32mg & 25mg Tab | AUR | 0.3008 | 0.3008 | YES | NO | NO |
| 02394812 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Candesartan HCT 16mg & 12.5mg Tab | SIV | 0.2156 | 0.2156 | YES | NO | NO |
| 02536064 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Candesartan/HCTZ 32mg & 12.5mg Tab | SAI | 0.2156 | 0.2156 | YES | NO | NO |
| 02394804 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Candesartan/HCTZ 16mg & 12.5mg Tab | SAI | 0.2156 | 0.2156 | YES | NO | NO |
| 02473267 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Jamp Candesartan-HCT 32mg & 25mg Tab | JPC | 0.3008 | 0.3008 | YES | NO | NO |
| 02473259 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Jamp Candesartan-HCT 32mg & 12.5mg Tab | JPC | 0.2156 | 0.2156 | YES | NO | NO |
| 02473240 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Jamp Candesartan-HCT 16mg & 12.5mg Tab | JPC | 0.2156 | 0.2156 | YES | NO | NO |
| 02531240 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | NRA-Candesartan HCTZ 16mg & 12.5mg Tab | NRA | 0.2156 | 0.2156 | YES | NO | NO |
| 02531259 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | NRA-Candesartan HCTZ 32mg & 12.5mg Tab | NRA | 0.2156 | 0.2156 | YES | NO | NO |
| 02531267 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | NRA-Candesartan HCTZ 32mg & 25mg Tab | NRA | 0.3008 | 0.3008 | YES | NO | NO |
| 02391295 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | PMS-Candesartan-HCTZ 16mg & 12.5mg Tab | PMS | 0.2156 | 0.2156 | YES | NO | NO |
| 02420740 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Sandoz Candesartan Plus 32mg & 25mg Tab | SDZ | 0.3008 | 0.3008 | YES | NO | NO |
| 02420732 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Sandoz Candesartan Plus 32mg & 12.5mg Tab | SDZ | 0.2156 | 0.2156 | YES | NO | NO |
| 02327902 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Sandoz Candesartan Plus 16mg & 12.5mg Tab | SDZ | 0.2156 | 0.2156 | YES | NO | NO |
| 02395568 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Teva-Candesartan/HCTZ 32mg & 12.5mg Tab | TEV | 0.2156 | 0.2156 | YES | NO | NO |
| 02395541 | CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDE | Teva-Candesartan/HCTZ 16mg & 12.5mg Tab | TEV | 0.2156 | 0.2156 | YES | NO | NO |
| 02426765 | CAPECITABINE | Ach-Capecitabine 500mg Tab | ACH | 1.5250 | 1.5250 | YES | NO | NO |
| 02426757 | CAPECITABINE | Ach-Capecitabine 150mg Tab | ACH | 0.4575 | 0.4575 | YES | NO | NO |
| 02514990 | CAPECITABINE | Capecitabine 500mg Tab | SAI | 1.5250 | 1.5250 | YES | NO | NO |
| 02519887 | CAPECITABINE | Capecitabine 500mg Tab | JPC | 1.5250 | 1.5250 | YES | NO | NO |
| 02514982 | CAPECITABINE | Capecitabine 150mg Tab | SAI | 0.4575 | 0.4575 | YES | NO | NO |
| 02519879 | CAPECITABINE | Capecitabine 150mg Tab | JPC | 0.4575 | 0.4575 | YES | NO | NO |
| 02508028 | CAPECITABINE | Mint-Capecitabine 500mg Tab | MIN | 1.5250 | 1.5250 | YES | NO | NO |
| 02421917 | CAPECITABINE | Sandoz Capecitabine 150mg Tab | SDZ | 0.4575 | 0.4575 | YES | NO | NO |
| 02421925 | CAPECITABINE | Sandoz Capecitabine 500mg Tab | SDZ | 1.5250 | 1.5250 | YES | NO | NO |
| 02457490 | CAPECITABINE | Taro-Capecitabine 150mg Tab | TAR | 0.4575 | 0.4575 | YES | NO | NO |
| 02457504 | CAPECITABINE | Taro-Capecitabine 500mg Tab | TAR | 1.5250 | 1.5250 | YES | NO | NO |
| 02400030 | CAPECITABINE | Teva-Capecitabine 500mg Tab | TEV | 1.5250 | 1.5250 | YES | NO | NO |
| 02400022 | CAPECITABINE | Teva-Capecitabine 150mg Tab | TEV | 0.4575 | 0.4575 | YES | NO | NO |
| 02238453 | CAPECITABINE | Xeloda 150mg Tab | HLR | 1.9478 | 0.4575 | YES | NO | NO |
| 02238454 | CAPECITABINE | Xeloda 500mg Tab | HLR | 6.4933 | 1.5250 | YES | NO | NO |
| 02543907 | CAPTOPRIL | Noyada 5mg/5mL Oral Sol | ETH | 0.6000 | 0.6000 | NO | YES | NO |
| 02543915 | CAPTOPRIL | Noyada 25mg/5mL Oral Sol | ETH | 0.6500 | 0.6500 | NO | YES | NO |
| 00893625 | CAPTOPRIL | Apo-Capto 100mg Tab | APX | 1.0395 | 1.0395 | YES | NO | NO |
| 00893617 | CAPTOPRIL | Apo-Capto 50mg Tab | APX | 0.5590 | 0.5590 | YES | NO | NO |
| 00893609 | CAPTOPRIL | Apo-Capto 25mg Tab | APX | 0.3000 | 0.3000 | YES | NO | NO |
| 00893595 | CAPTOPRIL | Apo-Capto 12.5mg Tab | APX | 0.2120 | 0.2120 | YES | NO | NO |
| 00546305 | CAPTOPRIL | Capoten (Not a Benefit) 100mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00546291 | CAPTOPRIL | Capoten (Not a Benefit) 50mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00546283 | CAPTOPRIL | Capoten (Not a Benefit) 25mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00695661 | CAPTOPRIL | Capoten (Not a Benefit) 12.5mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 01942972 | CAPTOPRIL | Teva-Captopril 25mg Tab | TEV | 0.3000 | 0.3000 | YES | NO | NO |
| 01942999 | CAPTOPRIL | Teva-Captopril 100mg Tab | TEV | 1.0395 | 1.0395 | YES | NO | NO |
| 01942964 | CAPTOPRIL | Teva-Captopril 12.5mg Tab | TEV | 0.2120 | 0.2120 | YES | NO | NO |
| 01942980 | CAPTOPRIL | Teva-Captopril 50mg Tab | TEV | 0.5590 | 0.5590 | YES | NO | NO |
| 00885568 | CARBACHOL | Carbachol 2mg Tab | GLA | 0.3727 | 0.3727 | NO | NO | NO |
| 02244404 | CARBAMAZEPINE | Taro-Carbamazepine 200mg Chew Tab | TAR | 0.3302 | 0.3302 | YES | NO | NO |
| 02244403 | CARBAMAZEPINE | Taro-Carbamazepine 100mg Chew Tab | TAR | 0.1702 | 0.1702 | YES | NO | NO |
| 00665088 | CARBAMAZEPINE | Tegretol (Not a Benefit) 200mg Chew Tab | NOV | N/A | N/A | YES | NO | NO |
| 00369810 | CARBAMAZEPINE | Tegretol (Not a Benefit) 100mg Chew Tab | NOV | N/A | N/A | YES | NO | NO |
| 09858341 | CARBAMAZEPINE | Carbamazepine ER Tablets, USP 200mg (Temporary Benefit) 200mg ER Tab | SET | 4.7080 | 4.7080 | NO | NO | NO |
| 09858342 | CARBAMAZEPINE | Carbamazepine ER Tablets, USP 400mg (Temporary Benefit) 400mg ER Tab | SET | 5.2216 | 5.2216 | NO | NO | NO |
| 02261839 | CARBAMAZEPINE | Sandoz Carbamazepine CR 200mg LA Tab | SDZ | 0.3845 | 0.3845 | YES | YES | NO |
| 02261847 | CARBAMAZEPINE | Sandoz Carbamazepine CR 400mg LA Tab | SDZ | 0.7689 | 0.7689 | YES | YES | NO |
| 00755583 | CARBAMAZEPINE | Tegretol CR 400mg LA Tab | NOV | 1.2083 | 0.7689 | YES | YES | NO |
| 00773611 | CARBAMAZEPINE | Tegretol CR 200mg LA Tab | NOV | 0.6041 | 0.3845 | YES | YES | NO |
| 02367394 | CARBAMAZEPINE | Taro-Carbamazepine 100mg/5mL Oral Susp | TAR | 0.0578 | 0.0578 | YES | NO | NO |
| 02194333 | CARBAMAZEPINE | Tegretol 100mg/5mL Oral Susp | NOV | 0.1159 | 0.0578 | YES | NO | NO |
| 02541238 | CARBAMAZEPINE | Mint-Carbamazepine 200mg Tab | MIN | 0.2217 | 0.2217 | YES | NO | NO |
| 00010405 | CARBAMAZEPINE | Tegretol (Not a Benefit) 200mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00782718 | CARBAMAZEPINE | Teva-Carbamazepine 200mg Tab | TEV | 0.2217 | 0.2217 | YES | NO | NO |
| 02526824 | CARIPRAZINE | Vraylar 6mg Cap | ABV | 4.9000 | 4.9000 | NO | NO | NO |
| 02526816 | CARIPRAZINE | Vraylar 4.5mg Cap | ABV | 4.9000 | 4.9000 | NO | NO | NO |
| 02526794 | CARIPRAZINE | Vraylar 1.5mg Cap | ABV | 4.9000 | 4.9000 | NO | NO | NO |
| 02526808 | CARIPRAZINE | Vraylar 3mg Cap | ABV | 4.9000 | 4.9000 | NO | NO | NO |
| 02247936 | CARVEDILOL | Apo-Carvedilol 25mg Tab | APX | 0.2060 | 0.2060 | YES | YES | NO |
| 02247934 | CARVEDILOL | Apo-Carvedilol 6.25mg Tab | APX | 0.2060 | 0.2060 | YES | YES | NO |
| 02247933 | CARVEDILOL | Apo-Carvedilol 3.125mg Tab | APX | 0.2060 | 0.2060 | YES | YES | NO |
| 02247935 | CARVEDILOL | Apo-Carvedilol 12.5mg Tab | APX | 0.2060 | 0.2060 | YES | YES | NO |
| 02418509 | CARVEDILOL | Auro-Carvedilol 6.25mg Tab | AUR | 0.2060 | 0.2060 | YES | YES | NO |
| 02418495 | CARVEDILOL | Auro-Carvedilol 3.125mg Tab | AUR | 0.2060 | 0.2060 | YES | YES | NO |
| 02418517 | CARVEDILOL | Auro-Carvedilol 12.5mg Tab | AUR | 0.2060 | 0.2060 | YES | YES | NO |
| 02418525 | CARVEDILOL | Auro-Carvedilol 25mg Tab | AUR | 0.2060 | 0.2060 | YES | YES | NO |
| 02248753 | CARVEDILOL | Carvedilol 6.25mg Tab | SIV | 0.2060 | 0.2060 | YES | YES | NO |
| 02364956 | CARVEDILOL | Carvedilol 25mg Tab | SAI | 0.2060 | 0.2060 | YES | YES | NO |
| 02364948 | CARVEDILOL | Carvedilol 12.5mg Tab | SAI | 0.2060 | 0.2060 | YES | YES | NO |
| 02248754 | CARVEDILOL | Carvedilol 12.5mg Tab | SIV | 0.2060 | 0.2060 | YES | YES | NO |
| 02248752 | CARVEDILOL | Carvedilol 3.125mg Tab | SIV | 0.2060 | 0.2060 | YES | YES | NO |
| 02364913 | CARVEDILOL | Carvedilol 3.125mg Tab | SAI | 0.2060 | 0.2060 | YES | YES | NO |
| 02364921 | CARVEDILOL | Carvedilol 6.25mg Tab | SAI | 0.2060 | 0.2060 | YES | YES | NO |
| 02248755 | CARVEDILOL | Carvedilol 25mg Tab | SIV | 0.2060 | 0.2060 | YES | YES | NO |
| 02229650 | CARVEDILOL | Coreg (Not a Benefit) 3.125mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02229652 | CARVEDILOL | Coreg (Not a Benefit) 12.5mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02229651 | CARVEDILOL | Coreg (Not a Benefit) 6.25mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02229653 | CARVEDILOL | Coreg (Not a Benefit) 25mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02368900 | CARVEDILOL | Jamp-Carvedilol 6.25mg Tab | JPC | 0.2060 | 0.2060 | YES | YES | NO |
| 02368919 | CARVEDILOL | Jamp-Carvedilol 12.5mg Tab | JPC | 0.2060 | 0.2060 | YES | YES | NO |
| 02368927 | CARVEDILOL | Jamp-Carvedilol 25mg Tab | JPC | 0.2060 | 0.2060 | YES | YES | NO |
| 02368897 | CARVEDILOL | Jamp-Carvedilol 3.125mg Tab | JPC | 0.2060 | 0.2060 | YES | YES | NO |
| 02245914 | CARVEDILOL | PMS-Carvedilol 3.125mg Tab | PMS | 0.2060 | 0.2060 | YES | YES | NO |
| 02245917 | CARVEDILOL | PMS-Carvedilol 25mg Tab | PMS | 0.2060 | 0.2060 | YES | YES | NO |
| 02245916 | CARVEDILOL | PMS-Carvedilol 12.5mg Tab | PMS | 0.2060 | 0.2060 | YES | YES | NO |
| 02245915 | CARVEDILOL | PMS-Carvedilol 6.25mg Tab | PMS | 0.2060 | 0.2060 | YES | YES | NO |
| 02268027 | CARVEDILOL | Ran-Carvedilol 3.125mg Tab | RAN | 0.2060 | 0.2060 | YES | YES | NO |
| 02268051 | CARVEDILOL | Ran-Carvedilol 25mg Tab | RAN | 0.2060 | 0.2060 | YES | YES | NO |
| 02268035 | CARVEDILOL | Ran-Carvedilol 6.25mg Tab | RAN | 0.2060 | 0.2060 | YES | YES | NO |
| 02268043 | CARVEDILOL | Ran-Carvedilol 12.5mg Tab | RAN | 0.2060 | 0.2060 | YES | YES | NO |
| 02252333 | CARVEDILOL | Ratio-Carvedilol 25mg Tab | RPH | 0.2060 | 0.2060 | YES | YES | NO |
| 02252325 | CARVEDILOL | Ratio-Carvedilol 12.5mg Tab | RPH | 0.2060 | 0.2060 | YES | YES | NO |
| 02252309 | CARVEDILOL | Ratio-Carvedilol 3.125mg Tab | RPH | 0.2060 | 0.2060 | YES | YES | NO |
| 02252317 | CARVEDILOL | Ratio-Carvedilol 6.25mg Tab | RPH | 0.2060 | 0.2060 | YES | YES | NO |
| 02244266 | CASPOFUNGIN | Cancidas (Off-Formulary Interchangeable) 70mg/Vial Inj Pd-Vial Pk | FRS | N/A | N/A | YES | NO | NO |
| 02460955 | CASPOFUNGIN | Caspofungin for Injection (Off-Formulary Interchangeable) 70mg/Vial Inj Pd-Vial Pk | JUN | 222.0000 | 222.0000 | YES | NO | NO |
| 02486997 | CASPOFUNGIN | Caspofungin for Injection (Off-Formulary Interchangeable) 70mg/Vial Inj Pd-Vial Pk | FKC | 222.5000 | 222.5000 | YES | NO | NO |
| 02244265 | CASPOFUNGIN ACETATE | Cancidas (Off-Formulary Interchangeable) 50mg/Vial Inj-Vial Pk | FRS | N/A | N/A | YES | NO | NO |
| 02460947 | CASPOFUNGIN ACETATE | Caspofungin for Injection (Off-Formulary Interchangeable) 50mg/Vial Inj-Vial Pk | JUN | 222.0000 | 222.0000 | YES | NO | NO |
| 02486989 | CASPOFUNGIN ACETATE | Caspofungin for Injection (Off-Formulary Interchangeable) 50mg/Vial Inj-Vial Pk | FKC | 222.5000 | 222.5000 | YES | NO | NO |
| 02240774 | CEFADROXIL | Apo-Cefadroxil 500mg Cap | APX | 0.5895 | 0.5895 | YES | NO | NO |
| 00507245 | CEFADROXIL | Duricef (Not a Benefit) 500mg Cap | BQU | N/A | N/A | YES | NO | NO |
| 02544792 | CEFADROXIL | Jamp Cefadroxil 500mg Cap | JPC | 0.5895 | 0.5895 | YES | NO | NO |
| 02235134 | CEFADROXIL | Teva-Cefadroxil 500mg Cap | TEV | 0.5895 | 0.5895 | YES | NO | NO |
| 02437120 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | STE | 56.0000 | 56.0000 | YES | NO | NO |
| 02108119 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 500mg/Vial Inj Pd-Vial Pk | TEV | N/A | N/A | YES | NO | NO |
| 02297213 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | ORC | 56.0000 | 56.0000 | YES | NO | NO |
| 02108135 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | TEV | N/A | N/A | YES | NO | NO |
| 02437112 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | STE | 6.0000 | 6.0000 | YES | NO | NO |
| 02297205 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | ORC | 6.0000 | 6.0000 | YES | NO | NO |
| 02108127 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | TEV | N/A | N/A | YES | NO | NO |
| 02437104 | CEFAZOLIN SODIUM | Cefazolin for Injection (Off-Formulary Interchangeable) 500mg/Vial Inj Pd-Vial Pk | STE | 4.0000 | 4.0000 | YES | NO | NO |
| 02465469 | CEFAZOLIN SODIUM | Cefazolin for Injection USP (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | STE | 6.0000 | 6.0000 | YES | NO | NO |
| 02308959 | CEFAZOLIN SODIUM | Cefazolin for Injection USP (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | SDZ | 6.0000 | 6.0000 | YES | NO | NO |
| 02308932 | CEFAZOLIN SODIUM | Cefazolin for Injection USP (Off-Formulary Interchangeable) 500mg/Vial Inj Pd-Vial Pk | SDZ | 4.0000 | 4.0000 | YES | NO | NO |
| 02308967 | CEFAZOLIN SODIUM | Cefazolin for Injection USP (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | SDZ | 56.0000 | 56.0000 | YES | NO | NO |
| 02465477 | CEFAZOLIN SODIUM | Cefazolin for Injection USP (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | STE | 56.0000 | 56.0000 | YES | NO | NO |
| 01919628 | CEFAZOLIN SODIUM | Ancef (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk (Preservative-Free) | SMJ | N/A | N/A | YES | NO | NO |
| 02237140 | CEFAZOLIN SODIUM | Cefazolin for Injection, USP (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk (Preservative-Free) | FKC | 56.0000 | 56.0000 | YES | NO | NO |
| 02467518 | CEFEPIME | Apo-Cefepime (Off-Formulary Interchangeable) 2g Inj Pd-Vial Pk | APX | 30.2000 | N/A | YES | NO | NO |
| 02467496 | CEFEPIME | Apo-Cefepime (Off-Formulary Interchangeable) 1g Inj Pd-Vial Pk | APX | 30.2000 | N/A | YES | NO | NO |
| 02319039 | CEFEPIME | Cefepime for Injection (Off-Formulary Interchangeable) 2g Inj Pd-Vial Pk | APX | 30.1963 | N/A | YES | NO | NO |
| 02319020 | CEFEPIME | Cefepime for Injection (Off-Formulary Interchangeable) 1g Inj Pd-Vial Pk | APX | 12.9360 | N/A | YES | NO | NO |
| 02163640 | CEFEPIME | Maxipime (Off-Formulary Interchangeable) 2g Inj Pd-Vial Pk | BQU | N/A | N/A | YES | NO | NO |
| 02163632 | CEFEPIME | Maxipime (Off-Formulary Interchangeable) 1g Inj Pd-Vial Pk | BQU | N/A | N/A | YES | NO | NO |
| 02468689 | CEFIXIME | Auro-Cefixime 20mg/mL Oral Susp | AUR | 0.3899 | 0.3899 | YES | NO | NO |
| 00868965 | CEFIXIME | Suprax 20mg/mL Oral Susp | ODN | 0.3899 | 0.3899 | YES | NO | NO |
| 02432773 | CEFIXIME | Auro-Cefixime 400mg Tab | AUR | 2.7172 | 2.7172 | YES | NO | NO |
| 00868981 | CEFIXIME | Suprax 400mg Tab | ODN | 2.7172 | 2.7172 | YES | NO | NO |
| 02291738 | CEFOXITIN SODIUM | Cefoxitin for Injection (Off-Formulary Interchangeable) 2g/Vial Inj Pd-Vial Pk | ORC | 21.2500 | 21.2500 | YES | NO | NO |
| 02291711 | CEFOXITIN SODIUM | Cefoxitin for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | ORC | 10.6000 | 10.6000 | YES | NO | NO |
| 02128195 | CEFOXITIN SODIUM | Cefoxitin for Injection USP (Off-Formulary Interchangeable) 2g/Vial Inj Pd-Vial Pk | TEV | 21.2500 | 21.2500 | YES | NO | NO |
| 02128187 | CEFOXITIN SODIUM | Cefoxitin for Injection USP (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | TEV | 10.6000 | 10.6000 | YES | NO | NO |
| 00663697 | CEFOXITIN SODIUM | Mefoxin (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | MSD | N/A | N/A | YES | NO | NO |
| 00663700 | CEFOXITIN SODIUM | Mefoxin (Off-Formulary Interchangeable) 2g/Vial Inj Pd-Vial Pk | MSD | N/A | N/A | YES | NO | NO |
| 09858333 | CEFPROZIL | Auro-Cefprozil 250mg/5mL Oral Susp-100mL Pk | AUR | 19.3800 | 19.3800 | YES | NO | NO |
| 09858332 | CEFPROZIL | Auro-Cefprozil 125mg/5mL Oral Susp-100mL Pk | AUR | 9.7000 | 9.7000 | YES | NO | NO |
| 09857358 | CEFPROZIL | Cefzil (Not a Benefit) 125mg/5mL Oral Susp-100mL Pk | BQU | N/A | N/A | YES | NO | NO |
| 09857359 | CEFPROZIL | Cefzil (Not a Benefit) 250mg/5mL Oral Susp-100mL Pk | BQU | N/A | N/A | YES | NO | NO |
| 09857365 | CEFPROZIL | Ran-Cefprozil 250mg/5mL Oral Susp-100mL Pk | RAN | 19.3800 | 19.3800 | YES | NO | NO |
| 09857356 | CEFPROZIL | Ran-Cefprozil 125mg/5mL Oral Susp-100mL Pk | RAN | 9.7000 | 9.7000 | YES | NO | NO |
| 02347288 | CEFPROZIL | Auro-Cefprozil 250mg/5mL Oral Susp-75mL Pk | AUR | 14.5350 | 14.5350 | YES | NO | NO |
| 02347261 | CEFPROZIL | Auro-Cefprozil 125mg/5mL Oral Susp-75mL Pk | AUR | 7.2750 | 7.2750 | YES | NO | NO |
| 02163675 | CEFPROZIL | Cefzil (Not a Benefit) 125mg/5mL Oral Susp-75mL Pk | BQU | N/A | N/A | YES | NO | NO |
| 02163683 | CEFPROZIL | Cefzil (Not a Benefit) 250mg/5mL Oral Susp-75mL Pk | BQU | N/A | N/A | YES | NO | NO |
| 02293579 | CEFPROZIL | Ran-Cefprozil 250mg/5mL Oral Susp-75mL Pk | RAN | 14.5350 | 14.5350 | YES | NO | NO |
| 02329204 | CEFPROZIL | Ran-Cefprozil 125mg/5mL Oral Susp-75mL Pk | RAN | 7.2750 | 7.2750 | YES | NO | NO |
| 02347253 | CEFPROZIL | Auro-Cefprozil 500mg Tab | AUR | 2.0038 | 2.0038 | YES | NO | NO |
| 02163667 | CEFPROZIL | Cefzil (Not a Benefit) 500mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02163659 | CEFPROZIL | Cefzil (Not a Benefit) 250mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02293536 | CEFPROZIL | Ran-Cefprozil 500mg Tab | RAN | 2.0038 | 2.0038 | YES | NO | NO |
| 02293528 | CEFPROZIL | Ran-Cefprozil 250mg Tab | RAN | 1.7374 | 1.7374 | YES | NO | NO |
| 02292289 | CEFTRIAXONE DISODIUM | Ceftriaxone 2g/Vial Inj Pd-Vial Pk | SDZ | 24.1395 | 24.1395 | YES | NO | NO |
| 02292270 | CEFTRIAXONE DISODIUM | Ceftriaxone 1g/Vial Inj Pd-Vial Pk | SDZ | 12.4950 | 12.4950 | YES | NO | NO |
| 02325594 | CEFTRIAXONE DISODIUM | Ceftriaxone Sodium For Injection BP 0.25g/Vial Inj Pd-Vial Pk | STE | 5.6430 | 5.6430 | YES | NO | NO |
| 02325632 | CEFTRIAXONE DISODIUM | Ceftriaxone Sodium For Injection BP (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | STE | 214.2000 | 214.2000 | YES | NO | NO |
| 02292297 | CEFTRIAXONE DISODIUM | Ceftriaxone Sodium For Injection BP (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | SDZ | 214.2000 | 214.2000 | YES | NO | NO |
| 02325624 | CEFTRIAXONE DISODIUM | Ceftriaxone Sodium For Injection BP 2g/Vial Inj Pd-Vial Pk | STE | 24.1395 | 24.1395 | YES | NO | NO |
| 02325616 | CEFTRIAXONE DISODIUM | Ceftriaxone Sodium For Injection BP 1g/Vial Inj Pd-Vial Pk | STE | 12.4950 | 12.4950 | YES | NO | NO |
| 02287633 | CEFTRIAXONE DISODIUM | Ceftriaxone Sodium for Injection 1g/Vial Inj Pd-Vial Pk | TEV | 12.4950 | 12.4950 | YES | NO | NO |
| 02289709 | CEFTRIAXONE DISODIUM | Ceftriaxone for Injection 2g/Vial Inj Pd-Vial Pk | FKC | 24.1395 | 24.1395 | YES | NO | NO |
| 02289695 | CEFTRIAXONE DISODIUM | Ceftriaxone for Injection 1g/Vial Inj Pd-Vial Pk | FKC | 12.4950 | 12.4950 | YES | NO | NO |
| 02292874 | CEFTRIAXONE DISODIUM | Ceftriaxone for Injection USP 1g/Vial Inj Pd-Vial Pk | ORC | 12.4950 | 12.4950 | YES | NO | NO |
| 00657409 | CEFTRIAXONE DISODIUM | Rocephin (Not a Benefit) 2g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |
| 00851957 | CEFTRIAXONE DISODIUM | Rocephin (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |
| 00657417 | CEFTRIAXONE DISODIUM | Rocephin (Not a Benefit) 1g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |
| 00657387 | CEFTRIAXONE DISODIUM | Rocephin (Not a Benefit) 0.25g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |
| 02212307 | CEFUROXIME AXETIL | Ceftin 125mg/5mL Susp | SDZ | 0.1791 | 0.1791 | NO | NO | NO |
| 02244393 | CEFUROXIME AXETIL | Apo-Cefuroxime 250mg Tab | APX | 0.4194 | 0.4194 | YES | NO | NO |
| 02244394 | CEFUROXIME AXETIL | Apo-Cefuroxime 500mg Tab | APX | 0.8308 | 0.8308 | YES | NO | NO |
| 02344823 | CEFUROXIME AXETIL | Auro-Cefuroxime 250mg Tab | AUR | 0.4194 | 0.4194 | YES | NO | NO |
| 02344831 | CEFUROXIME AXETIL | Auro-Cefuroxime 500mg Tab | AUR | 0.8308 | 0.8308 | YES | NO | NO |
| 02212277 | CEFUROXIME AXETIL | Ceftin (Not a Benefit) 250mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02212285 | CEFUROXIME AXETIL | Ceftin (Not a Benefit) 500mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02547198 | CEFUROXIME AXETIL | Jamp Cefuroxime 250mg Tab | JPC | 0.4194 | 0.4194 | YES | NO | NO |
| 02547201 | CEFUROXIME AXETIL | Jamp Cefuroxime 500mg Tab | JPC | 0.8308 | 0.8308 | YES | NO | NO |
| 02437589 | CELECOXIB | AG-Celecoxib 200mg Cap | ANG | 0.2558 | 0.2558 | YES | YES | YES |
| 02437570 | CELECOXIB | AG-Celecoxib 100mg Cap | ANG | 0.1279 | 0.1279 | YES | YES | YES |
| 02420163 | CELECOXIB | Act Celecoxib 200mg Cap | ACV | 0.2558 | 0.2558 | YES | YES | YES |
| 02420155 | CELECOXIB | Act Celecoxib 100mg Cap | ACV | 0.1279 | 0.1279 | YES | YES | YES |
| 02418940 | CELECOXIB | Apo-Celecoxib 200mg Cap | APX | 0.2558 | 0.2558 | YES | YES | YES |
| 02418932 | CELECOXIB | Apo-Celecoxib 100mg Cap | APX | 0.1279 | 0.1279 | YES | YES | YES |
| 02445689 | CELECOXIB | Auro-Celecoxib 200mg Cap | AUR | 0.2558 | 0.2558 | YES | YES | YES |
| 02445670 | CELECOXIB | Auro-Celecoxib 100mg Cap | AUR | 0.1279 | 0.1279 | YES | YES | YES |
| 02426382 | CELECOXIB | Bio-Celecoxib 100mg Cap | BMP | 0.1279 | 0.1279 | YES | YES | YES |
| 02426390 | CELECOXIB | Bio-Celecoxib 200mg Cap | BMP | 0.2558 | 0.2558 | YES | YES | YES |
| 02239942 | CELECOXIB | Celebrex 200mg Cap | UJC | 1.6601 | 0.2558 | YES | YES | YES |
| 02239941 | CELECOXIB | Celebrex 100mg Cap | UJC | 0.8299 | 0.1279 | YES | YES | YES |
| 02429675 | CELECOXIB | Celecoxib 100mg Cap | SIV | 0.1279 | 0.1279 | YES | YES | YES |
| 02436299 | CELECOXIB | Celecoxib 100mg Cap | SAI | 0.1279 | 0.1279 | YES | YES | YES |
| 02429683 | CELECOXIB | Celecoxib 200mg Cap | SIV | 0.2558 | 0.2558 | YES | YES | YES |
| 02436302 | CELECOXIB | Celecoxib 200mg Cap | SAI | 0.2558 | 0.2558 | YES | YES | YES |
| 02424541 | CELECOXIB | Jamp-Celecoxib 200mg Cap | JPC | 0.2558 | 0.2558 | YES | YES | YES |
| 02424533 | CELECOXIB | Jamp-Celecoxib 100mg Cap | JPC | 0.1279 | 0.1279 | YES | YES | YES |
| 02495465 | CELECOXIB | M-Celecoxib 100mg Cap | MAT | 0.1279 | 0.1279 | YES | YES | YES |
| 02495473 | CELECOXIB | M-Celecoxib 200mg Cap | MAT | 0.2558 | 0.2558 | YES | YES | YES |
| 02420066 | CELECOXIB | Mar-Celecoxib 200mg Cap | MAR | 0.2558 | 0.2558 | YES | YES | YES |
| 02420058 | CELECOXIB | Mar-Celecoxib 100mg Cap | MAR | 0.1279 | 0.1279 | YES | YES | YES |
| 02412500 | CELECOXIB | Mint-Celecoxib 200mg Cap | MIN | 0.2558 | 0.2558 | YES | YES | YES |
| 02412497 | CELECOXIB | Mint-Celecoxib 100mg Cap | MIN | 0.1279 | 0.1279 | YES | YES | YES |
| 02479737 | CELECOXIB | NRA-Celecoxib 100mg Cap | NRA | 0.1279 | 0.1279 | YES | YES | YES |
| 02479745 | CELECOXIB | NRA-Celecoxib 200mg Cap | NRA | 0.2558 | 0.2558 | YES | YES | YES |
| 02355450 | CELECOXIB | PMS-Celecoxib 200mg Cap | PMS | 0.2558 | 0.2558 | YES | YES | YES |
| 02355442 | CELECOXIB | PMS-Celecoxib 100mg Cap | PMS | 0.1279 | 0.1279 | YES | YES | YES |
| 02517116 | CELECOXIB | PMSC-Celecoxib 100mg Cap | PMS | 0.1279 | 0.1279 | YES | YES | YES |
| 02517124 | CELECOXIB | PMSC-Celecoxib 200mg Cap | PMS | 0.2558 | 0.2558 | YES | YES | YES |
| 02412373 | CELECOXIB | Ran-Celecoxib 100mg Cap | RAN | 0.1279 | 0.1279 | YES | YES | YES |
| 02412381 | CELECOXIB | Ran-Celecoxib 200mg Cap | RAN | 0.2558 | 0.2558 | YES | YES | YES |
| 02442647 | CELECOXIB | Sdz Celecoxib 200mg Cap | SDZ | 0.2558 | 0.2558 | YES | YES | YES |
| 02442639 | CELECOXIB | Sdz Celecoxib 100mg Cap | SDZ | 0.1279 | 0.1279 | YES | YES | YES |
| 02288923 | CELECOXIB | Teva-Celecoxib 200mg Cap | TEV | 0.2558 | 0.2558 | YES | YES | YES |
| 02288915 | CELECOXIB | Teva-Celecoxib 100mg Cap | TEV | 0.1279 | 0.1279 | YES | YES | YES |
| 02538652 | CENOBAMATE | Xcopri 12.5mg Tab | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538660 | CENOBAMATE | Xcopri 25mg Tab | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538725 | CENOBAMATE | Xcopri 50mg Tab | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538733 | CENOBAMATE | Xcopri 100mg Tab | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538741 | CENOBAMATE | Xcopri 150mg Tab | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538768 | CENOBAMATE | Xcopri 200mg Tab | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538776 | CENOBAMATE | Xcopri 12.5mg & 25mg Tab - (Starter Kit) | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538784 | CENOBAMATE | Xcopri 50mg & 100mg Tab - (Starter Kit) | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 02538792 | CENOBAMATE | Xcopri 150mg & 200mg Tab - (Starter Kit) | EVL | 8.8000 | 8.8000 | NO | YES | NO |
| 00253154 | CEPHALEXIN MONOHYDRATE | Ceporex (Not a Benefit) 250mg Cap | GLA | N/A | N/A | YES | NO | NO |
| 00253146 | CEPHALEXIN MONOHYDRATE | Ceporex (Not a Benefit) 500mg Cap | GLA | N/A | N/A | YES | NO | NO |
| 00342084 | CEPHALEXIN MONOHYDRATE | Teva-Cephalexin 250mg Cap | TEV | 0.3703 | 0.3703 | YES | NO | NO |
| 00342114 | CEPHALEXIN MONOHYDRATE | Teva-Cephalexin 500mg Cap | TEV | 0.7252 | 0.7252 | YES | NO | NO |
| 02497751 | CEPHALEXIN MONOHYDRATE | Auro-Cephalexin 50mg/mL Pd for Oral Susp | AUR | 0.2573 | 0.2573 | YES | NO | NO |
| 02497743 | CEPHALEXIN MONOHYDRATE | Auro-Cephalexin 25mg/mL Pd for Oral Susp | AUR | 0.1535 | 0.1535 | YES | NO | NO |
| 02528444 | CEPHALEXIN MONOHYDRATE | Jamp Cephalexin Suspension 50mg/mL Pd for Oral Susp | JPC | 0.2573 | 0.2573 | YES | NO | NO |
| 02528436 | CEPHALEXIN MONOHYDRATE | Jamp Cephalexin Suspension 25mg/mL Pd for Oral Susp | JPC | 0.1535 | 0.1535 | YES | NO | NO |
| 00035645 | CEPHALEXIN MONOHYDRATE | Keflex (Not a Benefit) 50mg/mL Pd for Oral Susp | PHE | N/A | N/A | YES | NO | NO |
| 00015547 | CEPHALEXIN MONOHYDRATE | Keflex (Not a Benefit) 25mg/mL Pd for Oral Susp | PHE | N/A | N/A | YES | NO | NO |
| 02469189 | CEPHALEXIN MONOHYDRATE | Lupin-Cephalexin 50mg/mL Pd for Oral Susp | LUP | 0.2573 | 0.2573 | YES | NO | NO |
| 02469170 | CEPHALEXIN MONOHYDRATE | Lupin-Cephalexin 25mg/mL Pd for Oral Susp | LUP | 0.1535 | 0.1535 | YES | NO | NO |
| 00342106 | CEPHALEXIN MONOHYDRATE | Teva-Cephalexin 125 25mg/mL Pd for Oral Susp | TEV | 0.1535 | 0.1535 | YES | NO | NO |
| 00342092 | CEPHALEXIN MONOHYDRATE | Teva-Cephalexin 250 50mg/mL Pd for Oral Susp | TEV | 0.2573 | 0.2573 | YES | NO | NO |
| 00768715 | CEPHALEXIN MONOHYDRATE | Apo-Cephalex 500mg Tab | APX | 0.1731 | 0.1731 | YES | NO | NO |
| 00768723 | CEPHALEXIN MONOHYDRATE | Apo-Cephalex 250mg Tab | APX | 0.0866 | 0.0866 | YES | NO | NO |
| 02470586 | CEPHALEXIN MONOHYDRATE | Auro-Cephalexin 500mg Tab | AUR | 0.1731 | 0.1731 | YES | NO | NO |
| 02470578 | CEPHALEXIN MONOHYDRATE | Auro-Cephalexin 250mg Tab | AUR | 0.0866 | 0.0866 | YES | NO | NO |
| 02521261 | CEPHALEXIN MONOHYDRATE | Cephalexin 500mg Tab | SAI | 0.1731 | 0.1731 | YES | NO | NO |
| 02521253 | CEPHALEXIN MONOHYDRATE | Cephalexin 250mg Tab | SAI | 0.0866 | 0.0866 | YES | NO | NO |
| 02495651 | CEPHALEXIN MONOHYDRATE | Cephalexin 500mg Tab | SIV | 0.1731 | 0.1731 | YES | NO | NO |
| 02494701 | CEPHALEXIN MONOHYDRATE | Jamp Cephalexin 500mg Tab | JPC | 0.1731 | 0.1731 | YES | NO | NO |
| 02494698 | CEPHALEXIN MONOHYDRATE | Jamp Cephalexin 250mg Tab | JPC | 0.0866 | 0.0866 | YES | NO | NO |
| 00244392 | CEPHALEXIN MONOHYDRATE | Keflex (Not a Benefit) 500mg Tab | PHE | N/A | N/A | YES | NO | NO |
| 00403628 | CEPHALEXIN MONOHYDRATE | Keflex (Not a Benefit) 250mg Tab | PHE | N/A | N/A | YES | NO | NO |
| 02471159 | CEPHALEXIN MONOHYDRATE | Lupin-Cephalexin 500mg Tab | LUP | 0.1731 | 0.1731 | YES | NO | NO |
| 02471140 | CEPHALEXIN MONOHYDRATE | Lupin-Cephalexin 250mg Tab | LUP | 0.0866 | 0.0866 | YES | NO | NO |
| 00583421 | CEPHALEXIN MONOHYDRATE | Teva-Cephalexin 500mg Tab | TEV | 0.1731 | 0.1731 | YES | NO | NO |
| 00583413 | CEPHALEXIN MONOHYDRATE | Teva-Cephalexin 250mg Tab | TEV | 0.0866 | 0.0866 | YES | NO | NO |
| 02231603 | CETIRIZINE HYDROCHLORIDE | Apo-Cetirizine (Off-Formulary Interchangeable) 10mg Tab | APX | 0.4083 | N/A | YES | NO | NO |
| 02453363 | CETIRIZINE HYDROCHLORIDE | Apo-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | APX | 0.7535 | N/A | YES | NO | NO |
| 02515695 | CETIRIZINE HYDROCHLORIDE | Cetirizine (Off-Formulary Interchangeable) 20mg Tab | SAI | 0.7535 | N/A | YES | NO | NO |
| 02534126 | CETIRIZINE HYDROCHLORIDE | Cetirizine (Off-Formulary Interchangeable) 20mg Tab | SIV | 0.7535 | N/A | YES | NO | NO |
| 02315955 | CETIRIZINE HYDROCHLORIDE | Extra Strength Allergy Relief (Off-Formulary Interchangeable) 10mg Tab | PMS | 0.3938 | N/A | YES | NO | NO |
| 02517566 | CETIRIZINE HYDROCHLORIDE | Jamp Cetirizine (Off-Formulary Interchangeable) 10mg Tab | JPC | 0.4083 | N/A | YES | NO | NO |
| 02517353 | CETIRIZINE HYDROCHLORIDE | Jamp Cetirizine Tablets (Off-Formulary Interchangeable) 20mg Tab | JPC | 0.7535 | N/A | YES | NO | NO |
| 02451778 | CETIRIZINE HYDROCHLORIDE | Jamp-Cetirizine (Off-Formulary Interchangeable) 10mg Tab | JPC | 0.4083 | N/A | YES | NO | NO |
| 02466171 | CETIRIZINE HYDROCHLORIDE | Jamp-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | JPC | 0.7535 | N/A | YES | NO | NO |
| 02512025 | CETIRIZINE HYDROCHLORIDE | M-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | MAT | 0.7535 | N/A | YES | NO | NO |
| 02427133 | CETIRIZINE HYDROCHLORIDE | Mar-Cetirizine (Off-Formulary Interchangeable) 10mg Tab | MAR | 0.4083 | N/A | YES | NO | NO |
| 02427141 | CETIRIZINE HYDROCHLORIDE | Mar-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | MAR | 0.7535 | N/A | YES | NO | NO |
| 02491125 | CETIRIZINE HYDROCHLORIDE | Mint-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | MIN | 0.7535 | N/A | YES | NO | NO |
| 02521806 | CETIRIZINE HYDROCHLORIDE | NRA-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | NRA | 0.7535 | N/A | YES | NO | NO |
| 02530236 | CETIRIZINE HYDROCHLORIDE | NRA-Cetirizine Tablets (Off-Formulary Interchangeable) 20mg Tab | NRA | 0.7535 | N/A | YES | NO | NO |
| 02496488 | CETIRIZINE HYDROCHLORIDE | Nat-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | NAT | 0.7535 | N/A | YES | NO | NO |
| 02496461 | CETIRIZINE HYDROCHLORIDE | Nat-Cetirizine (Off-Formulary Interchangeable) 10mg Tab | NAT | 0.4083 | N/A | YES | NO | NO |
| 02315963 | CETIRIZINE HYDROCHLORIDE | PMS-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | PMS | 0.7535 | N/A | YES | NO | NO |
| 02223554 | CETIRIZINE HYDROCHLORIDE | Reactine (Off-Formulary Interchangeable) 10mg Tab | MCL | N/A | N/A | YES | NO | NO |
| 01900978 | CETIRIZINE HYDROCHLORIDE | Reactine (Off-Formulary Interchangeable) 20mg Tab | MCL | N/A | N/A | YES | NO | NO |
| 02528681 | CETIRIZINE HYDROCHLORIDE | Teva-Cetirizine (Off-Formulary Interchangeable) 20mg Tab | TEV | 0.7535 | N/A | YES | NO | NO |
| 00004626 | CHLORAMBUCIL | Leukeran 2mg Tab | ASN | 2.1300 | 2.1300 | NO | NO | NO |
| 00522724 | CHLORDIAZEPOXIDE | Chlordiazepoxide 5mg Cap | AAP | 0.0825 | 0.0825 | YES | NO | NO |
| 00522996 | CHLORDIAZEPOXIDE | Chlordiazepoxide 25mg Cap | AAP | 0.2014 | 0.2014 | YES | NO | NO |
| 00522988 | CHLORDIAZEPOXIDE | Chlordiazepoxide 10mg Cap | AAP | 0.1115 | 0.1115 | YES | NO | NO |
| 00012645 | CHLORDIAZEPOXIDE | Librium (Not a Benefit) 25mg Cap | HLR | N/A | N/A | YES | NO | NO |
| 00012637 | CHLORDIAZEPOXIDE | Librium (Not a Benefit) 10mg Cap | HLR | N/A | N/A | YES | NO | NO |
| 00012629 | CHLORDIAZEPOXIDE | Librium (Not a Benefit) 5mg Cap | HLR | N/A | N/A | YES | NO | NO |
| 02240433 | CHLORHEXIDINE GLUCONATE | PMS-Chlorhexidine (Off-Formulary Interchangeable) 0.12% Oral Rinse | PMS | 0.0253 | N/A | YES | NO | NO |
| 02493160 | CHLORHEXIDINE GLUCONATE | PMS-Chlorhexidine Without Alcohol (Off-Formulary Interchangeable) 0.12% Oral Rinse | PMS | 0.0253 | N/A | YES | NO | NO |
| 02237452 | CHLORHEXIDINE GLUCONATE | Peridex (Off-Formulary Interchangeable) 0.12% Oral Rinse | ZIL | N/A | N/A | YES | NO | NO |
| 01929933 | CHLORPROMAZINE | Largactil (Not a Benefit) 100mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 01929917 | CHLORPROMAZINE | Largactil (Not a Benefit) 25mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 01929925 | CHLORPROMAZINE | Largactil (Not a Benefit) 50mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 00232831 | CHLORPROMAZINE | Teva-Chlorpromazine 100mg Tab | TEV | 0.7475 | 0.7475 | YES | NO | NO |
| 00232807 | CHLORPROMAZINE | Teva-Chlorpromazine 50mg Tab | TEV | 0.2808 | 0.2808 | YES | NO | NO |
| 00232823 | CHLORPROMAZINE | Teva-Chlorpromazine 25mg Tab | TEV | 0.2454 | 0.2454 | YES | NO | NO |
| 00360279 | CHLORTHALIDONE | Apo-Chlorthalidone 50mg Tab | APX | 0.1277 | 0.1277 | YES | NO | NO |
| 00010413 | CHLORTHALIDONE | Hygroton (Not a Benefit) 50mg Tab | GEI | N/A | N/A | YES | NO | NO |
| 02523817 | CHLORTHALIDONE | Jamp Chlorthalidone 50mg Tab | JPC | 0.1277 | 0.1277 | YES | NO | NO |
| 02455609 | CHOLESTYRAMINE RESIN | Cholestyramine-Odan 4g/sachet Oral Pd-Pouch Pk | ODN | 0.9217 | 0.9217 | YES | NO | NO |
| 02478595 | CHOLESTYRAMINE RESIN | Jamp-Cholestyramine 4g/Sachet Oral Pd-Pouch Pk | JPC | 0.9217 | 0.9217 | YES | NO | NO |
| 02210320 | CHOLESTYRAMINE RESIN | Olestyr 4g/9g Pk Oral Pd-Pouch Pk | PMS | 0.9217 | 0.9217 | YES | NO | NO |
| 01918486 | CHOLESTYRAMINE RESIN | Questran Light 4g Pk (Not a Benefit) Oral Pd-Pouch Pk | BQU | N/A | N/A | YES | NO | NO |
| 09858335 | CHOLESTYRAMINE RESIN | Cholestyramine for Oral Suspension USP (Temporary Benefit) 4g Pd for Oral Susp | JUN | 0.9000 | 0.9000 | NO | NO | NO |
| 02285606 | CICLESONIDE | Alvesco 100mcg/Actuation Inh-120 Dose Pk | COV | 55.2807 | 55.2807 | NO | NO | NO |
| 02285614 | CICLESONIDE | Alvesco 200mcg/Actuation Inh-120 Dose Pk | COV | 91.4739 | 91.4739 | NO | NO | NO |
| 02303671 | CICLESONIDE | Omnaris 50mcg/Actuation Metered Dose Nas Sp-120 Dose Pk | COP | 31.2444 | 31.2444 | NO | NO | NO |
| 02298953 | CICLOPIROX | Apo-Ciclopirox (Off-Formulary Interchangeable) 8% W/W Top Sol | APX | 7.7433 | N/A | YES | NO | YES |
| 02250535 | CICLOPIROX | Penlac (Off-Formulary Interchangeable) 8% W/W Top Sol | VAL | N/A | N/A | YES | NO | YES |
| 02353288 | CICLOPIROX | Taro-Ciclopirox (Off-Formulary Interchangeable) 8% W/W Top Sol | TAR | 7.7433 | N/A | YES | NO | YES |
| 02291142 | CILAZAPRIL | Apo-Cilazapril 2.5mg Tab | APX | 0.4295 | 0.4295 | YES | NO | NO |
| 02291150 | CILAZAPRIL | Apo-Cilazapril 5mg Tab | APX | 0.4989 | 0.4989 | YES | NO | NO |
| 01911465 | CILAZAPRIL | Inhibace (Not a Benefit) 1mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 01911473 | CILAZAPRIL | Inhibace (Not a Benefit) 2.5mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 01911481 | CILAZAPRIL | Inhibace 5mg Tab | CHE | 1.1469 | 0.4989 | YES | NO | NO |
| 02283794 | CILAZAPRIL | Mylan-Cilazapril 5mg Tab | MYL | 0.4989 | 0.4989 | YES | NO | NO |
| 02283786 | CILAZAPRIL | Mylan-Cilazapril 2.5mg Tab | MYL | 0.4295 | 0.4295 | YES | NO | NO |
| 02283778 | CILAZAPRIL | Mylan-Cilazapril 1mg Tab | MYL | 0.3426 | 0.3426 | YES | NO | NO |
| 02284987 | CILAZAPRIL & HYDROCHLOROTHIAZIDE | Apo-Cilazapril/HCTZ 5mg/12.5mg Tab | APX | 0.6306 | 0.6306 | YES | NO | NO |
| 02181479 | CILAZAPRIL & HYDROCHLOROTHIAZIDE | Inhibace Plus 5mg/12.5mg Tab | CHE | 1.1465 | 0.6306 | YES | NO | NO |
| 00584215 | CIMETIDINE | Cimetidine 200mg Tab | AAP | 0.3557 | 0.3557 | YES | NO | YES |
| 00749494 | CIMETIDINE | Cimetidine 800mg Tab | AAP | 0.2530 | 0.2530 | YES | NO | YES |
| 00600067 | CIMETIDINE | Cimetidine 600mg Tab | AAP | 0.3405 | 0.3405 | YES | NO | YES |
| 00600059 | CIMETIDINE | Cimetidine 400mg Tab | AAP | 0.2930 | 0.2930 | YES | NO | YES |
| 00487872 | CIMETIDINE | Cimetidine 300mg Tab | AAP | 0.3423 | 0.3423 | YES | NO | YES |
| 01916777 | CIMETIDINE | Tagamet (Not a Benefit) 600mg Tab | SMJ | N/A | N/A | YES | NO | YES |
| 01916785 | CIMETIDINE | Tagamet (Not a Benefit) 400mg Tab | SMJ | N/A | N/A | YES | NO | YES |
| 01916769 | CIMETIDINE | Tagamet (Not a Benefit) 800mg Tab | SMJ | N/A | N/A | YES | NO | YES |
| 01916815 | CIMETIDINE | Tagamet (Not a Benefit) 300mg Tab | SMJ | N/A | N/A | YES | NO | YES |
| 01916793 | CIMETIDINE | Tagamet (Not a Benefit) 200mg Tab | SMJ | N/A | N/A | YES | NO | YES |
| 02452693 | CINACALCET | Apo-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | APX | 10.1947 | 10.1947 | YES | NO | NO |
| 02452715 | CINACALCET | Apo-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab | APX | 27.0517 | 27.0517 | YES | NO | NO |
| 02452707 | CINACALCET | Apo-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab | APX | 18.5900 | 18.5900 | YES | NO | NO |
| 02478919 | CINACALCET | Auro-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab | AUR | 18.5900 | 18.5900 | YES | NO | NO |
| 02478943 | CINACALCET | Auro-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab | AUR | 27.0517 | 27.0517 | YES | NO | NO |
| 02478900 | CINACALCET | Auro-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | AUR | 10.1947 | 10.1947 | YES | NO | NO |
| 02524880 | CINACALCET | Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | SAI | 10.1947 | 10.1947 | YES | NO | NO |
| 02500116 | CINACALCET | Jamp Cinacalcet Tablets (Off-Formulary Interchangeable) 90mg Tab | JPC | 27.0517 | 27.0517 | YES | NO | NO |
| 02500094 | CINACALCET | Jamp Cinacalcet Tablets (Off-Formulary Interchangeable) 30mg Tab | JPC | 10.1947 | 10.1947 | YES | NO | NO |
| 02500108 | CINACALCET | Jamp Cinacalcet Tablets (Off-Formulary Interchangeable) 60mg Tab | JPC | 18.5900 | 18.5900 | YES | NO | NO |
| 02481987 | CINACALCET | M-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | MAT | 10.1947 | 10.1947 | YES | NO | NO |
| 02482002 | CINACALCET | M-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab | MAT | 27.0517 | 27.0517 | YES | NO | NO |
| 02481995 | CINACALCET | M-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab | MAT | 18.5900 | 18.5900 | YES | NO | NO |
| 02480298 | CINACALCET | Mar-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | MAR | 10.1947 | 10.1947 | YES | NO | NO |
| 02480301 | CINACALCET | Mar-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab | MAR | 18.5900 | 18.5900 | YES | NO | NO |
| 02480328 | CINACALCET | Mar-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab | MAR | 27.0517 | 27.0517 | YES | NO | NO |
| 02434547 | CINACALCET | Mylan-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab | MYL | 18.5900 | 18.5900 | YES | NO | NO |
| 02434555 | CINACALCET | Mylan-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab | MYL | 27.0517 | 27.0517 | YES | NO | NO |
| 02434539 | CINACALCET | Mylan-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | MYL | 10.1947 | 10.1947 | YES | NO | NO |
| 02517604 | CINACALCET | PMS-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | PMS | 10.1947 | 10.1947 | YES | NO | NO |
| 02517612 | CINACALCET | PMS-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab | PMS | 18.5900 | 18.5900 | YES | NO | NO |
| 02517620 | CINACALCET | PMS-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab | PMS | 27.0517 | 27.0517 | YES | NO | NO |
| 02257130 | CINACALCET | Sensipar (Not a Benefit) 30mg Tab | AMG | N/A | N/A | YES | NO | NO |
| 02257157 | CINACALCET | Sensipar (Not a Benefit) 90mg Tab | AMG | N/A | N/A | YES | NO | NO |
| 02257149 | CINACALCET | Sensipar (Not a Benefit) 60mg Tab | AMG | N/A | N/A | YES | NO | NO |
| 02441632 | CINACALCET | Teva-Cinacalcet (Off-Formulary Interchangeable) 60mg Tab | TEV | 18.5900 | 18.5900 | YES | NO | NO |
| 02441624 | CINACALCET | Teva-Cinacalcet (Off-Formulary Interchangeable) 30mg Tab | TEV | 10.1947 | 10.1947 | YES | NO | NO |
| 02441640 | CINACALCET | Teva-Cinacalcet (Off-Formulary Interchangeable) 90mg Tab | TEV | 27.0517 | 27.0517 | YES | NO | NO |
| 02263130 | CIPROFLOXACIN | Apo-Ciproflox (Off-Formulary Interchangeable) 0.3% Oph Sol-5mL Pk | APX | 1.7600 | N/A | YES | NO | YES |
| 01945270 | CIPROFLOXACIN | Ciloxan (Off-Formulary Interchangeable) 0.3% Oph Sol-5mL Pk | NOV | N/A | N/A | YES | NO | YES |
| 02387131 | CIPROFLOXACIN | Sandoz Ciprofloxacin (Off-Formulary Interchangeable) 0.3% Oph Sol-5mL Pk | SDZ | 9.3000 | N/A | YES | NO | YES |
| 02237514 | CIPROFLOXACIN | Cipro 10g/100mL Oral Susp | BAY | 0.5756 | 0.5756 | NO | YES | YES |
| 02229521 | CIPROFLOXACIN | Apo-Ciproflox 250mg Tab | APX | 0.4454 | 0.4454 | YES | NO | YES |
| 02229523 | CIPROFLOXACIN | Apo-Ciproflox 750mg Tab | APX | 0.9201 | 0.9201 | YES | NO | YES |
| 02229522 | CIPROFLOXACIN | Apo-Ciproflox 500mg Tab | APX | 0.5025 | 0.5025 | YES | NO | YES |
| 02381907 | CIPROFLOXACIN | Auro-Ciprofloxacin 250mg Tab | AUR | 0.4454 | 0.4454 | YES | NO | YES |
| 02381931 | CIPROFLOXACIN | Auro-Ciprofloxacin 750mg Tab | AUR | 0.9201 | 0.9201 | YES | NO | YES |
| 02381923 | CIPROFLOXACIN | Auro-Ciprofloxacin 500mg Tab | AUR | 0.5025 | 0.5025 | YES | NO | YES |
| 02155958 | CIPROFLOXACIN | Cipro (Not a Benefit) 250mg Tab | BAY | N/A | N/A | YES | NO | YES |
| 02155974 | CIPROFLOXACIN | Cipro (Not a Benefit) 750mg Tab | BAY | N/A | N/A | YES | NO | YES |
| 02155966 | CIPROFLOXACIN | Cipro (Not a Benefit) 500mg Tab | BAY | N/A | N/A | YES | NO | YES |
| 02386119 | CIPROFLOXACIN | Ciprofloxacin 250mg Tab | SIV | 0.4454 | 0.4454 | YES | NO | YES |
| 02386127 | CIPROFLOXACIN | Ciprofloxacin 500mg Tab | SIV | 0.5025 | 0.5025 | YES | NO | YES |
| 02353318 | CIPROFLOXACIN | Ciprofloxacin 250mg Tab | SAI | 0.4454 | 0.4454 | YES | NO | YES |
| 02353326 | CIPROFLOXACIN | Ciprofloxacin 500mg Tab | SAI | 0.5025 | 0.5025 | YES | NO | YES |
| 02247339 | CIPROFLOXACIN | Co Ciprofloxacin 250mg Tab | COB | 0.4454 | 0.4454 | YES | NO | YES |
| 02247341 | CIPROFLOXACIN | Co Ciprofloxacin 750mg Tab | COB | 0.9201 | 0.9201 | YES | NO | YES |
| 02247340 | CIPROFLOXACIN | Co Ciprofloxacin 500mg Tab | COB | 0.5025 | 0.5025 | YES | NO | YES |
| 02380366 | CIPROFLOXACIN | Jamp-Ciprofloxacin 500mg Tab | JPC | 0.5025 | 0.5025 | YES | NO | YES |
| 02380358 | CIPROFLOXACIN | Jamp-Ciprofloxacin 250mg Tab | JPC | 0.4454 | 0.4454 | YES | NO | YES |
| 02380374 | CIPROFLOXACIN | Jamp-Ciprofloxacin 750mg Tab | JPC | 0.9201 | 0.9201 | YES | NO | YES |
| 02379686 | CIPROFLOXACIN | Mar-Ciprofloxacin 250mg Tab | MAR | 0.4454 | 0.4454 | YES | NO | YES |
| 02379708 | CIPROFLOXACIN | Mar-Ciprofloxacin 750mg Tab | MAR | 0.9201 | 0.9201 | YES | NO | YES |
| 02379694 | CIPROFLOXACIN | Mar-Ciprofloxacin 500mg Tab | MAR | 0.5025 | 0.5025 | YES | NO | YES |
| 02423588 | CIPROFLOXACIN | Mint-Ciproflox 750mg Tab | MIN | 0.9201 | 0.9201 | YES | NO | YES |
| 02423553 | CIPROFLOXACIN | Mint-Ciproflox 250mg Tab | MIN | 0.4454 | 0.4454 | YES | NO | YES |
| 02423561 | CIPROFLOXACIN | Mint-Ciproflox 500mg Tab | MIN | 0.5025 | 0.5025 | YES | NO | YES |
| 02492008 | CIPROFLOXACIN | NRA-Ciprofloxacin 500mg Tab | NRA | 0.5025 | 0.5025 | YES | NO | YES |
| 02248439 | CIPROFLOXACIN | PMS-Ciprofloxacin 750mg Tab | PMS | 0.9201 | 0.9201 | YES | NO | YES |
| 02248437 | CIPROFLOXACIN | PMS-Ciprofloxacin 250mg Tab | PMS | 0.4454 | 0.4454 | YES | NO | YES |
| 02248438 | CIPROFLOXACIN | PMS-Ciprofloxacin 500mg Tab | PMS | 0.5025 | 0.5025 | YES | NO | YES |
| 02303736 | CIPROFLOXACIN | Ran-Ciproflox 500mg Tab | RAN | 0.5025 | 0.5025 | YES | NO | YES |
| 02303744 | CIPROFLOXACIN | Ran-Ciproflox 750mg Tab | RAN | 0.9201 | 0.9201 | YES | NO | YES |
| 02303728 | CIPROFLOXACIN | Ran-Ciproflox 250mg Tab | RAN | 0.4454 | 0.4454 | YES | NO | YES |
| 02246826 | CIPROFLOXACIN | Ratio-Ciprofloxacin 500mg Tab | RPH | 0.5025 | 0.5025 | YES | NO | YES |
| 02246825 | CIPROFLOXACIN | Ratio-Ciprofloxacin 250mg Tab | RPH | 0.4454 | 0.4454 | YES | NO | YES |
| 02246827 | CIPROFLOXACIN | Ratio-Ciprofloxacin 750mg Tab | RPH | 0.9201 | 0.9201 | YES | NO | YES |
| 02248757 | CIPROFLOXACIN | Sandoz Ciprofloxacin 500mg Tab | SDZ | 0.5025 | 0.5025 | YES | NO | YES |
| 02248756 | CIPROFLOXACIN | Sandoz Ciprofloxacin 250mg Tab | SDZ | 0.4454 | 0.4454 | YES | NO | YES |
| 02248758 | CIPROFLOXACIN | Sandoz Ciprofloxacin 750mg Tab | SDZ | 0.9201 | 0.9201 | YES | NO | YES |
| 02379627 | CIPROFLOXACIN | Septa-Ciprofloxacin 250mg Tab | SET | 0.4454 | 0.4454 | YES | NO | YES |
| 02379643 | CIPROFLOXACIN | Septa-Ciprofloxacin 750mg Tab | SET | 0.9201 | 0.9201 | YES | NO | YES |
| 02379635 | CIPROFLOXACIN | Septa-Ciprofloxacin 500mg Tab | SET | 0.5025 | 0.5025 | YES | NO | YES |
| 02161737 | CIPROFLOXACIN | Teva-Ciprofloxacin 250mg Tab | TEV | 0.4454 | 0.4454 | YES | NO | YES |
| 02252716 | CIPROFLOXACIN AND DEXAMETHASONE | Ciprodex 0.3% w/v & 0.1% w/v Otic Susp-7.5mL Pk (With Preservative) | NOV | 31.9700 | 14.4203 | YES | YES | NO |
| 02506882 | CIPROFLOXACIN AND DEXAMETHASONE | Sandoz Ciprofloxacin/Dexamethasone 0.3% w/v & 0.1% w/v Otic Susp-7.5mL Pk (With Preservative) | SDZ | 14.4203 | 14.4203 | YES | YES | NO |
| 02481901 | CIPROFLOXACIN AND DEXAMETHASONE | Taro-Ciprofloxacin/Dexamethasone 0.3% w/v & 0.1% w/v Otic Susp-7.5mL Pk (With Preservative) | TAR | 14.4203 | 14.4203 | YES | YES | NO |
| 02247916 | CIPROFLOXACIN HCL & CIPROFLOXACIN BASE | Cipro XL (Not a Benefit) 500mg ER Tab | BAY | N/A | N/A | YES | NO | NO |
| 02416433 | CIPROFLOXACIN HCL & CIPROFLOXACIN BASE | PMS-Ciprofloxacin XL 500mg ER Tab | PMS | 2.3110 | 2.3110 | YES | YES | NO |
| 02355264 | CITALOPRAM HYDROBROMIDE | Accel Citalopram Tablets 40mg Tab | ACC | 0.1332 | 0.1332 | YES | NO | NO |
| 02355256 | CITALOPRAM HYDROBROMIDE | Accel Citalopram Tablets 20mg Tab | ACC | 0.1332 | 0.1332 | YES | NO | NO |
| 02246056 | CITALOPRAM HYDROBROMIDE | Apo-Citalopram 20mg Tab | APX | 0.1332 | 0.1332 | YES | NO | NO |
| 02246057 | CITALOPRAM HYDROBROMIDE | Apo-Citalopram 40mg Tab | APX | 0.1332 | 0.1332 | YES | NO | NO |
| 02275562 | CITALOPRAM HYDROBROMIDE | Auro-Citalopram 20mg Tab | AUR | 0.1332 | 0.1332 | YES | NO | NO |
| 02275570 | CITALOPRAM HYDROBROMIDE | Auro-Citalopram 40mg Tab | AUR | 0.1332 | 0.1332 | YES | NO | NO |
| 02459922 | CITALOPRAM HYDROBROMIDE | CCP-Citalopram 40mg Tab | CCP | 0.1332 | 0.1332 | YES | NO | NO |
| 02459914 | CITALOPRAM HYDROBROMIDE | CCP-Citalopram 20mg Tab | CCP | 0.1332 | 0.1332 | YES | NO | NO |
| 02239607 | CITALOPRAM HYDROBROMIDE | Celexa 20mg Tab | VLH | 1.8408 | 0.1332 | YES | NO | NO |
| 02239608 | CITALOPRAM HYDROBROMIDE | Celexa 40mg Tab | VLH | 1.8408 | 0.1332 | YES | NO | NO |
| 02239606 | CITALOPRAM HYDROBROMIDE | Celexa (Off-Formulary Interchangeable) 10mg Tab | VLH | N/A | N/A | YES | NO | NO |
| 02430568 | CITALOPRAM HYDROBROMIDE | Citalopram 40mg Tab | JPC | 0.1332 | 0.1332 | YES | NO | NO |
| 02387956 | CITALOPRAM HYDROBROMIDE | Citalopram 20mg Tab | SIV | 0.1332 | 0.1332 | YES | NO | NO |
| 02430541 | CITALOPRAM HYDROBROMIDE | Citalopram 20mg Tab | JPC | 0.1332 | 0.1332 | YES | NO | NO |
| 02353660 | CITALOPRAM HYDROBROMIDE | Citalopram 20mg Tab | SAI | 0.1332 | 0.1332 | YES | NO | NO |
| 02387964 | CITALOPRAM HYDROBROMIDE | Citalopram 40mg Tab | SIV | 0.1332 | 0.1332 | YES | NO | NO |
| 02387948 | CITALOPRAM HYDROBROMIDE | Citalopram (Off-Formulary Interchangeable) 10mg Tab | SIV | 0.4464 | N/A | YES | NO | NO |
| 02353679 | CITALOPRAM HYDROBROMIDE | Citalopram 40mg Tab | SAI | 0.1332 | 0.1332 | YES | NO | NO |
| 02430517 | CITALOPRAM HYDROBROMIDE | Citalopram (Off-Formulary Interchangeable) 10mg Tab | JPC | 0.4464 | N/A | YES | NO | NO |
| 02248051 | CITALOPRAM HYDROBROMIDE | Co Citalopram 40mg Tab | COB | 0.1332 | 0.1332 | YES | NO | NO |
| 02248050 | CITALOPRAM HYDROBROMIDE | Co Citalopram 20mg Tab | COB | 0.1332 | 0.1332 | YES | NO | NO |
| 02313413 | CITALOPRAM HYDROBROMIDE | Jamp-Citalopram 40mg Tab | JPC | 0.1332 | 0.1332 | YES | NO | NO |
| 02313405 | CITALOPRAM HYDROBROMIDE | Jamp-Citalopram 20mg Tab | JPC | 0.1332 | 0.1332 | YES | NO | NO |
| 02532123 | CITALOPRAM HYDROBROMIDE | M-Citalopram (Off-Formulary Interchangeable) 10mg Tab | MAT | 0.4464 | N/A | YES | NO | NO |
| 02467844 | CITALOPRAM HYDROBROMIDE | M-Citalopram 40mg Tab | MAT | 0.1332 | 0.1332 | YES | NO | NO |
| 02467836 | CITALOPRAM HYDROBROMIDE | M-Citalopram 20mg Tab | MAT | 0.1332 | 0.1332 | YES | NO | NO |
| 02371901 | CITALOPRAM HYDROBROMIDE | Mar-Citalopram 40mg Tab | MAR | 0.1332 | 0.1332 | YES | NO | NO |
| 02371898 | CITALOPRAM HYDROBROMIDE | Mar-Citalopram 20mg Tab | MAR | 0.1332 | 0.1332 | YES | NO | NO |
| 02371871 | CITALOPRAM HYDROBROMIDE | Mar-Citalopram (Off-Formulary Interchangeable) 10mg Tab | MAR | 0.4464 | N/A | YES | NO | NO |
| 02429705 | CITALOPRAM HYDROBROMIDE | Mint-Citalopram 20mg Tab | MIN | 0.1332 | 0.1332 | YES | NO | NO |
| 02429713 | CITALOPRAM HYDROBROMIDE | Mint-Citalopram 40mg Tab | MIN | 0.1332 | 0.1332 | YES | NO | NO |
| 02477645 | CITALOPRAM HYDROBROMIDE | NRA-Citalopram 20mg Tab | NRA | 0.1332 | 0.1332 | YES | NO | NO |
| 02477653 | CITALOPRAM HYDROBROMIDE | NRA-Citalopram 40mg Tab | NRA | 0.1332 | 0.1332 | YES | NO | NO |
| 02409038 | CITALOPRAM HYDROBROMIDE | Nat-Citalopram 40mg Tab | NAT | 0.1332 | 0.1332 | YES | NO | NO |
| 02409011 | CITALOPRAM HYDROBROMIDE | Nat-Citalopram 20mg Tab | NAT | 0.1332 | 0.1332 | YES | NO | NO |
| 02409003 | CITALOPRAM HYDROBROMIDE | Natco-Citalopram (Off-Formulary Interchangeable) 10mg Tab | NAT | 0.4464 | N/A | YES | NO | NO |
| 02443899 | CITALOPRAM HYDROBROMIDE | Natco-Citalopram 40mg Tab | NAT | 0.1332 | 0.1332 | YES | NO | NO |
| 02443880 | CITALOPRAM HYDROBROMIDE | Natco-Citalopram 20mg Tab | NAT | 0.1332 | 0.1332 | YES | NO | NO |
| 02270609 | CITALOPRAM HYDROBROMIDE | PMS-Citalopram (Off-Formulary Interchangeable) 10mg Tab | PMS | 0.4464 | N/A | YES | NO | NO |
| 02248010 | CITALOPRAM HYDROBROMIDE | PMS-Citalopram 20mg Tab | PMS | 0.1332 | 0.1332 | YES | NO | NO |
| 02248011 | CITALOPRAM HYDROBROMIDE | PMS-Citalopram 40mg Tab | PMS | 0.1332 | 0.1332 | YES | NO | NO |
| 02285622 | CITALOPRAM HYDROBROMIDE | Ran-Citalo 20mg Tab | RAN | 0.1332 | 0.1332 | YES | NO | NO |
| 02285630 | CITALOPRAM HYDROBROMIDE | Ran-Citalo 40mg Tab | RAN | 0.1332 | 0.1332 | YES | NO | NO |
| 02303272 | CITALOPRAM HYDROBROMIDE | Riva-Citalopram 40mg Tab | RIA | 0.1332 | 0.1332 | YES | NO | NO |
| 02303264 | CITALOPRAM HYDROBROMIDE | Riva-Citalopram 20mg Tab | RIA | 0.1332 | 0.1332 | YES | NO | NO |
| 02248171 | CITALOPRAM HYDROBROMIDE | Sandoz Citalopram 40mg Tab | SDZ | 0.1332 | 0.1332 | YES | NO | NO |
| 02248170 | CITALOPRAM HYDROBROMIDE | Sandoz Citalopram 20mg Tab | SDZ | 0.1332 | 0.1332 | YES | NO | NO |
| 02355272 | CITALOPRAM HYDROBROMIDE | Septa-Citalopram 20mg Tab | SET | 0.1332 | 0.1332 | YES | NO | NO |
| 02355280 | CITALOPRAM HYDROBROMIDE | Septa-Citalopram 40mg Tab | SET | 0.1332 | 0.1332 | YES | NO | NO |
| 02293226 | CITALOPRAM HYDROBROMIDE | Teva-Citalopram 40mg Tab | TEV | 0.1332 | 0.1332 | YES | NO | NO |
| 02293218 | CITALOPRAM HYDROBROMIDE | Teva-Citalopram 20mg Tab | TEV | 0.1332 | 0.1332 | YES | NO | NO |
| 02403196 | CLARITHROMYCIN | Act Clarithromycin XL 500mg ER Tab | ACV | 1.2572 | 1.2572 | YES | NO | YES |
| 02413345 | CLARITHROMYCIN | Apo-Clarithromycin XL 500mg ER Tab | APX | 1.2572 | 1.2572 | YES | NO | YES |
| 02244756 | CLARITHROMYCIN | Biaxin XL 500mg ER Tab | BGP | 2.5672 | 1.2572 | YES | NO | YES |
| 02146908 | CLARITHROMYCIN | Biaxin 125mg/5mL Ped Gran | BGP | 0.3425 | 0.2388 | YES | NO | YES |
| 02390442 | CLARITHROMYCIN | Taro-Clarithromycin 125mg/5mL Ped Gran | TAR | 0.2388 | 0.2388 | YES | NO | YES |
| 02244641 | CLARITHROMYCIN | Biaxin 250mg/5mL Susp | BGP | 0.6718 | 0.4685 | YES | NO | YES |
| 02390450 | CLARITHROMYCIN | Taro-Clarithromycin 250mg/5mL Susp | TAR | 0.4685 | 0.4685 | YES | NO | YES |
| 02274744 | CLARITHROMYCIN | Apo-Clarithromycin 250mg Tab | APX | 0.4122 | 0.4122 | YES | NO | YES |
| 02274752 | CLARITHROMYCIN | Apo-Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | APX | 2.2009 | N/A | YES | NO | YES |
| 01984853 | CLARITHROMYCIN | Biaxin BID 250mg Tab | BGP | 1.9234 | 0.4122 | YES | NO | YES |
| 02126710 | CLARITHROMYCIN | Biaxin BID (Off-Formulary Interchangeable) 500mg Tab | BGP | N/A | N/A | YES | NO | YES |
| 02466120 | CLARITHROMYCIN | Clarithromycin 250mg Tab | SAI | 0.4122 | 0.4122 | YES | NO | YES |
| 02442469 | CLARITHROMYCIN | Clarithromycin 250mg Tab | SIV | 0.4122 | 0.4122 | YES | NO | YES |
| 02442485 | CLARITHROMYCIN | Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | SIV | 2.2009 | N/A | YES | NO | YES |
| 02466139 | CLARITHROMYCIN | Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | SAI | 2.2009 | N/A | YES | NO | YES |
| 02471396 | CLARITHROMYCIN | M-Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | MAT | 2.2009 | N/A | YES | NO | YES |
| 02471388 | CLARITHROMYCIN | M-Clarithromycin 250mg Tab | MAT | 0.4122 | 0.4122 | YES | NO | YES |
| 02247574 | CLARITHROMYCIN | PMS-Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | PMS | 2.2009 | N/A | YES | NO | YES |
| 02247573 | CLARITHROMYCIN | PMS-Clarithromycin 250mg Tab | PMS | 0.4122 | 0.4122 | YES | NO | YES |
| 02361426 | CLARITHROMYCIN | Ran-Clarithromycin 250mg Tab | RAN | 0.4122 | 0.4122 | YES | NO | YES |
| 02361434 | CLARITHROMYCIN | Ran-Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | RAN | 2.2009 | N/A | YES | NO | YES |
| 02266539 | CLARITHROMYCIN | Sandoz Clarithromycin 250mg Tab | SDZ | 0.4122 | 0.4122 | YES | NO | YES |
| 02266547 | CLARITHROMYCIN | Sandoz Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | SDZ | 2.2009 | N/A | YES | NO | YES |
| 02248804 | CLARITHROMYCIN | Teva-Clarithromycin 250mg Tab | TEV | 0.4122 | 0.4122 | YES | NO | YES |
| 02248805 | CLARITHROMYCIN | Teva-Clarithromycin (Off-Formulary Interchangeable) 500mg Tab | TEV | 2.2009 | N/A | YES | NO | YES |
| 02483769 | CLINDAMYCIN | Clindamycin Phosphate Topical Solution (Off-Formulary Interchangeable) 1% Top Sol | TEP | 0.2613 | N/A | YES | NO | NO |
| 00582301 | CLINDAMYCIN | Dalacin T 1% (Off-Formulary Interchangeable) 1% Top Sol | PFI | N/A | N/A | YES | NO | NO |
| 02266938 | CLINDAMYCIN | Taro-Clindamycin (Off-Formulary Interchangeable) 1% Top Sol | TAR | 0.5072 | N/A | YES | NO | NO |
| 02245233 | CLINDAMYCIN HCL | Apo-Clindamycin 300mg Cap | APX | 0.4434 | 0.4434 | YES | NO | NO |
| 02245232 | CLINDAMYCIN HCL | Apo-Clindamycin 150mg Cap | APX | 0.2217 | 0.2217 | YES | NO | NO |
| 02436906 | CLINDAMYCIN HCL | Auro-Clindamycin 150mg Cap | AUR | 0.2217 | 0.2217 | YES | NO | NO |
| 02436914 | CLINDAMYCIN HCL | Auro-Clindamycin 300mg Cap | AUR | 0.4434 | 0.4434 | YES | NO | NO |
| 02400529 | CLINDAMYCIN HCL | Clindamycin 150mg Cap | SAI | 0.2217 | 0.2217 | YES | NO | NO |
| 02400537 | CLINDAMYCIN HCL | Clindamycin 300mg Cap | SAI | 0.4434 | 0.4434 | YES | NO | NO |
| 00030570 | CLINDAMYCIN HCL | Dalacin C (Not a Benefit) 150mg Cap | PFI | N/A | N/A | YES | NO | NO |
| 02182866 | CLINDAMYCIN HCL | Dalacin C 300mg Cap | PFI | 2.9008 | 0.4434 | YES | NO | NO |
| 02483742 | CLINDAMYCIN HCL | Jamp-Clindamycin 300mg Cap | JPC | 0.4434 | 0.4434 | YES | NO | NO |
| 02483734 | CLINDAMYCIN HCL | Jamp-Clindamycin 150mg Cap | JPC | 0.2217 | 0.2217 | YES | NO | NO |
| 02479923 | CLINDAMYCIN HCL | M-Clindamycin 150mg Cap | MAT | 0.2217 | 0.2217 | YES | NO | NO |
| 02479931 | CLINDAMYCIN HCL | M-Clindamycin 300mg Cap | MAT | 0.4434 | 0.4434 | YES | NO | NO |
| 02462656 | CLINDAMYCIN HCL | Med-Clindamycin 150mg Cap | GMP | 0.2217 | 0.2217 | YES | NO | NO |
| 02462664 | CLINDAMYCIN HCL | Med-Clindamycin 300mg Cap | GMP | 0.4434 | 0.4434 | YES | NO | NO |
| 02493748 | CLINDAMYCIN HCL | NRA-Clindamycin 150mg Cap | NRA | 0.2217 | 0.2217 | YES | NO | NO |
| 02493756 | CLINDAMYCIN HCL | NRA-Clindamycin 300mg Cap | NRA | 0.4434 | 0.4434 | YES | NO | NO |
| 02468484 | CLINDAMYCIN HCL | Riva-Clindamycin 300mg Cap | RIA | 0.4434 | 0.4434 | YES | NO | NO |
| 02468476 | CLINDAMYCIN HCL | Riva-Clindamycin 150mg Cap | RIA | 0.2217 | 0.2217 | YES | NO | NO |
| 02241709 | CLINDAMYCIN HCL | Teva-Clindamycin 150mg Cap | TEV | 0.2217 | 0.2217 | YES | NO | NO |
| 02241710 | CLINDAMYCIN HCL | Teva-Clindamycin 300mg Cap | TEV | 0.4434 | 0.4434 | YES | NO | NO |
| 00225851 | CLINDAMYCIN PALMITATE | Dalacin C Flavoured Granules 15mg/mL Pd for Oral Susp | PFI | 0.3152 | 0.3152 | NO | NO | NO |
| 02230540 | CLINDAMYCIN PHOSPHATE | Clindamycin Phosphate Injection USP (Not a Benefit) 300mg/2mL Inj Sol-2mL Pk | SDZ | N/A | N/A | YES | NO | YES |
| 00260436 | CLINDAMYCIN PHOSPHATE | Dalacin C 300mg/2mL Inj Sol-2mL Pk | PFI | 8.8938 | 8.8938 | YES | NO | YES |
| 02550423 | CLINDAMYCIN PHOSPHATE & ADAPALENE & BENZOYL PEROXIDE | Cabtreo 1.2% w/w & 0.15% w/w & 3.1% w/w Top Gel Pump | BHC | 2.9483 | 2.9483 | NO | YES | NO |
| 02243158 | CLINDAMYCIN PHOSPHATE & BENZOYL PEROXIDE | Clindoxyl 1% & 5% Gel | STI | 0.7500 | 0.6857 | YES | NO | NO |
| 02440180 | CLINDAMYCIN PHOSPHATE & BENZOYL PEROXIDE | Taro-Clindamycin/Benzoyl Peroxide Gel 1% & 5% Gel | TAR | 0.6857 | 0.6857 | YES | NO | NO |
| 02248472 | CLINDAMYCIN PHOSPHATE & BENZOYL PEROXIDE | BenzaClin Topical Gel 1% & 5% Top Gel | VAL | 1.3169 | 0.7422 | YES | NO | NO |
| 02464519 | CLINDAMYCIN PHOSPHATE & BENZOYL PEROXIDE | Taro-Benzoyl Peroxide / Clindamycin Kit 1% & 5% Top Gel | TAR | 0.7422 | 0.7422 | YES | NO | NO |
| 02244638 | CLOBAZAM | Apo-Clobazam 10mg Tab | APX | 0.2197 | 0.2197 | YES | YES | NO |
| 02221799 | CLOBAZAM | Frisium (Not a Benefit) 10mg Tab | OVA | N/A | N/A | YES | NO | NO |
| 02238334 | CLOBAZAM | Teva-Clobazam 10mg Tab | TEV | 0.2197 | 0.2197 | YES | YES | NO |
| 02213265 | CLOBETASOL PROPIONATE | Dermovate 0.05% Cr | TPH | 0.9964 | 0.2279 | YES | NO | YES |
| 02024187 | CLOBETASOL PROPIONATE | Mylan-Clobetasol 0.05% Cr | MYL | 0.2279 | 0.2279 | YES | NO | YES |
| 02245523 | CLOBETASOL PROPIONATE | Taro-Clobetasol Cream USP 0.05% Cr | TAR | 0.2279 | 0.2279 | YES | NO | YES |
| 01910272 | CLOBETASOL PROPIONATE | Teva-Clobetasol 0.05% Cr | TEV | 0.2279 | 0.2279 | YES | NO | YES |
| 02213273 | CLOBETASOL PROPIONATE | Dermovate 0.05% Oint | TPH | 0.9964 | 0.2279 | YES | NO | YES |
| 02026767 | CLOBETASOL PROPIONATE | Mylan-Clobetasol 0.05% Oint | MYL | 0.2279 | 0.2279 | YES | NO | YES |
| 02245524 | CLOBETASOL PROPIONATE | Taro-Clobetasol Ointment USP 0.05% Oint | TAR | 0.2279 | 0.2279 | YES | NO | YES |
| 01910280 | CLOBETASOL PROPIONATE | Teva-Clobetasol 0.05% Oint | TEV | 0.2279 | 0.2279 | YES | NO | YES |
| 02213281 | CLOBETASOL PROPIONATE | Dermovate 0.05% Scalp Lot | TPH | 0.7992 | 0.3996 | YES | NO | YES |
| 02216213 | CLOBETASOL PROPIONATE | Mylan-Clobetasol Scalp Application 0.05% Scalp Lot | MYL | 0.3996 | 0.3996 | YES | NO | YES |
| 02245522 | CLOBETASOL PROPIONATE | Taro-Clobetasol Topical Solution USP 0.05% Scalp Lot | TAR | 0.3996 | 0.3996 | YES | NO | YES |
| 02256371 | CLOBETASOL PROPIONATE | Clobex Shampoo (Off-Formulary Interchangeable) 0.05% w/w Top Shampoo | GAC | N/A | N/A | YES | NO | YES |
| 02519437 | CLOBETASOL PROPIONATE | Reddy-Clobetasol Shampoo (Off-Formulary Interchangeable) 0.05% w/w Top Shampoo | DRR | 1.0838 | N/A | YES | NO | YES |
| 02506203 | CLOBETASOL PROPIONATE | Taro-Clobetasol Shampoo (Off-Formulary Interchangeable) 0.05% w/w Top Shampoo | TAR | 1.0838 | N/A | YES | NO | YES |
| 02475162 | CLOBETASOL PROPIONATE | Apo-Clobetasol Spray (Off-Formulary Interchangeable) 0.05% w/w Top Sol Sp | APX | 1.9259 | N/A | YES | NO | YES |
| 02299739 | CLOBETASOL PROPIONATE | Clobex Spray (Off-Formulary Interchangeable) 0.05% w/w Top Sol Sp | GAC | N/A | N/A | YES | NO | YES |
| 02534665 | CLOBETASOL PROPIONATE | Jamp Clobetasol Spray (Off-Formulary Interchangeable) 0.05% w/w Top Sol Sp | JPC | 1.9259 | N/A | YES | NO | YES |
| 02490706 | CLOBETASOL PROPIONATE | Odan Clobetasol (Off-Formulary Interchangeable) 0.05% w/w Top Sol Sp | ODN | 1.9260 | N/A | YES | NO | YES |
| 02495023 | CLOBETASOL PROPIONATE | Sandoz Clobetasol (Off-Formulary Interchangeable) 0.05% w/w Top Sol Sp | SDZ | 1.9259 | N/A | YES | NO | YES |
| 02489619 | CLOBETASOL PROPIONATE | Taro-Clobetasol Spray (Off-Formulary Interchangeable) 0.05% w/w Top Sol Sp | TAR | 1.9259 | N/A | YES | NO | YES |
| 02245828 | CLODRONATE DISODIUM | Clasteon 400mg Cap | SUO | 1.2083 | 1.2083 | YES | YES | NO |
| 01927078 | CLODRONATE DISODIUM | Ostac (Not a Benefit) 400mg Cap | HLR | N/A | N/A | YES | NO | NO |
| 00002038 | CLOFIBRATE | Atromid-S (Not a Benefit) 500mg Cap | AYE | N/A | N/A | YES | NO | NO |
| 00337382 | CLOFIBRATE | Novo-Fibrate (Not a Benefit) 500mg Cap | NOP | N/A | N/A | YES | NO | NO |
| 00324019 | CLOMIPRAMINE HCL | Anafranil Tab 25mg | APX | 0.4020 | 0.3417 | YES | NO | NO |
| 00402591 | CLOMIPRAMINE HCL | Anafranil Tab 50mg | APX | 0.7401 | 0.6291 | YES | NO | NO |
| 02497514 | CLOMIPRAMINE HCL | Taro-Clomipramine Cap 50mg | TAR | 0.6291 | 0.6291 | YES | NO | NO |
| 02497506 | CLOMIPRAMINE HCL | Taro-Clomipramine Cap 25mg | TAR | 0.3417 | 0.3417 | YES | NO | NO |
| 00330566 | CLOMIPRAMINE HCL | Anafranil 10mg Tab | APX | 0.2949 | 0.2949 | NO | NO | NO |
| 02177889 | CLONAZEPAM | Apo-Clonazepam 0.5mg Tab | APX | 0.0418 | 0.0418 | YES | NO | NO |
| 02177897 | CLONAZEPAM | Apo-Clonazepam 2mg Tab | APX | 0.0721 | 0.0721 | YES | NO | NO |
| 02048701 | CLONAZEPAM | PMS-Clonazepam 0.5mg Tab | PMS | 0.0418 | 0.0418 | YES | NO | NO |
| 02048736 | CLONAZEPAM | PMS-Clonazepam 2mg Tab | PMS | 0.0721 | 0.0721 | YES | NO | NO |
| 02207818 | CLONAZEPAM | PMS-Clonazepam-R 0.5mg Tab | PMS | 0.0418 | 0.0418 | YES | NO | NO |
| 00382841 | CLONAZEPAM | Rivotril 2mg Tab | HLR | 0.4912 | 0.0721 | YES | NO | NO |
| 00382825 | CLONAZEPAM | Rivotril 0.5mg Tab | HLR | 0.2849 | 0.0418 | YES | NO | NO |
| 02239025 | CLONAZEPAM | Teva-Clonazepam 2mg Tab | TEV | 0.0721 | 0.0721 | YES | NO | NO |
| 02239024 | CLONAZEPAM | Teva-Clonazepam 0.5mg Tab | TEV | 0.0418 | 0.0418 | YES | NO | NO |
| 00259527 | CLONIDINE HCL | Catapres (Not a Benefit) 0.1mg Tab | BOE | N/A | N/A | YES | NO | YES |
| 00291889 | CLONIDINE HCL | Catapres (Not a Benefit) 0.2mg Tab | BOE | N/A | N/A | YES | NO | YES |
| 02538504 | CLONIDINE HCL | Clonidine 0.2mg Tab | SIV | 0.1212 | 0.1212 | YES | NO | YES |
| 02538490 | CLONIDINE HCL | Clonidine 0.1mg Tab | SIV | 0.0679 | 0.0679 | YES | NO | YES |
| 02540061 | CLONIDINE HCL | Clonidine (Off-Formulary Interchangeable) 0.025mg Tab | SIV | 0.2713 | N/A | YES | NO | YES |
| 00519251 | CLONIDINE HCL | Dixarit (Off-Formulary Interchangeable) 0.025mg Tab | BOE | N/A | N/A | YES | NO | YES |
| 02528207 | CLONIDINE HCL | Jamp Clonidine (Off-Formulary Interchangeable) 0.025mg Tab | JPC | 0.2713 | N/A | YES | NO | YES |
| 02524198 | CLONIDINE HCL | Mar-Clonidine (Off-Formulary Interchangeable) 0.025mg Tab | MAR | 0.2713 | N/A | YES | NO | YES |
| 02462192 | CLONIDINE HCL | Mint-Clonidine 0.1mg Tab | MIN | 0.0679 | 0.0679 | YES | NO | YES |
| 02462206 | CLONIDINE HCL | Mint-Clonidine 0.2mg Tab | MIN | 0.1212 | 0.1212 | YES | NO | YES |
| 02534738 | CLONIDINE HCL | Mint-Clonidine (Off-Formulary Interchangeable) 0.025mg Tab | MIN | 0.2713 | N/A | YES | NO | YES |
| 02515792 | CLONIDINE HCL | Sandoz Clonidine 0.2mg Tab | SDZ | 0.1212 | 0.1212 | YES | NO | YES |
| 02515784 | CLONIDINE HCL | Sandoz Clonidine 0.1mg Tab | SDZ | 0.0679 | 0.0679 | YES | NO | YES |
| 02516217 | CLONIDINE HCL | Sandoz Clonidine (Off-Formulary Interchangeable) 0.025mg Tab | SDZ | 0.2713 | N/A | YES | NO | YES |
| 02046148 | CLONIDINE HCL | Teva-Clonidine 0.2mg Tab | TEV | 0.1212 | 0.1212 | YES | NO | YES |
| 02046121 | CLONIDINE HCL | Teva-Clonidine 0.1mg Tab | TEV | 0.0679 | 0.0679 | YES | NO | YES |
| 02304163 | CLONIDINE HCL | Teva-Clonidine (Off-Formulary Interchangeable) 0.025mg Tab | TEV | 0.2713 | N/A | YES | NO | YES |
| 02398591 | CLOPIDOGREL BISULFATE | Apo-Clopidogrel (Off-Formulary Interchangeable) 300mg Tab | APX | 9.5447 | N/A | YES | NO | NO |
| 02252767 | CLOPIDOGREL BISULFATE | Apo-Clopidogrel 75mg Tab | APX | 0.2631 | 0.2631 | YES | NO | NO |
| 02416387 | CLOPIDOGREL BISULFATE | Auro-Clopidogrel 75mg Tab | AUR | 0.2631 | 0.2631 | YES | NO | NO |
| 02400553 | CLOPIDOGREL BISULFATE | Clopidogrel 75mg Tab | SAI | 0.2631 | 0.2631 | YES | NO | NO |
| 02385813 | CLOPIDOGREL BISULFATE | Clopidogrel 75mg Tab | SIV | 0.2631 | 0.2631 | YES | NO | NO |
| 02303027 | CLOPIDOGREL BISULFATE | Co Clopidogrel 75mg Tab | COB | 0.2631 | 0.2631 | YES | NO | NO |
| 02415550 | CLOPIDOGREL BISULFATE | Jamp-Clopidogrel 75mg Tab | JPC | 0.2631 | 0.2631 | YES | NO | NO |
| 02502283 | CLOPIDOGREL BISULFATE | M-Clopidogrel 75mg Tab | MAT | 0.2631 | 0.2631 | YES | NO | NO |
| 02422255 | CLOPIDOGREL BISULFATE | Mar-Clopidogrel 75mg Tab | MAR | 0.2631 | 0.2631 | YES | NO | NO |
| 02408910 | CLOPIDOGREL BISULFATE | Mint-Clopidogrel 75mg Tab | MIN | 0.2631 | 0.2631 | YES | NO | NO |
| 02482037 | CLOPIDOGREL BISULFATE | NRA-Clopidogrel 75mg Tab | NRA | 0.2631 | 0.2631 | YES | NO | NO |
| 02348004 | CLOPIDOGREL BISULFATE | PMS-Clopidogrel 75mg Tab | PMS | 0.2631 | 0.2631 | YES | NO | NO |
| 02238682 | CLOPIDOGREL BISULFATE | Plavix 75mg Tab | SAV | 2.8180 | 0.2631 | YES | NO | NO |
| 02330555 | CLOPIDOGREL BISULFATE | Plavix (Off-Formulary Interchangeable) 300mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02379813 | CLOPIDOGREL BISULFATE | Ran-Clopidogrel 75mg Tab | RAN | 0.2631 | 0.2631 | YES | NO | NO |
| 02359316 | CLOPIDOGREL BISULFATE | Sandoz Clopidogrel 75mg Tab | SDZ | 0.2631 | 0.2631 | YES | NO | NO |
| 02293161 | CLOPIDOGREL BISULFATE | Teva-Clopidogrel 75mg Tab | TEV | 0.2631 | 0.2631 | YES | NO | NO |
| 02388065 | CLOPIDOGREL BISULFATE | Teva-Clopidogrel (Off-Formulary Interchangeable) 300mg Tab | TEV | 9.5447 | N/A | YES | NO | NO |
| 00860689 | CLORAZEPATE DIPOTASSIUM | Clorazepate 3.75mg Cap | AAP | 0.1793 | 0.1793 | YES | NO | NO |
| 00860700 | CLORAZEPATE DIPOTASSIUM | Clorazepate 7.5mg Cap | AAP | 0.2337 | 0.2337 | YES | NO | NO |
| 00860697 | CLORAZEPATE DIPOTASSIUM | Clorazepate 15mg Cap | AAP | 0.4405 | 0.4405 | YES | NO | NO |
| 00264911 | CLORAZEPATE DIPOTASSIUM | Tranxene (Not a Benefit) 15mg Cap | ABB | N/A | N/A | YES | NO | NO |
| 00264938 | CLORAZEPATE DIPOTASSIUM | Tranxene (Not a Benefit) 3.75mg Cap | ABB | N/A | N/A | YES | NO | NO |
| 00264946 | CLORAZEPATE DIPOTASSIUM | Tranxene (Not a Benefit) 7.5mg Cap | ABB | N/A | N/A | YES | NO | NO |
| 02324032 | CLOSTRIDIUM BOTULINUM NEUROTOXIN TYPE A | Xeomin 100 LD50 Units Pd for Inj-Vial Pk | MEZ | 338.9100 | 338.9100 | NO | YES | NO |
| 02371081 | CLOSTRIDIUM BOTULINUM NEUROTOXIN TYPE A | Xeomin 50 LD50 Units Pd for Inj-Vial Pk | MEZ | 169.4550 | 169.4550 | NO | YES | NO |
| 02150867 | CLOTRIMAZOLE | Canesten 1% Topical Cream (Not a Benefit) 10mg/g Cr | BAY | N/A | N/A | YES | NO | YES |
| 00812382 | CLOTRIMAZOLE | Clotrimaderm 10mg/g Cr | TAR | 0.2233 | 0.2233 | YES | NO | YES |
| 02264102 | CLOTRIMAZOLE | Canesten 1 Comfortab Combi-Pak 500mg & 1% Tab & Cr | BAY | 12.0800 | 12.0800 | NO | NO | YES |
| 02150905 | CLOTRIMAZOLE | Canesten 3 Cream 20mg/g Vag Cr-App | BAY | 0.4424 | 0.3624 | YES | NO | YES |
| 02150891 | CLOTRIMAZOLE | Canesten 6 Cream 10mg/g Vag Cr-App | BAY | 0.2212 | 0.1812 | YES | NO | YES |
| 00812374 | CLOTRIMAZOLE | Clotrimaderm Vaginal Cream 20mg/g Vag Cr-App | TAR | 0.3624 | 0.3624 | YES | NO | YES |
| 00812366 | CLOTRIMAZOLE | Clotrimaderm Vaginal Cream 10mg/g Vag Cr-App | TAR | 0.1812 | 0.1812 | YES | NO | YES |
| 00611174 | CLOTRIMAZOLE & BETAMETHASONE DIPROPIONATE | Lotriderm Cream (Off-Formulary Interchangeable) 1% w/w & 0.05% w/w Top Cr | MEK | N/A | N/A | YES | NO | YES |
| 02496410 | CLOTRIMAZOLE & BETAMETHASONE DIPROPIONATE | TaroClotrimazole/BetamethasoneDipropiona (Off-Formulary Interchangeable) 1% w/w & 0.05% w/w Top Cr | TAR | 1.0832 | N/A | YES | NO | YES |
| 02510731 | CLOXACILLIN | Jamp Cloxacillin 250mg Cap | JPC | 0.2141 | 0.2141 | YES | NO | NO |
| 02510758 | CLOXACILLIN | Jamp Cloxacillin 500mg Cap | JPC | 0.4045 | 0.4045 | YES | NO | NO |
| 00002046 | CLOXACILLIN | Orbenin (Not a Benefit) 250mg Cap | AYE | N/A | N/A | YES | NO | NO |
| 00002054 | CLOXACILLIN | Orbenin (Not a Benefit) 500mg Cap | AYE | N/A | N/A | YES | NO | NO |
| 00337773 | CLOXACILLIN | Teva-Cloxacillin 500mg Cap | TEV | 0.4045 | 0.4045 | YES | NO | NO |
| 00337765 | CLOXACILLIN | Teva-Cloxacillin 250mg Cap | TEV | 0.2141 | 0.2141 | YES | NO | NO |
| 02042975 | CLOXACILLIN | Orbenin (Not a Benefit) 25mg/mL O/L | WAY | N/A | N/A | YES | NO | NO |
| 00337757 | CLOXACILLIN | Teva-Cloxacillin 25mg/mL O/L | TEV | 0.0606 | 0.0606 | YES | NO | NO |
| 02248034 | CLOZAPINE | AA-Clozapine (Off-Formulary Interchangeable) 25mg Tab | AAP | 0.6594 | N/A | YES | NO | NO |
| 02248035 | CLOZAPINE | AA-Clozapine (Off-Formulary Interchangeable) 100mg Tab | AAP | 2.6446 | N/A | YES | NO | NO |
| 02458756 | CLOZAPINE | AA-Clozapine (Off-Formulary Interchangeable) 200mg Tab | AAP | 5.2892 | N/A | YES | NO | NO |
| 02458748 | CLOZAPINE | AA-Clozapine (Off-Formulary Interchangeable) 50mg Tab | AAP | 1.3206 | N/A | YES | NO | NO |
| 02490676 | CLOZAPINE | Clozaril (Off-Formulary Interchangeable) 200mg Tab | HLS | N/A | N/A | YES | NO | NO |
| 02490668 | CLOZAPINE | Clozaril (Off-Formulary Interchangeable) 50mg Tab | HLS | N/A | N/A | YES | NO | NO |
| 00894737 | CLOZAPINE | Clozaril (Off-Formulary Interchangeable) 25mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00894745 | CLOZAPINE | Clozaril (Off-Formulary Interchangeable) 100mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02247244 | CLOZAPINE | Gen-Clozapine (Off-Formulary Interchangeable) 100mg Tab | MYL | 2.6446 | N/A | YES | NO | NO |
| 02247243 | CLOZAPINE | Gen-Clozapine (Off-Formulary Interchangeable) 25mg Tab | MYL | 0.6594 | N/A | YES | NO | NO |
| 02397137 | COBICISTAT & ELVITEGRAVIR & EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Stribild 150mg & 150mg & 200mg & 300mg Tab | GIL | 48.0177 | 48.0177 | NO | NO | NO |
| 00779458 | CODEINE PHOSPHATE | Codeine (Not a Benefit) 15mg Tab | ROG | N/A | N/A | YES | NO | YES |
| 00593435 | CODEINE PHOSPHATE | Teva-Codeine 15mg Tab | TEV | 0.0596 | 0.0596 | YES | NO | YES |
| 00593451 | CODEINE PHOSPHATE | Teva-Codeine 30mg Tab | TEV | 0.0966 | 0.0966 | NO | NO | YES |
| 02230302 | CODEINE SULFATE TRIHYDRATE & MONOHYDRATE | Codeine Contin 50mg CR Tab | PFP | 0.5032 | 0.5032 | NO | YES | YES |
| 02163748 | CODEINE SULFATE TRIHYDRATE & MONOHYDRATE | Codeine Contin 100mg CR Tab | PFP | 1.0074 | 1.0074 | NO | YES | YES |
| 02163780 | CODEINE SULFATE TRIHYDRATE & MONOHYDRATE | Codeine Contin 150mg CR Tab | PFP | 1.5116 | 1.5116 | NO | YES | YES |
| 02163799 | CODEINE SULFATE TRIHYDRATE & MONOHYDRATE | Codeine Contin 200mg CR Tab | PFP | 2.0148 | 2.0148 | NO | YES | YES |
| 02494051 | COLESEVELAM HYDROCHLORIDE | Apo-Colesevelam 625mg Tab | APX | 0.5931 | 0.5931 | YES | NO | YES |
| 09858334 | COLESEVELAM HYDROCHLORIDE | Colesevelam (Temporary Benefit) 625mg Tab | GLP | 0.5931 | 0.5931 | NO | NO | YES |
| 02373955 | COLESEVELAM HYDROCHLORIDE | Lodalis 625mg Tab | VAL | 1.3906 | 0.5931 | YES | NO | YES |
| 00642975 | COLESTIPOL HCL | Colestid Regular Gran-5g Pk | PFI | 1.4595 | 1.4595 | NO | NO | YES |
| 02063670 | COLLAGENASE | Santyl Ointment 250Unit/g 30g Pk | SNE | 87.5000 | 87.5000 | NO | NO | NO |
| 09858336 | COLLAGENASE | Santyl (Temporary Benefit) 250Unit/g Oint-30g Pk | SNE | 87.5000 | 87.5000 | NO | NO | NO |
| 02414686 | CONJUGATED ESTROGENS | Premarin 0.625mg SR Tab | PFI | 0.4088 | 0.4088 | NO | YES | NO |
| 02043440 | CONJUGATED ESTROGENS | Premarin Vaginal Cream 0.625mg/g Vag Cr | PFI | 0.9110 | 0.9110 | NO | NO | NO |
| 00253952 | COSYNTROPIN ZINC HYDROXIDE | Synacthen Depot 1mg/mL Inj Susp-1mL Pk | QUO | 680.0000 | 680.0000 | NO | NO | NO |
| 01987003 | CYANOCOBALAMIN | Cyanocobalamin 1mg/mL Inj Sol-10mL Pk | STE | 3.0600 | 3.0600 | YES | NO | NO |
| 02413795 | CYANOCOBALAMIN | Cyanocobalamin Injection USP 1mg/mL Inj Sol-10mL Pk | MYL | 3.0600 | 3.0600 | YES | NO | NO |
| 02420147 | CYANOCOBALAMIN | Jamp-Cyanocobalamin 1mg/mL Inj Sol-10mL Pk | JPC | 3.0600 | 3.0600 | YES | NO | NO |
| 00029165 | CYANOCOBALAMIN | Rubramin (Not a Benefit) 1mg/mL Inj Sol-10mL Pk | BQU | N/A | N/A | YES | NO | NO |
| 00521515 | CYANOCOBALAMIN | Vitamin B12-1000mcg/mL 1mg/mL Inj Sol-10mL Pk | SDZ | 3.0600 | 3.0600 | YES | NO | NO |
| 02485419 | CYCLOBENZAPRINE HCL | AG-Cyclobenzaprine (Not a Benefit) 10mg Tab | ANG | N/A | N/A | YES | NO | YES |
| 02177145 | CYCLOBENZAPRINE HCL | Apo-Cyclobenzaprine (Not a Benefit) 10mg Tab | APX | N/A | N/A | YES | NO | YES |
| 02348853 | CYCLOBENZAPRINE HCL | Auro-Cyclobenzaprine (Not a Benefit) 10mg Tab | AUR | N/A | N/A | YES | NO | YES |
| 02287064 | CYCLOBENZAPRINE HCL | Cyclobenzaprine (Not a Benefit) 10mg Tab | SAI | N/A | N/A | YES | NO | YES |
| 02424584 | CYCLOBENZAPRINE HCL | Cyclobenzaprine (Not a Benefit) 10mg Tab | SIV | N/A | N/A | YES | NO | YES |
| 00782742 | CYCLOBENZAPRINE HCL | Flexeril (Not a Benefit) 10mg Tab | FRS | N/A | N/A | YES | NO | YES |
| 02495422 | CYCLOBENZAPRINE HCL | Flexeril (Not a Benefit) 10mg Tab | ORI | N/A | N/A | YES | NO | YES |
| 02357127 | CYCLOBENZAPRINE HCL | Jamp-Cyclobenzaprine (Not a Benefit) 10mg Tab | JPC | N/A | N/A | YES | NO | YES |
| 02212048 | CYCLOBENZAPRINE HCL | PMS-Cyclobenzaprine (Not a Benefit) 10mg Tab | PMS | N/A | N/A | YES | NO | YES |
| 02236506 | CYCLOBENZAPRINE HCL | Ratio-Cyclobenzaprine (Not a Benefit) 10mg Tab | RPH | N/A | N/A | YES | NO | YES |
| 02242079 | CYCLOBENZAPRINE HCL | Riva-Cyclobenzaprine (Not a Benefit) 10mg Tab | RIA | N/A | N/A | YES | NO | YES |
| 02080052 | CYCLOBENZAPRINE HCL | Teva-Cyclobenzaprine HCL (Not a Benefit) 10mg Tab | TEV | N/A | N/A | YES | NO | YES |
| 00252506 | CYCLOPENTOLATE HCL | Cyclogyl (Off-Formulary Interchangeable) 1% Oph Sol | NOV | N/A | N/A | YES | NO | NO |
| 00626627 | CYCLOPENTOLATE HCL | Odan-Cyclopentolate (Off-Formulary Interchangeable) 1% Oph Sol | ODN | 0.8925 | N/A | YES | NO | NO |
| 00344885 | CYCLOPHOSPHAMIDE | Cytoxan (Not a Benefit) 50mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02241796 | CYCLOPHOSPHAMIDE | Procytox 50mg Tab | BAX | 0.4773 | 0.4773 | YES | NO | NO |
| 02241795 | CYCLOPHOSPHAMIDE | Procytox 25mg Tab | BAX | 0.3545 | 0.3545 | NO | NO | NO |
| 02150689 | CYCLOSPORINE | Neoral 25mg Cap | NOV | 1.7850 | 0.8657 | YES | NO | NO |
| 02150670 | CYCLOSPORINE | Neoral 100mg Cap | NOV | 6.9680 | 3.3792 | YES | NO | NO |
| 02237671 | CYCLOSPORINE | Neoral 10mg Cap | NOV | 0.7676 | 0.7676 | NO | NO | NO |
| 02150662 | CYCLOSPORINE | Neoral 50mg Cap | NOV | 3.4816 | 1.6885 | YES | NO | NO |
| 02247073 | CYCLOSPORINE | Sandoz Cyclosporine 25mg Cap | SDZ | 0.8657 | 0.8657 | YES | NO | NO |
| 02247074 | CYCLOSPORINE | Sandoz Cyclosporine 50mg Cap | SDZ | 1.6885 | 1.6885 | YES | NO | NO |
| 02242821 | CYCLOSPORINE | Sandoz Cyclosporine 100mg Cap | SDZ | 3.3792 | 3.3792 | YES | NO | NO |
| 02150697 | CYCLOSPORINE | Neoral 100mg/mL O/L | NOV | 6.1952 | 6.1952 | NO | NO | NO |
| 02355655 | CYCLOSPORINE | Restasis (Off-Formulary Interchangeable) 0.05% w/v Oph Emuls-0.4mL Pk | ALL | N/A | N/A | YES | NO | NO |
| 02462486 | CYCLOSPORINE | Teva-Cyclosporine (Off-Formulary Interchangeable) 0.05% w/v Oph Emuls-0.4mL Pk | TEV | 4.1658 | N/A | YES | NO | NO |
| 00704431 | CYPROTERONE ACETATE | Androcur 50mg Tab | AMD | 1.4085 | 1.4000 | YES | NO | NO |
| 02245898 | CYPROTERONE ACETATE | Cyproterone 50mg Tab | AAP | 1.4085 | 1.4000 | YES | NO | NO |
| 02390760 | CYPROTERONE ACETATE | Med-Cyproterone 50mg Tab | GMP | 1.4000 | 1.4000 | YES | NO | NO |
| 02436736 | CYPROTERONE ACETATE & ETHINYL ESTRADIOL | Cleo-35 (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk | ALH | 23.3394 | N/A | YES | NO | NO |
| 02290308 | CYPROTERONE ACETATE & ETHINYL ESTRADIOL | Cyestra-35 (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk | PAL | 23.3394 | N/A | YES | NO | NO |
| 02233542 | CYPROTERONE ACETATE & ETHINYL ESTRADIOL | Diane-35 (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk | BAY | N/A | N/A | YES | NO | NO |
| 02425017 | CYPROTERONE ACETATE & ETHINYL ESTRADIOL | Ran-Cyproterone/Ethinyl Estradiol (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk | RAN | 23.3394 | N/A | YES | NO | NO |
| 02309556 | CYPROTERONE ACETATE & ETHINYL ESTRADIOL | Teva-Cyproterone/Ethinyl Estradiol (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk | TEV | 23.3400 | N/A | YES | NO | NO |
| 02468891 | DABIGATRAN ETEXILATE | Apo-Dabigatran (Off-Formulary Interchangeable) 75mg Cap | APX | 1.6443 | N/A | YES | NO | NO |
| 02468905 | DABIGATRAN ETEXILATE | Apo-Dabigatran 110mg Cap | APX | 1.2540 | 1.2540 | YES | NO | NO |
| 02468913 | DABIGATRAN ETEXILATE | Apo-Dabigatran 150mg Cap | APX | 1.2540 | 1.2540 | YES | NO | NO |
| 02358808 | DABIGATRAN ETEXILATE | Pradaxa 150mg Cap | BOE | 1.7310 | 1.2540 | YES | NO | NO |
| 02312433 | DABIGATRAN ETEXILATE | Pradaxa (Off-Formulary Interchangeable) 75mg Cap | BOE | N/A | N/A | YES | NO | NO |
| 02312441 | DABIGATRAN ETEXILATE | Pradaxa 110mg Cap | BOE | 1.7310 | 1.2540 | YES | NO | NO |
| 02480522 | DALBAVANCIN HYDROCHLORIDE | Xydalba 500mg/Vial Pd for Sol (Preservative-Free) | EVL | 985.8900 | 985.8900 | NO | YES | NO |
| 02352648 | DALTEPARIN SODIUM | Fragmin 7500IU/0.3mL Inj Pref Syr | PFI | 17.8120 | 17.8120 | NO | YES | NO |
| 02132621 | DALTEPARIN SODIUM | Fragmin 2500IU/0.2mL Inj Pref Syr | PFI | 5.9370 | 5.9370 | NO | YES | NO |
| 02132648 | DALTEPARIN SODIUM | Fragmin 5000IU/0.2mL Inj Pref Syr | PFI | 11.8740 | 11.8740 | NO | YES | NO |
| 02352656 | DALTEPARIN SODIUM | Fragmin 10000IU/0.4mL Inj Pref Syr | PFI | 23.7500 | 23.7500 | NO | YES | NO |
| 02352672 | DALTEPARIN SODIUM | Fragmin 15000IU/0.6mL Inj Pref Syr | PFI | 35.6160 | 35.6160 | NO | YES | NO |
| 02352680 | DALTEPARIN SODIUM | Fragmin 18000IU/0.72mL Inj Pref Syr | PFI | 42.7400 | 42.7400 | NO | YES | NO |
| 02430789 | DALTEPARIN SODIUM | Fragmin 3500IU/0.28mL Inj Pref Syr | PFI | 8.3110 | 8.3110 | NO | YES | NO |
| 02352664 | DALTEPARIN SODIUM | Fragmin 12500IU/0.5mL Inj Pref Syr | PFI | 29.6880 | 29.6880 | NO | YES | NO |
| 02494582 | DALTEPARIN SODIUM | Fragmin 16500IU/0.66mL Inj Pref Syr-0.66mL Pk | PFI | 39.1780 | 39.1780 | NO | YES | NO |
| 02231171 | DALTEPARIN SODIUM | Fragmin 25000IU/mL Multidose 3.8mL Pk | PFI | 178.1000 | 178.1000 | NO | YES | NO |
| 02018144 | DANAZOL | Cyclomen 50mg Cap | SAV | 1.0720 | 1.0720 | NO | NO | NO |
| 02018152 | DANAZOL | Cyclomen 100mg Cap | SAV | 1.5910 | 1.5910 | NO | NO | NO |
| 02018160 | DANAZOL | Cyclomen 200mg Cap | SAV | 2.5425 | 2.5425 | NO | NO | NO |
| 01997602 | DANTROLENE SODIUM | Dantrium Capsules 25mg Cap | EDO | 0.7198 | 0.7198 | NO | NO | YES |
| 02527189 | DAPAGLIFLOZIN | Apo-Dapagliflozin 5mg Tab | APX | 0.6825 | 0.6825 | YES | NO | YES |
| 02527197 | DAPAGLIFLOZIN | Apo-Dapagliflozin 10mg Tab | APX | 0.6825 | 0.6825 | YES | NO | YES |
| 02531410 | DAPAGLIFLOZIN | Auro-Dapagliflozin 10mg Tab | AUR | 0.6825 | 0.6825 | YES | NO | YES |
| 02531402 | DAPAGLIFLOZIN | Auro-Dapagliflozin 5mg Tab | AUR | 0.6825 | 0.6825 | YES | NO | YES |
| 02435470 | DAPAGLIFLOZIN | Forxiga 10mg Tab | AZC | 2.7300 | 0.6825 | YES | NO | YES |
| 02435462 | DAPAGLIFLOZIN | Forxiga 5mg Tab | AZC | 2.7300 | 0.6825 | YES | NO | YES |
| 02519860 | DAPAGLIFLOZIN | GLN-Dapagliflozin 10mg Tab | GLP | 0.6825 | 0.6825 | YES | NO | YES |
| 02519852 | DAPAGLIFLOZIN | GLN-Dapagliflozin 5mg Tab | GLP | 0.6825 | 0.6825 | YES | NO | YES |
| 02531372 | DAPAGLIFLOZIN | Jamp Dapagliflozin 10mg Tab | JPC | 0.6825 | 0.6825 | YES | NO | YES |
| 02531364 | DAPAGLIFLOZIN | Jamp Dapagliflozin 5mg Tab | JPC | 0.6825 | 0.6825 | YES | NO | YES |
| 02535300 | DAPAGLIFLOZIN | M-Dapagliflozin 10mg Tab | MAT | 0.6825 | 0.6825 | YES | NO | YES |
| 02535297 | DAPAGLIFLOZIN | M-Dapagliflozin 5mg Tab | MAT | 0.6825 | 0.6825 | YES | NO | YES |
| 02538342 | DAPAGLIFLOZIN | NRA-Dapagliflozin 10mg Tab | NRA | 0.6825 | 0.6825 | YES | NO | YES |
| 02538334 | DAPAGLIFLOZIN | NRA-Dapagliflozin 5mg Tab | NRA | 0.6825 | 0.6825 | YES | NO | YES |
| 02531569 | DAPAGLIFLOZIN | PMS-Dapagliflozin 10mg Tab | PMS | 0.6825 | 0.6825 | YES | NO | YES |
| 02531550 | DAPAGLIFLOZIN | PMS-Dapagliflozin 5mg Tab | PMS | 0.6825 | 0.6825 | YES | NO | YES |
| 02518740 | DAPAGLIFLOZIN | Sandoz Dapagliflozin 10mg Tab | SDZ | 0.6825 | 0.6825 | YES | NO | YES |
| 02518732 | DAPAGLIFLOZIN | Sandoz Dapagliflozin 5mg Tab | SDZ | 0.6825 | 0.6825 | YES | NO | YES |
| 02536153 | DAPAGLIFLOZIN & METFORMIN | Apo-Dapagliflozin-Metformin 5mg & 850mg Tab | APX | 0.6432 | 0.6432 | YES | NO | YES |
| 02536161 | DAPAGLIFLOZIN & METFORMIN | Apo-Dapagliflozin-Metformin 5mg & 1000mg Tab | APX | 0.6432 | 0.6432 | YES | NO | YES |
| 02533073 | DAPAGLIFLOZIN & METFORMIN | Auro-Dapagliflozin / Metformin 5mg & 850mg Tab | AUR | 0.6432 | 0.6432 | YES | NO | YES |
| 02533081 | DAPAGLIFLOZIN & METFORMIN | Auro-Dapagliflozin / Metformin 5mg & 1000mg Tab | AUR | 0.6432 | 0.6432 | YES | NO | YES |
| 02449935 | DAPAGLIFLOZIN & METFORMIN | Xigduo 5mg & 850mg Tab | AZC | 1.2863 | 0.6432 | YES | NO | YES |
| 02449943 | DAPAGLIFLOZIN & METFORMIN | Xigduo 5mg & 1000mg Tab | AZC | 1.2863 | 0.6432 | YES | NO | YES |
| 02041510 | DAPSONE | Dapsone 100mg Tab | JAC | 1.4061 | 1.1952 | YES | NO | NO |
| 02481227 | DAPSONE | Mar-Dapsone 100mg Tab | MAR | 1.1952 | 1.1952 | YES | NO | NO |
| 02299909 | DAPTOMYCIN | Cubicin (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol-Vial Pk | SUO | N/A | N/A | YES | NO | NO |
| 02511738 | DAPTOMYCIN | Daptomycin for Injection (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol-Vial Pk | JUN | 162.3500 | 162.3500 | YES | NO | NO |
| 02490463 | DAPTOMYCIN | Daptomycin for Injection (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol-Vial Pk | DRR | 162.3500 | 162.3500 | YES | NO | NO |
| 02490838 | DAPTOMYCIN | Daptomycin for Injection (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol-Vial Pk | SDZ | 162.3500 | 162.3500 | YES | NO | NO |
| 02391791 | DARBEPOETIN ALFA | Aranesp 150mcg/0.3mL Pref Syr-0.3mL Pk | AMG | 402.0000 | 402.0000 | NO | YES | NO |
| 02391805 | DARBEPOETIN ALFA | Aranesp 200mcg/0.4mL Pref Syr-0.4mL Pk | AMG | 701.0200 | 701.0200 | NO | YES | NO |
| 02391821 | DARBEPOETIN ALFA | Aranesp 300mcg/0.6mL Pref Syr-0.6mL Pk | AMG | 1082.9500 | 1082.9500 | NO | YES | NO |
| 02392364 | DARBEPOETIN ALFA | Aranesp 500mcg/1.0mL Pref Syr-1.0mL Pk | AMG | 1804.9400 | 1804.9400 | NO | YES | NO |
| 02452529 | DARIFENACIN | Apo-Darifenacin 15mg ER Tab | APX | 0.8058 | 0.8058 | YES | YES | NO |
| 02452510 | DARIFENACIN | Apo-Darifenacin 7.5mg ER Tab | APX | 0.8058 | 0.8058 | YES | YES | NO |
| 02273225 | DARIFENACIN | Enablex 15mg ER Tab | SLP | 1.6116 | 0.8058 | YES | YES | NO |
| 02273217 | DARIFENACIN | Enablex 7.5mg ER Tab | SLP | 1.6116 | 0.8058 | YES | YES | NO |
| 02491877 | DARIFENACIN | Jamp Darifenacin 15mg ER Tab | JPC | 0.8058 | 0.8058 | YES | YES | NO |
| 02491869 | DARIFENACIN | Jamp Darifenacin 7.5mg ER Tab | JPC | 0.8058 | 0.8058 | YES | YES | NO |
| 02487241 | DARUNAVIR | Apo-Darunavir 600mg Tab | APX | 4.2970 | 4.2970 | YES | NO | NO |
| 02487268 | DARUNAVIR | Apo-Darunavir 800mg Tab | APX | 5.8295 | 5.8295 | YES | NO | NO |
| 02486148 | DARUNAVIR | Auro-Darunavir 800mg Tab | AUR | 5.8295 | 5.8295 | YES | NO | NO |
| 02486121 | DARUNAVIR | Auro-Darunavir 600mg Tab | AUR | 4.2970 | 4.2970 | YES | NO | NO |
| 02521342 | DARUNAVIR | Darunavir 600mg Tab | JPC | 4.2970 | 4.2970 | YES | NO | NO |
| 02521350 | DARUNAVIR | Darunavir 800mg Tab | JPC | 5.8295 | 5.8295 | YES | NO | NO |
| 02393050 | DARUNAVIR | Prezista (Not a Benefit) 800mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02324024 | DARUNAVIR | Prezista (Not a Benefit) 600mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02426501 | DARUNAVIR & COBICISTAT | Prezcobix 800mg & 150mg Tab | JAN | 25.1870 | 25.1870 | NO | NO | NO |
| 02481499 | DASATINIB | Apo-Dasatinib (Off-Formulary Interchangeable) 70mg Tab | APX | 72.9336 | 72.9336 | YES | NO | NO |
| 02481502 | DASATINIB | Apo-Dasatinib (Off-Formulary Interchangeable) 80mg Tab | APX | 117.3255 | N/A | YES | NO | NO |
| 02470713 | DASATINIB | Apo-Dasatinib (Off-Formulary Interchangeable) 50mg Tab | APX | 66.1782 | 66.1782 | YES | NO | NO |
| 02470705 | DASATINIB | Apo-Dasatinib (Off-Formulary Interchangeable) 20mg Tab | APX | 32.8823 | 32.8823 | YES | NO | NO |
| 02470721 | DASATINIB | Apo-Dasatinib (Off-Formulary Interchangeable) 100mg Tab | APX | 132.2671 | 132.2671 | YES | NO | NO |
| 02514753 | DASATINIB | Reddy-Dasatinib (Off-Formulary Interchangeable) 70mg Tab | DRR | 72.9336 | 72.9336 | YES | NO | NO |
| 02514761 | DASATINIB | Reddy-Dasatinib (Off-Formulary Interchangeable) 80mg Tab | DRR | 117.3255 | N/A | YES | NO | NO |
| 02514788 | DASATINIB | Reddy-Dasatinib (Off-Formulary Interchangeable) 100mg Tab | DRR | 132.2670 | 132.2670 | YES | NO | NO |
| 02514796 | DASATINIB | Reddy-Dasatinib (Off-Formulary Interchangeable) 140mg Tab | DRR | 141.8806 | N/A | YES | NO | NO |
| 02514737 | DASATINIB | Reddy-Dasatinib (Off-Formulary Interchangeable) 20mg Tab | DRR | 32.8823 | 32.8823 | YES | NO | NO |
| 02514745 | DASATINIB | Reddy-Dasatinib (Off-Formulary Interchangeable) 50mg Tab | DRR | 66.1782 | 66.1782 | YES | NO | NO |
| 02293145 | DASATINIB | Sprycel (Off-Formulary Interchangeable) 70mg Tab | BQU | 85.8042 | 72.9337 | YES | NO | NO |
| 02360829 | DASATINIB | Sprycel (Off-Formulary Interchangeable) 140mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02360810 | DASATINIB | Sprycel (Off-Formulary Interchangeable) 80mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02293129 | DASATINIB | Sprycel (Off-Formulary Interchangeable) 20mg Tab | BQU | 38.6850 | 32.8823 | YES | NO | NO |
| 02320193 | DASATINIB | Sprycel (Off-Formulary Interchangeable) 100mg Tab | BQU | 155.6083 | 132.2671 | YES | NO | NO |
| 02293137 | DASATINIB | Sprycel (Off-Formulary Interchangeable) 50mg Tab | BQU | 77.8567 | 66.1783 | YES | NO | NO |
| 02499347 | DASATINIB | Taro-Dasatinib (Off-Formulary Interchangeable) 140mg Tab | TAR | 141.8806 | N/A | YES | NO | NO |
| 02499339 | DASATINIB | Taro-Dasatinib (Off-Formulary Interchangeable) 100mg Tab | TAR | 132.2670 | 132.2670 | YES | NO | NO |
| 02499304 | DASATINIB | Taro-Dasatinib (Off-Formulary Interchangeable) 50mg Tab | TAR | 66.1783 | 66.1783 | YES | NO | NO |
| 02499312 | DASATINIB | Taro-Dasatinib (Off-Formulary Interchangeable) 70mg Tab | TAR | 72.9337 | 72.9337 | YES | NO | NO |
| 02499282 | DASATINIB | Taro-Dasatinib (Off-Formulary Interchangeable) 20mg Tab | TAR | 32.8823 | 32.8823 | YES | NO | NO |
| 02499320 | DASATINIB | Taro-Dasatinib (Off-Formulary Interchangeable) 80mg Tab | TAR | 117.3257 | N/A | YES | NO | NO |
| 02478307 | DASATINIB | Teva-Dasatinib (Off-Formulary Interchangeable) 20mg Tab | TEV | 32.8823 | 32.8823 | YES | NO | NO |
| 02478358 | DASATINIB | Teva-Dasatinib (Off-Formulary Interchangeable) 100mg Tab | TEV | 132.2671 | 132.2671 | YES | NO | NO |
| 02478331 | DASATINIB | Teva-Dasatinib (Off-Formulary Interchangeable) 80mg Tab | TEV | 117.3255 | N/A | YES | NO | NO |
| 02478323 | DASATINIB | Teva-Dasatinib (Off-Formulary Interchangeable) 70mg Tab | TEV | 72.9336 | 72.9336 | YES | NO | NO |
| 02478315 | DASATINIB | Teva-Dasatinib (Off-Formulary Interchangeable) 50mg Tab | TEV | 66.1782 | 66.1782 | YES | NO | NO |
| 01926683 | DAUNORUBICIN | Cerubidine Inj Pd-20mg Pk | SLP | 91.0000 | 91.0000 | NO | NO | NO |
| 02485265 | DEFERASIROX | Apo-Deferasirox (Type J) 90mg Tab | APX | 2.6303 | 2.6303 | YES | NO | NO |
| 02485273 | DEFERASIROX | Apo-Deferasirox (Type J) 180mg Tab | APX | 5.2610 | 5.2610 | YES | NO | NO |
| 02485281 | DEFERASIROX | Apo-Deferasirox (Type J) 360mg Tab | APX | 10.5228 | 10.5228 | YES | NO | NO |
| 02527782 | DEFERASIROX | Auro-Deferasirox (Type J) 180mg Tab | AUR | 5.2610 | 5.2610 | YES | NO | NO |
| 02527774 | DEFERASIROX | Auro-Deferasirox (Type J) 90mg Tab | AUR | 2.6303 | 2.6303 | YES | NO | NO |
| 02527790 | DEFERASIROX | Auro-Deferasirox (Type J) 360mg Tab | AUR | 10.5228 | 10.5228 | YES | NO | NO |
| 02452235 | DEFERASIROX | Jadenu 360mg Tab | NOV | 43.5730 | 10.5228 | YES | NO | NO |
| 02452219 | DEFERASIROX | Jadenu 90mg Tab | NOV | 10.8920 | 2.6303 | YES | NO | NO |
| 02452227 | DEFERASIROX | Jadenu 180mg Tab | NOV | 21.7850 | 5.2610 | YES | NO | NO |
| 02528290 | DEFERASIROX | PMS-Deferasirox (Type J) 90mg Tab | PMS | 2.6303 | 2.6303 | YES | NO | NO |
| 02528304 | DEFERASIROX | PMS-Deferasirox (Type J) 180mg Tab | PMS | 5.2610 | 5.2610 | YES | NO | NO |
| 02528312 | DEFERASIROX | PMS-Deferasirox (Type J) 360mg Tab | PMS | 10.5228 | 10.5228 | YES | NO | NO |
| 02489899 | DEFERASIROX | Sandoz Deferasirox (Type J) 90mg Tab | SDZ | 2.6303 | 2.6303 | YES | NO | NO |
| 02489910 | DEFERASIROX | Sandoz Deferasirox (Type J) 360mg Tab | SDZ | 10.5228 | 10.5228 | YES | NO | NO |
| 02489902 | DEFERASIROX | Sandoz Deferasirox (Type J) 180mg Tab | SDZ | 5.2610 | 5.2610 | YES | NO | NO |
| 02507331 | DEFERASIROX | Taro-Deferasirox (Type J) 360mg Tab | TAR | 10.5228 | 10.5228 | YES | NO | NO |
| 02507315 | DEFERASIROX | Taro-Deferasirox (Type J) 90mg Tab | TAR | 2.6303 | 2.6303 | YES | NO | NO |
| 02507323 | DEFERASIROX | Taro-Deferasirox (Type J) 180mg Tab | TAR | 5.2610 | 5.2610 | YES | NO | NO |
| 02461544 | DEFERASIROX | Apo-Deferasirox 125mg Tab for Susp | APX | 5.2408 | 5.2408 | YES | NO | NO |
| 02461552 | DEFERASIROX | Apo-Deferasirox 250mg Tab for Susp | APX | 10.4820 | 10.4820 | YES | NO | NO |
| 02461560 | DEFERASIROX | Apo-Deferasirox 500mg Tab for Susp | APX | 20.9649 | 20.9649 | YES | NO | NO |
| 02287447 | DEFERASIROX | Exjade 500mg Tab for Susp | NOV | 44.1507 | 20.9649 | YES | NO | NO |
| 02287420 | DEFERASIROX | Exjade 125mg Tab for Susp | NOV | 11.0375 | 5.2408 | YES | NO | NO |
| 02287439 | DEFERASIROX | Exjade 250mg Tab for Susp | NOV | 22.0757 | 10.4820 | YES | NO | NO |
| 02464454 | DEFERASIROX | Sandoz Deferasirox 125mg Tab for Susp | SDZ | 5.2408 | 5.2408 | YES | NO | NO |
| 02464462 | DEFERASIROX | Sandoz Deferasirox 250mg Tab for Susp | SDZ | 10.4820 | 10.4820 | YES | NO | NO |
| 02464470 | DEFERASIROX | Sandoz Deferasirox 500mg Tab for Susp | SDZ | 20.9649 | 20.9649 | YES | NO | NO |
| 02436558 | DEFERIPRONE | Ferriprox (Off-Formulary Interchangeable) 1000mg Tab | APO | 33.4740 | 18.4107 | YES | NO | NO |
| 02553112 | DEFERIPRONE | Taro-Deferiprone (Off-Formulary Interchangeable) 1000mg Tab | TAR | 18.4107 | 18.4107 | YES | NO | NO |
| 02337037 | DEGARELIX ACETATE | Firmagon 120mg Pd for Inj-Vial Pk | FEI | 370.9440 | 370.9440 | NO | NO | NO |
| 02337029 | DEGARELIX ACETATE | Firmagon 80mg Pd for Inj-Vial Pk | FEI | 274.1760 | 274.1760 | NO | NO | NO |
| 02238348 | DELAVIRDINE MESYLATE | Rescriptor 100mg Tab | PFI | 0.7609 | 0.7609 | NO | NO | NO |
| 02560917 | DENOSUMAB | Stoboclo 60mg/mL Inj Sol-1.0mL Pref Syr Pk (Preservative-Free) | CEI | 194.7000 | 194.7000 | NO | YES | NO |
| 02545411 | DENOSUMAB | Jubbonti (Preservative Free) 60mg/mL Inj Sol-Pref Syr | SDZ | 194.7000 | 194.7000 | NO | YES | NO |
| 02343541 | DENOSUMAB | Prolia (Preservative Free) 60mg/mL Inj Sol-Pref Syr | AMG | 440.1000 | 440.1000 | NO | YES | NO |
| 02545764 | DENOSUMAB | Wyost (Preservative Free) 120mg/1.7mL Inj Sol-Vial Pk | SDZ | 312.0000 | 312.0000 | NO | YES | NO |
| 02560895 | DENOSUMAB | Osenvelt 120mg/1.7mL Inj Sol-Vial Pk (Preservative-Free) | CEI | 312.0000 | 312.0000 | NO | YES | NO |
| 02216256 | DESIPRAMINE | Desipramine 25mg Tab | AAP | 0.4345 | 0.4345 | YES | NO | NO |
| 02216272 | DESIPRAMINE | Desipramine 75mg Tab | AAP | 1.0184 | 1.0184 | YES | NO | NO |
| 02216264 | DESIPRAMINE | Desipramine 50mg Tab | AAP | 0.7659 | 0.7659 | YES | NO | NO |
| 02099128 | DESIPRAMINE | Norpramin (Not a Benefit) 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02099136 | DESIPRAMINE | Norpramin (Not a Benefit) 50mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02099144 | DESIPRAMINE | Norpramin (Not a Benefit) 75mg Tab | HMR | N/A | N/A | YES | NO | NO |
| 00010448 | DESIPRAMINE | Pertofrane (Not a Benefit) 25mg Tab | GEI | N/A | N/A | YES | NO | NO |
| 02513579 | DESMOPRESSIN ACETATE | Bipazen (Off-Formulary Interchangeable) 4mcg/mL Inj Sol-1mL Amp Pk | KVR | 9.0000 | 9.0000 | YES | NO | NO |
| 00873993 | DESMOPRESSIN ACETATE | DDAVP (Off-Formulary Interchangeable) 4mcg/mL Inj Sol-1mL Amp Pk | RIP | N/A | N/A | YES | NO | NO |
| 00402516 | DESMOPRESSIN ACETATE | DDAVP 0.1mg/mL Nas Sol-2.5mL Pk | FEI | 52.0375 | 52.0375 | NO | NO | NO |
| 00836362 | DESMOPRESSIN ACETATE | DDAVP (Not a Benefit) 10mcg/Metered Dose Nas Sp-2.5mL Pk | FEI | N/A | N/A | YES | NO | NO |
| 02242465 | DESMOPRESSIN ACETATE | Desmopressin Spray 10mcg/Metered Dose Nas Sp-2.5mL Pk | AAP | 42.1661 | 42.1661 | YES | NO | NO |
| 02285010 | DESMOPRESSIN ACETATE | DDAVP Melt 240mcg Orally Disintegrating Tab | FEI | 3.9382 | 3.9382 | NO | NO | NO |
| 02284995 | DESMOPRESSIN ACETATE | DDAVP Melt 60mcg Orally Disintegrating Tab | FEI | 1.4556 | 1.4556 | NO | NO | NO |
| 02285002 | DESMOPRESSIN ACETATE | DDAVP Melt 120mcg Orally Disintegrating Tab | FEI | 2.9121 | 2.9121 | NO | NO | NO |
| 02284030 | DESMOPRESSIN ACETATE | Apo-Desmopressin 0.1mg Tab | APX | 0.6609 | 0.6609 | YES | NO | NO |
| 02284049 | DESMOPRESSIN ACETATE | Apo-Desmopressin 0.2mg Tab | APX | 1.3217 | 1.3217 | YES | NO | NO |
| 00824305 | DESMOPRESSIN ACETATE | DDAVP 0.1mg Tab | FEI | 1.3217 | 0.6609 | YES | NO | NO |
| 00824143 | DESMOPRESSIN ACETATE | DDAVP 0.2mg Tab | FEI | 2.6434 | 1.3217 | YES | NO | NO |
| 02304376 | DESMOPRESSIN ACETATE | PMS-Desmopressin 0.2mg Tab | PMS | 1.3217 | 1.3217 | YES | NO | NO |
| 02304368 | DESMOPRESSIN ACETATE | PMS-Desmopressin 0.1mg Tab | PMS | 0.6609 | 0.6609 | YES | NO | NO |
| 02317192 | DESOGESTREL & ETHINYL ESTRADIOL | Apri 21 0.15mg & 0.03mg Tab-21 Pk | BAR | 5.2773 | 5.2773 | YES | NO | NO |
| 02396491 | DESOGESTREL & ETHINYL ESTRADIOL | Freya 21 0.15mg & 0.03mg Tab-21 Pk | FAM | 5.2773 | 5.2773 | YES | NO | NO |
| 02042487 | DESOGESTREL & ETHINYL ESTRADIOL | Marvelon 21 0.15mg & 0.03mg Tab-21 Pk | ORG | 21.1050 | 5.2773 | YES | NO | NO |
| 02556553 | DESOGESTREL & ETHINYL ESTRADIOL | Miley 21 0.15mg & 0.03mg Tab-21 Pk | AMB | 5.2773 | 5.2773 | YES | NO | NO |
| 02410249 | DESOGESTREL & ETHINYL ESTRADIOL | Mirvala 21 0.15mg & 0.03mg Tab-21 Pk | APX | 5.2773 | 5.2773 | YES | NO | NO |
| 02317206 | DESOGESTREL & ETHINYL ESTRADIOL | Apri 28 0.15mg & 0.03mg Tab-28 Pk | BAR | 5.2780 | 5.2780 | YES | NO | NO |
| 02396610 | DESOGESTREL & ETHINYL ESTRADIOL | Freya 28 0.15mg & 0.03mg Tab-28 Pk | FAM | 5.2780 | 5.2780 | YES | NO | NO |
| 02042479 | DESOGESTREL & ETHINYL ESTRADIOL | Marvelon 28 0.15mg & 0.03mg Tab-28 Pk | ORG | 21.1050 | 5.2780 | YES | NO | NO |
| 02556561 | DESOGESTREL & ETHINYL ESTRADIOL | Miley 28 0.15mg & 0.03mg Tab-28 Pk | AMB | 5.2780 | 5.2780 | YES | NO | NO |
| 02410257 | DESOGESTREL & ETHINYL ESTRADIOL | Mirvala 28 0.15mg & 0.03mg Tab-28 Pk | APX | 5.2780 | 5.2780 | YES | NO | NO |
| 02272903 | DESOGESTREL & ETHINYL ESTRADIOL | Linessa 21 3 Phase Tabs-21 Pk | ASN | 19.7888 | 19.7888 | NO | NO | NO |
| 02257238 | DESOGESTREL & ETHINYL ESTRADIOL | Linessa 28 3 Phase Tabs-28 Pk | ASN | 19.7941 | 19.7941 | NO | NO | NO |
| 02229315 | DESONIDE | PDP-Desonide 0.05% Cr | PEN | 0.2857 | 0.2857 | YES | NO | NO |
| 02154862 | DESONIDE | Tridesilon (Not a Benefit) 0.05% Cr | CPL | N/A | N/A | YES | NO | NO |
| 02229323 | DESONIDE | PDP-Desonide 0.05% Oint | PEN | 0.2853 | 0.2853 | YES | NO | NO |
| 02154870 | DESONIDE | Tridesilon (Not a Benefit) 0.05% Oint | CPL | N/A | N/A | YES | NO | NO |
| 02466996 | DESVENLAFAXINE | Apo-Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | APX | 2.3409 | N/A | YES | NO | NO |
| 02466988 | DESVENLAFAXINE | Apo-Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | APX | 2.3409 | N/A | YES | NO | NO |
| 02467127 | DESVENLAFAXINE | Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | APX | 2.3409 | N/A | YES | NO | NO |
| 02535114 | DESVENLAFAXINE | Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | SAI | 2.3409 | N/A | YES | NO | NO |
| 02554976 | DESVENLAFAXINE | Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | SIV | 2.3409 | N/A | YES | NO | NO |
| 02467119 | DESVENLAFAXINE | Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | APX | 2.3409 | N/A | YES | NO | NO |
| 02535106 | DESVENLAFAXINE | Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | SAI | 2.3409 | N/A | YES | NO | NO |
| 02554968 | DESVENLAFAXINE | Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | SIV | 2.3409 | N/A | YES | NO | NO |
| 02495147 | DESVENLAFAXINE | Jamp Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | JPC | 2.3409 | N/A | YES | NO | NO |
| 02495139 | DESVENLAFAXINE | Jamp Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | JPC | 2.3409 | N/A | YES | NO | NO |
| 02321092 | DESVENLAFAXINE | Pristiq (Off-Formulary Interchangeable) 50mg ER Tab | PFI | N/A | N/A | YES | NO | NO |
| 02321106 | DESVENLAFAXINE | Pristiq (Off-Formulary Interchangeable) 100mg ER Tab | PFI | N/A | N/A | YES | NO | NO |
| 02538415 | DESVENLAFAXINE | Sandoz Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | SDZ | 2.3409 | N/A | YES | NO | NO |
| 02538423 | DESVENLAFAXINE | Sandoz Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | SDZ | 2.3409 | N/A | YES | NO | NO |
| 02532158 | DESVENLAFAXINE | Taro-Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | TAR | 2.3409 | N/A | YES | NO | NO |
| 02532166 | DESVENLAFAXINE | Taro-Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | TAR | 2.3409 | N/A | YES | NO | NO |
| 02458217 | DESVENLAFAXINE | Teva-Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab | TEV | 2.3409 | N/A | YES | NO | NO |
| 02458225 | DESVENLAFAXINE | Teva-Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab | TEV | 2.3409 | N/A | YES | NO | NO |
| 00042579 | DEXAMETHASONE | Maxidex 0.1% Oph Oint-3.5g Pk | NOV | 9.7200 | 9.7200 | NO | NO | YES |
| 00042560 | DEXAMETHASONE | Maxidex 0.1% Oph Susp | NOV | 1.7900 | 1.7900 | NO | NO | YES |
| 02250055 | DEXAMETHASONE | Apo-Dexamethasone 4mg Tab | APX | 0.6112 | 0.6112 | YES | NO | NO |
| 02261081 | DEXAMETHASONE | Apo-Dexamethasone 0.5mg Tab | APX | 0.1564 | 0.1564 | YES | NO | NO |
| 00016462 | DEXAMETHASONE | Decadron (Not a Benefit) 0.5mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 00354309 | DEXAMETHASONE | Decadron (Not a Benefit) 4mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 01964070 | DEXAMETHASONE | PMS-Dexamethasone 4mg Tab | PMS | 0.6112 | 0.6112 | YES | NO | NO |
| 01964976 | DEXAMETHASONE | PMS-Dexamethasone 0.5mg Tab | PMS | 0.1564 | 0.1564 | YES | NO | NO |
| 00213624 | DEXAMETHASONE 21-PHOSPHATE | Decadron (Not a Benefit) 4mg/mL Inj Sol | MSD | N/A | N/A | YES | NO | NO |
| 01977547 | DEXAMETHASONE 21-PHOSPHATE | Dexamethasone Sodium 4mg/mL Inj Sol | STE | 1.6900 | 1.6900 | YES | NO | NO |
| 00664227 | DEXAMETHASONE 21-PHOSPHATE | Dexamethasone Sodium 4mg/mL Inj Sol | SDZ | 1.6900 | 1.6900 | YES | NO | NO |
| 02528991 | DEXLANSOPRAZOLE | Apo-Dexlansoprazole (Off-Formulary Interchangeable) 30mg DR Cap | APX | 2.2380 | N/A | YES | NO | NO |
| 02529025 | DEXLANSOPRAZOLE | Apo-Dexlansoprazole (Off-Formulary Interchangeable) 60mg DR Cap | APX | 2.2380 | N/A | YES | NO | NO |
| 02354950 | DEXLANSOPRAZOLE | Dexilant (Off-Formulary Interchangeable) 30mg DR Cap | TAK | N/A | N/A | YES | NO | NO |
| 02354969 | DEXLANSOPRAZOLE | Dexilant (Off-Formulary Interchangeable) 60mg DR Cap | TAK | N/A | N/A | YES | NO | NO |
| 02536390 | DEXLANSOPRAZOLE | Dexlansoprazole (Off-Formulary Interchangeable) 30mg DR Cap | ALH | 2.0526 | N/A | YES | NO | NO |
| 02536404 | DEXLANSOPRAZOLE | Dexlansoprazole (Off-Formulary Interchangeable) 60mg DR Cap | ALH | 2.0526 | N/A | YES | NO | NO |
| 00743445 | DEXTRAN 70 & HYDROXYPROPYL METHYLCELLULOSE & POLYQUAD | Tears Naturale II 0.1%/0.3%/0.001% Oph-Sol | ALC | 0.4387 | 0.4387 | NO | YES | NO |
| 02448327 | DEXTROAMPHETAMINE SULFATE | Act Dextroamphetamine SR 15mg SR Cap | ACV | 0.9898 | 0.9898 | YES | NO | YES |
| 02448319 | DEXTROAMPHETAMINE SULFATE | Act Dextroamphetamine SR 10mg SR Cap | ACV | 0.8096 | 0.8096 | YES | NO | YES |
| 01924567 | DEXTROAMPHETAMINE SULFATE | Dexedrine Spansules 15mg SR Cap | PPI | 1.4924 | 0.9898 | YES | NO | YES |
| 01924559 | DEXTROAMPHETAMINE SULFATE | Dexedrine Spansules 10mg SR Cap | PPI | 1.2207 | 0.8096 | YES | NO | YES |
| 01924516 | DEXTROAMPHETAMINE SULFATE | Dexedrine 5mg Tab | PPI | 0.8267 | 0.5081 | YES | NO | YES |
| 02443236 | DEXTROAMPHETAMINE SULFATE | Dextroamphetamine 5mg Tab | AAP | 0.5081 | 0.5081 | YES | NO | YES |
| 00391069 | DEXTROMETHORPHAN HBR | DM-Syrup (Not a Benefit) 3mg/mL O/L | PDA | N/A | N/A | YES | NO | NO |
| 01928783 | DEXTROMETHORPHAN HBR | Koffex DM 3mg/mL O/L | ROG | 0.0190 | 0.0190 | YES | NO | NO |
| 00399728 | DIAZEPAM | Diazepam Injection USP 5mg/mL Inj Sol (Preservative Free) | SDZ | 1.6415 | 1.6415 | NO | YES | NO |
| 02238162 | DIAZEPAM | Diastat 5mg/mL Rect Gel-2x 5mg Pk | BHC | 214.0310 | 214.0310 | NO | NO | NO |
| 02519070 | DIAZEPAM | Diastat 10mg/2mL Rect Gel-2x10mg Pk | BHC | 214.0310 | 214.0310 | NO | NO | NO |
| 02519089 | DIAZEPAM | Diastat 15mg/3mL Rect Gel-2x15mg Pk | BHC | 214.0310 | 214.0310 | NO | NO | NO |
| 00362158 | DIAZEPAM | Diazepam 5mg Tab | AAP | 0.1662 | 0.1662 | YES | NO | NO |
| 00405337 | DIAZEPAM | Diazepam 10mg Tab | AAP | 0.1204 | 0.1204 | YES | NO | NO |
| 00405329 | DIAZEPAM | Diazepam 2mg Tab | AAP | 0.0532 | 0.0532 | YES | NO | NO |
| 00013293 | DIAZEPAM | Valium (Not a Benefit) 10mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 00013285 | DIAZEPAM | Valium (Not a Benefit) 5mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 00013277 | DIAZEPAM | Valium (Not a Benefit) 2mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02243433 | DICLOFENAC POTASSIUM | Apo-Diclo Rapide (Off-Formulary Interchangeable) 50mg Tab | APX | 0.3937 | N/A | YES | NO | YES |
| 02261774 | DICLOFENAC POTASSIUM | Sandoz Diclofenac Rapide (Off-Formulary Interchangeable) 50mg Tab | SDZ | 0.4165 | N/A | YES | NO | YES |
| 02239355 | DICLOFENAC POTASSIUM | Teva-Diclofenac-K (Off-Formulary Interchangeable) 50mg Tab | TEV | 0.3937 | N/A | YES | NO | YES |
| 00881635 | DICLOFENAC POTASSIUM | Voltaren Rapide (Off-Formulary Interchangeable) 50mg Tab | NOV | N/A | N/A | YES | NO | YES |
| 00839175 | DICLOFENAC SODIUM | Apo-Diclo 25mg Ent Tab | APX | 0.0781 | 0.0781 | YES | NO | YES |
| 00839183 | DICLOFENAC SODIUM | Apo-Diclo 50mg Ent Tab | APX | 0.2064 | 0.2064 | YES | NO | YES |
| 02302616 | DICLOFENAC SODIUM | PMS-Diclofenac 25mg Ent Tab | PMS | 0.0781 | 0.0781 | YES | NO | YES |
| 02302624 | DICLOFENAC SODIUM | PMS-Diclofenac 50mg Ent Tab | PMS | 0.2064 | 0.2064 | YES | NO | YES |
| 02261960 | DICLOFENAC SODIUM | Sandoz Diclofenac 50mg Ent Tab | SDZ | 0.2064 | 0.2064 | YES | NO | YES |
| 00808539 | DICLOFENAC SODIUM | Teva-Diclofenac 25mg Ent Tab | TEV | 0.0781 | 0.0781 | YES | NO | YES |
| 00808547 | DICLOFENAC SODIUM | Teva-Diclofenac 50mg Ent Tab | TEV | 0.2064 | 0.2064 | YES | NO | YES |
| 00514012 | DICLOFENAC SODIUM | Voltaren 50mg Ent Tab | NOV | 1.1384 | 0.2064 | YES | NO | YES |
| 00514004 | DICLOFENAC SODIUM | Voltaren (Not a Benefit) 25mg Ent Tab | GEI | N/A | N/A | YES | NO | YES |
| 02162814 | DICLOFENAC SODIUM | Apo-Diclo SR 75mg LA Tab | APX | 0.7699 | 0.7699 | YES | NO | YES |
| 02091194 | DICLOFENAC SODIUM | Apo-Diclo SR 100mg LA Tab | APX | 1.1053 | 1.1053 | YES | NO | YES |
| 00590827 | DICLOFENAC SODIUM | Voltaren SR (Not a Benefit) 100mg LA Tab | NOV | N/A | N/A | YES | NO | YES |
| 00782459 | DICLOFENAC SODIUM | Voltaren SR (Not a Benefit) 75mg LA Tab | NOV | N/A | N/A | YES | NO | YES |
| 02441020 | DICLOFENAC SODIUM | Apo-Diclofenac Ophthalmic 0.1% Oph Sol | APX | 1.2397 | 1.2397 | YES | NO | YES |
| 02475065 | DICLOFENAC SODIUM | Diclofenac 0.1% Oph Sol | PHS | 1.2397 | 1.2397 | YES | NO | YES |
| 02534525 | DICLOFENAC SODIUM | Jamp Diclofenac 0.1% Oph Sol | JPC | 1.2397 | 1.2397 | YES | NO | YES |
| 02475197 | DICLOFENAC SODIUM | Mint-Diclofenac 0.1% Oph Sol | MIN | 1.2397 | 1.2397 | YES | NO | YES |
| 02454807 | DICLOFENAC SODIUM | Sandoz Diclofenac Ophtha 0.1% Oph Sol | SDZ | 1.2397 | 1.2397 | YES | NO | YES |
| 01940414 | DICLOFENAC SODIUM | Voltaren Ophtha 0.1% Oph Sol | NOV | 4.3500 | 1.2397 | YES | NO | YES |
| 02261928 | DICLOFENAC SODIUM | Sandoz Diclofenac 50mg Sup | SDZ | 1.2818 | 1.2818 | YES | NO | YES |
| 02261936 | DICLOFENAC SODIUM | Sandoz Diclofenac 100mg Sup | SDZ | 0.5840 | 0.5840 | YES | NO | YES |
| 00632732 | DICLOFENAC SODIUM | Voltaren (Not a Benefit) 100mg Sup | NOV | N/A | N/A | YES | NO | YES |
| 00632724 | DICLOFENAC SODIUM | Voltaren 50mg Sup | NOV | 2.0130 | 1.2818 | YES | NO | YES |
| 02476134 | DICLOFENAC SODIUM | Diclofenac Sodium Solution (Off-Formulary Interchangeable) 1.5% W/W Top Sol | TEL | 0.6226 | N/A | YES | NO | NO |
| 02434571 | DICLOFENAC SODIUM | Diclofenac Topical Solution (Off-Formulary Interchangeable) 1.5% W/W Top Sol | STE | 0.6226 | N/A | YES | NO | NO |
| 02472309 | DICLOFENAC SODIUM | Jamp-Diclofenac (Off-Formulary Interchangeable) 1.5% W/W Top Sol | JPC | 0.6226 | N/A | YES | NO | NO |
| 02356783 | DICLOFENAC SODIUM | PMS-Diclofenac (Off-Formulary Interchangeable) 1.5% W/W Top Sol | PMS | 0.6227 | N/A | YES | NO | NO |
| 02247265 | DICLOFENAC SODIUM | Pennsaid (Off-Formulary Interchangeable) 1.5% W/W Top Sol | PAL | N/A | N/A | YES | NO | NO |
| 02420988 | DICLOFENAC SODIUM | Taro-Diclofenac (Off-Formulary Interchangeable) 1.5% W/W Top Sol | TAR | 0.6226 | N/A | YES | NO | NO |
| 01917056 | DICLOFENAC SODIUM & MISOPROSTOL | Arthrotec 50 50mg & 200mcg Tab | PFI | 0.7643 | 0.3149 | YES | NO | YES |
| 02229837 | DICLOFENAC SODIUM & MISOPROSTOL | Arthrotec 75 75mg & 200mcg Tab | PFI | 1.0402 | 0.4286 | YES | NO | YES |
| 02341689 | DICLOFENAC SODIUM & MISOPROSTOL | Gd-Diclofenac/Misoprostol 50 50mg & 200mcg Tab | GEM | 0.3149 | 0.3149 | YES | NO | YES |
| 02341697 | DICLOFENAC SODIUM & MISOPROSTOL | Gd-Diclofenac/Misoprostol 75 75mg & 200mcg Tab | GEM | 0.4286 | 0.4286 | YES | NO | YES |
| 02413469 | DICLOFENAC SODIUM & MISOPROSTOL | PMS-Diclofenac-Misoprostol 50mg & 200mcg Tab | PMS | 0.3149 | 0.3149 | YES | NO | YES |
| 02413477 | DICLOFENAC SODIUM & MISOPROSTOL | PMS-Diclofenac-Misoprostol 75mg & 200mcg Tab | PMS | 0.4286 | 0.4286 | YES | NO | YES |
| 02493055 | DIENOGEST | Aspen-Dienogest 2mg Tab | ASI | 0.5115 | 0.5115 | YES | YES | NO |
| 02498189 | DIENOGEST | Jamp Dienogest 2mg Tab | JPC | 0.5115 | 0.5115 | YES | YES | NO |
| 02543613 | DIENOGEST | M-Dienogest 2mg Tab | MAT | 0.5115 | 0.5115 | YES | YES | NO |
| 02551683 | DIENOGEST | Mar-Dienogest 2mg Tab | MAR | 0.5115 | 0.5115 | YES | YES | NO |
| 02374900 | DIENOGEST | Visanne 2mg Tab | BAH | 2.1876 | 0.5115 | YES | YES | NO |
| 02242320 | DIGOXIN | PMS-Digoxin 0.05mg/mL O/L | PMS | 0.3692 | 0.3692 | NO | NO | YES |
| 02554399 | DIGOXIN | Auro-Digoxin 0.0625mg Tab | AUR | 0.1089 | 0.1089 | YES | NO | YES |
| 02554402 | DIGOXIN | Auro-Digoxin 0.125mg Tab | AUR | 0.1030 | 0.1030 | YES | NO | YES |
| 02498510 | DIGOXIN | Jamp Digoxin 0.125mg Tab | JPC | 0.1030 | 0.1030 | YES | NO | YES |
| 02498502 | DIGOXIN | Jamp Digoxin 0.0625mg Tab | JPC | 0.1089 | 0.1089 | YES | NO | YES |
| 02335719 | DIGOXIN | PMS-Digoxin 0.125mg Tab | PMS | 0.1030 | 0.1030 | YES | NO | YES |
| 02335700 | DIGOXIN | PMS-Digoxin 0.0625mg Tab | PMS | 0.1089 | 0.1089 | YES | NO | YES |
| 02429349 | DILTIAZEM HCL | Teva-Diltiazem XC 300mg ER Tab | TEV | 1.2175 | 1.2175 | YES | NO | NO |
| 02429357 | DILTIAZEM HCL | Teva-Diltiazem XC 360mg ER Tab | TEV | 1.2211 | 1.2211 | YES | NO | NO |
| 02429330 | DILTIAZEM HCL | Teva-Diltiazem XC 240mg ER Tab | TEV | 1.2212 | 1.2212 | YES | NO | NO |
| 02429322 | DILTIAZEM HCL | Teva-Diltiazem XC 180mg ER Tab | TEV | 0.9195 | 0.9195 | YES | NO | NO |
| 02256746 | DILTIAZEM HCL | Tiazac XC 180mg ER Tab | BIO | 1.4218 | 0.9195 | YES | NO | NO |
| 02256738 | DILTIAZEM HCL | Tiazac XC 120mg ER Tab | BIO | 1.0697 | 1.0697 | NO | NO | NO |
| 02256754 | DILTIAZEM HCL | Tiazac XC 240mg ER Tab | BIO | 1.8882 | 1.2212 | YES | NO | NO |
| 02256770 | DILTIAZEM HCL | Tiazac XC 360mg ER Tab | BIO | 1.8880 | 1.2211 | YES | NO | NO |
| 02256762 | DILTIAZEM HCL | Tiazac XC 300mg ER Tab | BIO | 1.8825 | 1.2175 | YES | NO | NO |
| 02230998 | DILTIAZEM HCL | Apo-Diltiaz CD 180mg LA Cap | APX | 0.4824 | 0.4824 | YES | NO | NO |
| 02230999 | DILTIAZEM HCL | Apo-Diltiaz CD 240mg LA Cap | APX | 0.6399 | 0.6399 | YES | NO | NO |
| 02230997 | DILTIAZEM HCL | Apo-Diltiaz CD 120mg LA Cap | APX | 0.3634 | 0.3634 | YES | NO | NO |
| 02229526 | DILTIAZEM HCL | Apo-Diltiaz CD 300mg LA Cap | APX | 0.7999 | 0.7999 | YES | NO | NO |
| 02097249 | DILTIAZEM HCL | Cardizem CD 120mg LA Cap | VAL | 1.6244 | 0.3634 | YES | NO | NO |
| 02097257 | DILTIAZEM HCL | Cardizem CD 180mg LA Cap | VAL | 2.1565 | 0.4824 | YES | NO | NO |
| 02097273 | DILTIAZEM HCL | Cardizem CD 300mg LA Cap | VAL | 3.5755 | 0.7999 | YES | NO | NO |
| 02097265 | DILTIAZEM HCL | Cardizem CD 240mg LA Cap | VAL | 2.8604 | 0.6399 | YES | NO | NO |
| 02370646 | DILTIAZEM HCL | Co Diltiazem CD 240mg LA Cap | COB | 0.6399 | 0.6399 | YES | NO | NO |
| 02370638 | DILTIAZEM HCL | Co Diltiazem CD 180mg LA Cap | COB | 0.4824 | 0.4824 | YES | NO | NO |
| 02370611 | DILTIAZEM HCL | Co Diltiazem CD 120mg LA Cap | COB | 0.3634 | 0.3634 | YES | NO | NO |
| 02370654 | DILTIAZEM HCL | Co Diltiazem CD 300mg LA Cap | COB | 0.7999 | 0.7999 | YES | NO | NO |
| 02446014 | DILTIAZEM HCL | Diltiazem CD 240mg LA Cap | SIV | 0.6399 | 0.6399 | YES | NO | NO |
| 02400464 | DILTIAZEM HCL | Diltiazem CD 300mg LA Cap | SAI | 0.7999 | 0.7999 | YES | NO | NO |
| 02445999 | DILTIAZEM HCL | Diltiazem CD 120mg LA Cap | SIV | 0.3634 | 0.3634 | YES | NO | NO |
| 02446022 | DILTIAZEM HCL | Diltiazem CD 300mg LA Cap | SIV | 0.7999 | 0.7999 | YES | NO | NO |
| 02400421 | DILTIAZEM HCL | Diltiazem CD 120mg LA Cap | SAI | 0.3634 | 0.3634 | YES | NO | NO |
| 02446006 | DILTIAZEM HCL | Diltiazem CD 180mg LA Cap | SIV | 0.4824 | 0.4824 | YES | NO | NO |
| 02400448 | DILTIAZEM HCL | Diltiazem CD 180mg LA Cap | SAI | 0.4824 | 0.4824 | YES | NO | NO |
| 02400456 | DILTIAZEM HCL | Diltiazem CD 240mg LA Cap | SAI | 0.6399 | 0.6399 | YES | NO | NO |
| 02528061 | DILTIAZEM HCL | Jamp Diltiazem CD 300mg LA Cap | JPC | 0.7999 | 0.7999 | YES | NO | NO |
| 02528037 | DILTIAZEM HCL | Jamp Diltiazem CD 120mg LA Cap | JPC | 0.3634 | 0.3634 | YES | NO | NO |
| 02528045 | DILTIAZEM HCL | Jamp Diltiazem CD 180mg LA Cap | JPC | 0.4824 | 0.4824 | YES | NO | NO |
| 02528053 | DILTIAZEM HCL | Jamp Diltiazem CD 240mg LA Cap | JPC | 0.6399 | 0.6399 | YES | NO | NO |
| 02546108 | DILTIAZEM HCL | M-Diltiazem CD 240mg LA Cap | MAT | 0.6399 | 0.6399 | YES | NO | NO |
| 02546094 | DILTIAZEM HCL | M-Diltiazem CD 180mg LA Cap | MAT | 0.4824 | 0.4824 | YES | NO | NO |
| 02546116 | DILTIAZEM HCL | M-Diltiazem CD 300mg LA Cap | MAT | 0.7999 | 0.7999 | YES | NO | NO |
| 02546086 | DILTIAZEM HCL | M-Diltiazem CD 120mg LA Cap | MAT | 0.3634 | 0.3634 | YES | NO | NO |
| 02484099 | DILTIAZEM HCL | Mar-Diltiazem CD 300mg LA Cap | MAR | 0.7999 | 0.7999 | YES | NO | NO |
| 02484064 | DILTIAZEM HCL | Mar-Diltiazem CD 120mg LA Cap | MAR | 0.3634 | 0.3634 | YES | NO | NO |
| 02484072 | DILTIAZEM HCL | Mar-Diltiazem CD 180mg LA Cap | MAR | 0.4824 | 0.4824 | YES | NO | NO |
| 02484080 | DILTIAZEM HCL | Mar-Diltiazem CD 240mg LA Cap | MAR | 0.6399 | 0.6399 | YES | NO | NO |
| 02243341 | DILTIAZEM HCL | Sandoz Diltiazem CD 300mg LA Cap | SDZ | 0.7999 | 0.7999 | YES | NO | NO |
| 02243338 | DILTIAZEM HCL | Sandoz Diltiazem CD 120mg LA Cap | SDZ | 0.3634 | 0.3634 | YES | NO | NO |
| 02243340 | DILTIAZEM HCL | Sandoz Diltiazem CD 240mg LA Cap | SDZ | 0.6399 | 0.6399 | YES | NO | NO |
| 02243339 | DILTIAZEM HCL | Sandoz Diltiazem CD 180mg LA Cap | SDZ | 0.4824 | 0.4824 | YES | NO | NO |
| 02242539 | DILTIAZEM HCL | Teva-Diltazem CD 180mg LA Cap | TEV | 0.4824 | 0.4824 | YES | NO | NO |
| 02242540 | DILTIAZEM HCL | Teva-Diltazem CD 240mg LA Cap | TEV | 0.6399 | 0.6399 | YES | NO | NO |
| 02242541 | DILTIAZEM HCL | Teva-Diltazem CD 300mg LA Cap | TEV | 0.7999 | 0.7999 | YES | NO | NO |
| 02242538 | DILTIAZEM HCL | Teva-Diltazem CD 120mg LA Cap | TEV | 0.3634 | 0.3634 | YES | NO | NO |
| 02516136 | DILTIAZEM HCL | Diltiazem T 240mg SR Cap | SAI | 0.3832 | 0.3832 | YES | NO | NO |
| 02516101 | DILTIAZEM HCL | Diltiazem T 120mg SR Cap | SAI | 0.2133 | 0.2133 | YES | NO | NO |
| 02516144 | DILTIAZEM HCL | Diltiazem T 300mg SR Cap | SAI | 0.4720 | 0.4720 | YES | NO | NO |
| 02516128 | DILTIAZEM HCL | Diltiazem T 180mg SR Cap | SAI | 0.2889 | 0.2889 | YES | NO | NO |
| 02516152 | DILTIAZEM HCL | Diltiazem T 360mg SR Cap | SAI | 0.5778 | 0.5778 | YES | NO | NO |
| 02495414 | DILTIAZEM HCL | Jamp Diltiazem T 360mg SR Cap | JPC | 0.5778 | 0.5778 | YES | NO | NO |
| 02495384 | DILTIAZEM HCL | Jamp Diltiazem T 180mg SR Cap | JPC | 0.2889 | 0.2889 | YES | NO | NO |
| 02495406 | DILTIAZEM HCL | Jamp Diltiazem T 300mg SR Cap | JPC | 0.4720 | 0.4720 | YES | NO | NO |
| 02495376 | DILTIAZEM HCL | Jamp Diltiazem T 120mg SR Cap | JPC | 0.2133 | 0.2133 | YES | NO | NO |
| 02495392 | DILTIAZEM HCL | Jamp Diltiazem T 240mg SR Cap | JPC | 0.3832 | 0.3832 | YES | NO | NO |
| 02546477 | DILTIAZEM HCL | M-Diltiazem T 360mg SR Cap | MAT | 0.5778 | 0.5778 | YES | NO | NO |
| 02546469 | DILTIAZEM HCL | M-Diltiazem T 300mg SR Cap | MAT | 0.4720 | 0.4720 | YES | NO | NO |
| 02546434 | DILTIAZEM HCL | M-Diltiazem T 120mg SR Cap | MAT | 0.2133 | 0.2133 | YES | NO | NO |
| 02546450 | DILTIAZEM HCL | M-Diltiazem T 240mg SR Cap | MAT | 0.3832 | 0.3832 | YES | NO | NO |
| 02546442 | DILTIAZEM HCL | M-Diltiazem T 180mg SR Cap | MAT | 0.2889 | 0.2889 | YES | NO | NO |
| 02465361 | DILTIAZEM HCL | Mar-Diltiazem T 180mg SR Cap | MAR | 0.2889 | 0.2889 | YES | NO | NO |
| 02465388 | DILTIAZEM HCL | Mar-Diltiazem T 240mg SR Cap | MAR | 0.3832 | 0.3832 | YES | NO | NO |
| 02465353 | DILTIAZEM HCL | Mar-Diltiazem T 120mg SR Cap | MAR | 0.2133 | 0.2133 | YES | NO | NO |
| 02465418 | DILTIAZEM HCL | Mar-Diltiazem T 360mg SR Cap | MAR | 0.5778 | 0.5778 | YES | NO | NO |
| 02465396 | DILTIAZEM HCL | Mar-Diltiazem T 300mg SR Cap | MAR | 0.4720 | 0.4720 | YES | NO | NO |
| 02245919 | DILTIAZEM HCL | Sandoz Diltiazem T 180mg SR Cap | SDZ | 0.2889 | 0.2889 | YES | NO | NO |
| 02245918 | DILTIAZEM HCL | Sandoz Diltiazem T 120mg SR Cap | SDZ | 0.2133 | 0.2133 | YES | NO | NO |
| 02245921 | DILTIAZEM HCL | Sandoz Diltiazem T 300mg SR Cap | SDZ | 0.4720 | 0.4720 | YES | NO | NO |
| 02245922 | DILTIAZEM HCL | Sandoz Diltiazem T 360mg SR Cap | SDZ | 0.5778 | 0.5778 | YES | NO | NO |
| 02245920 | DILTIAZEM HCL | Sandoz Diltiazem T 240mg SR Cap | SDZ | 0.3832 | 0.3832 | YES | NO | NO |
| 02271656 | DILTIAZEM HCL | Teva-Diltiazem HCL ER 360mg SR Cap | TEV | 0.5778 | 0.5778 | YES | NO | NO |
| 02271605 | DILTIAZEM HCL | Teva-Diltiazem HCL ER 120mg SR Cap | TEV | 0.2133 | 0.2133 | YES | NO | NO |
| 02271648 | DILTIAZEM HCL | Teva-Diltiazem HCL ER 300mg SR Cap | TEV | 0.4720 | 0.4720 | YES | NO | NO |
| 02271613 | DILTIAZEM HCL | Teva-Diltiazem HCL ER 180mg SR Cap | TEV | 0.2889 | 0.2889 | YES | NO | NO |
| 02271621 | DILTIAZEM HCL | Teva-Diltiazem HCL ER 240mg SR Cap | TEV | 0.3832 | 0.3832 | YES | NO | NO |
| 02370522 | DILTIAZEM HCL | Teva-Diltiazem T 360mg SR Cap | TEV | 0.5778 | 0.5778 | YES | NO | NO |
| 02370492 | DILTIAZEM HCL | Teva-Diltiazem T 180mg SR Cap | TEV | 0.2889 | 0.2889 | YES | NO | NO |
| 02370506 | DILTIAZEM HCL | Teva-Diltiazem T 240mg SR Cap | TEV | 0.3832 | 0.3832 | YES | NO | NO |
| 02370514 | DILTIAZEM HCL | Teva-Diltiazem T 300mg SR Cap | TEV | 0.4720 | 0.4720 | YES | NO | NO |
| 02370441 | DILTIAZEM HCL | Teva-Diltiazem T 120mg SR Cap | TEV | 0.2133 | 0.2133 | YES | NO | NO |
| 02231155 | DILTIAZEM HCL | Tiazac 360mg SR Cap | VAL | 3.2124 | 0.5778 | YES | NO | NO |
| 02231150 | DILTIAZEM HCL | Tiazac 120mg SR Cap | VAL | 1.2023 | 0.2133 | YES | NO | NO |
| 02231151 | DILTIAZEM HCL | Tiazac 180mg SR Cap | VAL | 1.6062 | 0.2889 | YES | NO | NO |
| 02231152 | DILTIAZEM HCL | Tiazac 240mg SR Cap | VAL | 2.1304 | 0.3832 | YES | NO | NO |
| 02231154 | DILTIAZEM HCL | Tiazac 300mg SR Cap | VAL | 2.6682 | 0.4720 | YES | NO | NO |
| 00771376 | DILTIAZEM HCL | AA-Diltiaz 30mg Tab | AAP | 0.2168 | 0.2168 | YES | NO | NO |
| 00771384 | DILTIAZEM HCL | AA-Diltiaz 60mg Tab | AAP | 0.3802 | 0.3802 | YES | NO | NO |
| 02097370 | DILTIAZEM HCL | Cardizem (Not a Benefit) 30mg Tab | BIO | N/A | N/A | YES | NO | NO |
| 02097389 | DILTIAZEM HCL | Cardizem (Not a Benefit) 60mg Tab | BIO | N/A | N/A | YES | NO | NO |
| 00392537 | DIMENHYDRINATE | Dimenhydrinate Inj 50mg USP 50mg/mL Inj Sol (with Preservative) | SDZ | 1.3800 | 1.3800 | NO | YES | NO |
| 02373785 | DIMETHICONE. | NYDA 50% w/w Top Sol-50mL Pk | GPB | 22.4200 | 22.4200 | NO | NO | NO |
| 02495341 | DIMETHYL FUMARATE | Ach-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap | ACH | 9.1933 | 9.1933 | YES | NO | NO |
| 02495368 | DIMETHYL FUMARATE | Ach-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap | ACH | 18.3867 | 18.3867 | YES | NO | NO |
| 02505762 | DIMETHYL FUMARATE | Apo-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap | APX | 9.1933 | 9.1933 | YES | NO | NO |
| 02505770 | DIMETHYL FUMARATE | Apo-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap | APX | 18.3867 | 18.3867 | YES | NO | NO |
| 02540746 | DIMETHYL FUMARATE | Auro-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap | AUR | 4.4266 | 4.4266 | YES | NO | NO |
| 02540754 | DIMETHYL FUMARATE | Auro-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap | AUR | 8.6888 | 8.6888 | YES | NO | NO |
| 02494809 | DIMETHYL FUMARATE | GLN-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap | GLP | 9.1933 | 9.1933 | YES | NO | NO |
| 02494817 | DIMETHYL FUMARATE | GLN-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap | GLP | 18.3867 | 18.3867 | YES | NO | NO |
| 02516055 | DIMETHYL FUMARATE | Jamp Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap | JPC | 18.3867 | 18.3867 | YES | NO | NO |
| 02516047 | DIMETHYL FUMARATE | Jamp Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap | JPC | 9.1933 | 9.1933 | YES | NO | NO |
| 02502690 | DIMETHYL FUMARATE | Mar-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap | MAR | 9.1933 | 9.1933 | YES | NO | NO |
| 02502704 | DIMETHYL FUMARATE | Mar-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap | MAR | 18.3867 | 18.3867 | YES | NO | NO |
| 02497034 | DIMETHYL FUMARATE | PMS-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR Cap | PMS | 18.3867 | 18.3867 | YES | NO | NO |
| 02497026 | DIMETHYL FUMARATE | PMS-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR Cap | PMS | 9.1933 | 9.1933 | YES | NO | NO |
| 02513781 | DIMETHYL FUMARATE | Sandoz Dimethyl Fumarate DR Capsules (Off-Formulary Interchangeable) 120mg DR Cap | SDZ | 9.1933 | 9.1933 | YES | NO | NO |
| 02513803 | DIMETHYL FUMARATE | Sandoz Dimethyl Fumarate DR Capsules (Off-Formulary Interchangeable) 240mg DR Cap | SDZ | 18.3867 | 18.3867 | YES | NO | NO |
| 02404508 | DIMETHYL FUMARATE | Tecfidera (Off-Formulary Interchangeable) 120mg DR Cap | BIG | 18.3866 | 9.1933 | YES | NO | NO |
| 02420201 | DIMETHYL FUMARATE | Tecfidera (Off-Formulary Interchangeable) 240mg DR Cap | BIG | 36.7734 | 18.3867 | YES | NO | NO |
| 00036323 | DIPHENOXYLATE HYDROCHLORIDE & ATROPINE SULFATE | Lomotil 2.5mg & 0.025mg Tab | PFI | 0.5729 | 0.5729 | NO | YES | NO |
| 00895652 | DIPYRIDAMOLE | Apo-Dipyridamole (Off-Formulary Interchangeable) 50mg Tab | APX | 0.3685 | 0.3685 | YES | NO | NO |
| 00895644 | DIPYRIDAMOLE | Apo-Dipyridamole (Off-Formulary Interchangeable) 25mg Tab | APX | 0.2633 | N/A | YES | NO | NO |
| 00895660 | DIPYRIDAMOLE | Apo-Dipyridamole (Off-Formulary Interchangeable) 75mg Tab | APX | 0.4963 | N/A | YES | NO | NO |
| 00067393 | DIPYRIDAMOLE | Persantine (Off-Formulary Interchangeable) 50mg Tab | BOE | N/A | N/A | YES | NO | NO |
| 00067385 | DIPYRIDAMOLE | Persantine (Off-Formulary Interchangeable) 25mg Tab | BOE | N/A | N/A | YES | NO | NO |
| 00452092 | DIPYRIDAMOLE | Persantine (Off-Formulary Interchangeable) 75mg Tab | BOE | N/A | N/A | YES | NO | NO |
| 02242119 | DIPYRIDAMOLE & ACETYLSALICYLIC ACID | Aggrenox (Not a Benefit) 200mg/25mg Cap | BOE | N/A | N/A | YES | NO | NO |
| 02471051 | DIPYRIDAMOLE & ACETYLSALICYLIC ACID | Taro-Dipyridamole/ASA 200mg/25mg Cap | TAR | 0.6656 | 0.6656 | YES | YES | NO |
| 09858365 | DISOPYRAMIDE | Disopyramide Phosphate USP (Temporary Benefit) 100mg Cap | DRR | 1.4000 | 1.4000 | NO | NO | NO |
| 02030799 | DISOPYRAMIDE | Norpace (Not a Benefit) 100mg Cap | RBT | N/A | N/A | YES | NO | NO |
| 02224801 | DISOPYRAMIDE | Rythmodan 100mg Cap | CHE | 0.3390 | 0.3390 | YES | NO | NO |
| 02239699 | DIVALPROEX SODIUM | Apo-Divalproex 250mg Ent Tab | APX | 0.2767 | 0.2767 | YES | NO | NO |
| 02239700 | DIVALPROEX SODIUM | Apo-Divalproex 500mg Ent Tab | APX | 0.5537 | 0.5537 | YES | NO | NO |
| 02239698 | DIVALPROEX SODIUM | Apo-Divalproex 125mg Ent Tab | APX | 0.1539 | 0.1539 | YES | NO | NO |
| 00596434 | DIVALPROEX SODIUM | Epival 500mg Ent Tab | BGP | 1.3476 | 0.5537 | YES | NO | NO |
| 00596426 | DIVALPROEX SODIUM | Epival 250mg Ent Tab | BGP | 0.6735 | 0.2767 | YES | NO | NO |
| 00596418 | DIVALPROEX SODIUM | Epival 125mg Ent Tab | BGP | 0.3746 | 0.1539 | YES | NO | NO |
| 02458934 | DIVALPROEX SODIUM | Mylan-Divalproex 250mg Ent Tab | MYL | 0.2767 | 0.2767 | YES | NO | NO |
| 02458926 | DIVALPROEX SODIUM | Mylan-Divalproex 125mg Ent Tab | MYL | 0.1539 | 0.1539 | YES | NO | NO |
| 02459019 | DIVALPROEX SODIUM | Mylan-Divalproex 500mg Ent Tab | MYL | 0.5537 | 0.5537 | YES | NO | NO |
| 02106256 | DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE) | Colace 100mg Cap | WEL | 0.1310 | 0.0328 | YES | NO | NO |
| 00716731 | DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE) | Docusate Sodium 100mg Cap | TAR | 0.0328 | 0.0328 | YES | NO | NO |
| 02245946 | DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE) | Jamp-Docusate Sodium 100mg Cap | JPC | 0.0328 | 0.0328 | YES | NO | NO |
| 01994344 | DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE) | Soflax 100mg Cap | PMS | 0.0328 | 0.0328 | YES | NO | NO |
| 02090163 | DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE) | Colace 10mg/mL O/L | WEL | 0.1770 | 0.1770 | NO | NO | NO |
| 02086018 | DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE) | Colace 4mg/mL O/L | WEL | 0.0232 | 0.0232 | NO | NO | NO |
| 02414945 | DOLUTEGRAVIR | Tivicay 50mg Tab | VIH | 23.5367 | 23.5367 | NO | NO | NO |
| 02430932 | DOLUTEGRAVIR & ABACAVIR & LAMIVUDINE | Triumeq 50mg & 600mg & 300mg Tab | VIH | 52.1447 | 52.1447 | NO | NO | NO |
| 02475774 | DOLUTEGRAVIR & RILPIVIRINE | Juluca 50mg & 25mg Tab | VIH | 40.9343 | 40.9343 | NO | NO | NO |
| 02491753 | DOLUTEGRAVIR SODIUM/LAMIVUDINE | Dovato 50mg & 300mg Tab | VIH | 35.7367 | 35.7367 | NO | NO | NO |
| 02103613 | DOMPERIDONE MALEATE | Apo-Domperidone 10mg Tab | APX | 0.0428 | 0.0428 | YES | NO | NO |
| 02238341 | DOMPERIDONE MALEATE | Domperidone 10mg Tab | SIV | 0.0428 | 0.0428 | YES | NO | NO |
| 02350440 | DOMPERIDONE MALEATE | Domperidone 10mg Tab | SAI | 0.0428 | 0.0428 | YES | NO | NO |
| 02369206 | DOMPERIDONE MALEATE | Jamp-Domperidone 10mg Tab | JPC | 0.0428 | 0.0428 | YES | NO | NO |
| 02403870 | DOMPERIDONE MALEATE | Mar-Domperidone 10mg Tab | MAR | 0.0428 | 0.0428 | YES | NO | NO |
| 00855820 | DOMPERIDONE MALEATE | Motilium (Not a Benefit) 10mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02462834 | DOMPERIDONE MALEATE | PRZ-Domperidone 10mg Tab | PRZ | 0.0428 | 0.0428 | YES | NO | NO |
| 02268078 | DOMPERIDONE MALEATE | Ran-Domperidone 10mg Tab | RAN | 0.0428 | 0.0428 | YES | NO | NO |
| 01912070 | DOMPERIDONE MALEATE | Teva-Domperidone 10mg Tab | TEV | 0.0428 | 0.0428 | YES | NO | NO |
| 02269465 | DONEPEZIL HCL | Aricept RDT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | PFI | N/A | N/A | YES | NO | NO |
| 02269457 | DONEPEZIL HCL | Aricept RDT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | PFI | N/A | N/A | YES | NO | NO |
| 02397625 | DONEPEZIL HCL | Co Donepezil ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | COB | 3.6176 | N/A | YES | NO | NO |
| 02397617 | DONEPEZIL HCL | Co Donepezil ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | COB | 3.6176 | N/A | YES | NO | NO |
| 02367696 | DONEPEZIL HCL | Sandoz Donepezil ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | SDZ | 3.6176 | N/A | YES | NO | NO |
| 02367688 | DONEPEZIL HCL | Sandoz Donepezil ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | SDZ | 3.6176 | N/A | YES | NO | NO |
| 02432692 | DONEPEZIL HCL | AG-Donepezil 10mg Tab | ANG | 0.4586 | 0.4586 | YES | YES | NO |
| 02432684 | DONEPEZIL HCL | AG-Donepezil 5mg Tab | ANG | 0.4586 | 0.4586 | YES | YES | NO |
| 02402645 | DONEPEZIL HCL | Ach-Donepezil 5mg Tab | ACH | 0.4586 | 0.4586 | YES | YES | NO |
| 02402653 | DONEPEZIL HCL | Ach-Donepezil 10mg Tab | ACH | 0.4586 | 0.4586 | YES | YES | NO |
| 02362260 | DONEPEZIL HCL | Apo-Donepezil 5mg Tab | APX | 0.4586 | 0.4586 | YES | YES | NO |
| 02362279 | DONEPEZIL HCL | Apo-Donepezil 10mg Tab | APX | 0.4586 | 0.4586 | YES | YES | NO |
| 02232043 | DONEPEZIL HCL | Aricept 5mg Tab | PFI | 5.1856 | 0.4586 | YES | YES | NO |
| 02232044 | DONEPEZIL HCL | Aricept 10mg Tab | PFI | 5.1856 | 0.4586 | YES | YES | NO |
| 02400561 | DONEPEZIL HCL | Auro-Donepezil 5mg Tab | AUR | 0.4586 | 0.4586 | YES | YES | NO |
| 02400588 | DONEPEZIL HCL | Auro-Donepezil 10mg Tab | AUR | 0.4586 | 0.4586 | YES | YES | NO |
| 02412853 | DONEPEZIL HCL | Bio-Donepezil 5mg Tab | BMP | 0.4586 | 0.4586 | YES | YES | NO |
| 02412861 | DONEPEZIL HCL | Bio-Donepezil 10mg Tab | BMP | 0.4586 | 0.4586 | YES | YES | NO |
| 02397609 | DONEPEZIL HCL | Co Donepezil 10mg Tab | COB | 0.4586 | 0.4586 | YES | YES | NO |
| 02397595 | DONEPEZIL HCL | Co Donepezil 5mg Tab | COB | 0.4586 | 0.4586 | YES | YES | NO |
| 02475286 | DONEPEZIL HCL | Donepezil 10mg Tab | RIA | 0.4586 | 0.4586 | YES | YES | NO |
| 02420600 | DONEPEZIL HCL | Donepezil 10mg Tab | SIV | 0.4586 | 0.4586 | YES | YES | NO |
| 02426854 | DONEPEZIL HCL | Donepezil 10mg Tab | SAI | 0.4586 | 0.4586 | YES | YES | NO |
| 02426846 | DONEPEZIL HCL | Donepezil 5mg Tab | SAI | 0.4586 | 0.4586 | YES | YES | NO |
| 02475278 | DONEPEZIL HCL | Donepezil 5mg Tab | RIA | 0.4586 | 0.4586 | YES | YES | NO |
| 02420597 | DONEPEZIL HCL | Donepezil 5mg Tab | SIV | 0.4586 | 0.4586 | YES | YES | NO |
| 02404427 | DONEPEZIL HCL | Jamp-Donepezil 10mg Tab | JPC | 0.4586 | 0.4586 | YES | YES | NO |
| 02404419 | DONEPEZIL HCL | Jamp-Donepezil 5mg Tab | JPC | 0.4586 | 0.4586 | YES | YES | NO |
| 02416948 | DONEPEZIL HCL | Jamp-Donepezil Tablets 5mg Tab | JPC | 0.4586 | 0.4586 | YES | YES | NO |
| 02416956 | DONEPEZIL HCL | Jamp-Donepezil Tablets 10mg Tab | JPC | 0.4586 | 0.4586 | YES | YES | NO |
| 02467461 | DONEPEZIL HCL | M-Donepezil 10mg Tab | MAT | 0.4586 | 0.4586 | YES | YES | NO |
| 02467453 | DONEPEZIL HCL | M-Donepezil 5mg Tab | MAT | 0.4586 | 0.4586 | YES | YES | NO |
| 02402106 | DONEPEZIL HCL | Mar-Donepezil 10mg Tab | MAR | 0.4586 | 0.4586 | YES | YES | NO |
| 02402092 | DONEPEZIL HCL | Mar-Donepezil 5mg Tab | MAR | 0.4586 | 0.4586 | YES | YES | NO |
| 02408600 | DONEPEZIL HCL | Mint-Donepezil 5mg Tab | MIN | 0.4586 | 0.4586 | YES | YES | NO |
| 02408619 | DONEPEZIL HCL | Mint-Donepezil 10mg Tab | MIN | 0.4586 | 0.4586 | YES | YES | NO |
| 02535386 | DONEPEZIL HCL | NRA-Donepezil 5mg Tab | NRA | 0.4586 | 0.4586 | YES | YES | NO |
| 02535394 | DONEPEZIL HCL | NRA-Donepezil 10mg Tab | NRA | 0.4586 | 0.4586 | YES | YES | NO |
| 02439565 | DONEPEZIL HCL | Nat-Donepezil 10mg Tab | NAT | 0.4586 | 0.4586 | YES | YES | NO |
| 02439557 | DONEPEZIL HCL | Nat-Donepezil 5mg Tab | NAT | 0.4586 | 0.4586 | YES | YES | NO |
| 02322358 | DONEPEZIL HCL | PMS-Donepezil 10mg Tab | PMS | 0.4586 | 0.4586 | YES | YES | NO |
| 02322331 | DONEPEZIL HCL | PMS-Donepezil 5mg Tab | PMS | 0.4586 | 0.4586 | YES | YES | NO |
| 02381516 | DONEPEZIL HCL | Ran-Donepezil 10mg Tab | RAN | 0.4586 | 0.4586 | YES | YES | NO |
| 02381508 | DONEPEZIL HCL | Ran-Donepezil 5mg Tab | RAN | 0.4586 | 0.4586 | YES | YES | NO |
| 02328682 | DONEPEZIL HCL | Sandoz Donepezil 10mg Tab | SDZ | 0.4586 | 0.4586 | YES | YES | NO |
| 02328666 | DONEPEZIL HCL | Sandoz Donepezil 5mg Tab | SDZ | 0.4586 | 0.4586 | YES | YES | NO |
| 02428482 | DONEPEZIL HCL | Septa-Donepezil 5mg Tab | SET | 0.4586 | 0.4586 | YES | YES | NO |
| 02428490 | DONEPEZIL HCL | Septa-Donepezil 10mg Tab | SET | 0.4586 | 0.4586 | YES | YES | NO |
| 02340607 | DONEPEZIL HCL | Teva-Donepezil 5mg Tab | TEV | 0.4586 | 0.4586 | YES | YES | NO |
| 02340615 | DONEPEZIL HCL | Teva-Donepezil 10mg Tab | TEV | 0.4586 | 0.4586 | YES | YES | NO |
| 02481545 | DORAVIRINE | Pifeltro 100mg Tab | MEK | 16.6500 | 16.6500 | NO | NO | NO |
| 02482592 | DORAVIRINE/LAMIVUDINE/TENOFOVIR DISOPROXIL FUMARATE | Delstrigo 100mg & 300mg & 300mg Tab | MEK | 28.7900 | 28.7900 | NO | NO | NO |
| 02522373 | DORZOLAMIDE HCL | Dorzolamide 2% Oph Sol | JPC | 1.4757 | 1.4757 | YES | YES | NO |
| 02453347 | DORZOLAMIDE HCL | Jamp-Dorzolamide 2% Oph Sol | JPC | 1.4757 | 1.4757 | YES | YES | NO |
| 02457210 | DORZOLAMIDE HCL | Med-Dorzolamide 2% Oph Sol | GMP | 1.4757 | 1.4757 | YES | YES | NO |
| 02316307 | DORZOLAMIDE HCL | Sandoz Dorzolamide 2% Oph Sol | SDZ | 1.4757 | 1.4757 | YES | YES | NO |
| 02216205 | DORZOLAMIDE HCL | Trusopt 2% Oph Sol | ELV | 6.1267 | 1.4757 | YES | YES | NO |
| 02299615 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Apo-Dorzo-Timop 2% & 0.5% Oph Sol | APX | 2.0951 | 2.0951 | YES | YES | NO |
| 02404389 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Co Dorzotimolol 2% & 0.5% Oph Sol | COB | 2.0951 | 2.0951 | YES | YES | NO |
| 02240113 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Cosopt 2% & 0.5% Oph Sol | ELV | 9.6613 | 2.0951 | YES | YES | NO |
| 02489635 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Dorzolamide and Timolol Eye Drops BP 2% & 0.5% Oph Sol | TCI | 2.0951 | 2.0951 | YES | YES | NO |
| 02522020 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Dorzolamide-Timolol 2% & 0.5% Oph Sol | JPC | 2.0951 | 2.0951 | YES | YES | NO |
| 02457539 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Jamp Dorzolamide-Timolol 2% & 0.5% Oph Sol | JPC | 2.0951 | 2.0951 | YES | YES | NO |
| 02537796 | DORZOLAMIDE HCL & TIMOLOL MALEATE | M-Dorzolamide-Timolol 2% & 0.5% Oph Sol | MAT | 2.0951 | 2.0951 | YES | YES | NO |
| 02437686 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Med-Dorzolamide-Timolol 2% & 0.5% Oph Sol | GMP | 2.0951 | 2.0951 | YES | YES | NO |
| 02443090 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Mint-Dorzolamide/Timolol 2% & 0.5% Oph Sol | MIN | 2.0951 | 2.0951 | YES | YES | NO |
| 02441659 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Riva-Dorzolamide/Timolol 2% & 0.5% Oph Sol | RIA | 2.0951 | 2.0951 | YES | YES | NO |
| 02344351 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Sandoz Dorzolamide/Timolol 2% & 0.5% Oph Sol | SDZ | 2.0951 | 2.0951 | YES | YES | NO |
| 02258692 | DORZOLAMIDE HCL & TIMOLOL MALEATE | Cosopt Preservative free 2% & 0.5% Oph Sol-0.2mL Pk | ELV | 0.8505 | 0.8505 | NO | YES | NO |
| 02240589 | DOXAZOSIN MESYLATE | Apo-Doxazosin 2mg Tab | APX | 0.2062 | 0.2062 | YES | NO | NO |
| 02240590 | DOXAZOSIN MESYLATE | Apo-Doxazosin 4mg Tab | APX | 0.2681 | 0.2681 | YES | NO | NO |
| 02240588 | DOXAZOSIN MESYLATE | Apo-Doxazosin 1mg Tab | APX | 0.1719 | 0.1719 | YES | NO | NO |
| 01958100 | DOXAZOSIN MESYLATE | Cardura-1 (Not a Benefit) 1mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 01958097 | DOXAZOSIN MESYLATE | Cardura-2 (Not a Benefit) 2mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 01958119 | DOXAZOSIN MESYLATE | Cardura-4 (Not a Benefit) 4mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02489953 | DOXAZOSIN MESYLATE | Jamp-Doxazosin 4mg Tab | JPC | 0.2681 | 0.2681 | YES | NO | NO |
| 02489937 | DOXAZOSIN MESYLATE | Jamp-Doxazosin 1mg Tab | JPC | 0.1719 | 0.1719 | YES | NO | NO |
| 02489945 | DOXAZOSIN MESYLATE | Jamp-Doxazosin 2mg Tab | JPC | 0.2062 | 0.2062 | YES | NO | NO |
| 02242728 | DOXAZOSIN MESYLATE | Teva-Doxazosin 1mg Tab | TEV | 0.1719 | 0.1719 | YES | NO | NO |
| 02242730 | DOXAZOSIN MESYLATE | Teva-Doxazosin 4mg Tab | TEV | 0.2681 | 0.2681 | YES | NO | NO |
| 02242729 | DOXAZOSIN MESYLATE | Teva-Doxazosin 2mg Tab | TEV | 0.2062 | 0.2062 | YES | NO | NO |
| 02050021 | DOXEPIN HCL | Apo-Doxepin (Off-Formulary Interchangeable) 75mg Cap | APX | 1.1363 | N/A | YES | NO | NO |
| 02050013 | DOXEPIN HCL | Apo-Doxepin 50mg Cap | APX | 0.4637 | 0.4637 | YES | NO | NO |
| 02050005 | DOXEPIN HCL | Apo-Doxepin 25mg Cap | APX | 0.2500 | 0.2500 | YES | NO | NO |
| 02050048 | DOXEPIN HCL | Apo-Doxepin (Off-Formulary Interchangeable) 100mg Cap | APX | 1.4944 | N/A | YES | NO | NO |
| 02559102 | DOXEPIN HCL | Mar-Doxepin 50mg Cap | MAR | 0.4637 | 0.4637 | YES | NO | NO |
| 02559080 | DOXEPIN HCL | Mar-Doxepin 10mg Cap | MAR | 0.2241 | 0.2241 | YES | NO | NO |
| 02559110 | DOXEPIN HCL | Mar-Doxepin (Off-Formulary Interchangeable) 75mg Cap | MAR | 1.1363 | N/A | YES | NO | NO |
| 02559099 | DOXEPIN HCL | Mar-Doxepin 25mg Cap | MAR | 0.2500 | 0.2500 | YES | NO | NO |
| 02559129 | DOXEPIN HCL | Mar-Doxepin (Off-Formulary Interchangeable) 100mg Cap | MAR | 1.4944 | N/A | YES | NO | NO |
| 00024325 | DOXEPIN HCL | Sinequan 10mg Cap | AAP | 0.4075 | 0.2241 | YES | NO | NO |
| 00024333 | DOXEPIN HCL | Sinequan 25mg Cap | AAP | 0.5000 | 0.2500 | YES | NO | NO |
| 00400750 | DOXEPIN HCL | Sinequan (Off-Formulary Interchangeable) 75mg Cap | AAP | N/A | N/A | YES | NO | NO |
| 00326925 | DOXEPIN HCL | Sinequan (Off-Formulary Interchangeable) 100mg Cap | AAP | N/A | N/A | YES | NO | NO |
| 00024341 | DOXEPIN HCL | Sinequan 50mg Cap | AAP | 0.9274 | 0.4637 | YES | NO | NO |
| 02512645 | DOXYCYCLINE | Apo-Doxycycline MR (Off-Formulary Interchangeable) 40mg MR Cap | APX | 3.0850 | N/A | YES | NO | NO |
| 02375885 | DOXYCYCLINE | Apprilon (Off-Formulary Interchangeable) 40mg MR Cap | GAC | N/A | N/A | YES | NO | NO |
| 02528568 | DOXYCYCLINE HYCLATE | Jamp Doxycycline (Off-Formulary Interchangeable) 20mg Cap | JPC | 1.3538 | N/A | YES | NO | NO |
| 02247104 | DOXYCYCLINE HYCLATE | Periostat (Off-Formulary Interchangeable) 20mg Cap | PEN | N/A | N/A | YES | NO | NO |
| 00874256 | DOXYCYCLINE HYCLATE | Apo-Doxy-Tabs 100mg Tab | APX | 0.4560 | 0.4560 | YES | NO | NO |
| 02351242 | DOXYCYCLINE HYCLATE | Doxycycline Tablets 100mg Tab | SAI | 0.4560 | 0.4560 | YES | NO | NO |
| 02543478 | DOXYCYCLINE HYCLATE | M-Doxycycline 100mg Tab | MAT | 0.4560 | 0.4560 | YES | NO | NO |
| 02536250 | DOXYCYCLINE HYCLATE | PRZ-Doxycycline 100mg Tab | PRZ | 0.4560 | 0.4560 | YES | NO | NO |
| 02158574 | DOXYCYCLINE HYCLATE | Teva-Doxycycline 100mg Tab | TEV | 0.4560 | 0.4560 | YES | NO | NO |
| 00578452 | DOXYCYCLINE HYCLATE | Vibra-Tabs (Not a Benefit) 100mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02552574 | DOXYLAMINE SUCCINATE AND PYRIDOXINE HCL | ALOG-Doxylamine/Pyridoxine 10mg & 10mg SR Tab | ANA | 0.3201 | 0.3201 | YES | NO | NO |
| 02413248 | DOXYLAMINE SUCCINATE AND PYRIDOXINE HCL | Apo-Doxylamine/B6 10mg & 10mg SR Tab | APX | 0.3201 | 0.3201 | YES | NO | NO |
| 00609129 | DOXYLAMINE SUCCINATE AND PYRIDOXINE HCL | Diclectin 10mg & 10mg SR Tab | DUI | 1.2803 | 0.3201 | YES | NO | NO |
| 02406187 | DOXYLAMINE SUCCINATE AND PYRIDOXINE HCL | PMS-Doxylamine-Pyridoxine 10mg & 10mg SR Tab | PMS | 0.3201 | 0.3201 | YES | NO | NO |
| 02522802 | DROSPIRENONE | Slynd 4mg Tab-28 Tab Pk | DUI | 12.6600 | 12.6600 | NO | NO | NO |
| 02421437 | DROSPIRENONE & ETHINYL ESTRADIOL | Drospirenone&Ethinyl Estradiol USP 21 3.0mg & 0.03mg Tab-21 Pk | GLP | 6.2181 | 6.2181 | YES | NO | NO |
| 02261723 | DROSPIRENONE & ETHINYL ESTRADIOL | Yasmin 21 3.0mg & 0.03mg Tab-21 Pk | BAH | 12.4400 | 6.2181 | YES | NO | NO |
| 02410788 | DROSPIRENONE & ETHINYL ESTRADIOL | Zamine 21 3.0mg & 0.03mg Tab-21 Pk | APX | 6.2181 | 6.2181 | YES | NO | NO |
| 02462060 | DROSPIRENONE & ETHINYL ESTRADIOL | Drospirenone&Ethinyl Estradiol USP 3.0mg & 0.02mg Tab-28 Pk | GLP | 8.2600 | 8.2600 | YES | NO | NO |
| 02421445 | DROSPIRENONE & ETHINYL ESTRADIOL | Drospirenone&Ethinyl Estradiol USP 28 3.0mg & 0.03mg Tab-28 Pk | GLP | 6.2188 | 6.2188 | YES | NO | NO |
| 02415380 | DROSPIRENONE & ETHINYL ESTRADIOL | MYA 3.0mg & 0.02mg Tab-28 Pk | APX | 8.2600 | 8.2600 | YES | NO | NO |
| 02261731 | DROSPIRENONE & ETHINYL ESTRADIOL | Yasmin 28 3.0mg & 0.03mg Tab-28 Pk | BAH | 12.4400 | 6.2188 | YES | NO | NO |
| 02321157 | DROSPIRENONE & ETHINYL ESTRADIOL | Yaz 3.0mg & 0.02mg Tab-28 Pk | BAH | 16.5200 | 8.2600 | YES | NO | NO |
| 02410796 | DROSPIRENONE & ETHINYL ESTRADIOL | Zamine 28 3.0mg & 0.03mg Tab-28 Pk | APX | 6.2188 | 6.2188 | YES | NO | NO |
| 02475308 | DULOXETINE | AG-Duloxetine 30mg DR Cap | ANG | 0.4814 | 0.3611 | YES | NO | NO |
| 02475316 | DULOXETINE | AG-Duloxetine 60mg DR Cap | ANG | 0.9769 | 0.7327 | YES | NO | NO |
| 02522861 | DULOXETINE | Accel-Duloxetine 30mg DR Cap | ACC | 0.3611 | 0.3611 | YES | NO | NO |
| 02522888 | DULOXETINE | Accel-Duloxetine 60mg DR Cap | ACC | 0.7327 | 0.7327 | YES | NO | NO |
| 02440423 | DULOXETINE | Apo-Duloxetine 30mg DR Cap | APX | 0.4814 | 0.3611 | YES | NO | NO |
| 02440431 | DULOXETINE | Apo-Duloxetine 60mg DR Cap | APX | 0.9769 | 0.7327 | YES | NO | NO |
| 02436647 | DULOXETINE | Auro-Duloxetine 30mg DR Cap | AUR | 0.4814 | 0.3611 | YES | NO | NO |
| 02436655 | DULOXETINE | Auro-Duloxetine 60mg DR Cap | AUR | 0.9769 | 0.7327 | YES | NO | NO |
| 02301482 | DULOXETINE | Cymbalta 30mg DR Cap | LIL | 2.6004 | 0.3611 | YES | NO | NO |
| 02301490 | DULOXETINE | Cymbalta 60mg DR Cap | LIL | 5.2779 | 0.7327 | YES | NO | NO |
| 02490889 | DULOXETINE | Duloxetine 30mg DR Cap | SAI | 0.4814 | 0.3611 | YES | NO | NO |
| 02453649 | DULOXETINE | Duloxetine 60mg DR Cap | SIV | 0.9769 | 0.7327 | YES | NO | NO |
| 02453630 | DULOXETINE | Duloxetine 30mg DR Cap | SIV | 0.4814 | 0.3611 | YES | NO | NO |
| 02490897 | DULOXETINE | Duloxetine 60mg DR Cap | SAI | 0.9769 | 0.7327 | YES | NO | NO |
| 02437090 | DULOXETINE | Duloxetine DR 60mg DR Cap | TEV | 0.9769 | 0.7327 | YES | NO | NO |
| 02437082 | DULOXETINE | Duloxetine DR 30mg DR Cap | TEV | 0.4814 | 0.3611 | YES | NO | NO |
| 02512513 | DULOXETINE | Jamp Duloxetine Capsules 60mg DR Cap | JPC | 0.9769 | 0.7327 | YES | NO | NO |
| 02512505 | DULOXETINE | Jamp Duloxetine Capsules 30mg DR Cap | JPC | 0.4814 | 0.3611 | YES | NO | NO |
| 02451913 | DULOXETINE | Jamp-Duloxetine 30mg DR Cap | JPC | 0.4814 | 0.3611 | YES | NO | NO |
| 02451921 | DULOXETINE | Jamp-Duloxetine 60mg DR Cap | JPC | 0.9769 | 0.7327 | YES | NO | NO |
| 02473216 | DULOXETINE | M-Duloxetine 60mg DR Cap | MAT | 0.9769 | 0.7327 | YES | NO | NO |
| 02473208 | DULOXETINE | M-Duloxetine 30mg DR Cap | MAT | 0.4814 | 0.3611 | YES | NO | NO |
| 02446081 | DULOXETINE | Mar-Duloxetine 30mg DR Cap | MAR | 0.4814 | 0.3611 | YES | NO | NO |
| 02446103 | DULOXETINE | Mar-Duloxetine 60mg DR Cap | MAR | 0.9769 | 0.7327 | YES | NO | NO |
| 02438984 | DULOXETINE | Mint-Duloxetine 30mg DR Cap | MIN | 0.4814 | 0.3611 | YES | NO | NO |
| 02438992 | DULOXETINE | Mint-Duloxetine 60mg DR Cap | MIN | 0.9769 | 0.7327 | YES | NO | NO |
| 02482126 | DULOXETINE | NRA-Duloxetine 30mg DR Cap | NRA | 0.4814 | 0.3611 | YES | NO | NO |
| 02482134 | DULOXETINE | NRA-Duloxetine 60mg DR Cap | NRA | 0.9769 | 0.7327 | YES | NO | NO |
| 02429446 | DULOXETINE | PMS-Duloxetine 30mg DR Cap | PMS | 0.4814 | 0.3611 | YES | NO | NO |
| 02429454 | DULOXETINE | PMS-Duloxetine 60mg DR Cap | PMS | 0.9769 | 0.7327 | YES | NO | NO |
| 02438259 | DULOXETINE | Ran-Duloxetine 30mg DR Cap | RAN | 0.4814 | 0.3611 | YES | NO | NO |
| 02438267 | DULOXETINE | Ran-Duloxetine 60mg DR Cap | RAN | 0.9769 | 0.7327 | YES | NO | NO |
| 02439948 | DULOXETINE | Sandoz Duloxetine 30mg DR Cap | SDZ | 0.4814 | 0.3611 | YES | NO | NO |
| 02439956 | DULOXETINE | Sandoz Duloxetine 60mg DR Cap | SDZ | 0.9769 | 0.7327 | YES | NO | NO |
| 02457202 | DULOXETINE | Taro-Duloxetine 60mg DR Cap | TAR | 0.9769 | 0.7327 | YES | NO | NO |
| 02457199 | DULOXETINE | Taro-Duloxetine 30mg DR Cap | TAR | 0.4814 | 0.3611 | YES | NO | NO |
| 02456761 | DULOXETINE | Teva-Duloxetine 60mg DR Cap | TEV | 0.9769 | 0.7327 | YES | NO | NO |
| 02456753 | DULOXETINE | Teva-Duloxetine 30mg DR Cap | TEV | 0.4814 | 0.3611 | YES | NO | NO |
| 02404206 | DUTASTERIDE | Apo-Dutasteride 0.5mg Cap | APX | 0.2565 | 0.2565 | YES | YES | NO |
| 02469308 | DUTASTERIDE | Auro-Dutasteride 0.5mg Cap | AUR | 0.2565 | 0.2565 | YES | YES | NO |
| 02247813 | DUTASTERIDE | Avodart 0.5mg Cap | GSK | 2.2293 | 0.2565 | YES | YES | NO |
| 02429012 | DUTASTERIDE | Dutasteride 0.5mg Cap | SIV | 0.2565 | 0.2565 | YES | YES | NO |
| 02443058 | DUTASTERIDE | Dutasteride 0.5mg Cap | SAI | 0.2565 | 0.2565 | YES | YES | NO |
| 02484870 | DUTASTERIDE | Jamp Dutasteride 0.5mg Cap | JPC | 0.2565 | 0.2565 | YES | YES | NO |
| 02546167 | DUTASTERIDE | Jamp Dutasteride Capsules 0.5mg Cap | JPC | 0.2565 | 0.2565 | YES | YES | NO |
| 02416298 | DUTASTERIDE | Med-Dutasteride 0.5mg Cap | GMP | 0.2565 | 0.2565 | YES | YES | NO |
| 02428873 | DUTASTERIDE | Mint-Dutasteride 0.5mg Cap | MIN | 0.2565 | 0.2565 | YES | YES | NO |
| 02490587 | DUTASTERIDE | Priva-Dutasteride 0.5mg Cap | PHP | 0.2565 | 0.2565 | YES | YES | NO |
| 02424444 | DUTASTERIDE | Sandoz Dutasteride 0.5mg Cap | SDZ | 0.2565 | 0.2565 | YES | YES | NO |
| 02408287 | DUTASTERIDE | Teva-Dutasteride 0.5mg Cap | TEV | 0.2565 | 0.2565 | YES | YES | NO |
| 02557282 | EDOXABAN | Jamp Edoxaban 30mg Tab | JPC | 0.7348 | 0.7348 | YES | NO | NO |
| 02557290 | EDOXABAN | Jamp Edoxaban 60mg Tab | JPC | 0.7348 | 0.7348 | YES | NO | NO |
| 02458667 | EDOXABAN | Lixiana 60mg Tab | SEV | 2.9393 | 0.7348 | YES | NO | NO |
| 02458659 | EDOXABAN | Lixiana 30mg Tab | SEV | 2.9393 | 0.7348 | YES | NO | NO |
| 02458640 | EDOXABAN | Lixiana 15mg Tab | SEV | 2.9393 | 1.4697 | YES | NO | NO |
| 02553422 | EDOXABAN | Sandoz Edoxaban 30mg Tab | SDZ | 0.7348 | 0.7348 | YES | NO | NO |
| 02553414 | EDOXABAN | Sandoz Edoxaban 15mg Tab | SDZ | 1.4697 | 1.4697 | YES | NO | NO |
| 02553430 | EDOXABAN | Sandoz Edoxaban 60mg Tab | SDZ | 0.7348 | 0.7348 | YES | NO | NO |
| 02554208 | EDOXABAN | Teva-Edoxaban 15mg Tab | TEV | 1.4697 | 1.4697 | YES | NO | NO |
| 02554216 | EDOXABAN | Teva-Edoxaban 30mg Tab | TEV | 0.7348 | 0.7348 | YES | NO | NO |
| 02554224 | EDOXABAN | Teva-Edoxaban 60mg Tab | TEV | 0.7348 | 0.7348 | YES | NO | NO |
| 02418428 | EFAVIRENZ | Auro-Efavirenz 600mg Tab | AUR | 3.8030 | 3.8030 | YES | NO | NO |
| 02458233 | EFAVIRENZ | Jamp-Efavirenz 600mg Tab | JPC | 3.8030 | 3.8030 | YES | NO | NO |
| 02381524 | EFAVIRENZ | Mylan-Efavirenz 600mg Tab | MYL | 3.8030 | 3.8030 | YES | NO | NO |
| 02246045 | EFAVIRENZ | Sustiva (Not a Benefit) 600mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02389762 | EFAVIRENZ | Teva-Efavirenz 600mg Tab | TEV | 3.8030 | 3.8030 | YES | NO | NO |
| 02468247 | EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINE | Apo-Efavirenz-Emtricitabine-Tenofovir 600mg/300mg/200mg Tab | APX | 11.3300 | 11.3300 | YES | NO | NO |
| 02300699 | EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINE | Atripla 600mg/300mg/200mg Tab | BQU | 45.3200 | 11.3300 | YES | NO | NO |
| 02478404 | EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINE | Auro-Efavirenz-Emtricitabine-Tenofovir 600mg/300mg/200mg Tab | AUR | 11.3300 | 11.3300 | YES | NO | NO |
| 02519461 | EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINE | Jamp Efavirenz/Emtricitabine/Tenofovir 600mg/300mg/200mg Tab | JPC | 11.3300 | 11.3300 | YES | NO | NO |
| 02461412 | EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINE | Mylan-Efavirenz/Emtricitabine/Tenofovir 600mg/300mg/200mg Tab | MYL | 11.3300 | 11.3300 | YES | NO | NO |
| 02487284 | EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINE | PMS-Efavirenz-Emtricitabine-Tenofovir 600mg/300mg/200mg Tab | PMS | 11.3300 | 11.3300 | YES | NO | NO |
| 02393549 | EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINE | Teva-Efavirenz/Emtricitabine/Tenofovir 600mg/300mg/200mg Tab | TEV | 11.3300 | 11.3300 | YES | NO | NO |
| 80074173 | ELECTROLYTE & DEXTROSE | Pedialyte Flavored O/L | ABB | 0.0079 | 0.0079 | YES | NO | NO |
| 80072902 | ELECTROLYTE & DEXTROSE | Pedialyte Regular O/L | ABB | 0.0079 | 0.0079 | YES | NO | NO |
| 02386062 | ELETRIPTAN | Apo-Eletriptan (Off-Formulary Interchangeable) 40mg Tab | APX | 10.0850 | N/A | YES | NO | NO |
| 02386054 | ELETRIPTAN | Apo-Eletriptan (Off-Formulary Interchangeable) 20mg Tab | APX | 10.0850 | N/A | YES | NO | NO |
| 02518023 | ELETRIPTAN | Apo-Eletriptan Tablets (Off-Formulary Interchangeable) 40mg Tab | APX | 10.0850 | N/A | YES | NO | NO |
| 02518015 | ELETRIPTAN | Apo-Eletriptan Tablets (Off-Formulary Interchangeable) 20mg Tab | APX | 10.0850 | N/A | YES | NO | NO |
| 02479478 | ELETRIPTAN | Auro-Eletriptan (Off-Formulary Interchangeable) 40mg Tab | AUR | 10.0850 | N/A | YES | NO | NO |
| 02479451 | ELETRIPTAN | Auro-Eletriptan (Off-Formulary Interchangeable) 20mg Tab | AUR | 10.0850 | N/A | YES | NO | NO |
| 02511266 | ELETRIPTAN | Eletriptan (Off-Formulary Interchangeable) 20mg Tab | SAI | 10.0850 | N/A | YES | NO | NO |
| 02511274 | ELETRIPTAN | Eletriptan (Off-Formulary Interchangeable) 40mg Tab | SAI | 10.0850 | N/A | YES | NO | NO |
| 02342235 | ELETRIPTAN | Gd-Eletriptan (Off-Formulary Interchangeable) 20mg Tab | UJC | 10.0850 | N/A | YES | NO | NO |
| 02342243 | ELETRIPTAN | Gd-Eletriptan (Off-Formulary Interchangeable) 40mg Tab | UJC | 10.0850 | N/A | YES | NO | NO |
| 02493683 | ELETRIPTAN | Jamp Eletriptan (Off-Formulary Interchangeable) 20mg Tab | JPC | 10.0850 | N/A | YES | NO | NO |
| 02493691 | ELETRIPTAN | Jamp Eletriptan (Off-Formulary Interchangeable) 40mg Tab | JPC | 10.0850 | N/A | YES | NO | NO |
| 02256290 | ELETRIPTAN | Relpax (Off-Formulary Interchangeable) 20mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02256304 | ELETRIPTAN | Relpax (Off-Formulary Interchangeable) 40mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02382105 | ELETRIPTAN | Teva-Eletriptan (Off-Formulary Interchangeable) 40mg Tab | TEV | 10.0850 | N/A | YES | NO | NO |
| 02382091 | ELETRIPTAN | Teva-Eletriptan (Off-Formulary Interchangeable) 20mg Tab | TEV | 10.0850 | N/A | YES | NO | NO |
| 02506769 | ELTROMBOPAG OLAMINE | Apo-Eltrombopag (Off-Formulary Interchangeable) 50mg Tab | APX | 110.5000 | 110.5000 | YES | NO | NO |
| 02506742 | ELTROMBOPAG OLAMINE | Apo-Eltrombopag (Off-Formulary Interchangeable) 25mg Tab | APX | 55.2500 | 55.2500 | YES | NO | NO |
| 02361825 | ELTROMBOPAG OLAMINE | Revolade (Off-Formulary Interchangeable) 25mg Tab | GSK | 65.0000 | 55.2500 | YES | NO | NO |
| 02361833 | ELTROMBOPAG OLAMINE | Revolade (Off-Formulary Interchangeable) 50mg Tab | GSK | 130.0000 | 110.5000 | YES | NO | NO |
| 02449498 | ELVITEGRAVIR & COBICISTAT & EMTRICITABINE & TENOFOVIR ALAFENAMIDE | Genvoya 150mg & 150mg & 200mg & 10mg Tab | GIL | 45.1440 | 45.1440 | NO | NO | NO |
| 02443937 | EMPAGLIFLOZIN | Jardiance 10mg Tab | BOE | 2.7671 | 2.7671 | NO | NO | YES |
| 02443945 | EMPAGLIFLOZIN | Jardiance 25mg Tab | BOE | 2.7671 | 2.7671 | NO | NO | YES |
| 02456621 | EMPAGLIFLOZIN & METFORMIN | Synjardy 12.5mg & 1000mg Tab | BOE | 1.3932 | 1.3932 | NO | NO | YES |
| 02456575 | EMPAGLIFLOZIN & METFORMIN | Synjardy 5mg & 500mg Tab | BOE | 1.3932 | 1.3932 | NO | NO | YES |
| 02456591 | EMPAGLIFLOZIN & METFORMIN | Synjardy 5mg & 1000mg Tab | BOE | 1.3932 | 1.3932 | NO | NO | YES |
| 02456605 | EMPAGLIFLOZIN & METFORMIN | Synjardy 12.5mg & 500mg Tab | BOE | 1.3932 | 1.3932 | NO | NO | YES |
| 02456613 | EMPAGLIFLOZIN & METFORMIN | Synjardy 12.5mg & 850mg Tab | BOE | 1.3932 | 1.3932 | NO | NO | YES |
| 02456583 | EMPAGLIFLOZIN & METFORMIN | Synjardy 5mg & 850mg Tab | BOE | 1.3932 | 1.3932 | NO | NO | YES |
| 02461463 | EMTRICITABINE & RILPIVIRINE HCL & TENOFOVIR ALAFENAMIDE HEMIFUMARATE | Odefsey 200mg & 25mg & 25mg Tab | GIL | 42.3670 | 42.3670 | NO | NO | NO |
| 02374129 | EMTRICITABINE & RILPIVIRINE HCL & TENOFOVIR DISOPROXIL | Complera 200mg & 25mg & 300mg Tab | GIL | 44.8643 | 44.8643 | NO | NO | NO |
| 02496356 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | AG-Emtricitabine & Tenofovir Disoproxil 200mg & 300mg Tab | ANG | 7.3035 | 7.3035 | YES | NO | NO |
| 02452006 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Apo-Emtricitabine-Tenofovir 200mg & 300mg Tab | APX | 7.3035 | 7.3035 | YES | NO | NO |
| 02490684 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Auro-Emtricitabine-Tenofovir 200mg & 300mg Tab | AUR | 7.3035 | 7.3035 | YES | NO | NO |
| 02487012 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Jamp-Emtricitabine/Tenofovir Disoproxil 200mg & 300mg Tab | JPC | 7.3035 | 7.3035 | YES | NO | NO |
| 02521547 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Mint-Emtricitabine/Tenofovir 200mg & 300mg Tab | MIN | 7.3035 | 7.3035 | YES | NO | NO |
| 02443902 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Mylan-Emtricitabine/Tenofovir Disoproxil 200mg & 300mg Tab | MYL | 7.3035 | 7.3035 | YES | NO | NO |
| 02461110 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | PMS-Emtricitabine/Tenofovir 200mg & 300mg Tab | PMS | 7.3035 | 7.3035 | YES | NO | NO |
| 02399059 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Teva-Emtricitabine/Tenofovir 200mg & 300mg Tab | TEV | 7.3035 | 7.3035 | YES | NO | NO |
| 02274906 | EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATE | Truvada 200mg & 300mg Tab | GIL | 29.2140 | 7.3035 | YES | NO | NO |
| 02019884 | ENALAPRIL MALEATE | Apo-Enalapril 5mg Tab | APX | 0.2203 | 0.2203 | YES | NO | NO |
| 02020025 | ENALAPRIL MALEATE | Apo-Enalapril 2.5mg Tab | APX | 0.1863 | 0.1863 | YES | NO | NO |
| 02019892 | ENALAPRIL MALEATE | Apo-Enalapril 10mg Tab | APX | 0.2647 | 0.2647 | YES | NO | NO |
| 02019906 | ENALAPRIL MALEATE | Apo-Enalapril 20mg Tab | APX | 0.3195 | 0.3195 | YES | NO | NO |
| 02291886 | ENALAPRIL MALEATE | Co Enalapril 5mg Tab | COB | 0.2203 | 0.2203 | YES | NO | YES |
| 02291878 | ENALAPRIL MALEATE | Co Enalapril 2.5mg Tab | COB | 0.1863 | 0.1863 | YES | NO | YES |
| 02291894 | ENALAPRIL MALEATE | Co Enalapril 10mg Tab | COB | 0.2647 | 0.2647 | YES | NO | YES |
| 02291908 | ENALAPRIL MALEATE | Co Enalapril 20mg Tab | COB | 0.3195 | 0.3195 | YES | NO | YES |
| 02442973 | ENALAPRIL MALEATE | Enalapril 10mg Tab | SIV | 0.2647 | 0.2647 | YES | NO | NO |
| 02400677 | ENALAPRIL MALEATE | Enalapril 10mg Tab | SAI | 0.2647 | 0.2647 | YES | NO | NO |
| 02400669 | ENALAPRIL MALEATE | Enalapril 5mg Tab | SAI | 0.2203 | 0.2203 | YES | NO | NO |
| 02442957 | ENALAPRIL MALEATE | Enalapril 2.5mg Tab | SIV | 0.1863 | 0.1863 | YES | NO | NO |
| 02400650 | ENALAPRIL MALEATE | Enalapril 2.5mg Tab | SAI | 0.1863 | 0.1863 | YES | NO | NO |
| 02442965 | ENALAPRIL MALEATE | Enalapril 5mg Tab | SIV | 0.2203 | 0.2203 | YES | NO | NO |
| 02442981 | ENALAPRIL MALEATE | Enalapril 20mg Tab | SIV | 0.3195 | 0.3195 | YES | NO | NO |
| 02400685 | ENALAPRIL MALEATE | Enalapril 20mg Tab | SAI | 0.3195 | 0.3195 | YES | NO | NO |
| 02474808 | ENALAPRIL MALEATE | Jamp-Enalapril 10mg Tab | JPC | 0.2647 | 0.2647 | YES | NO | NO |
| 02474786 | ENALAPRIL MALEATE | Jamp-Enalapril 2.5mg Tab | JPC | 0.1863 | 0.1863 | YES | NO | NO |
| 02474794 | ENALAPRIL MALEATE | Jamp-Enalapril 5mg Tab | JPC | 0.2203 | 0.2203 | YES | NO | NO |
| 02474816 | ENALAPRIL MALEATE | Jamp-Enalapril 20mg Tab | JPC | 0.3195 | 0.3195 | YES | NO | NO |
| 02444798 | ENALAPRIL MALEATE | Mar-Enalapril 20mg Tab | MAR | 0.3195 | 0.3195 | YES | NO | NO |
| 02444771 | ENALAPRIL MALEATE | Mar-Enalapril 10mg Tab | MAR | 0.2647 | 0.2647 | YES | NO | NO |
| 02459469 | ENALAPRIL MALEATE | Mar-Enalapril 5mg Tab | MAR | 0.2203 | 0.2203 | YES | NO | NO |
| 02459450 | ENALAPRIL MALEATE | Mar-Enalapril 2.5mg Tab | MAR | 0.1863 | 0.1863 | YES | NO | NO |
| 02300044 | ENALAPRIL MALEATE | Mylan-Enalapril 5mg Tab | MYL | 0.2203 | 0.2203 | YES | NO | YES |
| 02300060 | ENALAPRIL MALEATE | Mylan-Enalapril 20mg Tab | MYL | 0.3195 | 0.3195 | YES | NO | YES |
| 02300052 | ENALAPRIL MALEATE | Mylan-Enalapril 10mg Tab | MYL | 0.2647 | 0.2647 | YES | NO | YES |
| 02300036 | ENALAPRIL MALEATE | Mylan-Enalapril 2.5mg Tab | MYL | 0.1863 | 0.1863 | YES | NO | YES |
| 02300680 | ENALAPRIL MALEATE | Novo-Enalapril 2.5mg Tab | NOP | 0.1863 | 0.1863 | YES | NO | YES |
| 02352257 | ENALAPRIL MALEATE | Ran-Enalapril 10mg Tab | RAN | 0.2647 | 0.2647 | YES | NO | NO |
| 02352249 | ENALAPRIL MALEATE | Ran-Enalapril 5mg Tab | RAN | 0.2203 | 0.2203 | YES | NO | NO |
| 02352230 | ENALAPRIL MALEATE | Ran-Enalapril 2.5mg Tab | RAN | 0.1863 | 0.1863 | YES | NO | NO |
| 02352265 | ENALAPRIL MALEATE | Ran-Enalapril 20mg Tab | RAN | 0.3195 | 0.3195 | YES | NO | NO |
| 02300028 | ENALAPRIL MALEATE | Ratio-Enalapril 20mg Tab | RPH | 0.3195 | 0.3195 | YES | NO | YES |
| 02299984 | ENALAPRIL MALEATE | Ratio-Enalapril 2.5mg Tab | RPH | 0.1863 | 0.1863 | YES | NO | YES |
| 02300001 | ENALAPRIL MALEATE | Ratio-Enalapril 10mg Tab | RPH | 0.2647 | 0.2647 | YES | NO | YES |
| 02299992 | ENALAPRIL MALEATE | Ratio-Enalapril 5mg Tab | RPH | 0.2203 | 0.2203 | YES | NO | YES |
| 02299976 | ENALAPRIL MALEATE | Sandoz Enalapril 20mg Tab | SDZ | 0.3195 | 0.3195 | YES | NO | YES |
| 02299941 | ENALAPRIL MALEATE | Sandoz Enalapril 5mg Tab | SDZ | 0.2203 | 0.2203 | YES | NO | YES |
| 02299968 | ENALAPRIL MALEATE | Sandoz Enalapril 10mg Tab | SDZ | 0.2647 | 0.2647 | YES | NO | YES |
| 02299933 | ENALAPRIL MALEATE | Sandoz Enalapril 2.5mg Tab | SDZ | 0.1863 | 0.1863 | YES | NO | YES |
| 02300125 | ENALAPRIL MALEATE | Taro-Enalapril 5mg Tab | TAR | 0.2203 | 0.2203 | YES | NO | YES |
| 02300117 | ENALAPRIL MALEATE | Taro-Enalapril 2.5mg Tab | TAR | 0.1863 | 0.1863 | YES | NO | YES |
| 02300141 | ENALAPRIL MALEATE | Taro-Enalapril 20mg Tab | TAR | 0.3195 | 0.3195 | YES | NO | YES |
| 02300133 | ENALAPRIL MALEATE | Taro-Enalapril 10mg Tab | TAR | 0.2647 | 0.2647 | YES | NO | YES |
| 02233006 | ENALAPRIL MALEATE | Teva-Enalapril 10mg Tab | TEV | 0.2647 | 0.2647 | YES | NO | YES |
| 02233007 | ENALAPRIL MALEATE | Teva-Enalapril 20mg Tab | TEV | 0.3195 | 0.3195 | YES | NO | YES |
| 02233005 | ENALAPRIL MALEATE | Teva-Enalapril 5mg Tab | TEV | 0.2203 | 0.2203 | YES | NO | YES |
| 00670928 | ENALAPRIL MALEATE | Vasotec 20mg Tab | OCI | 1.7665 | 0.3195 | YES | NO | YES |
| 00670901 | ENALAPRIL MALEATE | Vasotec 10mg Tab | OCI | 1.4638 | 0.2647 | YES | NO | YES |
| 00851795 | ENALAPRIL MALEATE | Vasotec (Not a Benefit) 2.5mg Tab | MFC | N/A | N/A | YES | NO | YES |
| 00708879 | ENALAPRIL MALEATE | Vasotec 5mg Tab | OCI | 1.2182 | 0.2203 | YES | NO | YES |
| 02352923 | ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDE | Enalapril Maleate/HCTZ (Off-Formulary Interchangeable) 5mg & 12.5mg Tab | AAP | 0.8762 | N/A | YES | NO | NO |
| 02352931 | ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDE | Enalapril Maleate/HCTZ (Off-Formulary Interchangeable) 10mg & 25mg Tab | AAP | 1.2284 | N/A | YES | NO | NO |
| 00657298 | ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDE | Vaseretic (Off-Formulary Interchangeable) 10mg & 25mg Tab | OCI | N/A | N/A | YES | NO | NO |
| 02242826 | ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDE | Vaseretic (Off-Formulary Interchangeable) 5mg & 12.5mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 02506440 | ENOXAPARIN | Noromby 20mg/0.2mL Inj Sol-0.2mL Pref Syr (Preservative-Free) | JUN | 3.5280 | 3.5280 | NO | NO | NO |
| 02539977 | ENOXAPARIN | Axberi 30mg/0.3mL Inj Sol-0.3mL Pref Syr (Preservative-Free) | BAX | 4.9124 | 4.9124 | NO | NO | NO |
| 02532247 | ENOXAPARIN | Elonox 30mg/0.3mL Inj Sol-0.3mL Pref Syr (Preservative-Free) | FKC | 4.9124 | 4.9124 | NO | NO | NO |
| 02507501 | ENOXAPARIN | Inclunox 30mg/0.3mL Inj Sol-0.3mL Pref Syr (Preservative-Free) | SDZ | 4.9620 | 4.9620 | NO | NO | NO |
| 02506459 | ENOXAPARIN | Noromby 30mg/0.3mL Inj Sol-0.3mL Pref Syr (Preservative-Free) | JUN | 4.9124 | 4.9124 | NO | NO | NO |
| 02509075 | ENOXAPARIN | Redesca 30mg/0.3mL Inj Sol-0.3mL Pref Syr (Preservative-Free) | SHE | 4.9620 | 4.9620 | NO | NO | NO |
| 02539985 | ENOXAPARIN | Axberi 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | BAX | 6.5498 | 6.5498 | NO | NO | NO |
| 02532255 | ENOXAPARIN | Elonox 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | FKC | 6.5498 | 6.5498 | NO | NO | NO |
| 02507528 | ENOXAPARIN | Inclunox 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | SDZ | 6.6160 | 6.6160 | NO | NO | NO |
| 02506467 | ENOXAPARIN | Noromby 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | JUN | 6.5498 | 6.5498 | NO | NO | NO |
| 02509083 | ENOXAPARIN | Redesca 40mg/0.4mL Inj Sol-0.4mL Pref Syr (Preservative-Free) | SHE | 6.6160 | 6.6160 | NO | NO | NO |
| 02540002 | ENOXAPARIN | Axberi 60mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | BAX | 9.8248 | 9.8248 | NO | NO | NO |
| 02532263 | ENOXAPARIN | Elonox 60mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | FKC | 9.8248 | 9.8248 | NO | NO | NO |
| 02507536 | ENOXAPARIN | Inclunox 60mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | SDZ | 9.9240 | 9.9240 | NO | NO | NO |
| 02506475 | ENOXAPARIN | Noromby 60mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | JUN | 9.8248 | 9.8248 | NO | NO | NO |
| 02509091 | ENOXAPARIN | Redesca 60mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | SHE | 9.9240 | 9.9240 | NO | NO | NO |
| 02540010 | ENOXAPARIN | Axberi 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | BAX | 13.0997 | 13.0997 | NO | NO | NO |
| 02540029 | ENOXAPARIN | Axberi HP 120mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | BAX | 19.6495 | 19.6495 | NO | NO | NO |
| 02532271 | ENOXAPARIN | Elonox 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | FKC | 13.0997 | 13.0997 | NO | NO | NO |
| 02532301 | ENOXAPARIN | Elonox HP 120mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | FKC | 19.6495 | 19.6495 | NO | NO | NO |
| 02507544 | ENOXAPARIN | Inclunox 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | SDZ | 13.2320 | 13.2320 | NO | NO | NO |
| 02507560 | ENOXAPARIN | Inclunox HP 120mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | SDZ | 19.8480 | 19.8480 | NO | NO | NO |
| 02506483 | ENOXAPARIN | Noromby 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | JUN | 13.0997 | 13.0997 | NO | NO | NO |
| 02506505 | ENOXAPARIN | Noromby HP 120mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | JUN | 19.6495 | 19.6495 | NO | NO | NO |
| 02509105 | ENOXAPARIN | Redesca 80mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | SHE | 13.2320 | 13.2320 | NO | NO | NO |
| 02509148 | ENOXAPARIN | Redesca HP 120mg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | SHE | 19.8480 | 19.8480 | NO | NO | NO |
| 02540045 | ENOXAPARIN | Axberi 100mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | BAX | 16.3746 | 16.3746 | NO | NO | NO |
| 02540037 | ENOXAPARIN | Axberi HP 150mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | BAX | 24.5619 | 24.5619 | NO | NO | NO |
| 02532298 | ENOXAPARIN | Elonox 100mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | FKC | 16.3746 | 16.3746 | NO | NO | NO |
| 02532328 | ENOXAPARIN | Elonox HP 150mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | FKC | 24.5619 | 24.5619 | NO | NO | NO |
| 02507552 | ENOXAPARIN | Inclunox 100mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | SDZ | 16.5400 | 16.5400 | NO | NO | NO |
| 02507579 | ENOXAPARIN | Inclunox HP 150mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | SDZ | 24.8100 | 24.8100 | NO | NO | NO |
| 02506491 | ENOXAPARIN | Noromby 100mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | JUN | 16.3746 | 16.3746 | NO | NO | NO |
| 02506513 | ENOXAPARIN | Noromby HP 150mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | JUN | 24.5619 | 24.5619 | NO | NO | NO |
| 02509113 | ENOXAPARIN | Redesca 100mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | SHE | 16.5400 | 16.5400 | NO | NO | NO |
| 02509156 | ENOXAPARIN | Redesca HP 150mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | SHE | 24.8100 | 24.8100 | NO | NO | NO |
| 02236564 | ENOXAPARIN | Lovenox 100mg/mL Inj Sol-3mL Vial Pk | SAV | 68.7500 | 68.7500 | NO | YES | NO |
| 02509121 | ENOXAPARIN | Redesca 300mg/3mL Inj Sol-3mL Vial Pk (With Preservative) | SHE | 49.6200 | 49.6200 | NO | NO | NO |
| 02012472 | ENOXAPARIN | Lovenox 30mg/0.3mL Pref Syr-0.3mL Pk | SAV | 6.8750 | 6.8750 | NO | YES | NO |
| 02236883 | ENOXAPARIN | Lovenox 40mg/0.4mL Pref Syr-0.4mL Pk | SAV | 9.1660 | 9.1660 | NO | YES | NO |
| 02378426 | ENOXAPARIN | Lovenox 60mg/0.6mL Pref Syr-0.6mL Pk | SAV | 13.7490 | 13.7490 | NO | YES | NO |
| 02378434 | ENOXAPARIN | Lovenox 80mg/0.8mL Pref Syr-0.8mL Pk | SAV | 18.3330 | 18.3330 | NO | YES | NO |
| 02242692 | ENOXAPARIN | Lovenox HP 120mg/0.8mL Pref Syr-0.8mL Pk | SAV | 27.4990 | 27.4990 | NO | YES | NO |
| 02378442 | ENOXAPARIN | Lovenox 100mg/mL Pref Syr-1mL Pk | SAV | 22.9160 | 22.9160 | NO | YES | NO |
| 02378469 | ENOXAPARIN | Lovenox HP 150mg/mL Pref Syr-1mL Pk | SAV | 34.3750 | 34.3750 | NO | YES | NO |
| 02243763 | ENTACAPONE | Comtan 200mg Tab | SDZ | 1.6837 | 0.4010 | YES | YES | NO |
| 02535939 | ENTACAPONE | Mint-Entacapone 200mg Tab | MIN | 0.4010 | 0.4010 | YES | YES | NO |
| 02380005 | ENTACAPONE | Sandoz Entacapone 200mg Tab | SDZ | 0.4010 | 0.4010 | YES | YES | NO |
| 02375559 | ENTACAPONE | Teva-Entacapone 200mg Tab | TEV | 0.4010 | 0.4010 | YES | YES | NO |
| 02479907 | ENTECAVIR | Accel-Entecavir 0.5mg Tab | ACC | 4.4000 | 4.4000 | YES | YES | NO |
| 02396955 | ENTECAVIR | Apo-Entecavir 0.5mg Tab | APX | 5.5000 | 4.4000 | YES | YES | NO |
| 02448777 | ENTECAVIR | Auro-Entecavir 0.5mg Tab | AUR | 5.5000 | 4.4000 | YES | YES | NO |
| 02282224 | ENTECAVIR | Baraclude 0.5mg Tab | BQU | 22.6600 | 4.4000 | YES | YES | NO |
| 02527154 | ENTECAVIR | Entecavir 0.5mg Tab | SAI | 5.5000 | 4.4000 | YES | YES | NO |
| 02467232 | ENTECAVIR | Jamp-Entecavir 0.5mg Tab | JPC | 5.5000 | 4.4000 | YES | YES | NO |
| 02485907 | ENTECAVIR | Mint-Entecavir 0.5mg Tab | MIN | 5.5000 | 4.4000 | YES | YES | NO |
| 02430576 | ENTECAVIR | PMS-Entecavir 0.5mg Tab | PMS | 5.5000 | 4.4000 | YES | YES | NO |
| 00155357 | EPINEPHRINE HCL | Adrenalin 30mg/30mL Inj Sol-30mL Pk | SLP | 22.2300 | 22.2300 | NO | NO | NO |
| 02323060 | EPLERENONE | Inspra 50mg Tab | UJC | 3.2850 | 1.3730 | YES | YES | NO |
| 02323052 | EPLERENONE | Inspra 25mg Tab | UJC | 3.2850 | 1.3730 | YES | YES | NO |
| 02543389 | EPLERENONE | Jamp Eplerenone 25mg Tab | JPC | 1.3730 | 1.3730 | YES | YES | NO |
| 02543397 | EPLERENONE | Jamp Eplerenone 50mg Tab | JPC | 1.3730 | 1.3730 | YES | YES | NO |
| 02471442 | EPLERENONE | Mint-Eplerenone 25mg Tab | MIN | 1.3730 | 1.3730 | YES | YES | NO |
| 02471450 | EPLERENONE | Mint-Eplerenone 50mg Tab | MIN | 1.3730 | 1.3730 | YES | YES | NO |
| 02231587 | EPOETIN ALFA | Eprex 10,000IU/mL Pref Syr - 1mL Pk | JAN | 142.5000 | 142.5000 | NO | YES | NO |
| 02240722 | EPOETIN ALFA | Eprex 40,000IU/mL Pref Syr - 1mL Pk | JAN | 486.7900 | 486.7900 | NO | YES | NO |
| 02243239 | EPOETIN ALFA | Eprex 20,000IU/0.5mL Pref Syr-0.5mL Pk | JAN | 325.0900 | 325.0900 | NO | YES | NO |
| 02240432 | EPROSARTAN MESYLATE | Teveten 400mg Tab | SPH | 0.7790 | 0.7790 | NO | NO | NO |
| 02243942 | EPROSARTAN MESYLATE | Teveten 600mg Tab | SPH | 1.1910 | 1.1910 | NO | NO | NO |
| 02253631 | EPROSARTAN MESYLATE & HYDROCHLOROTHIAZIDE | Teveten Plus 600mg & 12.5mg Tab | SPH | 1.1910 | 1.1910 | NO | NO | NO |
| 02405083 | EPTIFIBATIDE | Eptifibatide Injection (Off-Formulary Interchangeable) 0.75mg/mL 100mL Vial Pk | TEV | 94.5600 | N/A | YES | NO | NO |
| 02240351 | EPTIFIBATIDE | Integrilin (Off-Formulary Interchangeable) 0.75mg/mL 100mL Vial Pk | MEK | N/A | N/A | YES | NO | NO |
| 02367858 | EPTIFIBATIDE | Eptifibatide Injection (Off-Formulary Interchangeable) 2mg/mL 10mL Vial Pk | TEV | 32.3000 | N/A | YES | NO | NO |
| 02240352 | EPTIFIBATIDE | Integrilin (Off-Formulary Interchangeable) 2mg/mL 10mL Vial Pk | MEK | N/A | N/A | YES | NO | NO |
| 02017598 | ERGOCALCIFEROL | Drisdol (Not a Benefit) 8288IU/mL O/L | SAV | N/A | N/A | YES | NO | NO |
| 80003615 | ERGOCALCIFEROL | Erdol 8288IU/mL O/L | ODN | 0.5767 | 0.5767 | YES | NO | NO |
| 02461889 | ERLOTINIB | Apo-Erlotinib (Off-Formulary Interchangeable) 150mg Tab | APX | 71.2000 | 71.2000 | YES | NO | NO |
| 02461862 | ERLOTINIB | Apo-Erlotinib (Off-Formulary Interchangeable) 25mg Tab | APX | 11.8667 | 11.8667 | YES | NO | NO |
| 02461870 | ERLOTINIB | Apo-Erlotinib (Off-Formulary Interchangeable) 100mg Tab | APX | 47.4667 | 47.4667 | YES | NO | NO |
| 02483912 | ERLOTINIB | Nat-Erlotinib (Off-Formulary Interchangeable) 25mg Tab | NAT | 11.8667 | 11.8667 | YES | NO | NO |
| 02483920 | ERLOTINIB | Nat-Erlotinib (Off-Formulary Interchangeable) 100mg Tab | NAT | 47.4667 | 47.4667 | YES | NO | NO |
| 02483939 | ERLOTINIB | Nat-Erlotinib (Off-Formulary Interchangeable) 150mg Tab | NAT | 71.2000 | 71.2000 | YES | NO | NO |
| 02454386 | ERLOTINIB | PMS-Erlotinib (Off-Formulary Interchangeable) 100mg Tab | PMS | 47.4667 | 47.4667 | YES | NO | NO |
| 02454394 | ERLOTINIB | PMS-Erlotinib (Off-Formulary Interchangeable) 150mg Tab | PMS | 71.2000 | 71.2000 | YES | NO | NO |
| 02269007 | ERLOTINIB | Tarceva (Off-Formulary Interchangeable) 25mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02269023 | ERLOTINIB | Tarceva (Off-Formulary Interchangeable) 150mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02269015 | ERLOTINIB | Tarceva (Off-Formulary Interchangeable) 100mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02377691 | ERLOTINIB | Teva-Erlotinib (Off-Formulary Interchangeable) 25mg Tab | TEV | 11.8666 | 11.8666 | YES | NO | NO |
| 02377705 | ERLOTINIB | Teva-Erlotinib (Off-Formulary Interchangeable) 100mg Tab | TEV | 47.4666 | 47.4666 | YES | NO | NO |
| 02377713 | ERLOTINIB | Teva-Erlotinib (Off-Formulary Interchangeable) 150mg Tab | TEV | 71.2000 | 71.2000 | YES | NO | NO |
| 02490773 | ERTAPENEM | Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | JUN | 52.2650 | 52.2650 | YES | NO | NO |
| 02492148 | ERTAPENEM | Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | AUR | 52.2650 | 52.2650 | YES | NO | NO |
| 02511150 | ERTAPENEM | Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | DRR | 52.2650 | 52.2650 | YES | NO | NO |
| 02496127 | ERTAPENEM | Ertapenem for Injection (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | FKC | 52.2650 | 52.2650 | YES | NO | NO |
| 02247437 | ERTAPENEM | Invanz (Off-Formulary Interchangeable) 1g/Vial Inj Pd-Vial Pk | MFC | N/A | N/A | YES | NO | NO |
| 00682020 | ERYTHROMYCIN BASE | Erythro-Base 250mg Tab | AAP | 0.1865 | 0.1865 | YES | NO | YES |
| 00244635 | ERYTHROMYCIN BASE | Erythromid (Not a Benefit) 250mg Tab | ABB | N/A | N/A | YES | NO | YES |
| 00210641 | ERYTHROMYCIN ESTOLATE | Ilosone (Not a Benefit) 50mg/mL O/L | LIL | N/A | N/A | YES | NO | YES |
| 00262595 | ERYTHROMYCIN ESTOLATE | Novo-Rythro Estolate 50mg/mL O/L | NOP | 0.0713 | 0.0713 | YES | NO | YES |
| 00000299 | ERYTHROMYCIN ETHYLSUCCINATE | EES-200 (Not a Benefit) 40mg/mL O/L | ABB | N/A | N/A | YES | NO | YES |
| 00453617 | ERYTHROMYCIN ETHYLSUCCINATE | EES-400 (Not a Benefit) 80mg/mL O/L | ABB | N/A | N/A | YES | NO | YES |
| 00605859 | ERYTHROMYCIN ETHYLSUCCINATE | Novo-Rythro Ethyl Succinate 40mg/mL O/L | NOP | 0.0669 | 0.0669 | YES | NO | YES |
| 00652318 | ERYTHROMYCIN ETHYLSUCCINATE | Novo-Rythro Ethyl Succinate 80mg/mL O/L | NOP | 0.1013 | 0.1013 | YES | NO | YES |
| 02454297 | ESCITALOPRAM | Act Escitalopram ODT 10mg Orally Disintegrating Tab | ACV | 1.3199 | 1.3199 | YES | NO | NO |
| 02391449 | ESCITALOPRAM | Cipralex MELTZ (Not a Benefit) 10mg Orally Disintegrating Tab | VLH | N/A | N/A | YES | NO | NO |
| 02454300 | ESCITALOPRAM | Act Escitalopram ODT 20mg Orally Disintegrating Tablet | ACV | 1.4052 | 1.4052 | YES | NO | NO |
| 02391457 | ESCITALOPRAM | Cipralex MELTZ (Not a Benefit) 20mg Orally Disintegrating Tablet | VLH | N/A | N/A | YES | NO | NO |
| 02434652 | ESCITALOPRAM | Ach-Escitalopram 10mg Tab | ACH | 0.3109 | 0.3109 | YES | NO | NO |
| 02434660 | ESCITALOPRAM | Ach-Escitalopram 20mg Tab | ACH | 0.3310 | 0.3310 | YES | NO | NO |
| 02295024 | ESCITALOPRAM | Apo-Escitalopram 20mg Tab | APX | 0.3310 | 0.3310 | YES | NO | NO |
| 02295016 | ESCITALOPRAM | Apo-Escitalopram 10mg Tab | APX | 0.3109 | 0.3109 | YES | NO | NO |
| 02397374 | ESCITALOPRAM | Auro-Escitalopram 20mg Tab | AUR | 0.3310 | 0.3310 | YES | NO | NO |
| 02397358 | ESCITALOPRAM | Auro-Escitalopram 10mg Tab | AUR | 0.3109 | 0.3109 | YES | NO | NO |
| 02263254 | ESCITALOPRAM | Cipralex 20mg Tab | VLH | 2.4939 | 0.3310 | YES | NO | NO |
| 02263238 | ESCITALOPRAM | Cipralex 10mg Tab | VLH | 2.3358 | 0.3109 | YES | NO | NO |
| 02430126 | ESCITALOPRAM | Escitalopram 20mg Tab | SAI | 0.3310 | 0.3310 | YES | NO | NO |
| 02430118 | ESCITALOPRAM | Escitalopram 10mg Tab | SAI | 0.3109 | 0.3109 | YES | NO | NO |
| 02429039 | ESCITALOPRAM | Escitalopram 10mg Tab | SIV | 0.3109 | 0.3109 | YES | NO | NO |
| 02429047 | ESCITALOPRAM | Escitalopram 20mg Tab | SIV | 0.3310 | 0.3310 | YES | NO | NO |
| 02508893 | ESCITALOPRAM | Jamp Escitalopram 10mg Tab | JPC | 0.3109 | 0.3109 | YES | NO | NO |
| 02508907 | ESCITALOPRAM | Jamp Escitalopram 20mg Tab | JPC | 0.3310 | 0.3310 | YES | NO | NO |
| 02429780 | ESCITALOPRAM | Jamp-Escitalopram 10mg Tab | JPC | 0.3109 | 0.3109 | YES | NO | NO |
| 02429799 | ESCITALOPRAM | Jamp-Escitalopram 20mg Tab | JPC | 0.3310 | 0.3310 | YES | NO | NO |
| 02471418 | ESCITALOPRAM | M-Escitalopram 10mg Tab | MAT | 0.3109 | 0.3109 | YES | NO | NO |
| 02471426 | ESCITALOPRAM | M-Escitalopram 20mg Tab | MAT | 0.3310 | 0.3310 | YES | NO | NO |
| 02423480 | ESCITALOPRAM | Mar-Escitalopram 10mg Tab | MAR | 0.3109 | 0.3109 | YES | NO | NO |
| 02423502 | ESCITALOPRAM | Mar-Escitalopram 20mg Tab | MAR | 0.3310 | 0.3310 | YES | NO | NO |
| 02407434 | ESCITALOPRAM | Mint-Escitalopram 20mg Tab | MIN | 0.3310 | 0.3310 | YES | NO | NO |
| 02407418 | ESCITALOPRAM | Mint-Escitalopram 10mg Tab | MIN | 0.3109 | 0.3109 | YES | NO | NO |
| 02309475 | ESCITALOPRAM | Mylan-Escitalopram 20mg Tab | MYL | 0.3310 | 0.3310 | YES | NO | NO |
| 02309467 | ESCITALOPRAM | Mylan-Escitalopram 10mg Tab | MYL | 0.3109 | 0.3109 | YES | NO | NO |
| 02476878 | ESCITALOPRAM | NRA-Escitalopram 20mg Tab | NRA | 0.3310 | 0.3310 | YES | NO | NO |
| 02476851 | ESCITALOPRAM | NRA-Escitalopram 10mg Tab | NRA | 0.3109 | 0.3109 | YES | NO | NO |
| 02440296 | ESCITALOPRAM | Nat-Escitalopram 10mg Tab | NAT | 0.3109 | 0.3109 | YES | NO | NO |
| 02440318 | ESCITALOPRAM | Nat-Escitalopram 20mg Tab | NAT | 0.3310 | 0.3310 | YES | NO | NO |
| 02554909 | ESCITALOPRAM | Natco-Escitalopram 10mg Tab | NAT | 0.3109 | 0.3109 | YES | NO | NO |
| 02554933 | ESCITALOPRAM | Natco-Escitalopram 20mg Tab | NAT | 0.3310 | 0.3310 | YES | NO | NO |
| 02469251 | ESCITALOPRAM | PMS-Escitalopram 20mg Tab | PMS | 0.3310 | 0.3310 | YES | NO | NO |
| 02469243 | ESCITALOPRAM | PMS-Escitalopram 10mg Tab | PMS | 0.3109 | 0.3109 | YES | NO | NO |
| 02385503 | ESCITALOPRAM | Ran-Escitalopram 20mg Tab | RAN | 0.3310 | 0.3310 | YES | NO | NO |
| 02385481 | ESCITALOPRAM | Ran-Escitalopram 10mg Tab | RAN | 0.3109 | 0.3109 | YES | NO | NO |
| 02364077 | ESCITALOPRAM | Sandoz Escitalopram 10mg Tab | SDZ | 0.3109 | 0.3109 | YES | NO | NO |
| 02364085 | ESCITALOPRAM | Sandoz Escitalopram 20mg Tab | SDZ | 0.3310 | 0.3310 | YES | NO | NO |
| 02318180 | ESCITALOPRAM | Teva-Escitalopram 10mg Tab | TEV | 0.3109 | 0.3109 | YES | NO | NO |
| 02318202 | ESCITALOPRAM | Teva-Escitalopram 20mg Tab | TEV | 0.3310 | 0.3310 | YES | NO | NO |
| 02537958 | ESLICARBAZEPINE ACETATE | Apo-Eslicarbazepine 400mg Tab | APX | 4.9350 | 4.9350 | YES | YES | NO |
| 02537966 | ESLICARBAZEPINE ACETATE | Apo-Eslicarbazepine 600mg Tab | APX | 4.9350 | 4.9350 | YES | YES | NO |
| 02537931 | ESLICARBAZEPINE ACETATE | Apo-Eslicarbazepine 200mg Tab | APX | 4.9350 | 4.9350 | YES | YES | NO |
| 02537974 | ESLICARBAZEPINE ACETATE | Apo-Eslicarbazepine 800mg Tab | APX | 4.9350 | 4.9350 | YES | YES | NO |
| 02426870 | ESLICARBAZEPINE ACETATE | Aptiom 400mg Tab | SUO | 9.8700 | 4.9350 | YES | YES | NO |
| 02426862 | ESLICARBAZEPINE ACETATE | Aptiom 200mg Tab | SUO | 9.8700 | 4.9350 | YES | YES | NO |
| 02426889 | ESLICARBAZEPINE ACETATE | Aptiom 600mg Tab | SUO | 9.8700 | 4.9350 | YES | YES | NO |
| 02426897 | ESLICARBAZEPINE ACETATE | Aptiom 800mg Tab | SUO | 9.8700 | 4.9350 | YES | YES | NO |
| 02527448 | ESLICARBAZEPINE ACETATE | Auro-Eslicarbazepine 400mg Tab | AUR | 4.9350 | 4.9350 | YES | YES | NO |
| 02527421 | ESLICARBAZEPINE ACETATE | Auro-Eslicarbazepine 200mg Tab | AUR | 4.9350 | 4.9350 | YES | YES | NO |
| 02527464 | ESLICARBAZEPINE ACETATE | Auro-Eslicarbazepine 800mg Tab | AUR | 4.9350 | 4.9350 | YES | YES | NO |
| 02527456 | ESLICARBAZEPINE ACETATE | Auro-Eslicarbazepine 600mg Tab | AUR | 4.9350 | 4.9350 | YES | YES | NO |
| 02339102 | ESOMEPRAZOLE | Apo-Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | APX | 1.8690 | N/A | YES | NO | NO |
| 02442507 | ESOMEPRAZOLE | Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | SIV | 1.8690 | N/A | YES | NO | NO |
| 02520702 | ESOMEPRAZOLE | Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | JPC | 1.8690 | N/A | YES | NO | NO |
| 02431173 | ESOMEPRAZOLE | Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | SAI | 1.8690 | N/A | YES | NO | NO |
| 02520117 | ESOMEPRAZOLE | M-Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | MAT | 1.8690 | N/A | YES | NO | NO |
| 02479427 | ESOMEPRAZOLE | Myl-Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | MYL | 1.8690 | N/A | YES | NO | NO |
| 02244522 | ESOMEPRAZOLE | Nexium DR Tab (Off-Formulary Interchangeable) 40mg | AZC | N/A | N/A | YES | NO | NO |
| 02528487 | ESOMEPRAZOLE | PMSC-Esomeprazole DR (Off-Formulary Interchangeable) 40mg | PMS | 1.8690 | N/A | YES | NO | NO |
| 02423987 | ESOMEPRAZOLE | Ran-Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | RAN | 1.8690 | N/A | YES | NO | NO |
| 02460939 | ESOMEPRAZOLE | Sandoz Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | SDZ | 1.8690 | N/A | YES | NO | NO |
| 02423863 | ESOMEPRAZOLE | Teva-Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mg | TEV | 1.8690 | N/A | YES | NO | NO |
| 02339099 | ESOMEPRAZOLE | Apo-Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | APX | 1.8690 | N/A | YES | NO | NO |
| 02520699 | ESOMEPRAZOLE | Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | JPC | 1.8690 | N/A | YES | NO | NO |
| 02535335 | ESOMEPRAZOLE | Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | SAI | 1.8690 | N/A | YES | NO | NO |
| 02442493 | ESOMEPRAZOLE | Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | SIV | 1.8690 | N/A | YES | NO | NO |
| 02520109 | ESOMEPRAZOLE | M-Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | MAT | 1.8690 | N/A | YES | NO | NO |
| 02479419 | ESOMEPRAZOLE | Myl-Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | MYL | 1.8690 | N/A | YES | NO | NO |
| 02244521 | ESOMEPRAZOLE | Nexium (Off-Formulary Interchangeable) 20mg DR Tab | AZC | N/A | N/A | YES | NO | NO |
| 02528479 | ESOMEPRAZOLE | PMSC-Esomeprazole DR (Off-Formulary Interchangeable) 20mg DR Tab | PMS | 1.8690 | N/A | YES | NO | NO |
| 02423979 | ESOMEPRAZOLE | Ran-Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | RAN | 1.8690 | N/A | YES | NO | NO |
| 02460920 | ESOMEPRAZOLE | Sandoz Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | SDZ | 1.8690 | N/A | YES | NO | NO |
| 02423855 | ESOMEPRAZOLE | Teva-Esomeprazole (Off-Formulary Interchangeable) 20mg DR Tab | TEV | 1.8690 | N/A | YES | NO | NO |
| 02148587 | ESTRADIOL | Estrace (Not a Benefit) 1mg Tab | APC | N/A | N/A | YES | NO | NO |
| 02148595 | ESTRADIOL | Estrace (Not a Benefit) 2mg Tab | APC | N/A | N/A | YES | NO | NO |
| 02225190 | ESTRADIOL | Estrace (Not a Benefit) 0.5mg Tab | APC | N/A | N/A | YES | NO | NO |
| 02449056 | ESTRADIOL | Lupin-Estradiol 1mg Tab | LUP | 0.2313 | 0.2313 | YES | NO | NO |
| 02449064 | ESTRADIOL | Lupin-Estradiol 2mg Tab | LUP | 0.4083 | 0.4083 | YES | NO | NO |
| 02449048 | ESTRADIOL | Lupin-Estradiol 0.5mg Tab | LUP | 0.1199 | 0.1199 | YES | NO | NO |
| 02168898 | ESTRADIOL | Estring 2mg Vag Ring | PFI | 104.4500 | 104.4500 | NO | NO | NO |
| 02325462 | ESTRADIOL 17-B | Vagifem 10 10mcg Vag Tab with Applicator | NOO | 4.8056 | 4.8056 | NO | NO | NO |
| 02503697 | ESTRADIOL HEMIHYDRATE | Imvexxy 10mcg Vag Insert | KNT | 3.6288 | 3.6288 | NO | NO | NO |
| 02503689 | ESTRADIOL HEMIHYDRATE | Imvexxy 4mcg Vag Insert | KNT | 3.6288 | 3.6288 | NO | NO | NO |
| 02505223 | ESTRADIOL HEMIHYDRATE & PROGESTERONE | Bijuva 1mg & 100mg Cap | KNT | 0.8962 | 0.8962 | NO | NO | NO |
| 02453223 | ESZOPICLONE | Lunesta (Off-Formulary Interchangeable) 3mg Tab | SMT | N/A | N/A | YES | NO | NO |
| 02453207 | ESZOPICLONE | Lunesta (Off-Formulary Interchangeable) 1mg Tab | SMT | N/A | N/A | YES | NO | NO |
| 02453215 | ESZOPICLONE | Lunesta (Off-Formulary Interchangeable) 2mg Tab | SMT | N/A | N/A | YES | NO | NO |
| 02549441 | ESZOPICLONE | Mar-Eszopiclone (Off-Formulary Interchangeable) 2mg Tab | MAR | 1.4365 | N/A | YES | NO | NO |
| 02549468 | ESZOPICLONE | Mar-Eszopiclone (Off-Formulary Interchangeable) 3mg Tab | MAR | 1.4365 | N/A | YES | NO | NO |
| 02549433 | ESZOPICLONE | Mar-Eszopiclone (Off-Formulary Interchangeable) 1mg Tab | MAR | 1.4365 | N/A | YES | NO | NO |
| 02462877 | ETANERCEPT | Erelzi 25mg/0.5mL Inj Sol-0.5mL Pref Syr Pk | SDZ | 120.5000 | 120.5000 | NO | YES | NO |
| 02462869 | ETANERCEPT | Erelzi 50mg/mL Inj Sol-1mL Pref Syr Pk | SDZ | 241.0000 | 241.0000 | NO | YES | NO |
| 02462850 | ETANERCEPT | Erelzi 50mg/mL Inj Sol-1mL Prefilled SensoReady Pen Pk | SDZ | 241.0000 | 241.0000 | NO | YES | NO |
| 02530309 | ETANERCEPT | Rymti 50mg/mL Inj Sol-Pref Autoinj Pen | LUP | 236.1800 | 236.1800 | NO | YES | NO |
| 02455323 | ETANERCEPT | Brenzys 50mg/mL Inj Sol-Pref Syr | SAM | 236.1800 | 236.1800 | NO | YES | NO |
| 02530295 | ETANERCEPT | Rymti 50mg/mL Inj Sol-Pref Syr | LUP | 236.1800 | 236.1800 | NO | YES | NO |
| 02455331 | ETANERCEPT | Brenzys 50mg/mL Sol- Pref AutoInj | SAM | 236.1800 | 236.1800 | NO | YES | NO |
| 00247960 | ETHAMBUTOL HCL | Etibi 100mg Tab | VAL | 0.2784 | 0.2784 | YES | NO | NO |
| 00247979 | ETHAMBUTOL HCL | Etibi 400mg Tab | VAL | 0.8355 | 0.8355 | YES | NO | NO |
| 00127957 | ETHAMBUTOL HCL | Myambutol (Not a Benefit) 100mg Tab | LED | N/A | N/A | YES | NO | NO |
| 02170078 | ETHAMBUTOL HCL | Myambutol (Not a Benefit) 400mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02520028 | ETHINYL ESTRADIOL & ETONOGESTREL | Haloette (Off-Formulary Interchangeable) 0.120mg & 0.015mg/24 hr Slow Release Vag Ring | SLP | 14.2120 | N/A | YES | NO | NO |
| 02253186 | ETHINYL ESTRADIOL & ETONOGESTREL | Nuvaring (Off-Formulary Interchangeable) 0.120mg & 0.015mg/24 hr Slow Release Vag Ring | OCI | N/A | N/A | YES | NO | NO |
| 02236974 | ETHINYL ESTRADIOL & LEVONORGESTREL | Alesse 21 20mcg & 100mcg Tab-21 Pk | PFI | 15.7700 | 3.9425 | YES | NO | NO |
| 02387875 | ETHINYL ESTRADIOL & LEVONORGESTREL | Alysena 21 20mcg & 100mcg Tab-21 Pk | APX | 3.9425 | 3.9425 | YES | NO | NO |
| 02532174 | ETHINYL ESTRADIOL & LEVONORGESTREL | Audrina 21 20mcg & 100mcg Tab-21 Pk | JPC | 3.9425 | 3.9425 | YES | NO | NO |
| 02298538 | ETHINYL ESTRADIOL & LEVONORGESTREL | Aviane 21 20mcg & 100mcg Tab-21 Pk | TEV | 3.9425 | 3.9425 | YES | NO | NO |
| 02424282 | ETHINYL ESTRADIOL & LEVONORGESTREL | Laylaa 21 20mcg & 100mcg Tab-21 Pk | LUP | 3.9425 | 3.9425 | YES | NO | NO |
| 02042320 | ETHINYL ESTRADIOL & LEVONORGESTREL | Min-Ovral 21 0.03mg & 0.15mg Tab-21 Pk | PFI | 19.2900 | 7.2800 | YES | NO | NO |
| 02387085 | ETHINYL ESTRADIOL & LEVONORGESTREL | Ovima 21 0.03mg & 0.15mg Tab-21 Pk | APX | 7.2800 | 7.2800 | YES | NO | NO |
| 02295946 | ETHINYL ESTRADIOL & LEVONORGESTREL | Portia 21 0.03mg & 0.15mg Tab-21 Pk | BAR | 10.6600 | 7.2800 | YES | NO | NO |
| 00707600 | ETHINYL ESTRADIOL & LEVONORGESTREL | Triquilar 21 3 Phase Tab-21 Pk | BAY | 15.7500 | 15.7500 | NO | NO | NO |
| 02236975 | ETHINYL ESTRADIOL & LEVONORGESTREL | Alesse 28 20mcg & 100mcg Tab-28 Pk | PFI | 15.7700 | 3.9425 | YES | NO | NO |
| 02387883 | ETHINYL ESTRADIOL & LEVONORGESTREL | Alysena 28 20mcg & 100mcg Tab-28 Pk | APX | 3.9425 | 3.9425 | YES | NO | NO |
| 02532182 | ETHINYL ESTRADIOL & LEVONORGESTREL | Audrina 28 20mcg & 100mcg Tab-28 Pk | JPC | 3.9425 | 3.9425 | YES | NO | NO |
| 02298546 | ETHINYL ESTRADIOL & LEVONORGESTREL | Aviane 28 20mcg & 100mcg Tab-28 Pk | TEV | 3.9425 | 3.9425 | YES | NO | NO |
| 02424290 | ETHINYL ESTRADIOL & LEVONORGESTREL | Laylaa 28 20mcg & 100mcg Tab-28 Pk | LUP | 3.9425 | 3.9425 | YES | NO | NO |
| 02042339 | ETHINYL ESTRADIOL & LEVONORGESTREL | Min-Ovral 28 0.03mg & 0.15mg Tab-28 Pk | PFI | 19.2900 | 7.2800 | YES | NO | NO |
| 02387093 | ETHINYL ESTRADIOL & LEVONORGESTREL | Ovima 28 0.03mg & 0.15mg Tab-28 Pk | APX | 7.2800 | 7.2800 | YES | NO | NO |
| 02295954 | ETHINYL ESTRADIOL & LEVONORGESTREL | Portia 28 0.03mg & 0.15mg Tab-28 Pk | BAR | 10.6600 | 7.2800 | YES | NO | NO |
| 00707503 | ETHINYL ESTRADIOL & LEVONORGESTREL | Triquilar 28 3 Phase Tab-28 Pk | BAY | 15.7500 | 15.7500 | NO | NO | NO |
| 02398869 | ETHINYL ESTRADIOL & LEVONORGESTREL | Indayo (Off-Formulary Interchangeable) 0.03mg & 0.15mg Tab-91 Pk | MYL | 45.9550 | N/A | YES | NO | NO |
| 02296659 | ETHINYL ESTRADIOL & LEVONORGESTREL | Seasonale (Off-Formulary Interchangeable) 0.03mg & 0.15mg Tab-91 Pk | TEW | N/A | N/A | YES | NO | NO |
| 02187086 | ETHINYL ESTRADIOL & NORETHINDRONE | Brevicon 0.035mg & 0.5mg Tab-21 Pk | PFI | 16.4500 | 16.4500 | NO | NO | NO |
| 02189054 | ETHINYL ESTRADIOL & NORETHINDRONE | Brevicon 1/35 0.035mg & 1mg Tab-21 Pk | PFI | 16.4500 | 16.4500 | NO | NO | NO |
| 02187108 | ETHINYL ESTRADIOL & NORETHINDRONE | Synphasic 3 Phase Tab-21 Pk | PFI | 13.6400 | 13.6400 | NO | NO | NO |
| 02187094 | ETHINYL ESTRADIOL & NORETHINDRONE | Brevicon 0.035mg & 0.5mg Tab-28 Pk | PFI | 16.4500 | 16.4500 | NO | NO | NO |
| 02189062 | ETHINYL ESTRADIOL & NORETHINDRONE | Brevicon 1/35 0.035mg & 1mg Tab-28 Pk | PFI | 16.4500 | 16.4500 | NO | NO | NO |
| 02187116 | ETHINYL ESTRADIOL & NORETHINDRONE | Synphasic 3 Phase Tab-28 Pk | PFI | 13.6400 | 13.6400 | NO | NO | NO |
| 00297143 | ETHINYL ESTRADIOL & NORETHINDRONE ACETATE | Loestrin 1.5/30 0.03mg & 1.5mg Tab-21 Pk | WAR | 16.9915 | 16.9915 | NO | NO | NO |
| 00315966 | ETHINYL ESTRADIOL & NORETHINDRONE ACETATE | Minestrin 1/20 0.02mg & 1mg Tab-21 Pk | WAR | 16.9915 | 16.9915 | NO | NO | NO |
| 00353027 | ETHINYL ESTRADIOL & NORETHINDRONE ACETATE | Loestrin 1.5/30 0.03mg & 1.5mg Tab-28 Pk | WAR | 16.9915 | 16.9915 | NO | NO | NO |
| 00343838 | ETHINYL ESTRADIOL & NORETHINDRONE ACETATE | Minestrin 1/20 0.02mg & 1mg Tab-28 Pk | WAR | 16.9915 | 16.9915 | NO | NO | NO |
| 01927744 | ETHOPROPAZINE HCL | Parsitan 50mg Tab | SLP | 0.3153 | 0.3153 | NO | NO | NO |
| 02545772 | ETHOSUXIMIDE | Mar-Ethosuximide 250mg Cap | MAR | 0.2628 | 0.2628 | YES | NO | NO |
| 02547171 | ETHOSUXIMIDE | Odan-Ethosuximide 250mg Cap | ODN | 0.2628 | 0.2628 | YES | NO | NO |
| 00022799 | ETHOSUXIMIDE | Zarontin 250mg Cap | SLP | 0.5255 | 0.2628 | YES | NO | NO |
| 00023485 | ETHOSUXIMIDE | Zarontin 50mg/mL O/L | SLP | 0.0740 | 0.0740 | NO | NO | NO |
| 02248686 | ETIDRONATE DISODIUM | Co Etidronate 200mg Tab | COB | 0.3569 | 0.3569 | YES | YES | NO |
| 01997629 | ETIDRONATE DISODIUM | Didronel (Not a Benefit) 200mg Tab | PGP | N/A | N/A | YES | NO | NO |
| 02499509 | ETONOGESTREL | Nexplanon 68mg/Implant ER Subdermal Implant | OCI | 314.2100 | 314.2100 | NO | NO | NO |
| 00616192 | ETOPOSIDE | Vepesid 50mg Cap | CHE | 47.8010 | 47.8010 | NO | NO | NO |
| 02306778 | ETRAVIRINE | Intelence 100mg Tab | JAN | 6.5710 | 6.5710 | NO | NO | NO |
| 02375931 | ETRAVIRINE | Intelence 200mg Tab | JAN | 12.6195 | 12.6195 | NO | NO | NO |
| 02339528 | EVEROLIMUS | Afinitor (Off-Formulary Interchangeable) 10mg Tab | NOV | 202.6540 | 172.2559 | YES | NO | NO |
| 02369257 | EVEROLIMUS | Afinitor (Off-Formulary Interchangeable) 2.5mg Tab | NOV | 202.6540 | 172.2559 | YES | NO | NO |
| 02339501 | EVEROLIMUS | Afinitor (Off-Formulary Interchangeable) 5mg Tab | NOV | 202.6540 | 172.2559 | YES | NO | NO |
| 02530090 | EVEROLIMUS | Nat-Everolimus (Off-Formulary Interchangeable) 2.5mg Tab | NAT | 172.2559 | 172.2559 | YES | NO | NO |
| 02530104 | EVEROLIMUS | Nat-Everolimus (Off-Formulary Interchangeable) 5mg Tab | NAT | 172.2559 | 172.2559 | YES | NO | NO |
| 02530120 | EVEROLIMUS | Nat-Everolimus (Off-Formulary Interchangeable) 10mg Tab | NAT | 172.2559 | 172.2559 | YES | NO | NO |
| 02504677 | EVEROLIMUS | PMS-Everolimus (Off-Formulary Interchangeable) 2.5mg Tab | PMS | 172.2559 | 172.2559 | YES | NO | NO |
| 02504693 | EVEROLIMUS | PMS-Everolimus (Off-Formulary Interchangeable) 10mg Tab | PMS | 172.2559 | 172.2559 | YES | NO | NO |
| 02504685 | EVEROLIMUS | PMS-Everolimus (Off-Formulary Interchangeable) 5mg Tab | PMS | 172.2559 | 172.2559 | YES | NO | NO |
| 02532433 | EVEROLIMUS | Reddy-Everolimus (Off-Formulary Interchangeable) 10mg Tab | DRR | 172.2559 | 172.2559 | YES | NO | NO |
| 02532409 | EVEROLIMUS | Reddy-Everolimus (Off-Formulary Interchangeable) 2.5mg Tab | DRR | 172.2559 | 172.2559 | YES | NO | NO |
| 02532417 | EVEROLIMUS | Reddy-Everolimus (Off-Formulary Interchangeable) 5mg Tab | DRR | 172.2559 | 172.2559 | YES | NO | NO |
| 02492946 | EVEROLIMUS | Sandoz Everolimus (Off-Formulary Interchangeable) 10mg Tab | SDZ | 172.2559 | 172.2559 | YES | NO | NO |
| 02492911 | EVEROLIMUS | Sandoz Everolimus (Off-Formulary Interchangeable) 2.5mg Tab | SDZ | 172.2559 | 172.2559 | YES | NO | NO |
| 02492938 | EVEROLIMUS | Sandoz Everolimus (Off-Formulary Interchangeable) 5mg Tab | SDZ | 172.2559 | 172.2559 | YES | NO | NO |
| 02463253 | EVEROLIMUS | Teva-Everolimus (Off-Formulary Interchangeable) 10mg Tab | TEV | 172.2559 | 172.2559 | YES | NO | NO |
| 02463229 | EVEROLIMUS | Teva-Everolimus (Off-Formulary Interchangeable) 2.5mg Tab | TEV | 172.2559 | 172.2559 | YES | NO | NO |
| 02463237 | EVEROLIMUS | Teva-Everolimus (Off-Formulary Interchangeable) 5mg Tab | TEV | 172.2559 | 172.2559 | YES | NO | NO |
| 02446057 | EVOLOCUMAB | Repatha 140mg/mL Inj Sol-Pref Syr Autoinj | AMG | 291.6650 | 291.6650 | NO | YES | NO |
| 02419726 | EXEMESTANE | Apo-Exemestane 25mg Tab | APX | 1.3263 | 1.3263 | YES | NO | NO |
| 02242705 | EXEMESTANE | Aromasin 25mg Tab | PFI | 6.2463 | 1.3263 | YES | NO | NO |
| 02390183 | EXEMESTANE | Co Exemestane 25mg Tab | COB | 1.3263 | 1.3263 | YES | NO | NO |
| 02407841 | EXEMESTANE | Med-Exemestane 25mg Tab | GMP | 1.3263 | 1.3263 | YES | NO | NO |
| 02408473 | EXEMESTANE | Teva-Exemestane 25mg Tab | TEV | 1.3263 | 1.3263 | YES | NO | NO |
| 02475898 | EZETIMIBE | AG-Ezetimibe 10mg Tab | ANG | 0.1811 | 0.1811 | YES | YES | NO |
| 02425610 | EZETIMIBE | Ach-Ezetimibe 10mg Tab | ACH | 0.1811 | 0.1811 | YES | YES | NO |
| 02414716 | EZETIMIBE | Act Ezetimibe 10mg Tab | ACV | 0.1811 | 0.1811 | YES | YES | NO |
| 02427826 | EZETIMIBE | Apo-Ezetimibe 10mg Tab | APX | 0.1811 | 0.1811 | YES | YES | NO |
| 02469286 | EZETIMIBE | Auro-Ezetimibe 10mg Tab | AUR | 0.1811 | 0.1811 | YES | YES | NO |
| 02429659 | EZETIMIBE | Ezetimibe 10mg Tab | SIV | 0.1811 | 0.1811 | YES | YES | NO |
| 02431300 | EZETIMIBE | Ezetimibe 10mg Tab | SAI | 0.1811 | 0.1811 | YES | YES | NO |
| 02247521 | EZETIMIBE | Ezetrol 10mg Tab | OCI | 2.1436 | 0.1811 | YES | YES | NO |
| 02460750 | EZETIMIBE | GLN-Ezetimibe 10mg Tab | GLP | 0.1811 | 0.1811 | YES | YES | NO |
| 02423235 | EZETIMIBE | Jamp-Ezetimibe 10mg Tab | JPC | 0.1811 | 0.1811 | YES | YES | NO |
| 02467437 | EZETIMIBE | M-Ezetimibe 10mg Tab | MAT | 0.1811 | 0.1811 | YES | YES | NO |
| 02422662 | EZETIMIBE | Mar-Ezetimibe 10mg Tab | MAR | 0.1811 | 0.1811 | YES | YES | NO |
| 02423243 | EZETIMIBE | Mint-Ezetimibe 10mg Tab | MIN | 0.1811 | 0.1811 | YES | YES | NO |
| 02481669 | EZETIMIBE | NRA-Ezetimibe 10mg Tab | NRA | 0.1811 | 0.1811 | YES | YES | NO |
| 02536420 | EZETIMIBE | NRA-Ezetimibe Tablets 10mg Tab | NRA | 0.1811 | 0.1811 | YES | YES | NO |
| 02416409 | EZETIMIBE | PMS-Ezetimibe 10mg Tab | PMS | 0.1811 | 0.1811 | YES | YES | NO |
| 02419548 | EZETIMIBE | Ran-Ezetimibe 10mg Tab | RAN | 0.1811 | 0.1811 | YES | YES | NO |
| 02416778 | EZETIMIBE | Sandoz Ezetimibe 10mg Tab | SDZ | 0.1811 | 0.1811 | YES | YES | NO |
| 02354101 | EZETIMIBE | Teva-Ezetimibe 10mg Tab | TEV | 0.1811 | 0.1811 | YES | YES | NO |
| 09857453 | FAD GLUCOSE DEHYDROGENASE (ASPERGILLUS SP.) | Contour Next Blood Glucose Test Strips Strip | ADC | N/A | 0.7290 | NO | NO | NO |
| 09857563 | FAD-GLUCOSE DEHYDROGENASE (FAD-GDH) | Accu-Chek Guide Test Strips Strip | RCH | N/A | 0.7154 | NO | NO | NO |
| 09857525 | FAD-GLUCOSE DEHYDROGENASE (FAD-GDH) | GE200 Blood Glucose Test Strips Strip | BIN | N/A | 0.5508 | NO | NO | NO |
| 09857593 | FAD-GLUCOSE DEHYDROGENASE (FAD-GDH) | GlucoDr. Auto Test Strip Strip | AMC | N/A | 0.7290 | NO | NO | NO |
| 09857549 | FAD-GLUCOSE DEHYDROGENASE (FAD-GDH) | Fora Test N' Go Test Strip Test Strip | TAI | N/A | 0.7244 | NO | NO | NO |
| 02292041 | FAMCICLOVIR | Apo-Famciclovir (Off-Formulary Interchangeable) 250mg Tab | APX | 2.7200 | 2.7200 | YES | NO | NO |
| 02292025 | FAMCICLOVIR | Apo-Famciclovir (Off-Formulary Interchangeable) 125mg Tab | APX | 2.0240 | 2.0240 | YES | NO | NO |
| 02292068 | FAMCICLOVIR | Apo-Famciclovir 500mg Tab | APX | 4.2591 | 4.2591 | YES | YES | NO |
| 02177102 | FAMCICLOVIR | Famvir 500mg Tab | APU | 7.7438 | 4.2591 | YES | YES | NO |
| 02229129 | FAMCICLOVIR | Famvir (Off-Formulary Interchangeable) 250mg Tab | APU | N/A | N/A | YES | NO | NO |
| 02229110 | FAMCICLOVIR | Famvir (Off-Formulary Interchangeable) 125mg Tab | APU | N/A | N/A | YES | NO | NO |
| 02509970 | FAMOTIDINE | AG-Famotidine 20mg Tab | ANG | 0.2658 | 0.2658 | YES | NO | YES |
| 02509989 | FAMOTIDINE | AG-Famotidine 40mg Tab | ANG | 0.4834 | 0.4834 | YES | NO | YES |
| 01953842 | FAMOTIDINE | Apo-Famotidine 20mg Tab | APX | 0.2658 | 0.2658 | YES | NO | YES |
| 01953834 | FAMOTIDINE | Apo-Famotidine 40mg Tab | APX | 0.4834 | 0.4834 | YES | NO | YES |
| 02549107 | FAMOTIDINE | Famotidine 20mg Tab | SIV | 0.2658 | 0.2658 | YES | NO | YES |
| 02549115 | FAMOTIDINE | Famotidine 40mg Tab | SIV | 0.4834 | 0.4834 | YES | NO | YES |
| 02351102 | FAMOTIDINE | Famotidine 20mg Tab | SAI | 0.2658 | 0.2658 | YES | NO | YES |
| 02351110 | FAMOTIDINE | Famotidine 40mg Tab | SAI | 0.4834 | 0.4834 | YES | NO | YES |
| 02507749 | FAMOTIDINE | Jamp Famotidine 20mg Tab | JPC | 0.2658 | 0.2658 | YES | NO | YES |
| 02507757 | FAMOTIDINE | Jamp Famotidine 40mg Tab | JPC | 0.4834 | 0.4834 | YES | NO | YES |
| 02538628 | FAMOTIDINE | Mint-Famotidine 20mg Tab | MIN | 0.2658 | 0.2658 | YES | NO | YES |
| 02538636 | FAMOTIDINE | Mint-Famotidine 40mg Tab | MIN | 0.4834 | 0.4834 | YES | NO | YES |
| 00710121 | FAMOTIDINE | Pepcid (Not a Benefit) 20mg Tab | MFC | N/A | N/A | YES | NO | YES |
| 00710113 | FAMOTIDINE | Pepcid (Not a Benefit) 40mg Tab | MFC | N/A | N/A | YES | NO | YES |
| 02022141 | FAMOTIDINE | Teva-Famotidine 40mg Tab | TEV | 0.4834 | 0.4834 | YES | NO | YES |
| 02022133 | FAMOTIDINE | Teva-Famotidine 20mg Tab | TEV | 0.2658 | 0.2658 | YES | NO | YES |
| 02379910 | FAMPRIDINE | Fampyra (Off-Formulary Interchangeable) 10mg ER Tab | BIG | N/A | N/A | YES | NO | NO |
| 02496216 | FAMPRIDINE | PMS-Fampridine (Off-Formulary Interchangeable) 10mg ER Tab | PMS | 8.4730 | N/A | YES | NO | NO |
| 02482398 | FAMPRIDINE | Taro-Fampridine (Off-Formulary Interchangeable) 10mg ER Tab | TAR | 8.4730 | N/A | YES | NO | NO |
| 02554003 | FARICIMAB | Vabysmo 6mg/0.05mL Inj Sol-0.05mL Pref Syr (Preservative-Free) | HLR | 1350.0000 | 1350.0000 | NO | YES | NO |
| 02527618 | FARICIMAB | Vabysmo 6mg/0.05mL Inj Sol-0.24mL Vial Pk (Preservative-Free) | HLR | 1350.0000 | 1350.0000 | NO | YES | NO |
| 02533243 | FEBUXOSTAT | Auro-Febuxostat (Off-Formulary Interchangeable) 80mg Tab | AUR | 1.3515 | 1.3515 | YES | NO | NO |
| 02539837 | FEBUXOSTAT | Febuxostat (Off-Formulary Interchangeable) 80mg Tab | SAI | 1.3515 | 1.3515 | YES | NO | NO |
| 02490870 | FEBUXOSTAT | Jamp-Febuxostat (Off-Formulary Interchangeable) 80mg Tab | JPC | 1.3515 | 1.3515 | YES | NO | NO |
| 02473607 | FEBUXOSTAT | Mar-Febuxostat (Off-Formulary Interchangeable) 80mg Tab | MAR | 1.3515 | 1.3515 | YES | NO | NO |
| 02466198 | FEBUXOSTAT | Teva-Febuxostat (Off-Formulary Interchangeable) 80mg Tab | TEV | 1.3515 | 1.3515 | YES | NO | NO |
| 02357380 | FEBUXOSTAT | Uloric (Off-Formulary Interchangeable) 80mg Tab | TAK | N/A | N/A | YES | NO | NO |
| 02452383 | FELODIPINE | Apo-Felodipine 10mg ER Tab | APX | 0.5350 | 0.5350 | YES | NO | YES |
| 02452375 | FELODIPINE | Apo-Felodipine 5mg ER Tab | APX | 0.3565 | 0.3565 | YES | NO | YES |
| 02452367 | FELODIPINE | Apo-Felodipine 2.5mg ER Tab | APX | 0.4050 | 0.4050 | YES | NO | YES |
| 00851787 | FELODIPINE | Plendil 10mg ER Tab | GPE | 1.2027 | 0.5350 | YES | NO | YES |
| 00851779 | FELODIPINE | Plendil 5mg ER Tab | GPE | 0.8020 | 0.3565 | YES | NO | YES |
| 02057778 | FELODIPINE | Plendil 2.5mg ER Tab | GPE | 0.6063 | 0.4050 | YES | NO | YES |
| 02280264 | FELODIPINE | Sandoz Felodipine 5mg ER Tab | SDZ | 0.3565 | 0.3565 | YES | NO | YES |
| 02280272 | FELODIPINE | Sandoz Felodipine 10mg ER Tab | SDZ | 0.5350 | 0.5350 | YES | NO | YES |
| 02222000 | FELODIPINE | Renedil (Not a Benefit) 10mg SR Tab | SAV | N/A | N/A | YES | NO | YES |
| 02221993 | FELODIPINE | Renedil (Not a Benefit) 5mg SR Tab | SAV | N/A | N/A | YES | NO | YES |
| 09857203 | FELODIPINE | Sandoz Felodipine 5mg SR Tab | SDZ | 0.5592 | 0.5592 | YES | NO | YES |
| 09857204 | FELODIPINE | Sandoz Felodipine 10mg SR Tab | SDZ | 0.8390 | 0.8390 | YES | NO | YES |
| 02239864 | FENOFIBRATE | AA-Feno-Micro 200mg Cap | AAP | 0.9257 | 0.9257 | YES | NO | NO |
| 02243180 | FENOFIBRATE | AA-Feno-Micro (Off-Formulary Interchangeable) 67mg Cap | AAP | 0.6025 | N/A | YES | NO | NO |
| 02225980 | FENOFIBRATE | Apo-Fenofibrate 100mg Cap | APX | 0.6105 | 0.6105 | YES | NO | NO |
| 00885827 | FENOFIBRATE | Lipidil (Not a Benefit) 100mg Cap | JOU | N/A | N/A | YES | NO | NO |
| 02230283 | FENOFIBRATE | Lipidil Micro (Off-Formulary Interchangeable) 67mg Cap | FOU | N/A | N/A | YES | NO | NO |
| 02146959 | FENOFIBRATE | Lipidil Micro (Not a Benefit) 200mg Cap | SPH | N/A | N/A | YES | NO | NO |
| 02246860 | FENOFIBRATE | AA-Feno-Super 160mg Tab | AAP | 1.0022 | 1.0022 | YES | NO | NO |
| 02246859 | FENOFIBRATE | AA-Feno-Super (Off-Formulary Interchangeable) 100mg Tab | AAP | 0.9883 | N/A | YES | NO | NO |
| 02269074 | FENOFIBRATE | Lipidil EZ 48mg Tab | FOU | 0.4986 | 0.3560 | YES | NO | NO |
| 02269082 | FENOFIBRATE | Lipidil EZ 145mg Tab | FOU | 1.2768 | 0.5489 | YES | NO | NO |
| 02241602 | FENOFIBRATE | Lipidil Supra 160mg Tab | BGP | 1.4513 | 1.0022 | YES | NO | NO |
| 02241601 | FENOFIBRATE | Lipidil Supra (Off-Formulary Interchangeable) 100mg Tab | LAF | N/A | N/A | YES | NO | NO |
| 02390698 | FENOFIBRATE | Sandoz Fenofibrate E 48mg Tab | SDZ | 0.3560 | 0.3560 | YES | NO | NO |
| 02390701 | FENOFIBRATE | Sandoz Fenofibrate E 145mg Tab | SDZ | 0.5489 | 0.5489 | YES | NO | NO |
| 02288044 | FENOFIBRATE | Sandoz Fenofibrate S (Off-Formulary Interchangeable) 100mg Tab | SDZ | 0.7874 | N/A | YES | NO | NO |
| 02454696 | FENOFIBRATE | Taro-Fenofibrate E 145mg Tab | SPC | 0.5489 | 0.5489 | YES | NO | NO |
| 02275821 | FENTANYL TRANSDERMAL SYSTEM | Duragesic (Not a Benefit) 50mcg/hr Trans Patch | JAN | N/A | N/A | YES | NO | YES |
| 02275813 | FENTANYL TRANSDERMAL SYSTEM | Duragesic (Not a Benefit) 25mcg/hr Trans Patch | JAN | N/A | N/A | YES | NO | YES |
| 02275856 | FENTANYL TRANSDERMAL SYSTEM | Duragesic (Off-Formulary Interchangeable) 100mcg/hr Trans Patch | JAN | N/A | N/A | YES | NO | YES |
| 02275848 | FENTANYL TRANSDERMAL SYSTEM | Duragesic (Off-Formulary Interchangeable) 75mcg/hr Trans Patch | JAN | N/A | N/A | YES | NO | YES |
| 01937413 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 100 (Off-Formulary Interchangeable) 100mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
| 02280345 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 12 (Not a Benefit) 12mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
| 09858350 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 12 (Not a Benefit) 12mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
| 01937383 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 25 (Not a Benefit) 25mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
| 01937391 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 50 (Not a Benefit) 50mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
| 01937405 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 75 (Off-Formulary Interchangeable) 75mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
| 02327163 | FENTANYL TRANSDERMAL SYSTEM | Sandoz Fentanyl Patch (Off-Formulary Interchangeable) 100mcg/hr Trans Patch | SDZ | 28.1950 | N/A | YES | NO | YES |
| 02327155 | FENTANYL TRANSDERMAL SYSTEM | Sandoz Fentanyl Patch (Off-Formulary Interchangeable) 75mcg/hr Trans Patch | SDZ | 22.6500 | N/A | YES | NO | YES |
| 02327120 | FENTANYL TRANSDERMAL SYSTEM | Sandoz Fentanyl Patch 25mcg/hr Trans Patch | SDZ | 8.5600 | 8.5600 | YES | YES | YES |
| 02327147 | FENTANYL TRANSDERMAL SYSTEM | Sandoz Fentanyl Patch 50mcg/hr Trans Patch | SDZ | 16.1100 | 16.1100 | YES | YES | YES |
| 09858348 | FENTANYL TRANSDERMAL SYSTEM | Sandoz Fentanyl Patch 12mcg/hr Trans Patch | SDZ | 3.3200 | 3.3200 | YES | YES | YES |
| 02327112 | FENTANYL TRANSDERMAL SYSTEM | Sandoz Fentanyl Patch 12mcg/hr Trans Patch | SDZ | 3.3200 | 3.3200 | YES | YES | YES |
| 02311925 | FENTANYL TRANSDERMAL SYSTEM | Teva-Fentanyl 12mcg/hr Trans Patch | TEV | 3.3200 | 3.3200 | YES | YES | YES |
| 09858349 | FENTANYL TRANSDERMAL SYSTEM | Teva-Fentanyl 12mcg/hr Trans Patch | TEV | 3.3200 | 3.3200 | YES | YES | YES |
| 02282968 | FENTANYL TRANSDERMAL SYSTEM | Teva-Fentanyl 50mcg/hr Trans Patch | TEV | 16.1100 | 16.1100 | YES | YES | YES |
| 02282976 | FENTANYL TRANSDERMAL SYSTEM | Teva-Fentanyl (Off-Formulary Interchangeable) 75mcg/hr Trans Patch | TEV | 22.6500 | N/A | YES | NO | YES |
| 02282984 | FENTANYL TRANSDERMAL SYSTEM | Teva-Fentanyl (Off-Formulary Interchangeable) 100mcg/hr Trans Patch | TEV | 28.1950 | N/A | YES | NO | YES |
| 02282941 | FENTANYL TRANSDERMAL SYSTEM | Teva-Fentanyl 25mcg/hr Trans Patch | TEV | 8.5600 | 8.5600 | YES | YES | YES |
| 02477777 | FERRIC DERISOMALTOSE | Monoferric 100mg elemental iron/mL Inj Sol (Preservative-Free) | PHC | 45.0000 | 45.0000 | NO | YES | NO |
| 02237556 | FERROUS FUMARATE | Euro-Fer 300mg Cap | SDZ | 0.1057 | 0.1057 | YES | NO | NO |
| 80024232 | FERROUS FUMARATE | Jamp-Fer 300mg Cap | JPC | 0.1057 | 0.1057 | YES | NO | NO |
| 01923420 | FERROUS FUMARATE | Palafer (Not a Benefit) 300mg Cap | GSK | N/A | N/A | YES | NO | NO |
| 01923439 | FERROUS FUMARATE | Palafer 60mg/mL O/L | GSK | 0.0981 | 0.0981 | NO | NO | NO |
| 00031097 | FERROUS GLUCONATE | Ferrous Gluconate (Not a Benefit) 300mg Tab | JPC | N/A | N/A | YES | NO | NO |
| 00545031 | FERROUS GLUCONATE | Ferrous Gluconate 300mg 300mg Tab | AAP | 0.0424 | 0.0424 | YES | NO | NO |
| 00762954 | FERROUS SULFATE | Fer-In-Sol 75mg/mL O/L | MJS | 0.2436 | 0.2436 | NO | NO | NO |
| 02521768 | FESOTERODINE FUMARATE | Sandoz Fesoterodine Fumarate 4mg Tab | SDZ | 1.1250 | 1.1250 | YES | YES | NO |
| 02521776 | FESOTERODINE FUMARATE | Sandoz Fesoterodine Fumarate 8mg Tab | SDZ | 1.1250 | 1.1250 | YES | YES | NO |
| 02380021 | FESOTERODINE FUMARATE | Toviaz 4mg Tab | PFI | 1.5500 | 1.1250 | YES | YES | NO |
| 02380048 | FESOTERODINE FUMARATE | Toviaz 8mg Tab | PFI | 1.5500 | 1.1250 | YES | YES | NO |
| 09853464 | FILGRASTIM | Neupogen 480mcg/1.6mL 1.6mL Vial | AMG | 281.8120 | 281.8120 | NO | YES | NO |
| 01968017 | FILGRASTIM | Neupogen 300mcg/mL 1mL Vial | AMG | 176.1330 | 176.1330 | NO | YES | NO |
| 02485575 | FILGRASTIM | Nivestym 300mcg/0.5mL Inj Sol-0.5mL Pref Syr | PFI | 138.5376 | 138.5376 | NO | NO | NO |
| 02556537 | FILGRASTIM | Filra 300mcg/0.5mL Inj Sol-0.5mL Pref Syr (Preservative-Free) | JPC | 105.6798 | 105.6798 | NO | NO | NO |
| 02520990 | FILGRASTIM | Nypozi 300mcg/0.5mL Inj Sol-0.5mL Pref Syr (Preservative-Free) | TAV | 138.5376 | 138.5376 | NO | NO | NO |
| 02485583 | FILGRASTIM | Nivestym 480mcg/0.8mL Inj Sol-0.8mL Pref Syr | PFI | 221.6640 | 221.6640 | NO | NO | NO |
| 02556545 | FILGRASTIM | Filra 480mcg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | JPC | 169.0872 | 169.0872 | NO | NO | NO |
| 02521008 | FILGRASTIM | Nypozi 480mcg/0.8mL Inj Sol-0.8mL Pref Syr (Preservative-Free) | TAV | 221.6640 | 221.6640 | NO | NO | NO |
| 02485656 | FILGRASTIM | Nivestym 480mcg/1.6mL Inj Sol-1.6mL Vial Pk | PFI | 221.6640 | 221.6640 | NO | NO | NO |
| 02485591 | FILGRASTIM | Nivestym 300mcg/mL Inj Sol-1mL Vial Pk | PFI | 138.5376 | 138.5376 | NO | NO | NO |
| 02441489 | FILGRASTIM | Grastofil 300mcg/0.5mL Pref Syr-0.5mL Pk | APX | 138.5380 | 138.5380 | NO | NO | NO |
| 02454548 | FILGRASTIM | Grastofil 480mcg/0.8mL Pref Syr-0.8mL Pk | APX | 221.6600 | 221.6600 | NO | NO | NO |
| 02365383 | FINASTERIDE | Apo-Finasteride 5mg Tab | APX | 0.3506 | 0.3506 | YES | YES | NO |
| 02405814 | FINASTERIDE | Auro-Finasteride 5mg Tab | AUR | 0.3506 | 0.3506 | YES | YES | NO |
| 02428148 | FINASTERIDE | Auro-Finasteride 1mg (Off-Formulary Interchangeable) 1mg Tab | AUR | 1.1455 | N/A | YES | NO | NO |
| 02447541 | FINASTERIDE | Finasteride 5mg Tab | SIV | 0.3506 | 0.3506 | YES | YES | NO |
| 02447568 | FINASTERIDE | Finasteride (Off-Formulary Interchangeable) 1mg Tab | SIV | 1.1455 | N/A | YES | NO | NO |
| 02445077 | FINASTERIDE | Finasteride 5mg Tab | SAI | 0.3506 | 0.3506 | YES | YES | NO |
| 02445085 | FINASTERIDE | Finasteride (Off-Formulary Interchangeable) 1mg Tab | SAI | 1.1453 | N/A | YES | NO | NO |
| 02355043 | FINASTERIDE | Finasteride Tablets USP 5mg Tab | ACH | 0.3506 | 0.3506 | YES | YES | NO |
| 02554461 | FINASTERIDE | Jamp Finasteride Tablets (Off-Formulary Interchangeable) 1mg Tab | JPC | 1.1453 | N/A | YES | NO | NO |
| 02357224 | FINASTERIDE | Jamp-Finasteride 5mg Tab | JPC | 0.3506 | 0.3506 | YES | YES | NO |
| 02522489 | FINASTERIDE | M-Finasteride 5mg Tab | MAT | 0.3506 | 0.3506 | YES | YES | NO |
| 02389878 | FINASTERIDE | Mint-Finasteride 5mg Tab | MIN | 0.3506 | 0.3506 | YES | YES | NO |
| 02537427 | FINASTERIDE | Mint-Finasteride (Off-Formulary Interchangeable) 1mg Tab | MIN | 1.1453 | N/A | YES | NO | NO |
| 02348500 | FINASTERIDE | Novo-Finasteride 5mg Tab | TEV | 0.3506 | 0.3506 | YES | YES | NO |
| 02320169 | FINASTERIDE | PMS-Finasteride (Off-Formulary Interchangeable) 1mg Tab | PMS | 1.1453 | N/A | YES | NO | NO |
| 02310112 | FINASTERIDE | PMS-Finasteride 5mg Tab | PMS | 0.3506 | 0.3506 | YES | YES | NO |
| 02238213 | FINASTERIDE | Propecia (Off-Formulary Interchangeable) 1mg Tab | OCI | N/A | N/A | YES | NO | NO |
| 02010909 | FINASTERIDE | Proscar 5mg Tab | OCI | 2.5610 | 0.3506 | YES | YES | NO |
| 02306905 | FINASTERIDE | Ratio-Finasteride 5mg Tab | RPH | 0.3506 | 0.3506 | YES | YES | NO |
| 02455013 | FINASTERIDE | Riva-Finasteride 5mg Tab | RIA | 0.3506 | 0.3506 | YES | YES | NO |
| 02322579 | FINASTERIDE | Sandoz Finasteride 5mg Tab | SDZ | 0.3506 | 0.3506 | YES | YES | NO |
| 02339471 | FINASTERIDE | Sandoz Finasteride A (Off-Formulary Interchangeable) 1mg Tab | SDZ | 1.1453 | N/A | YES | NO | NO |
| 02531925 | FINERENONE | Kerendia 20mg Tab | BAH | 3.2565 | 3.2565 | NO | YES | NO |
| 02531917 | FINERENONE | Kerendia 10mg Tab | BAH | 3.2565 | 3.2565 | NO | YES | NO |
| 02475669 | FINGOLIMOD | Ach-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | ACH | 73.9100 | 73.9100 | YES | NO | NO |
| 02469936 | FINGOLIMOD | Apo-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | APX | 73.9096 | 73.9096 | YES | NO | NO |
| 02365480 | FINGOLIMOD | Gilenya (Off-Formulary Interchangeable) 0.5mg Cap | NOV | 86.9525 | 73.9100 | YES | NO | NO |
| 02487772 | FINGOLIMOD | Jamp Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | JPC | 73.9096 | 73.9096 | YES | NO | NO |
| 02474743 | FINGOLIMOD | Mar-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | MAR | 73.9096 | 73.9096 | YES | NO | NO |
| 02469715 | FINGOLIMOD | Mylan-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | MYL | 73.9096 | 73.9096 | YES | NO | NO |
| 02469782 | FINGOLIMOD | PMS-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | PMS | 73.9096 | 73.9096 | YES | NO | NO |
| 02482606 | FINGOLIMOD | Sandoz Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | SDZ | 73.9096 | 73.9096 | YES | NO | NO |
| 02469618 | FINGOLIMOD | Taro-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | TAR | 73.9096 | 73.9096 | YES | NO | NO |
| 02469561 | FINGOLIMOD | Teva-Fingolimod (Off-Formulary Interchangeable) 0.5mg Cap | TEV | 73.9096 | 73.9096 | YES | NO | NO |
| 02244842 | FLAVOXATE HCL | Apo-Flavoxate (Not a Benefit) 200mg Tab | APX | N/A | N/A | YES | NO | NO |
| 00728179 | FLAVOXATE HCL | Urispas (Not a Benefit) 200mg Tab | PAL | N/A | N/A | YES | NO | NO |
| 02275538 | FLECAINIDE ACETATE | Apo-Flecainide 50mg Tab | APX | 0.1389 | 0.1389 | YES | NO | NO |
| 02275546 | FLECAINIDE ACETATE | Apo-Flecainide 100mg Tab | APX | 0.2779 | 0.2779 | YES | NO | NO |
| 02459957 | FLECAINIDE ACETATE | Auro-Flecainide 50mg Tab | AUR | 0.1389 | 0.1389 | YES | NO | NO |
| 02459965 | FLECAINIDE ACETATE | Auro-Flecainide 100mg Tab | AUR | 0.2779 | 0.2779 | YES | NO | NO |
| 02534800 | FLECAINIDE ACETATE | Flecainide 50mg Tab | SAI | 0.1389 | 0.1389 | YES | NO | NO |
| 02534819 | FLECAINIDE ACETATE | Flecainide 100mg Tab | SAI | 0.2779 | 0.2779 | YES | NO | NO |
| 02493713 | FLECAINIDE ACETATE | Jamp Flecainide 100mg Tab | JPC | 0.2779 | 0.2779 | YES | NO | NO |
| 02493705 | FLECAINIDE ACETATE | Jamp Flecainide 50mg Tab | JPC | 0.1389 | 0.1389 | YES | NO | NO |
| 02476185 | FLECAINIDE ACETATE | Mar-Flecainide 100mg Tab | MAR | 0.2779 | 0.2779 | YES | NO | NO |
| 02476177 | FLECAINIDE ACETATE | Mar-Flecainide 50mg Tab | MAR | 0.1389 | 0.1389 | YES | NO | NO |
| 02530066 | FLECAINIDE ACETATE | NRA-Flecainide 50mg Tab | NRA | 0.1389 | 0.1389 | YES | NO | NO |
| 02530074 | FLECAINIDE ACETATE | NRA-Flecainide 100mg Tab | NRA | 0.2779 | 0.2779 | YES | NO | NO |
| 01966197 | FLECAINIDE ACETATE | Tambocor (Not a Benefit) 50mg Tab | GRA | N/A | N/A | YES | NO | NO |
| 01966200 | FLECAINIDE ACETATE | Tambocor (Not a Benefit) 100mg Tab | GRA | N/A | N/A | YES | NO | NO |
| 02241895 | FLUCONAZOLE | Apo-Fluconazole-150 150mg Cap | APX | 3.9424 | 3.9424 | YES | YES | YES |
| 02141442 | FLUCONAZOLE | Diflucan-150 150mg Cap | PFI | 15.7697 | 3.9424 | YES | YES | YES |
| 02521229 | FLUCONAZOLE | Fluconazole-150 150mg Cap | SAI | 3.9424 | 3.9424 | YES | YES | YES |
| 02547864 | FLUCONAZOLE | Jamp Fluconazole 150mg 150mg Cap | JPC | 3.9424 | 3.9424 | YES | YES | YES |
| 02432471 | FLUCONAZOLE | Jamp-Fluconazole 150mg Cap | JPC | 3.9424 | 3.9424 | YES | YES | YES |
| 02428792 | FLUCONAZOLE | Mar-Fluconazole-150 150mg Cap | MAR | 3.9424 | 3.9424 | YES | YES | YES |
| 02433702 | FLUCONAZOLE | Priva-Fluconazole 150mg Cap | PHP | 3.9424 | 3.9424 | YES | YES | YES |
| 02255510 | FLUCONAZOLE | Riva-Fluconazole 150mg Cap | RIA | 3.9424 | 3.9424 | YES | YES | YES |
| 02024152 | FLUCONAZOLE | Diflucan P.O.S. 10mg/mL O/L | PFI | 1.3654 | 1.3654 | NO | YES | NO |
| 02281260 | FLUCONAZOLE | Act Fluconazole 50mg Tab | ACV | 1.2904 | 1.2904 | YES | NO | NO |
| 02281279 | FLUCONAZOLE | Act Fluconazole 100mg Tab | ACV | 2.2891 | 2.2891 | YES | NO | NO |
| 02237371 | FLUCONAZOLE | Apo-Fluconazole 100mg Tab | APX | 2.2891 | 2.2891 | YES | NO | NO |
| 02237370 | FLUCONAZOLE | Apo-Fluconazole 50mg Tab | APX | 1.2904 | 1.2904 | YES | NO | NO |
| 00891819 | FLUCONAZOLE | Diflucan (Not a Benefit) 100mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 00891800 | FLUCONAZOLE | Diflucan (Not a Benefit) 50mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02517396 | FLUCONAZOLE | Fluconazole 50mg Tab | SAI | 1.2904 | 1.2904 | YES | NO | NO |
| 02534894 | FLUCONAZOLE | Fluconazole 100mg Tab | SIV | 2.2891 | 2.2891 | YES | NO | NO |
| 02517418 | FLUCONAZOLE | Fluconazole 100mg Tab | SAI | 2.2891 | 2.2891 | YES | NO | NO |
| 02534886 | FLUCONAZOLE | Fluconazole 50mg Tab | SIV | 1.2904 | 1.2904 | YES | NO | NO |
| 02245292 | FLUCONAZOLE | Mylan-Fluconazole 50mg Tab | MYL | 1.2904 | 1.2904 | YES | NO | NO |
| 02245293 | FLUCONAZOLE | Mylan-Fluconazole 100mg Tab | MYL | 2.2891 | 2.2891 | YES | NO | NO |
| 02245643 | FLUCONAZOLE | PMS-Fluconazole 50mg Tab | PMS | 1.2904 | 1.2904 | YES | NO | NO |
| 02245644 | FLUCONAZOLE | PMS-Fluconazole 100mg Tab | PMS | 2.2891 | 2.2891 | YES | NO | NO |
| 02236979 | FLUCONAZOLE | Teva-Fluconazole 100mg Tab | TEV | 2.2891 | 2.2891 | YES | NO | NO |
| 02236978 | FLUCONAZOLE | Teva-Fluconazole 50mg Tab | TEV | 1.2904 | 1.2904 | YES | NO | NO |
| 02246226 | FLUDARABINE PHOSPHATE | Fludara 10mg Tab | GZM | 41.8940 | 41.8940 | NO | YES | NO |
| 02086026 | FLUDROCORTISONE ACETATE | Florinef 0.1mg Tab | PPI | 0.5692 | 0.3131 | YES | NO | NO |
| 02552248 | FLUDROCORTISONE ACETATE | Jamp Fludrocortisone 0.1mg Tab | JPC | 0.3131 | 0.3131 | YES | NO | NO |
| 00074454 | FLUMETHASONE PIVALATE & IODOCHLORHYDROXYQUIN | Locacorten Vioform Eardrops 0.02% & 1% Ot Sol | PPI | 2.5782 | 2.5782 | NO | NO | YES |
| 02246082 | FLUNARIZINE HCL | Flunarizine 5mg Cap | AAP | 0.8320 | 0.8320 | YES | YES | NO |
| 00846341 | FLUNARIZINE HCL | Sibelium (Not a Benefit) 5mg Cap | PMS | N/A | N/A | YES | NO | NO |
| 02161923 | FLUOCINONIDE | Lidex (Not a Benefit) 0.05% Cr | VAE | N/A | N/A | YES | NO | NO |
| 00716863 | FLUOCINONIDE | Lyderm 0.05% Cr | TAR | 0.2550 | 0.2550 | YES | NO | NO |
| 02163152 | FLUOCINONIDE | Lidemol (Not a Benefit) 0.05% Emol Cr | VAE | N/A | N/A | YES | NO | NO |
| 00598933 | FLUOCINONIDE | Tiamol 0.05% Emol Cr | TAR | 0.1980 | 0.1980 | YES | NO | NO |
| 02161974 | FLUOCINONIDE | Lidex (Not a Benefit) 0.05% Gel | VAE | N/A | N/A | YES | NO | NO |
| 02236997 | FLUOCINONIDE | Lyderm 0.05% Gel | TAR | 0.3517 | 0.3517 | YES | NO | NO |
| 02161966 | FLUOCINONIDE | Lidex (Not a Benefit) 0.05% Oint | VAE | N/A | N/A | YES | NO | NO |
| 02236996 | FLUOCINONIDE | Lyderm 0.05% Oint | TAR | 0.3370 | 0.3370 | YES | NO | NO |
| 00247855 | FLUOROMETHOLONE | FML 0.1% Oph Susp | ALL | 3.5440 | 3.5440 | NO | NO | YES |
| 00756784 | FLUOROMETHOLONE ACETATE | Flarex 0.1% Oph Susp | NOV | 2.0240 | 2.0240 | NO | NO | YES |
| 00330582 | FLUOROURACIL | Efudex 5% Cr | VAL | 1.1341 | 1.1341 | NO | NO | NO |
| 02428946 | FLUOROURACIL & SALICYLIC ACID | Actikerall 0.5% w/w & 10% w/w Top Sol | CIP | 2.0878 | 2.0878 | NO | NO | NO |
| 02485060 | FLUOXETINE HCL | AG-Fluoxetine 20mg Cap | ANG | 0.3311 | 0.3311 | YES | NO | YES |
| 02485052 | FLUOXETINE HCL | AG-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | ANG | 1.1773 | N/A | YES | NO | YES |
| 02393441 | FLUOXETINE HCL | Ach-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | ACH | 1.1773 | N/A | YES | NO | YES |
| 02383241 | FLUOXETINE HCL | Ach-Fluoxetine 20mg Cap | ACH | 0.3311 | 0.3311 | YES | NO | YES |
| 02216361 | FLUOXETINE HCL | Apo-Fluoxetine 20mg Cap | APX | 0.3311 | 0.3311 | YES | NO | YES |
| 02216353 | FLUOXETINE HCL | Apo-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | APX | 1.1773 | N/A | YES | NO | YES |
| 02385627 | FLUOXETINE HCL | Auro-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | AUR | 1.1773 | N/A | YES | NO | YES |
| 02385635 | FLUOXETINE HCL | Auro-Fluoxetine 20mg Cap | AUR | 0.3311 | 0.3311 | YES | NO | YES |
| 02448432 | FLUOXETINE HCL | Bio-Fluoxetine 20mg Cap | BMP | 0.3311 | 0.3311 | YES | NO | YES |
| 02448424 | FLUOXETINE HCL | Bio-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | BMP | 1.1773 | N/A | YES | NO | YES |
| 02242177 | FLUOXETINE HCL | Co Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | COB | 1.1773 | N/A | YES | NO | YES |
| 02242178 | FLUOXETINE HCL | Co Fluoxetine 20mg Cap | COB | 0.3311 | 0.3311 | YES | NO | YES |
| 02286068 | FLUOXETINE HCL | Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | SAI | 1.1773 | N/A | YES | NO | YES |
| 02374447 | FLUOXETINE HCL | Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | SIV | 1.1773 | N/A | YES | NO | YES |
| 02374455 | FLUOXETINE HCL | Fluoxetine 20mg Cap | SIV | 0.3311 | 0.3311 | YES | NO | YES |
| 02286076 | FLUOXETINE HCL | Fluoxetine 20mg Cap | SAI | 0.3311 | 0.3311 | YES | NO | YES |
| 02401894 | FLUOXETINE HCL | Jamp-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | JPC | 1.1773 | N/A | YES | NO | YES |
| 02386402 | FLUOXETINE HCL | Jamp-Fluoxetine 20mg Cap | JPC | 0.3311 | 0.3311 | YES | NO | YES |
| 02529432 | FLUOXETINE HCL | M-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | MAT | 1.1773 | N/A | YES | NO | YES |
| 02529440 | FLUOXETINE HCL | M-Fluoxetine 20mg Cap | MAT | 0.3311 | 0.3311 | YES | NO | YES |
| 02392917 | FLUOXETINE HCL | Mar-Fluoxetine 20mg Cap | MAR | 0.3311 | 0.3311 | YES | NO | YES |
| 02392909 | FLUOXETINE HCL | Mar-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | MAR | 1.1773 | N/A | YES | NO | YES |
| 02380560 | FLUOXETINE HCL | Mint-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | MIN | 1.1773 | N/A | YES | NO | YES |
| 02380579 | FLUOXETINE HCL | Mint-Fluoxetine 20mg Cap | MIN | 0.3311 | 0.3311 | YES | NO | YES |
| 02503875 | FLUOXETINE HCL | NRA-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | NRA | 1.1773 | N/A | YES | NO | YES |
| 02503883 | FLUOXETINE HCL | NRA-Fluoxetine 20mg Cap | NRA | 0.3311 | 0.3311 | YES | NO | YES |
| 02177587 | FLUOXETINE HCL | PMS-Fluoxetine 20mg Cap | PMS | 0.3311 | 0.3311 | YES | NO | YES |
| 02177579 | FLUOXETINE HCL | PMS-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | PMS | 1.1773 | N/A | YES | NO | YES |
| 02464659 | FLUOXETINE HCL | PMS-Fluoxetine 60mg Cap | PMS | 0.9933 | 0.9933 | NO | NO | YES |
| 02464640 | FLUOXETINE HCL | PMS-Fluoxetine 40mg Cap | PMS | 0.6622 | 0.6622 | NO | NO | YES |
| 00636622 | FLUOXETINE HCL | Prozac 20mg Cap | LIL | 2.4865 | 0.3311 | YES | NO | YES |
| 02018985 | FLUOXETINE HCL | Prozac (Off-Formulary Interchangeable) 10mg Cap | LIL | N/A | N/A | YES | NO | YES |
| 02405709 | FLUOXETINE HCL | Ran-Fluoxetine 20mg Cap | RAN | 0.3311 | 0.3311 | YES | NO | YES |
| 02479486 | FLUOXETINE HCL | Sandoz Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | SDZ | 1.1773 | N/A | YES | NO | YES |
| 02479494 | FLUOXETINE HCL | Sandoz Fluoxetine 20mg Cap | SDZ | 0.3311 | 0.3311 | YES | NO | YES |
| 02216590 | FLUOXETINE HCL | Teva-Fluoxetine 20mg Cap | TEV | 0.3311 | 0.3311 | YES | NO | YES |
| 02216582 | FLUOXETINE HCL | Teva-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap | TEV | 1.1773 | N/A | YES | NO | YES |
| 02231328 | FLUOXETINE HCL | Apo-Fluoxetine 20mg/5mL Oral Sol | APX | 0.2158 | 0.2158 | YES | NO | YES |
| 02546752 | FLUOXETINE HCL | Jamp Fluoxetine Solution 20mg/5mL Oral Sol | JPC | 0.2158 | 0.2158 | YES | NO | YES |
| 02459361 | FLUOXETINE HCL | Odan-Fluoxetine 20mg/5mL Oral Sol | ODN | 0.2158 | 0.2158 | YES | NO | YES |
| 01917021 | FLUOXETINE HCL | Prozac (Not a Benefit) 20mg/5mL Oral Sol | LIL | N/A | N/A | YES | NO | YES |
| 02156032 | FLUPENTIXOL DECANOATE | Fluanxol Depot 20mg/mL Inj Sol-1mL Amp Pk | VLH | 10.2708 | 10.2708 | NO | NO | NO |
| 02156040 | FLUPENTIXOL DECANOATE | Fluanxol Depot 100mg/mL Inj Sol-1mL Amp Pk | VLH | 51.3536 | 51.3536 | NO | NO | NO |
| 02156016 | FLUPENTIXOL DIHYDROCHLORIDE | Fluanxol 3mg Tab | VLH | 0.7663 | 0.7663 | NO | NO | NO |
| 02156008 | FLUPENTIXOL DIHYDROCHLORIDE | Fluanxol 0.5mg Tab | VLH | 0.3548 | 0.3548 | NO | NO | NO |
| 00405361 | FLUPHENAZINE HCL | Fluphenazine 5mg Tab | AAP | 0.1720 | 0.1720 | YES | NO | NO |
| 00410632 | FLUPHENAZINE HCL | Fluphenazine 2mg Tab | AAP | 0.2252 | 0.2252 | YES | NO | NO |
| 00405345 | FLUPHENAZINE HCL | Fluphenazine 1mg Tab | AAP | 0.1739 | 0.1739 | YES | NO | NO |
| 00029408 | FLUPHENAZINE HCL | Moditen HCL (Not a Benefit) 5mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00029386 | FLUPHENAZINE HCL | Moditen HCL (Not a Benefit) 2mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00029378 | FLUPHENAZINE HCL | Moditen HCL (Not a Benefit) 1mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00012718 | FLURAZEPAM | Dalmane (Not a Benefit) 30mg Cap | VAL | N/A | N/A | YES | NO | NO |
| 00012696 | FLURAZEPAM | Dalmane (Not a Benefit) 15mg Cap | VAL | N/A | N/A | YES | NO | NO |
| 00521698 | FLURAZEPAM | Flurazepam 15mg Cap | AAP | 0.1166 | 0.1166 | YES | NO | NO |
| 00521701 | FLURAZEPAM | Flurazepam 30mg Cap | AAP | 0.1364 | 0.1364 | YES | NO | NO |
| 00600792 | FLURBIPROFEN | Ansaid (Not a Benefit) 100mg Tab | PFI | N/A | N/A | YES | NO | YES |
| 00647942 | FLURBIPROFEN | Ansaid (Not a Benefit) 50mg Tab | PFI | N/A | N/A | YES | NO | YES |
| 01912038 | FLURBIPROFEN | Flurbiprofen 100mg Tab | AAP | 0.5930 | 0.5930 | YES | NO | YES |
| 01912046 | FLURBIPROFEN | Flurbiprofen 50mg Tab | AAP | 0.4530 | 0.4530 | YES | NO | YES |
| 00637726 | FLUTAMIDE | Euflex (Not a Benefit) 250mg Tab | SCH | N/A | N/A | YES | NO | NO |
| 02238560 | FLUTAMIDE | Flutamide 250mg Tab | AAP | 1.8255 | 1.8255 | YES | NO | NO |
| 02446588 | FLUTICASONE FUROATE | Arnuity Ellipta 200mcg Blister Pd Inh-30 Dose Pk | GSK | 101.5900 | 101.5900 | NO | NO | NO |
| 02446561 | FLUTICASONE FUROATE | Arnuity Ellipta 100mcg Blister Pd Inh-30 Dose Pk | GSK | 50.8100 | 50.8100 | NO | NO | NO |
| 02474522 | FLUTICASONE FUROATE & UMECLIDINIUM BROMIDE & VILANTEROL TRIFENATATE | Trelegy Ellipta 100mcg & 62.5mcg & 25mcg Pd Inh-30 Dose Pk | GSK | 137.6700 | 137.6700 | NO | YES | YES |
| 02408872 | FLUTICASONE FUROATE & VILANTEROL | Breo Ellipta 100mcg & 25mcg Blister Pd Inh-30 Dose Pk | GSK | 110.5000 | 110.5000 | NO | YES | NO |
| 02444186 | FLUTICASONE FUROATE & VILANTEROL | Breo Ellipta 200mcg & 25mcg Blister Pd Inh-30 Dose Pk | GSK | 171.8900 | 171.8900 | NO | YES | NO |
| 02528428 | FLUTICASONE PROPIONATE | Apo-Fluticasone HFA 50mcg/Metered Dose Inh-120 Dose Pk | APX | 14.2080 | 14.2080 | YES | NO | NO |
| 02510987 | FLUTICASONE PROPIONATE | Apo-Fluticasone HFA 250mcg/Metered Dose Inh-120 Dose Pk | APX | 45.0200 | 45.0200 | YES | NO | NO |
| 02526557 | FLUTICASONE PROPIONATE | Apo-Fluticasone HFA 125mcg/Metered Dose Inh-120 Dose Pk | APX | 23.4100 | 23.4100 | YES | NO | NO |
| 02244291 | FLUTICASONE PROPIONATE | Flovent HFA 50mcg/Metered Dose Inh-120 Dose Pk | GSK | 33.7500 | 14.2080 | YES | NO | NO |
| 02244293 | FLUTICASONE PROPIONATE | Flovent HFA 250mcg/Metered Dose Inh-120 Dose Pk | GSK | 116.4200 | 45.0200 | YES | NO | NO |
| 02244292 | FLUTICASONE PROPIONATE | Flovent HFA 125mcg/Metered Dose Inh-120 Dose Pk | GSK | 58.2100 | 23.4100 | YES | NO | NO |
| 02503131 | FLUTICASONE PROPIONATE | PMS-Fluticasone 250mcg/Metered Dose Inh-120 Dose Pk | PMS | 45.0200 | 45.0200 | YES | NO | NO |
| 02503123 | FLUTICASONE PROPIONATE | PMS-Fluticasone HFA 125mcg/Metered Dose Inh-120 Dose Pk | PMS | 23.4100 | 23.4100 | YES | NO | NO |
| 02503115 | FLUTICASONE PROPIONATE | PMS-Fluticasone HFA 50mcg/Metered Dose Inh-120 Dose Pk | PMS | 14.2080 | 14.2080 | YES | NO | NO |
| 02294745 | FLUTICASONE PROPIONATE | Apo-Fluticasone (Off-Formulary Interchangeable) 50mcg/Actuation Nas Sp-120 Dose Pk | APX | 21.9700 | N/A | YES | NO | YES |
| 02213672 | FLUTICASONE PROPIONATE | Flonase (Off-Formulary Interchangeable) 50mcg/Actuation Nas Sp-120 Dose Pk | GSK | N/A | N/A | YES | NO | YES |
| 02296071 | FLUTICASONE PROPIONATE | Ratio-Fluticasone (Off-Formulary Interchangeable) 50mcg/Actuation Nas Sp-120 Dose Pk | RPH | 21.9700 | N/A | YES | NO | YES |
| 02453738 | FLUTICASONE PROPIONATE | Teva-Fluticasone (Off-Formulary Interchangeable) 50mcg/Actuation Nas Sp-120 Dose Pk | TEV | 21.9700 | N/A | YES | NO | YES |
| 02467895 | FLUTICASONE PROPIONATE | Aermony Respiclick 55mcg/Actuation Pd Inh-60 Dose Pk | TEV | 16.9560 | 16.9560 | NO | NO | NO |
| 02467917 | FLUTICASONE PROPIONATE | Aermony Respiclick 232mcg/Actuation Pd Inh-60 Dose Pk | TEV | 48.1524 | 48.1524 | NO | NO | NO |
| 02467909 | FLUTICASONE PROPIONATE | Aermony Respiclick 113mcg/Actuation Pd Inh-60 Dose Pk | TEV | 30.9619 | 30.9619 | NO | NO | NO |
| 02237246 | FLUTICASONE PROPIONATE | Flovent Diskus 250mcg/Blister Pd Inh-60 Dose Pk | GSK | 58.2100 | 58.2100 | NO | NO | NO |
| 02237247 | FLUTICASONE PROPIONATE | Flovent Diskus 500mcg/Blister Pd Inh-60 Dose Pk | GSK | 90.5500 | 90.5500 | NO | NO | NO |
| 02061570 | FLUVASTATIN SODIUM | Lescol (Not a Benefit) 40mg Cap | NOV | N/A | N/A | YES | NO | NO |
| 02061562 | FLUVASTATIN SODIUM | Lescol (Not a Benefit) 20mg Cap | NOV | N/A | N/A | YES | NO | NO |
| 02299232 | FLUVASTATIN SODIUM | Teva-Fluvastatin 40mg Cap | TEV | 0.9671 | 0.9671 | YES | NO | NO |
| 02299224 | FLUVASTATIN SODIUM | Teva-Fluvastatin 20mg Cap | TEV | 0.6882 | 0.6882 | YES | NO | NO |
| 02250527 | FLUVASTATIN SODIUM | Lescol XL 80mg ER Tab | NOV | 1.6225 | 1.6225 | NO | NO | NO |
| 02231330 | FLUVOXAMINE MALEATE | Apo-Fluvoxamine 100mg Tab | APX | 0.9728 | 0.9728 | YES | NO | YES |
| 02231329 | FLUVOXAMINE MALEATE | Apo-Fluvoxamine 50mg Tab | APX | 0.5410 | 0.5410 | YES | NO | YES |
| 01919369 | FLUVOXAMINE MALEATE | Luvox 100mg Tab | BGP | 2.0214 | 0.9728 | YES | NO | YES |
| 01919342 | FLUVOXAMINE MALEATE | Luvox 50mg Tab | BGP | 1.1241 | 0.5410 | YES | NO | YES |
| 02255529 | FLUVOXAMINE MALEATE | Teva-Fluvoxamine 50mg Tab | TEV | 0.5410 | 0.5410 | YES | NO | YES |
| 02255537 | FLUVOXAMINE MALEATE | Teva-Fluvoxamine 100mg Tab | TEV | 0.9728 | 0.9728 | YES | NO | YES |
| 00426849 | FOLIC ACID | Folic Acid 5mg Tab | AAP | 0.0404 | 0.0404 | YES | NO | NO |
| 00014966 | FOLIC ACID | Folvite (Not a Benefit) 5mg Tab | LED | N/A | N/A | YES | NO | NO |
| 02245531 | FONDAPARINUX SODIUM | Arixtra 2.5mg/0.5mL Inj Sol-Pref Syr 0.5mL Pk (Preservative Free) | ASN | 12.8230 | 11.1944 | YES | YES | NO |
| 02406853 | FONDAPARINUX SODIUM | Fondaparinux Sodium Injection 2.5mg/0.5mL Inj Sol-Pref Syr 0.5mL Pk (Preservative Free) | DRR | 11.1944 | 11.1944 | YES | YES | NO |
| 02258056 | FONDAPARINUX SODIUM | Arixtra (Off-Formulary Interchangeable) 7.5mg/0.6mL Inj Sol-Pref Syr 0.6mL Pk (Preservative Free) | ASN | N/A | N/A | YES | NO | NO |
| 02406896 | FONDAPARINUX SODIUM | Fondaparinux Sodium Injection (Off-Formulary Interchangeable) 7.5mg/0.6mL Inj Sol-Pref Syr 0.6mL Pk (Preservative Free) | DRR | 18.1356 | 18.1356 | YES | NO | NO |
| 02230898 | FORMOTEROL FUMARATE | Foradil 12mcg/Cap Inh Pd-Device Pk | NOV | 55.7700 | 55.7700 | NO | YES | NO |
| 02237224 | FORMOTEROL FUMARATE DIHYDRATE | Oxeze Turbuhaler 12mcg/Metered Dose Pd Inh-60 Dose Pk | AZC | 51.0245 | 51.0245 | NO | YES | NO |
| 02237225 | FORMOTEROL FUMARATE DIHYDRATE | Oxeze Turbuhaler 6mcg/Metered Dose Pd Inh-60 Dose Pk | AZC | 38.3350 | 38.3350 | NO | YES | NO |
| 02261553 | FOSAMPRENAVIR CALCIUM | Telzir 50mg/mL Oral Susp | VIH | 0.6535 | 0.6535 | NO | NO | NO |
| 02261545 | FOSAMPRENAVIR CALCIUM | Telzir 700mg Tab | VIH | 9.4389 | 9.4389 | NO | NO | NO |
| 02473801 | FOSFOMYCIN TROMETHAMINE | Jamp-Fosfomycin Sachet-3g Pk | JPC | 14.0250 | 14.0250 | YES | NO | YES |
| 02240335 | FOSFOMYCIN TROMETHAMINE | Monurol Sachet-3g Pk | PAL | 21.6700 | 14.0250 | YES | NO | YES |
| 02266016 | FOSINOPRIL SODIUM | Apo-Fosinopril 20mg Tab | APX | 0.2619 | 0.2619 | YES | NO | NO |
| 02266008 | FOSINOPRIL SODIUM | Apo-Fosinopril 10mg Tab | APX | 0.2178 | 0.2178 | YES | NO | NO |
| 02459388 | FOSINOPRIL SODIUM | Fosinopril 10mg Tab | SAI | 0.2178 | 0.2178 | YES | NO | NO |
| 02459396 | FOSINOPRIL SODIUM | Fosinopril 20mg Tab | SAI | 0.2619 | 0.2619 | YES | NO | NO |
| 02331012 | FOSINOPRIL SODIUM | Jamp-Fosinopril 20mg Tab | JPC | 0.2619 | 0.2619 | YES | NO | NO |
| 02331004 | FOSINOPRIL SODIUM | Jamp-Fosinopril 10mg Tab | JPC | 0.2178 | 0.2178 | YES | NO | NO |
| 01907115 | FOSINOPRIL SODIUM | Monopril (Not a Benefit) 20mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 01907107 | FOSINOPRIL SODIUM | Monopril (Not a Benefit) 10mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02294524 | FOSINOPRIL SODIUM | Ran-Fosinopril 10mg Tab | RAN | 0.2178 | 0.2178 | YES | NO | NO |
| 02294532 | FOSINOPRIL SODIUM | Ran-Fosinopril 20mg Tab | RAN | 0.2619 | 0.2619 | YES | NO | NO |
| 02247802 | FOSINOPRIL SODIUM | Teva-Fosinopril 10mg Tab | TEV | 0.2178 | 0.2178 | YES | NO | NO |
| 02247803 | FOSINOPRIL SODIUM | Teva-Fosinopril 20mg Tab | TEV | 0.2619 | 0.2619 | YES | NO | NO |
| 02224895 | FRAMYCETIN SULFATE | Soframycin 0.5% Oph Oint-5g Pk | SLP | 19.6100 | 19.6100 | NO | NO | NO |
| 02224887 | FRAMYCETIN SULFATE | Soframycin 0.5% Oph Sol | SLP | 1.3663 | 1.3663 | NO | NO | NO |
| 02224623 | FRAMYCETIN SULFATE & GRAMICIDIN & DEXAMETHASONE | Sofracort 5mg & 50mcg & 0.5mg/mL Oph/Ot Sol | SAV | 2.1263 | 2.1263 | NO | NO | YES |
| 02426471 | FROVATRIPTAN SUCCINATE | Apo-Frovatriptan (Off-Formulary Interchangeable) 2.5mg Tab | APX | 12.5033 | N/A | YES | NO | NO |
| 02257084 | FROVATRIPTAN SUCCINATE | Frova (Off-Formulary Interchangeable) 2.5mg Tab | EDO | N/A | N/A | YES | NO | NO |
| 02535475 | FROVATRIPTAN SUCCINATE | Frovatriptan (Off-Formulary Interchangeable) 2.5mg Tab | SAI | 12.5033 | N/A | YES | NO | NO |
| 02497131 | FROVATRIPTAN SUCCINATE | Jamp Frovatriptan (Off-Formulary Interchangeable) 2.5mg Tab | JPC | 12.5033 | N/A | YES | NO | NO |
| 02509687 | FROVATRIPTAN SUCCINATE | Mint-Frovatriptan (Off-Formulary Interchangeable) 2.5mg Tab | MIN | 12.5033 | N/A | YES | NO | NO |
| 02415844 | FROVATRIPTAN SUCCINATE | Teva-Frovatriptan (Off-Formulary Interchangeable) 2.5mg Tab | EDO | 12.5033 | N/A | YES | NO | NO |
| 02248624 | FULVESTRANT | Faslodex 50mg/mL Inj Sol | AZC | 132.8093 | 40.8027 | YES | NO | NO |
| 02530635 | FULVESTRANT | Fulvestrant Injectable 50mg/mL Inj Sol | JPC | 40.8027 | 40.8027 | YES | NO | NO |
| 02483610 | FULVESTRANT | Fulvestrant Injection 50mg/mL Inj Sol | SDZ | 40.8027 | 40.8027 | YES | NO | NO |
| 02536293 | FULVESTRANT | Fulvestrant Injection 50mg/mL Inj Sol | FOM | 40.8027 | 40.8027 | YES | NO | NO |
| 02558971 | FULVESTRANT | Fulvestrant Injection 50mg/mL Inj Sol | STE | 40.8027 | 40.8027 | YES | NO | NO |
| 02460130 | FULVESTRANT | Teva-Fulvestrant Injection 50mg/mL Inj Sol | TEV | 40.8027 | 40.8027 | YES | NO | NO |
| 02527502 | FUROSEMIDE | Furosemide Injection USP 10mg/mL Inj Sol (Preservative Free) | JPC | 0.6055 | 0.6055 | YES | YES | NO |
| 00527033 | FUROSEMIDE | Furosemide Injection USP 10mg/mL Inj Sol (Preservative Free) | SDZ | 0.6055 | 0.6055 | YES | YES | NO |
| 02224720 | FUROSEMIDE | Lasix 10mg/mL O/L | SAV | 0.3465 | 0.3465 | NO | NO | NO |
| 00396788 | FUROSEMIDE | Apo-Furosemide 20mg Tab | APX | 0.0219 | 0.0218 | YES | NO | NO |
| 00362166 | FUROSEMIDE | Apo-Furosemide 40mg Tab | APX | 0.0327 | 0.0327 | YES | NO | NO |
| 02351439 | FUROSEMIDE | Furosemide 40mg Tab | SAI | 0.0327 | 0.0327 | YES | NO | NO |
| 02351420 | FUROSEMIDE | Furosemide 20mg Tab | SAI | 0.0218 | 0.0218 | YES | NO | NO |
| 02224704 | FUROSEMIDE | Lasix (Not a Benefit) 40mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02224690 | FUROSEMIDE | Lasix (Not a Benefit) 20mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02224755 | FUROSEMIDE | Lasix Special 500mg Tab | SAV | 3.5700 | 3.5700 | NO | YES | NO |
| 02466759 | FUROSEMIDE | Mint-Furosemide 20mg Tab | MIN | 0.0219 | 0.0218 | YES | NO | NO |
| 02466767 | FUROSEMIDE | Mint-Furosemide 40mg Tab | MIN | 0.0327 | 0.0327 | YES | NO | NO |
| 00337730 | FUROSEMIDE | Teva-Furosemide 20mg Tab | TEV | 0.0219 | 0.0218 | YES | NO | NO |
| 00337749 | FUROSEMIDE | Teva-Furosemide 40mg Tab | TEV | 0.0327 | 0.0327 | YES | NO | NO |
| 00586668 | FUSIDIC ACID | Fucidin 2% Cr | LEO | 1.1202 | 0.5676 | YES | NO | NO |
| 02528096 | FUSIDIC ACID | Taro-Fusidic Acid 2% Cr | TAR | 0.5676 | 0.5676 | YES | NO | NO |
| 02477939 | GABAPENTIN | AG-Gabapentin 400mg Cap | ANG | 0.1206 | 0.1206 | YES | NO | NO |
| 02477920 | GABAPENTIN | AG-Gabapentin 300mg Cap | ANG | 0.1012 | 0.1012 | YES | NO | NO |
| 02477912 | GABAPENTIN | AG-Gabapentin 100mg Cap | ANG | 0.0416 | 0.0416 | YES | NO | NO |
| 02244304 | GABAPENTIN | Apo-Gabapentin 100mg Cap | APX | 0.0416 | 0.0416 | YES | NO | NO |
| 02244305 | GABAPENTIN | Apo-Gabapentin 300mg Cap | APX | 0.1012 | 0.1012 | YES | NO | NO |
| 02244306 | GABAPENTIN | Apo-Gabapentin 400mg Cap | APX | 0.1206 | 0.1206 | YES | NO | NO |
| 02321238 | GABAPENTIN | Auro-Gabapentin 400mg Cap | AUR | 0.1206 | 0.1206 | YES | NO | NO |
| 02321211 | GABAPENTIN | Auro-Gabapentin 300mg Cap | AUR | 0.1012 | 0.1012 | YES | NO | NO |
| 02321203 | GABAPENTIN | Auro-Gabapentin 100mg Cap | AUR | 0.0416 | 0.0416 | YES | NO | NO |
| 02256150 | GABAPENTIN | Co Gabapentin 300mg Cap | COB | 0.1012 | 0.1012 | YES | NO | NO |
| 02256142 | GABAPENTIN | Co Gabapentin 100mg Cap | COB | 0.0416 | 0.0416 | YES | NO | NO |
| 02256169 | GABAPENTIN | Co Gabapentin 400mg Cap | COB | 0.1206 | 0.1206 | YES | NO | NO |
| 02246315 | GABAPENTIN | Gabapentin 300mg Cap | SIV | 0.1012 | 0.1012 | YES | NO | NO |
| 02246314 | GABAPENTIN | Gabapentin 100mg Cap | SIV | 0.0416 | 0.0416 | YES | NO | NO |
| 02353253 | GABAPENTIN | Gabapentin 300mg Cap | SAI | 0.1012 | 0.1012 | YES | NO | NO |
| 02353261 | GABAPENTIN | Gabapentin 400mg Cap | SAI | 0.1206 | 0.1206 | YES | NO | NO |
| 02353245 | GABAPENTIN | Gabapentin 100mg Cap | SAI | 0.0416 | 0.0416 | YES | NO | NO |
| 02246316 | GABAPENTIN | Gabapentin 400mg Cap | SIV | 0.1206 | 0.1206 | YES | NO | NO |
| 02416859 | GABAPENTIN | Gabapentin Capsules USP 300mg Cap | ACH | 0.1012 | 0.1012 | YES | NO | NO |
| 02416867 | GABAPENTIN | Gabapentin Capsules USP 400mg Cap | ACH | 0.1206 | 0.1206 | YES | NO | NO |
| 02416840 | GABAPENTIN | Gabapentin Capsules USP 100mg Cap | ACH | 0.0416 | 0.0416 | YES | NO | NO |
| 02535254 | GABAPENTIN | Jamp Gabapentin Capsules 300mg Cap | JPC | 0.1012 | 0.1012 | YES | NO | NO |
| 02535246 | GABAPENTIN | Jamp Gabapentin Capsules 100mg Cap | JPC | 0.0416 | 0.0416 | YES | NO | NO |
| 02535262 | GABAPENTIN | Jamp Gabapentin Capsules 400mg Cap | JPC | 0.1206 | 0.1206 | YES | NO | NO |
| 02361469 | GABAPENTIN | Jamp-Gabapentin 100mg Cap | JPC | 0.0416 | 0.0416 | YES | NO | NO |
| 02361493 | GABAPENTIN | Jamp-Gabapentin 400mg Cap | JPC | 0.1206 | 0.1206 | YES | NO | NO |
| 02361485 | GABAPENTIN | Jamp-Gabapentin 300mg Cap | JPC | 0.1012 | 0.1012 | YES | NO | NO |
| 02391481 | GABAPENTIN | Mar-Gabapentin 300mg Cap | MAR | 0.1012 | 0.1012 | YES | NO | NO |
| 02391503 | GABAPENTIN | Mar-Gabapentin 400mg Cap | MAR | 0.1206 | 0.1206 | YES | NO | NO |
| 02391473 | GABAPENTIN | Mar-Gabapentin 100mg Cap | MAR | 0.0416 | 0.0416 | YES | NO | NO |
| 02408902 | GABAPENTIN | Mint-Gabapentin 400mg Cap | MIN | 0.1206 | 0.1206 | YES | NO | NO |
| 02408899 | GABAPENTIN | Mint-Gabapentin 300mg Cap | MIN | 0.1012 | 0.1012 | YES | NO | NO |
| 02408880 | GABAPENTIN | Mint-Gabapentin 100mg Cap | MIN | 0.0416 | 0.0416 | YES | NO | NO |
| 02550024 | GABAPENTIN | NRA-Gabapentin 300mg Cap | NRA | 0.1012 | 0.1012 | YES | NO | NO |
| 02550016 | GABAPENTIN | NRA-Gabapentin 100mg Cap | NRA | 0.0416 | 0.0416 | YES | NO | NO |
| 02550032 | GABAPENTIN | NRA-Gabapentin 400mg Cap | NRA | 0.1206 | 0.1206 | YES | NO | NO |
| 02084260 | GABAPENTIN | Neurontin 100mg Cap | UJC | 0.5494 | 0.0416 | YES | NO | NO |
| 02084279 | GABAPENTIN | Neurontin 300mg Cap | UJC | 1.3141 | 0.1012 | YES | NO | NO |
| 02084287 | GABAPENTIN | Neurontin 400mg Cap | UJC | 1.5660 | 0.1206 | YES | NO | NO |
| 02243446 | GABAPENTIN | PMS-Gabapentin 100mg Cap | PMS | 0.0416 | 0.0416 | YES | NO | NO |
| 02243448 | GABAPENTIN | PMS-Gabapentin 400mg Cap | PMS | 0.1206 | 0.1206 | YES | NO | NO |
| 02243447 | GABAPENTIN | PMS-Gabapentin 300mg Cap | PMS | 0.1012 | 0.1012 | YES | NO | NO |
| 02319071 | GABAPENTIN | Ran-Gabapentin 400mg Cap | RAN | 0.1206 | 0.1206 | YES | NO | NO |
| 02319055 | GABAPENTIN | Ran-Gabapentin 100mg Cap | RAN | 0.0416 | 0.0416 | YES | NO | NO |
| 02319063 | GABAPENTIN | Ran-Gabapentin 300mg Cap | RAN | 0.1012 | 0.1012 | YES | NO | NO |
| 02260905 | GABAPENTIN | Ratio-Gabapentin 400mg Cap | RPH | 0.1206 | 0.1206 | YES | NO | NO |
| 02244515 | GABAPENTIN | Teva-Gabapentin 400mg Cap | TEV | 0.1206 | 0.1206 | YES | NO | NO |
| 02244513 | GABAPENTIN | Teva-Gabapentin 100mg Cap | TEV | 0.0416 | 0.0416 | YES | NO | NO |
| 02244514 | GABAPENTIN | Teva-Gabapentin 300mg Cap | TEV | 0.1012 | 0.1012 | YES | NO | NO |
| 02293358 | GABAPENTIN | Apo-Gabapentin (Off-Formulary Interchangeable) 600mg Tab | APX | 1.3045 | N/A | YES | NO | NO |
| 02293366 | GABAPENTIN | Apo-Gabapentin (Off-Formulary Interchangeable) 800mg Tab | APX | 1.7393 | N/A | YES | NO | NO |
| 02428334 | GABAPENTIN | Auro-Gabapentin Tablets (Off-Formulary Interchangeable) 600mg Tab | AUR | 1.3045 | N/A | YES | NO | NO |
| 02428342 | GABAPENTIN | Auro-Gabapentin Tablets (Off-Formulary Interchangeable) 800mg Tab | AUR | 1.7393 | N/A | YES | NO | NO |
| 02410990 | GABAPENTIN | GLN-Gabapentin (Off-Formulary Interchangeable) 600mg Tab | GLP | 1.3045 | N/A | YES | NO | NO |
| 02411008 | GABAPENTIN | GLN-Gabapentin (Off-Formulary Interchangeable) 800mg Tab | GLP | 1.7393 | N/A | YES | NO | NO |
| 02431289 | GABAPENTIN | Gabapentin (Off-Formulary Interchangeable) 600mg Tab | SAI | 1.3045 | N/A | YES | NO | NO |
| 02432072 | GABAPENTIN | Gabapentin (Off-Formulary Interchangeable) 600mg Tab | JPC | 1.3045 | N/A | YES | NO | NO |
| 02388219 | GABAPENTIN | Gabapentin (Off-Formulary Interchangeable) 800mg Tab | SIV | 1.7393 | N/A | YES | NO | NO |
| 02431297 | GABAPENTIN | Gabapentin (Off-Formulary Interchangeable) 800mg Tab | SAI | 1.7393 | N/A | YES | NO | NO |
| 02432080 | GABAPENTIN | Gabapentin (Off-Formulary Interchangeable) 800mg Tab | JPC | 1.7393 | N/A | YES | NO | NO |
| 02388200 | GABAPENTIN | Gabapentin (Off-Formulary Interchangeable) 600mg Tab | SIV | 1.3045 | N/A | YES | NO | NO |
| 02392534 | GABAPENTIN | Gabapentin Tablets USP (Off-Formulary Interchangeable) 800mg Tab | ACH | 1.7393 | N/A | YES | NO | NO |
| 02392526 | GABAPENTIN | Gabapentin Tablets USP (Off-Formulary Interchangeable) 600mg Tab | ACH | 1.3045 | N/A | YES | NO | NO |
| 02402297 | GABAPENTIN | Jamp-Gabapentin Tablets (Off-Formulary Interchangeable) 800mg Tab | JPC | 1.7393 | N/A | YES | NO | NO |
| 02402289 | GABAPENTIN | Jamp-Gabapentin Tablets (Off-Formulary Interchangeable) 600mg Tab | JPC | 1.3045 | N/A | YES | NO | NO |
| 02239718 | GABAPENTIN | Neurontin (Off-Formulary Interchangeable) 800mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02239717 | GABAPENTIN | Neurontin (Off-Formulary Interchangeable) 600mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02247346 | GABAPENTIN | Teva-Gabapentin (Off-Formulary Interchangeable) 800mg Tab | TEV | 1.7393 | N/A | YES | NO | NO |
| 02248457 | GABAPENTIN | Teva-Gabapentin (Off-Formulary Interchangeable) 600mg Tab | TEV | 1.3045 | N/A | YES | NO | NO |
| 02425173 | GALANTAMINE HYDROBROMIDE | Auro-Galantamine ER 24mg ER Cap | AUR | 1.2465 | 1.2465 | YES | YES | NO |
| 02425157 | GALANTAMINE HYDROBROMIDE | Auro-Galantamine ER 8mg ER Cap | AUR | 1.2465 | 1.2465 | YES | YES | NO |
| 02425165 | GALANTAMINE HYDROBROMIDE | Auro-Galantamine ER 16mg ER Cap | AUR | 1.2465 | 1.2465 | YES | YES | NO |
| 02443031 | GALANTAMINE HYDROBROMIDE | Galantamine ER 24mg ER Cap | SAI | 1.2465 | 1.2465 | YES | YES | NO |
| 02443023 | GALANTAMINE HYDROBROMIDE | Galantamine ER 16mg ER Cap | SAI | 1.2465 | 1.2465 | YES | YES | NO |
| 02443015 | GALANTAMINE HYDROBROMIDE | Galantamine ER 8mg ER Cap | SAI | 1.2465 | 1.2465 | YES | YES | NO |
| 02339439 | GALANTAMINE HYDROBROMIDE | Mylan-Galantamine ER 8mg ER Cap | MYL | 1.2465 | 1.2465 | YES | YES | NO |
| 02339447 | GALANTAMINE HYDROBROMIDE | Mylan-Galantamine ER 16mg ER Cap | MYL | 1.2465 | 1.2465 | YES | YES | NO |
| 02339455 | GALANTAMINE HYDROBROMIDE | Mylan-Galantamine ER 24mg ER Cap | MYL | 1.2465 | 1.2465 | YES | YES | NO |
| 02316943 | GALANTAMINE HYDROBROMIDE | Pat-Galantamine ER 8mg ER Cap | PAR | 1.2465 | 1.2465 | YES | YES | NO |
| 02316978 | GALANTAMINE HYDROBROMIDE | Pat-Galantamine ER 24mg ER Cap | PAR | 1.2465 | 1.2465 | YES | YES | NO |
| 02316951 | GALANTAMINE HYDROBROMIDE | Pat-Galantamine ER 16mg ER Cap | PAR | 1.2465 | 1.2465 | YES | YES | NO |
| 02266733 | GALANTAMINE HYDROBROMIDE | Reminyl ER (Not a Benefit) 24mg ER Cap | JAN | N/A | N/A | YES | NO | NO |
| 02266717 | GALANTAMINE HYDROBROMIDE | Reminyl ER (Not a Benefit) 8mg ER Cap | JAN | N/A | N/A | YES | NO | NO |
| 02266725 | GALANTAMINE HYDROBROMIDE | Reminyl ER (Not a Benefit) 16mg ER Cap | JAN | N/A | N/A | YES | NO | NO |
| 02162695 | GANCICLOVIR SODIUM | Cytovene 500mg/Vial Pd Inj-10mL Pk | CHE | 51.2041 | 51.2041 | NO | NO | NO |
| 02327260 | GATIFLOXACIN | Apo-Gatifloxacin (with preservative) (Off-Formulary Interchangeable) 0.3% w/v Oph Sol | APX | 2.0320 | N/A | YES | NO | NO |
| 02533235 | GATIFLOXACIN | Jamp Gatifloxacin (Off-Formulary Interchangeable) 0.3% w/v Oph Sol | JPC | 2.0320 | N/A | YES | NO | NO |
| 02257270 | GATIFLOXACIN | Zymar (with preservative) (Off-Formulary Interchangeable) 0.3% w/v Oph Sol | ALL | N/A | N/A | YES | NO | NO |
| 09857297 | GDH-FAD ENZYME | Freestyle Lite Strip | ABB | N/A | 0.7290 | NO | NO | NO |
| 09857392 | GDH-FAD GLUCOSE DEHYDROGENASE | One Touch Verio Strip | LIF | N/A | 0.7290 | NO | NO | NO |
| 02468050 | GEFITINIB | Apo-Gefitinib (Off-Formulary Interchangeable) 250mg Tab | APX | 62.3050 | 62.3050 | YES | NO | NO |
| 02248676 | GEFITINIB | Iressa (Off-Formulary Interchangeable) 250mg Tab | AZC | 74.1063 | 62.3050 | YES | NO | NO |
| 02500663 | GEFITINIB | Jamp-Gefitinib (Off-Formulary Interchangeable) 250mg Tab | JPC | 62.3050 | 62.3050 | YES | NO | NO |
| 02491796 | GEFITINIB | Nat-Gefitinib (Off-Formulary Interchangeable) 250mg Tab | NAT | 62.3050 | 62.3050 | YES | NO | NO |
| 02487748 | GEFITINIB | Sandoz Gefitinib (Off-Formulary Interchangeable) 250mg Tab | SDZ | 62.3050 | 62.3050 | YES | NO | NO |
| 01979574 | GEMFIBROZIL | Apo-Gemfibrozil 300mg Cap | APX | 0.1340 | 0.1340 | YES | NO | NO |
| 00599026 | GEMFIBROZIL | Lopid (Not a Benefit) 300mg Cap | PFI | N/A | N/A | YES | NO | NO |
| 02241704 | GEMFIBROZIL | Teva-Gemfibrozil 300mg Cap | TEV | 0.1340 | 0.1340 | YES | NO | NO |
| 01979582 | GEMFIBROZIL | Apo-Gemfibrozil (Off-Formulary Interchangeable) 600mg Tab | APX | 0.7520 | N/A | YES | NO | NO |
| 00659606 | GEMFIBROZIL | Lopid (Off-Formulary Interchangeable) 600mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02142074 | GEMFIBROZIL | Teva-Gemfibrozil (Off-Formulary Interchangeable) 600mg Tab | TEV | 1.3982 | N/A | YES | NO | NO |
| 00682217 | GENTAMICIN & BETAMETHASONE SODIUM PHOSPHATE | Garasone 3mg & 1mg/mL Oph/Ot Drops | SCH | 1.2813 | 1.2813 | NO | NO | YES |
| 00028339 | GENTAMICIN SULFATE | Garamycin 0.3% Oph Oint-3.5g Pk | SCH | 4.0000 | 4.0000 | NO | NO | NO |
| 02245619 | GLATIRAMER ACETATE | Copaxone 20mg/mL Inj Sol Pref Syr-1mL Pk | TEI | 50.6522 | 27.8587 | YES | YES | NO |
| 02541440 | GLATIRAMER ACETATE | Glatiramer Acetate Injection 20mg/mL Inj Sol Pref Syr-1mL Pk | MYL | 27.8587 | 27.8587 | YES | YES | NO |
| 02460661 | GLATIRAMER ACETATE | Glatect 20mg/mL Inj Sol-Pref Syr 1mL Pk | PMS | 35.0000 | 35.0000 | NO | YES | NO |
| 02467550 | GLECAPREVIR & PIBRENTASVIR | Maviret 100mg & 40mg Tab | ABV | 238.0952 | 238.0952 | NO | YES | NO |
| 02407124 | GLICLAZIDE | Apo-Gliclazide MR 60mg ER Tab | APX | 0.0632 | 0.0632 | YES | NO | NO |
| 02356422 | GLICLAZIDE | Diamicron MR 60mg ER Tab | SEV | 0.2932 | 0.0632 | YES | NO | NO |
| 02524864 | GLICLAZIDE | Gliclazide MR 60mg ER Tab | SAI | 0.0632 | 0.0632 | YES | NO | NO |
| 02429772 | GLICLAZIDE | Jamp Gliclazide-MR 60mg ER Tab | JPC | 0.0632 | 0.0632 | YES | NO | NO |
| 02423294 | GLICLAZIDE | Mint-Gliclazide MR 60mg ER Tab | MIN | 0.0632 | 0.0632 | YES | NO | NO |
| 02461331 | GLICLAZIDE | Sandoz Gliclazide MR 60mg ER Tab | SDZ | 0.0632 | 0.0632 | YES | NO | NO |
| 02439328 | GLICLAZIDE | Taro-Gliclazide MR 60mg ER Tab | SPC | 0.0632 | 0.0632 | YES | NO | NO |
| 02297795 | GLICLAZIDE | Apo-Gliclazide MR 30mg SR Tab | APX | 0.0931 | 0.0931 | YES | NO | NO |
| 02242987 | GLICLAZIDE | Diamicron MR 30mg SR Tab | SEV | 0.1628 | 0.0931 | YES | NO | NO |
| 02524856 | GLICLAZIDE | Gliclazide MR 30mg SR Tab | SAI | 0.0931 | 0.0931 | YES | NO | NO |
| 02429764 | GLICLAZIDE | Jamp Gliclazide MR 30mg SR Tab | JPC | 0.0931 | 0.0931 | YES | NO | NO |
| 02423286 | GLICLAZIDE | Mint-Gliclazide MR 30mg SR Tab | MIN | 0.0931 | 0.0931 | YES | NO | NO |
| 02438658 | GLICLAZIDE | Mylan-Gliclazide MR 30mg SR Tab | MYL | 0.0931 | 0.0931 | YES | NO | NO |
| 02461323 | GLICLAZIDE | Sandoz Gliclazide MR 30mg SR Tab | SDZ | 0.0931 | 0.0931 | YES | NO | NO |
| 02463571 | GLICLAZIDE | Taro-Gliclazide MR 30mg SR Tab | SPC | 0.0931 | 0.0931 | YES | NO | NO |
| 02245247 | GLICLAZIDE | Apo-Gliclazide 80mg Tab | APX | 0.0931 | 0.0931 | YES | NO | NO |
| 00765996 | GLICLAZIDE | Diamicron (Not a Benefit) 80mg Tab | SEV | N/A | N/A | YES | NO | NO |
| 02287072 | GLICLAZIDE | Gliclazide 80mg Tab | SAI | 0.0931 | 0.0931 | YES | NO | NO |
| 02238103 | GLICLAZIDE | Teva-Gliclazide 80mg Tab | TEV | 0.0931 | 0.0931 | YES | NO | NO |
| 02245273 | GLIMEPIRIDE | Amaryl (Off-Formulary Interchangeable) 2mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02245274 | GLIMEPIRIDE | Amaryl (Off-Formulary Interchangeable) 4mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02245272 | GLIMEPIRIDE | Amaryl (Off-Formulary Interchangeable) 1mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02269619 | GLIMEPIRIDE | Sandoz Glimepiride (Off-Formulary Interchangeable) 4mg Tab | SDZ | 1.0487 | N/A | YES | NO | NO |
| 02269589 | GLIMEPIRIDE | Sandoz Glimepiride (Off-Formulary Interchangeable) 1mg Tab | SDZ | 0.8187 | N/A | YES | NO | NO |
| 02269597 | GLIMEPIRIDE | Sandoz Glimepiride (Off-Formulary Interchangeable) 2mg Tab | SDZ | 0.9800 | N/A | YES | NO | NO |
| 09858279 | GLUCAGON | Glucagon Injection Kit (Temporary Benefit) 1mg/Vial Inj Pd-1mL Vial Pk (Kit) | AMP | 280.0000 | 280.0000 | NO | NO | NO |
| 02492415 | GLUCAGON | Baqsimi 3mg Nas Pd Device | AMP | 160.5200 | 160.5200 | NO | YES | NO |
| 02333627 | GLUCAGON RDNA ORIGIN | GlucaGen HypoKit 1mg/Vial Inj Pd-Syr Pk | NOO | 112.6700 | 112.6700 | NO | NO | NO |
| 02333619 | GLUCAGON RDNA ORIGIN | GlucaGen 1mg/Vial Inj Pd-Vial Pk | NOO | 108.3300 | 108.3300 | NO | NO | NO |
| 09857127 | GLUCOSE DEHYDROGENASE | Contour Blood Glucose Test Strips Strip | ADC | N/A | 0.7290 | NO | NO | NO |
| 09857502 | GLUCOSE DEHYDROGENASE | FreeStyle Precision Test Strips Strip | ABD | N/A | 0.7290 | NO | NO | NO |
| 09858386 | GLUCOSE MONITORING SYSTEM | FreeStyle Libre 3 Reader Continuous Glucose Monitoring System - Reader | ABD | N/A | 60.0000 | NO | NO | YES |
| 09858385 | GLUCOSE MONITORING SYSTEM | FreeStyle Libre 3 Plus Sensor Continuous Glucose Monitoring System - Sensor | ABD | N/A | 97.5000 | NO | NO | YES |
| 09858361 | GLUCOSE MONITORING SYSTEM | Dexcom G7 Receiver Continuous Glucose Monitoring System-Receiver Kit | DEX | N/A | 60.0000 | NO | NO | YES |
| 09858362 | GLUCOSE MONITORING SYSTEM | Dexcom G7 Sensor Continuous Glucose Monitoring System-Sensor Kit | DEX | N/A | 75.0000 | NO | NO | YES |
| 09857452 | GLUCOSE OXI-REDUCTASE | Accu-Chek Mobile Strip | RCH | N/A | 0.7481 | NO | NO | NO |
| 09857547 | GLUCOSE OXIDASE | Spirit Blood Glucose Test Strip Strip | ARA | N/A | 0.6912 | NO | NO | NO |
| 09857526 | GLUCOSE OXIDASE | CareSens N Blood Glucose Test Strip Strip | ISE | N/A | 0.6912 | NO | NO | NO |
| 09857538 | GLUCOSE OXIDASE | Ideal Life Glucose Test Strip Strip | IDL | N/A | 0.6800 | NO | NO | NO |
| 09857522 | GLUCOSE OXIDASE | Suretest Blood Glucose Test Strips Strip | SKY | N/A | 0.7290 | NO | NO | NO |
| 09858179 | GLUCOSE OXIDASE A. NIGER | Tykess Blood Glucose Test Strips Strip | TAI | N/A | 1.0798 | NO | NO | NO |
| 09853626 | GLUCOSE OXIDASE REAGENT | Accu-Chek Advantage Strip | ROD | N/A | 0.7481 | NO | NO | NO |
| 09857178 | GLUCOSE OXIDASE REAGENT | Accu-Chek Aviva Strip | RCH | N/A | 0.7481 | NO | NO | NO |
| 09854282 | GLUCOSE OXIDASE REAGENT | Accu-Chek Compact Strip | RCH | N/A | 0.7481 | NO | NO | NO |
| 09853162 | GLUCOSE OXIDASE REAGENT | Accutrend Strip | ROD | N/A | 0.7679 | NO | NO | NO |
| 09854002 | GLUCOSE OXIDASE REAGENT | Advantage Comfort Strip | ROD | N/A | 0.7481 | NO | NO | NO |
| 09857132 | GLUCOSE OXIDASE REAGENT | BD Strip | BED | N/A | 0.7655 | NO | NO | NO |
| 09857293 | GLUCOSE OXIDASE REAGENT | Breeze 2 Blood Glucose Test Strip Strip | ADC | N/A | 0.7290 | NO | NO | NO |
| 09857357 | GLUCOSE OXIDASE REAGENT | EZ Health Oracle Strip | TRE | N/A | 0.7290 | NO | NO | NO |
| 09857141 | GLUCOSE OXIDASE REAGENT | Freestyle Strip | TER | N/A | 0.7290 | NO | NO | NO |
| 09857432 | GLUCOSE OXIDASE REAGENT | MediSure Blood Glucose Strip Strip | MEH | N/A | 0.6900 | NO | NO | NO |
| 09857454 | GLUCOSE OXIDASE REAGENT | MyGlucoHealth Strip | EHS | N/A | 0.6851 | NO | NO | NO |
| 09857313 | GLUCOSE OXIDASE REAGENT | Nova Max Strip | NOB | N/A | 0.7290 | NO | NO | NO |
| 09857340 | GLUCOSE OXIDASE REAGENT | On Call Plus Strip | ACO | N/A | 0.4500 | NO | NO | NO |
| 09854290 | GLUCOSE OXIDASE REAGENT | One Touch Ultra Strip | LIF | N/A | 0.7290 | NO | NO | NO |
| 09854070 | GLUCOSE OXIDASE REAGENT | Precision Xtra Strip | ABB | N/A | 0.7290 | NO | NO | NO |
| 09857283 | GLUCOSE OXIDASE REAGENT | TrueTrack Smart System Strip | HOM | N/A | 0.4000 | NO | NO | NO |
| 01913662 | GLYBURIDE | Apo-Glyburide 5mg Tab | APX | 0.0574 | 0.0573 | YES | NO | NO |
| 01913654 | GLYBURIDE | Apo-Glyburide 2.5mg Tab | APX | 0.0321 | 0.0321 | YES | NO | NO |
| 02224569 | GLYBURIDE | Diabeta (Not a Benefit) 5mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02224550 | GLYBURIDE | Diabeta (Not a Benefit) 2.5mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02350467 | GLYBURIDE | Glyburide 5mg Tab | SAI | 0.0573 | 0.0573 | YES | NO | NO |
| 02248008 | GLYBURIDE | Sandoz Glyburide 2.5mg Tab | SDZ | 0.0321 | 0.0321 | YES | NO | NO |
| 01913689 | GLYBURIDE | Teva-Glyburide 5mg Tab | TEV | 0.0574 | 0.0573 | YES | NO | NO |
| 01913670 | GLYBURIDE | Teva-Glyburide 2.5mg Tab | TEV | 0.0321 | 0.0321 | YES | NO | NO |
| 02382857 | GLYCOPYRROLATE | Glycopyrrolate Injection 0.2mg/mL Inj Sol | OMG | 2.7825 | 2.7825 | YES | YES | NO |
| 02473879 | GLYCOPYRROLATE | Glycopyrrolate Injection USP 0.2mg/mL Inj Sol | STE | 2.7825 | 2.7825 | YES | YES | NO |
| 02043610 | GLYCOPYRROLATE | Robinul (Not a Benefit) 0.2mg/mL Inj Sol | WYA | N/A | N/A | YES | NO | NO |
| 02039508 | GLYCOPYRROLATE | Sandoz Glycopyrrolate 0.2mg/mL Inj Sol | SDZ | 2.7825 | 2.7825 | YES | YES | NO |
| 02513749 | GLYCOPYRROLATE | Glycopyrrolate Injection USP 0.4mg/2mL Inj Sol (Preservative Free) | JPC | 2.7825 | 2.7825 | YES | YES | NO |
| 02473895 | GLYCOPYRROLATE | Glycopyrrolate Injection USP 0.4mg/2mL Inj Sol (Preservative Free) | STE | 2.7825 | 2.7825 | YES | YES | NO |
| 09858163 | GLYCOPYRROLATE | Robinul (Not a Benefit) 0.4mg/2mL Inj Sol (Preservative Free) | WYA | N/A | N/A | YES | NO | NO |
| 02473887 | GLYCOPYRROLATE | Glycopyrrolate Injection USP 4mg/20mL Inj Sol (With Preservative) | STE | 2.7825 | 2.7825 | YES | YES | NO |
| 02532379 | GLYCOPYRROLATE | Glycopyrrolate Injection USP 4mg/20mL Inj Sol (With Preservative) | JPC | 2.7825 | 2.7825 | YES | YES | NO |
| 09858164 | GLYCOPYRROLATE | Robinul (Not a Benefit) 4mg/20mL Inj Sol (With Preservative) | WYA | N/A | N/A | YES | NO | NO |
| 02394936 | GLYCOPYRRONIUM BROMIDE | Seebri Breezhaler 50mcg Inh Pd-Cap | NOV | 1.8302 | 1.8302 | NO | NO | YES |
| 02049325 | GOSERELIN ACETATE | Zoladex 3.6mg Depot Inj | TRS | 422.6778 | 422.6778 | NO | NO | NO |
| 02225905 | GOSERELIN ACETATE | Zoladex LA 10.8mg Depot Inj | TRS | 1204.7322 | 1204.7322 | NO | NO | NO |
| 00779768 | GRAIN & CITRUS FIBRE | Fibyrax (Not a Benefit) Tab | LED | N/A | N/A | YES | NO | NO |
| 00595829 | GRAIN & CITRUS FIBRE | Novo-Fibre Tab | NOP | 0.0706 | 0.0706 | YES | NO | NO |
| 02308894 | GRANISETRON HCL | Apo-Granisetron 1mg Tab | APX | 4.5000 | 4.5000 | YES | YES | NO |
| 02472686 | GRANISETRON HCL | Jamp Granisetron 1mg Tab | JPC | 4.5000 | 4.5000 | YES | YES | NO |
| 02185881 | GRANISETRON HCL | Kytril (Not a Benefit) 1mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02452359 | GRANISETRON HCL | Nat-Granisetron 1mg Tab | NAT | 4.5000 | 4.5000 | YES | YES | NO |
| 02381893 | GRASS POLLEN ALLERGEN EXTRACT | Oralair 300IR SL Tab | STL | 4.1895 | 4.1895 | NO | YES | NO |
| 02381885 | GRASS POLLEN ALLERGEN EXTRACT | Oralair 100IR SL Tab | STL | 1.3892 | 1.3892 | NO | YES | NO |
| 00026794 | GUAIFENESIN | Guaifenesin (Not a Benefit) 20mg/mL O/L | ROG | N/A | N/A | YES | NO | NO |
| 00990930 | GUAIFENESIN | Guaifenesin Sugar Free (Not a Benefit) 20mg/mL O/L | ROG | N/A | N/A | YES | NO | NO |
| 00026468 | GUAIFENESIN | Robitussin (Not a Benefit) 20mg/mL O/L | WHB | N/A | N/A | YES | NO | NO |
| 02523728 | GUANFACINE | Apo-Guanfacine XR 1mg ER Tab | APX | 1.5375 | 1.5375 | YES | YES | NO |
| 02523744 | GUANFACINE | Apo-Guanfacine XR 3mg ER Tab | APX | 2.2038 | 2.2038 | YES | YES | NO |
| 02523752 | GUANFACINE | Apo-Guanfacine XR 4mg ER Tab | APX | 2.5369 | 2.5369 | YES | YES | NO |
| 02523736 | GUANFACINE | Apo-Guanfacine XR 2mg ER Tab | APX | 1.8707 | 1.8707 | YES | YES | NO |
| 02409100 | GUANFACINE | Intuniv XR 1mg ER Tab | TAK | 3.0750 | 1.5375 | YES | YES | NO |
| 02409127 | GUANFACINE | Intuniv XR 3mg ER Tab | TAK | 4.4075 | 2.2038 | YES | YES | NO |
| 02409135 | GUANFACINE | Intuniv XR 4mg ER Tab | TAK | 5.0738 | 2.5369 | YES | YES | NO |
| 02409119 | GUANFACINE | Intuniv XR 2mg ER Tab | TAK | 3.7413 | 1.8707 | YES | YES | NO |
| 02523566 | GUANFACINE | Jamp Guanfacine XR 2mg ER Tab | JPC | 1.8707 | 1.8707 | YES | YES | NO |
| 02523582 | GUANFACINE | Jamp Guanfacine XR 4mg ER Tab | JPC | 2.5369 | 2.5369 | YES | YES | NO |
| 02523558 | GUANFACINE | Jamp Guanfacine XR 1mg ER Tab | JPC | 1.5375 | 1.5375 | YES | YES | NO |
| 02523574 | GUANFACINE | Jamp Guanfacine XR 3mg ER Tab | JPC | 2.2038 | 2.2038 | YES | YES | NO |
| 02487314 | GUSELKUMAB | Tremfya One-Press 100mg/mL Inj Sol-1mL Autoinj (Preservative-Free) | JAN | 3059.7400 | 3059.7400 | NO | YES | NO |
| 02469758 | GUSELKUMAB | Tremfya 100mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | JAN | 3059.7400 | 3059.7400 | NO | YES | NO |
| 02506262 | HALOBETASOL PROPIONATE | Bryhali 0.01% w/w Lot | BHC | 0.9816 | 0.9816 | NO | NO | YES |
| 02499967 | HALOBETASOL PROPIONATE & TAZAROTENE | Duobrii 0.01% & 0.045% Lot | BHC | 1.9300 | 1.9300 | NO | NO | NO |
| 00017574 | HALOPERIDOL | Haldol (Not a Benefit) 5mg/mL Inj Sol-1mL Pk | OMC | N/A | N/A | YES | NO | NO |
| 00808652 | HALOPERIDOL | Haloperidol 5mg/mL Inj Sol-1mL Pk | SDZ | 4.8300 | 4.8300 | YES | NO | NO |
| 00017655 | HALOPERIDOL | Haldol (Not a Benefit) 0.5mg Tab | OMC | N/A | N/A | YES | NO | NO |
| 00381772 | HALOPERIDOL | Haldol (Not a Benefit) 10mg Tab | OMC | N/A | N/A | YES | NO | NO |
| 00017671 | HALOPERIDOL | Haldol (Not a Benefit) 2mg Tab | OMC | N/A | N/A | YES | NO | NO |
| 00017698 | HALOPERIDOL | Haldol (Not a Benefit) 5mg Tab | OMC | N/A | N/A | YES | NO | NO |
| 00017663 | HALOPERIDOL | Haldol (Not a Benefit) 1mg Tab | OMC | N/A | N/A | YES | NO | NO |
| 00499579 | HALOPERIDOL | Haldol (Not a Benefit) 20mg Tab | OMC | N/A | N/A | YES | NO | NO |
| 00363669 | HALOPERIDOL | Teva-Haloperidol 2mg Tab | TEV | 0.3211 | 0.3211 | YES | NO | NO |
| 00363650 | HALOPERIDOL | Teva-Haloperidol 5mg Tab | TEV | 0.5121 | 0.5121 | YES | NO | NO |
| 00713449 | HALOPERIDOL | Teva-Haloperidol 10mg Tab | TEV | 0.7450 | 0.7450 | YES | NO | NO |
| 00363677 | HALOPERIDOL | Teva-Haloperidol 1mg Tab | TEV | 0.2148 | 0.2148 | YES | NO | NO |
| 00768820 | HALOPERIDOL | Teva-Haloperidol 20mg Tab | TEV | 1.3047 | 1.3047 | YES | NO | NO |
| 00363685 | HALOPERIDOL | Teva-Haloperidol 0.5mg Tab | TEV | 0.1430 | 0.1430 | YES | NO | NO |
| 00980803 | HALOPERIDOL DECANOATE | Haldol-LA (Not a Benefit) 100mg/mL Oily Inj Sol-5mL Pk | OMC | N/A | N/A | YES | NO | NO |
| 09853758 | HALOPERIDOL DECANOATE | Haloperidol LA 100mg/mL Oily Inj Sol-5mL Pk | SDZ | 84.6150 | 84.6150 | YES | NO | NO |
| 00701130 | HEXAVITAMINS USP | Apo-Hexa (Not a Benefit) Tab | APX | N/A | N/A | YES | NO | NO |
| 00269034 | HEXAVITAMINS USP | Hexavitamins (Not a Benefit) Tab | NOP | N/A | N/A | YES | NO | NO |
| 00723754 | HYDRALAZINE HCL | Apresoline 20mg/mL Inj Sol-1mL Vial Pk | STE | 11.6500 | 8.7375 | YES | NO | NO |
| 02516160 | HYDRALAZINE HCL | Hydralazine Hydrochloride Injection, USP 20mg/mL Inj Sol-1mL Vial Pk | AUR | 8.7375 | 8.7375 | YES | NO | NO |
| 00441635 | HYDRALAZINE HCL | Apo-Hydralazine 50mg Tab | APX | 0.0956 | 0.0956 | YES | NO | NO |
| 00441619 | HYDRALAZINE HCL | Apo-Hydralazine 10mg Tab | APX | 0.0355 | 0.0355 | YES | NO | NO |
| 00441627 | HYDRALAZINE HCL | Apo-Hydralazine 25mg Tab | APX | 0.0609 | 0.0609 | YES | NO | NO |
| 00005533 | HYDRALAZINE HCL | Apresoline (Not a Benefit) 25mg Tab | STE | N/A | N/A | YES | NO | NO |
| 00005525 | HYDRALAZINE HCL | Apresoline (Not a Benefit) 10mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00005541 | HYDRALAZINE HCL | Apresoline (Not a Benefit) 50mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02539829 | HYDRALAZINE HCL | Hydralazine 50mg Tab | SAI | 0.0956 | 0.0956 | YES | NO | NO |
| 02539810 | HYDRALAZINE HCL | Hydralazine 25mg Tab | SAI | 0.0609 | 0.0609 | YES | NO | NO |
| 02539802 | HYDRALAZINE HCL | Hydralazine 10mg Tab | SAI | 0.0355 | 0.0355 | YES | NO | NO |
| 02457873 | HYDRALAZINE HCL | Jamp-Hydralazine 25mg Tab | JPC | 0.0609 | 0.0609 | YES | NO | NO |
| 02457881 | HYDRALAZINE HCL | Jamp-Hydralazine 50mg Tab | JPC | 0.0956 | 0.0956 | YES | NO | NO |
| 02457865 | HYDRALAZINE HCL | Jamp-Hydralazine 10mg Tab | JPC | 0.0355 | 0.0355 | YES | NO | NO |
| 02468794 | HYDRALAZINE HCL | Mint-Hydralazine 50mg Tab | MIN | 0.0956 | 0.0956 | YES | NO | NO |
| 02468786 | HYDRALAZINE HCL | Mint-Hydralazine 25mg Tab | MIN | 0.0609 | 0.0609 | YES | NO | NO |
| 02468778 | HYDRALAZINE HCL | Mint-Hydralazine 10mg Tab | MIN | 0.0355 | 0.0355 | YES | NO | NO |
| 02327856 | HYDROCHLOROTHIAZIDE | Apo-Hydro (Off-Formulary Interchangeable) 12.5mg Tab | APX | 0.0322 | N/A | YES | NO | NO |
| 00326844 | HYDROCHLOROTHIAZIDE | Apo-Hydro 25 25mg Tab | APX | 0.0157 | 0.0157 | YES | NO | NO |
| 00312800 | HYDROCHLOROTHIAZIDE | Apo-Hydro 50 50mg Tab | APX | 0.0217 | 0.0217 | YES | NO | NO |
| 00016500 | HYDROCHLOROTHIAZIDE | HydroDIURIL (Not a Benefit) 25mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 00016519 | HYDROCHLOROTHIAZIDE | HydroDIURIL (Not a Benefit) 50mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 02425947 | HYDROCHLOROTHIAZIDE | Mint-Hydrochlorothiazide (Off-Formulary Interchangeable) 12.5mg Tab | MIN | 0.0322 | N/A | YES | NO | NO |
| 02426196 | HYDROCHLOROTHIAZIDE | Mint-Hydrochlorothiazide 25mg Tab | MIN | 0.0157 | 0.0157 | YES | NO | NO |
| 02274086 | HYDROCHLOROTHIAZIDE | PMS-Hydrochlorothiazide (Off-Formulary Interchangeable) 12.5mg Tab | PMS | N/A | N/A | YES | NO | NO |
| 02247386 | HYDROCHLOROTHIAZIDE | PMS-Hydrochlorothiazide 25mg Tab | PMS | 0.0157 | 0.0157 | YES | NO | NO |
| 02247387 | HYDROCHLOROTHIAZIDE | PMS-Hydrochlorothiazide 50mg Tab | PMS | 0.0217 | 0.0217 | YES | NO | NO |
| 00021474 | HYDROCHLOROTHIAZIDE | Teva-Hydrochlorothiazide 25mg Tab | TEV | 0.0157 | 0.0157 | YES | NO | NO |
| 00021482 | HYDROCHLOROTHIAZIDE | Teva-Hydrochlorothiazide 50mg Tab | TEV | 0.0217 | 0.0217 | YES | NO | NO |
| 00180408 | HYDROCHLOROTHIAZIDE & SPIRONOLACTONE | Aldactazide-25 (Not a Benefit) 25mg & 25mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 00594377 | HYDROCHLOROTHIAZIDE & SPIRONOLACTONE | Aldactazide-50 (Not a Benefit) 50mg & 50mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 00613231 | HYDROCHLOROTHIAZIDE & SPIRONOLACTONE | Teva-Spironolactone/HCTZ 25mg & 25mg Tab | TEV | 0.1372 | 0.1372 | YES | NO | NO |
| 00657182 | HYDROCHLOROTHIAZIDE & SPIRONOLACTONE | Teva-Spironolactone/HCTZ 50mg & 50mg Tab | TEV | 0.2903 | 0.2903 | YES | NO | NO |
| 00441775 | HYDROCHLOROTHIAZIDE & TRIAMTERENE | Apo-Triazide 25mg & 50mg Tab | APX | 0.0608 | 0.0608 | YES | NO | NO |
| 01919547 | HYDROCHLOROTHIAZIDE & TRIAMTERENE | Dyazide (Not a Benefit) 25mg & 50mg Tab | SMJ | N/A | N/A | YES | NO | NO |
| 00532657 | HYDROCHLOROTHIAZIDE & TRIAMTERENE | Teva-Triamterene/HCTZ 25mg & 50mg Tab | TEV | 0.0608 | 0.0608 | YES | NO | NO |
| 01916580 | HYDROCODONE BITARTRATE | Hycodan (Not a Benefit) 1mg/mL O/L | BQU | N/A | N/A | YES | NO | NO |
| 02324253 | HYDROCODONE BITARTRATE | PMS-Hydrocodone 1mg/mL O/L | PMS | 0.0617 | 0.0617 | YES | NO | NO |
| 00513261 | HYDROCORTISONE | Cortate (Not a Benefit) 0.5% Oint | SCH | N/A | N/A | YES | NO | NO |
| 00502197 | HYDROCORTISONE | Cortate (Not a Benefit) 1% Oint | SCH | N/A | N/A | YES | NO | NO |
| 00716685 | HYDROCORTISONE | Cortoderm 0.5% Oint | TAR | 0.1400 | 0.1400 | YES | NO | NO |
| 00716693 | HYDROCORTISONE | Cortoderm 1% Oint | TAR | 0.0390 | 0.0390 | YES | NO | NO |
| 02524473 | HYDROCORTISONE | Auro-Hydrocortisone 20mg Tab | AUR | 0.2958 | 0.2958 | YES | NO | NO |
| 02524465 | HYDROCORTISONE | Auro-Hydrocortisone 10mg Tab | AUR | 0.1639 | 0.1639 | YES | NO | NO |
| 00030929 | HYDROCORTISONE | Cortef 20mg Tab | PFI | 0.4078 | 0.2958 | YES | NO | NO |
| 09858155 | HYDROCORTISONE | Cortef (Temporary Benefit) 10mg Tab | PFI | 0.2185 | 0.2185 | NO | NO | NO |
| 00030910 | HYDROCORTISONE | Cortef 10mg Tab | PFI | 0.2259 | 0.1639 | YES | NO | NO |
| 00477699 | HYDROCORTISONE ACETATE | Corticreme (Not a Benefit) 1% Cr | ROG | N/A | N/A | YES | NO | NO |
| 00716839 | HYDROCORTISONE ACETATE | Hyderm 1% Cr | TAR | 0.2056 | 0.2056 | YES | NO | NO |
| 02242984 | HYDROCORTISONE VALERATE | Hydroval 0.2% Cr | TPH | 0.1667 | 0.1667 | YES | NO | NO |
| 01910124 | HYDROCORTISONE VALERATE | Westcort (Not a Benefit) 0.2% Cr | BQU | N/A | N/A | YES | NO | NO |
| 02242985 | HYDROCORTISONE VALERATE | Hydroval 0.2% Oint | TPH | 0.1667 | 0.1667 | YES | NO | NO |
| 01910132 | HYDROCORTISONE VALERATE | Westcort (Not a Benefit) 0.2% Oint | BQU | N/A | N/A | YES | NO | NO |
| 02125382 | HYDROMORPHONE HCL | Hydromorph Contin (Off-Formulary Interchangeable) 24mg CR Cap | PFP | 4.3022 | 4.3022 | NO | NO | YES |
| 02243562 | HYDROMORPHONE HCL | Hydromorph Contin 18mg CR Cap | PFP | 2.9661 | 2.9661 | NO | NO | YES |
| 02125331 | HYDROMORPHONE HCL | Hydromorph Contin 6mg CR Cap | PFP | 1.1823 | 1.1823 | NO | NO | YES |
| 02359502 | HYDROMORPHONE HCL | Hydromorph Contin 4.5mg CR Cap | PFP | 0.9549 | 0.9549 | NO | NO | YES |
| 02359510 | HYDROMORPHONE HCL | Hydromorph Contin 9mg CR Cap | PFP | 1.5600 | 1.5600 | NO | NO | YES |
| 02125323 | HYDROMORPHONE HCL | Hydromorph Contin 3mg CR Cap | PFP | 0.7913 | 0.7913 | NO | NO | YES |
| 02125390 | HYDROMORPHONE HCL | Hydromorph Contin (Off-Formulary Interchangeable) 30mg CR Cap | PFP | 5.1553 | 5.1553 | NO | NO | YES |
| 02125366 | HYDROMORPHONE HCL | Hydromorph Contin 12mg CR Cap | PFP | 2.0559 | 2.0559 | NO | NO | YES |
| 00627100 | HYDROMORPHONE HCL | Dilaudid (Not a Benefit) 2mg/mL Inj Sol-1mL Pk | PFP | N/A | N/A | YES | NO | YES |
| 00622133 | HYDROMORPHONE HCL | Dilaudid-HP (Not a Benefit) 10mg/mL Inj Sol-1mL Pk | PFP | N/A | N/A | YES | NO | YES |
| 02145901 | HYDROMORPHONE HCL | Hydromorphone 2mg/mL Inj Sol-1mL Pk | SDZ | 1.7830 | 1.7830 | YES | NO | YES |
| 02145928 | HYDROMORPHONE HCL | Hydromorphone HP-10 10mg/mL Inj Sol-1mL Pk | SDZ | 4.3460 | 4.3460 | YES | NO | YES |
| 00786535 | HYDROMORPHONE HCL | Dilaudid (Not a Benefit) 1mg/mL Oral Sol | PFP | N/A | N/A | YES | NO | YES |
| 01916386 | HYDROMORPHONE HCL | PMS-HYDROmorphone 1mg/mL Oral Sol | PMS | 0.0931 | 0.0931 | YES | NO | YES |
| 02364131 | HYDROMORPHONE HCL | Apo-Hydromorphone 4mg Tab | APX | 0.2240 | 0.2240 | YES | NO | YES |
| 02364158 | HYDROMORPHONE HCL | Apo-Hydromorphone 8mg Tab | APX | 0.3528 | 0.3528 | YES | NO | YES |
| 02364123 | HYDROMORPHONE HCL | Apo-Hydromorphone 2mg Tab | APX | 0.1417 | 0.1417 | YES | NO | YES |
| 02364115 | HYDROMORPHONE HCL | Apo-Hydromorphone 1mg Tab | APX | 0.0959 | 0.0959 | YES | NO | YES |
| 00705438 | HYDROMORPHONE HCL | Dilaudid 1mg Tab | PFP | 0.1039 | 0.0959 | YES | NO | YES |
| 00125121 | HYDROMORPHONE HCL | Dilaudid 4mg Tab | PFP | 0.2418 | 0.2240 | YES | NO | YES |
| 00125083 | HYDROMORPHONE HCL | Dilaudid 2mg Tab | PFP | 0.1533 | 0.1417 | YES | NO | YES |
| 00786543 | HYDROMORPHONE HCL | Dilaudid 8mg Tab | PFP | 0.3812 | 0.3528 | YES | NO | YES |
| 00885444 | HYDROMORPHONE HCL | PMS-HYDROmorphone 1mg Tab | PMS | 0.0959 | 0.0959 | YES | NO | YES |
| 00885428 | HYDROMORPHONE HCL | PMS-HYDROmorphone 8mg Tab | PMS | 0.3528 | 0.3528 | YES | NO | YES |
| 00885436 | HYDROMORPHONE HCL | PMS-HYDROmorphone 2mg Tab | PMS | 0.1417 | 0.1417 | YES | NO | YES |
| 00885401 | HYDROMORPHONE HCL | PMS-HYDROmorphone 4mg Tab | PMS | 0.2240 | 0.2240 | YES | NO | YES |
| 02319411 | HYDROMORPHONE HCL | Teva-Hydromorphone 2mg Tab | TEV | 0.1417 | 0.1417 | YES | NO | YES |
| 02319403 | HYDROMORPHONE HCL | Teva-Hydromorphone 1mg Tab | TEV | 0.0959 | 0.0959 | YES | NO | YES |
| 02319446 | HYDROMORPHONE HCL | Teva-Hydromorphone 8mg Tab | TEV | 0.3528 | 0.3528 | YES | NO | YES |
| 02319438 | HYDROMORPHONE HCL | Teva-Hydromorphone 4mg Tab | TEV | 0.2240 | 0.2240 | YES | NO | YES |
| 02246691 | HYDROXYCHLOROQUINE SULFATE | Apo-Hydroxyquine 200mg Tab | APX | 0.1576 | 0.1576 | YES | NO | NO |
| 02519348 | HYDROXYCHLOROQUINE SULFATE | Hydroxychloroquine 200mg Tab | SAI | 0.1576 | 0.1576 | YES | NO | NO |
| 02491427 | HYDROXYCHLOROQUINE SULFATE | Jamp-Hydroxychloroquine 200mg Tab | JPC | 0.1576 | 0.1576 | YES | NO | NO |
| 02424991 | HYDROXYCHLOROQUINE SULFATE | Mint-Hydroxychloroquine 200mg Tab | MIN | 0.1576 | 0.1576 | YES | NO | NO |
| 02511886 | HYDROXYCHLOROQUINE SULFATE | NRA-Hydroxychloroquine 200mg Tab | NRA | 0.1576 | 0.1576 | YES | NO | NO |
| 02017709 | HYDROXYCHLOROQUINE SULFATE | Plaquenil 200mg Tab | SAV | 0.6516 | 0.1576 | YES | NO | NO |
| 02247937 | HYDROXYUREA | Apo-Hydroxyurea 500mg Cap | APX | 1.0203 | 1.0203 | YES | NO | NO |
| 00465283 | HYDROXYUREA | Hydrea 500mg Cap | BQU | 1.1727 | 1.0203 | YES | NO | NO |
| 02242920 | HYDROXYUREA | Mylan-Hydroxyurea 500mg Cap | MYL | 1.0203 | 1.0203 | YES | NO | NO |
| 00024376 | HYDROXYZINE HCL | Atarax (Not a Benefit) 10mg Cap | PFI | N/A | N/A | YES | NO | NO |
| 00024392 | HYDROXYZINE HCL | Atarax (Not a Benefit) 50mg Cap | PFI | N/A | N/A | YES | NO | NO |
| 00024384 | HYDROXYZINE HCL | Atarax (Not a Benefit) 25mg Cap | PFI | N/A | N/A | YES | NO | NO |
| 00646016 | HYDROXYZINE HCL | Hydroxyzine (Not a Benefit) 50mg Cap | AAP | N/A | N/A | YES | NO | NO |
| 00646024 | HYDROXYZINE HCL | Hydroxyzine (Not a Benefit) 25mg Cap | AAP | N/A | N/A | YES | NO | NO |
| 00646059 | HYDROXYZINE HCL | Hydroxyzine (Not a Benefit) 10mg Cap | AAP | N/A | N/A | YES | NO | NO |
| 00738840 | HYDROXYZINE HCL | Novo-Hydroxyzin (Not a Benefit) 50mg Cap | NOP | N/A | N/A | YES | NO | NO |
| 00738824 | HYDROXYZINE HCL | Novo-Hydroxyzin (Not a Benefit) 10mg Cap | NOP | N/A | N/A | YES | NO | NO |
| 00363839 | HYOSCINE BUTYLBROMIDE | Buscopan 20mg/mL Inj Sol | SCO | 4.8880 | 4.8880 | NO | YES | NO |
| 02512335 | HYOSCINE BUTYLBROMIDE | Accel-Hyoscine 10mg Tab | ACC | 0.2711 | 0.2711 | YES | YES | NO |
| 00363812 | HYOSCINE BUTYLBROMIDE | Buscopan 10mg Tab | SCO | 0.3655 | 0.2711 | YES | YES | NO |
| 00506052 | IBUPROFEN | Apo-Ibuprofen 400mg Tab | APX | 0.0468 | 0.0468 | YES | NO | YES |
| 00441643 | IBUPROFEN | Apo-Ibuprofen 200mg Tab | APX | 0.0309 | 0.0309 | YES | NO | YES |
| 00441651 | IBUPROFEN | Apo-Ibuprofen 300mg Tab | APX | 0.1377 | 0.1377 | YES | NO | YES |
| 00585114 | IBUPROFEN | Apo-Ibuprofen 600mg Tab | APX | 0.1313 | 0.1313 | YES | NO | YES |
| 02257912 | IBUPROFEN | Ibuprofen 200mg Tab | JPC | 0.0309 | 0.0309 | YES | NO | YES |
| 02317338 | IBUPROFEN | Ibuprofen 400mg Tab | JPC | 0.0468 | 0.0468 | YES | NO | YES |
| 00484911 | IBUPROFEN | Motrin (Not a Benefit) 600mg Tab | UPJ | N/A | N/A | YES | NO | YES |
| 00327794 | IBUPROFEN | Motrin (Not a Benefit) 300mg Tab | UPJ | N/A | N/A | YES | NO | YES |
| 00252409 | IBUPROFEN | Motrin (Not a Benefit) 200mg Tab | UPJ | N/A | N/A | YES | NO | YES |
| 00364142 | IBUPROFEN | Motrin 400mg Tab | UPJ | 0.1871 | 0.0468 | YES | NO | YES |
| 00629359 | IBUPROFEN | Novo-Profen 600mg Tab | NOP | 0.1313 | 0.1313 | YES | NO | YES |
| 02425696 | ICATIBANT | Firazyr (Off-Formulary Interchangeable) 30mg/3mL Inj Sol-Pref Syr 3mL Pk | TAK | 2700.0000 | 1485.0000 | YES | NO | NO |
| 02547562 | ICATIBANT | Icatibant Injection (Off-Formulary Interchangeable) 30mg/3mL Inj Sol-Pref Syr 3mL Pk | JPC | 1485.0000 | 1485.0000 | YES | NO | NO |
| 02490986 | IMATINIB MESYLATE | Ach-Imatinib 100mg Tab | ACH | 5.2079 | 5.2079 | YES | NO | YES |
| 02490994 | IMATINIB MESYLATE | Ach-Imatinib 400mg Tab | ACH | 20.8314 | 20.8314 | YES | NO | YES |
| 02355337 | IMATINIB MESYLATE | Apo-Imatinib 100mg Tab | APX | 5.2079 | 5.2079 | YES | NO | YES |
| 02355345 | IMATINIB MESYLATE | Apo-Imatinib 400mg Tab | APX | 20.8314 | 20.8314 | YES | NO | YES |
| 02253275 | IMATINIB MESYLATE | Gleevec 100mg Tab | NOV | 29.7475 | 5.2079 | YES | NO | YES |
| 02253283 | IMATINIB MESYLATE | Gleevec 400mg Tab | NOV | 118.9900 | 20.8314 | YES | NO | YES |
| 02504618 | IMATINIB MESYLATE | Imatinib 400mg Tab | SAI | 20.8314 | 20.8314 | YES | NO | YES |
| 02521210 | IMATINIB MESYLATE | Imatinib 400mg Tab | SIV | 20.8314 | 20.8314 | YES | NO | YES |
| 02521202 | IMATINIB MESYLATE | Imatinib 100mg Tab | SIV | 5.2079 | 5.2079 | YES | NO | YES |
| 02504596 | IMATINIB MESYLATE | Imatinib 100mg Tab | SAI | 5.2079 | 5.2079 | YES | NO | YES |
| 02495066 | IMATINIB MESYLATE | Jamp Imatinib 100mg Tab | JPC | 5.2079 | 5.2079 | YES | NO | YES |
| 02495074 | IMATINIB MESYLATE | Jamp Imatinib 400mg Tab | JPC | 20.8314 | 20.8314 | YES | NO | YES |
| 02492334 | IMATINIB MESYLATE | Mint-Imatinib 100mg Tab | MIN | 5.2079 | 5.2079 | YES | NO | YES |
| 02492342 | IMATINIB MESYLATE | Mint-Imatinib 400mg Tab | MIN | 20.8314 | 20.8314 | YES | NO | YES |
| 02397293 | IMATINIB MESYLATE | Nat-Imatinib 400mg Tab | NAT | 20.8314 | 20.8314 | YES | NO | YES |
| 02397285 | IMATINIB MESYLATE | Nat-Imatinib 100mg Tab | NAT | 5.2079 | 5.2079 | YES | NO | YES |
| 02431114 | IMATINIB MESYLATE | PMS-Imatinib 100mg Tab | PMS | 5.2079 | 5.2079 | YES | NO | YES |
| 02431122 | IMATINIB MESYLATE | PMS-Imatinib 400mg Tab | PMS | 20.8314 | 20.8314 | YES | NO | YES |
| 02399806 | IMATINIB MESYLATE | Teva-Imatinib 100mg Tab | TEV | 5.2079 | 5.2079 | YES | NO | YES |
| 02399814 | IMATINIB MESYLATE | Teva-Imatinib 400mg Tab | TEV | 20.8314 | 20.8314 | YES | NO | YES |
| 00326852 | IMIPRAMINE | Apo-Imipramine Tablets 50mg Tab | APX | 0.4519 | 0.4519 | YES | NO | NO |
| 00312797 | IMIPRAMINE | Apo-Imipramine Tablets 25mg Tab | APX | 0.2316 | 0.2316 | YES | NO | NO |
| 00360201 | IMIPRAMINE | Apo-Imipramine Tablets 10mg Tab | APX | 0.1257 | 0.1257 | YES | NO | NO |
| 02546337 | IMIPRAMINE | Jamp Imipramine 10mg Tab | JPC | 0.1257 | 0.1257 | YES | NO | NO |
| 02546353 | IMIPRAMINE | Jamp Imipramine 50mg Tab | JPC | 0.4519 | 0.4519 | YES | NO | NO |
| 02546345 | IMIPRAMINE | Jamp Imipramine 25mg Tab | JPC | 0.2316 | 0.2316 | YES | NO | NO |
| 00010480 | IMIPRAMINE | Tofranil (Not a Benefit) 50mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00010472 | IMIPRAMINE | Tofranil (Not a Benefit) 25mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00010464 | IMIPRAMINE | Tofranil (Not a Benefit) 10mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 09857622 | IMIQUIMOD | Aldara P (Off-Formulary Interchangeable) 5% Top Cr | VAL | N/A | N/A | YES | NO | NO |
| 02482983 | IMIQUIMOD | Taro-Imiquimod Pump (Off-Formulary Interchangeable) 5% Top Cr | TAR | 54.2147 | N/A | YES | NO | NO |
| 02518376 | INCLISIRAN | Leqvio 284mg/1.5mL Inj Sol-1.5mL Pref Syr | NOV | 2839.2800 | 2839.2800 | NO | YES | NO |
| 02376938 | INDACATEROL | Onbrez Breezhaler 75mcg Inh Pd-Cap | NOV | 1.5500 | 1.5500 | NO | YES | NO |
| 02418282 | INDACATEROL & GLYCOPYRRONIUM | Ultibro Breezhaler 110mcg & 50mcg Inh Pd-Cap | NOV | 2.5830 | 2.5830 | NO | YES | NO |
| 02501244 | INDACATEROL ACETATE & GLYCOPYRRONIUM BROMIDE & MOMETASONE FUROATE | Enerzair Breezhaler 150mcg & 50mcg & 160mcg Inh Pd-Cap | NOV | 3.4277 | 3.4277 | NO | YES | NO |
| 02498693 | INDACATEROL ACETATE & MOMETASONE FUROATE | Atectura Breezhaler 150mcg & 320mcg Inh Pd-Cap | NOV | 1.8473 | 1.8473 | NO | YES | NO |
| 02498685 | INDACATEROL ACETATE & MOMETASONE FUROATE | Atectura Breezhaler 150mcg & 80mcg Inh Pd-Cap | NOV | 1.0731 | 1.0731 | NO | YES | NO |
| 02498707 | INDACATEROL ACETATE & MOMETASONE FUROATE | Atectura Breezhaler 150mcg & 160mcg Inh Pd-Cap | NOV | 1.3419 | 1.3419 | NO | YES | NO |
| 02223678 | INDAPAMIDE | Apo-Indapamide 2.5mg Tab | APX | 0.2364 | 0.2364 | YES | NO | NO |
| 02245246 | INDAPAMIDE | Apo-Indapamide 1.25mg Tab | APX | 0.1490 | 0.1490 | YES | NO | NO |
| 02179709 | INDAPAMIDE | Lozide (Not a Benefit) 1.25mg Tab | SEV | N/A | N/A | YES | NO | NO |
| 00564966 | INDAPAMIDE | Lozide (Not a Benefit) 2.5mg Tab | SEV | N/A | N/A | YES | NO | NO |
| 02240067 | INDAPAMIDE | Mylan-Indapamide 1.25mg Tab | MYL | 0.1490 | 0.1490 | YES | NO | NO |
| 02153483 | INDAPAMIDE | Mylan-Indapamide 2.5mg Tab | MYL | 0.2364 | 0.2364 | YES | NO | NO |
| 00016039 | INDOMETHACIN | Indocid (Not a Benefit) 25mg Cap | MSD | N/A | N/A | YES | NO | YES |
| 00016047 | INDOMETHACIN | Indocid (Not a Benefit) 50mg Cap | MSD | N/A | N/A | YES | NO | YES |
| 02461536 | INDOMETHACIN | Mint-Indomethacin 50mg Cap | MIN | 0.2469 | 0.2469 | YES | NO | YES |
| 02461811 | INDOMETHACIN | Mint-Indomethacin 25mg Cap | MIN | 0.1519 | 0.1519 | YES | NO | YES |
| 00337439 | INDOMETHACIN | Teva-Indomethacin 50mg Cap | TEV | 0.2469 | 0.2469 | YES | NO | YES |
| 00337420 | INDOMETHACIN | Teva-Indomethacin 25mg Cap | TEV | 0.1519 | 0.1519 | YES | NO | YES |
| 00594466 | INDOMETHACIN | Indocid (Not a Benefit) 50mg Sup | MSD | N/A | N/A | YES | NO | YES |
| 00016233 | INDOMETHACIN | Indocid (Not a Benefit) 100mg Sup | MSD | N/A | N/A | YES | NO | YES |
| 02231799 | INDOMETHACIN | Odan-Indomethacin 50mg Sup | ODN | 1.2500 | 1.2500 | YES | NO | YES |
| 02231800 | INDOMETHACIN | Odan-Indomethacin 100mg Sup | ODN | 1.6500 | 1.6500 | YES | NO | YES |
| 02523191 | INFLIXIMAB | Ixifi 100mg/Vial Inj Pd-Vial Pk | PFI | 493.0000 | 493.0000 | NO | YES | NO |
| 02419475 | INFLIXIMAB | Remdantry 100mg/Vial Inj Pd-Vial Pk | CEI | 493.0000 | 493.0000 | NO | YES | NO |
| 02470373 | INFLIXIMAB | Renflexis 100mg/Vial Inj Pd-Vial Pk | SAM | 493.0000 | 493.0000 | NO | YES | NO |
| 02511584 | INFLIXIMAB | Remsima SC 120mg/mL Inj Sol-1mL Pref Pen Pk (Preservative-Free) | CEH | 474.5100 | 474.5100 | NO | YES | NO |
| 02511576 | INFLIXIMAB | Remsima SC 120mg/mL Inj Sol-1mL Pref Syr Pk (Preservative-Free) | CEH | 474.5100 | 474.5100 | NO | YES | NO |
| 02496933 | INFLIXIMAB | Avsola 100mg/Vial Pd for Sol-Vial Pk | AMG | 493.0000 | 493.0000 | NO | YES | NO |
| 02024217 | INSULIN (30% NEUTRAL & 70% ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge 30/70 1000U/10mL Inj Susp-10mL Pk | NOO | 25.9100 | 25.9100 | NO | NO | NO |
| 09853812 | INSULIN (30% NEUTRAL & 70% ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge 30/70 Penfill 100U/mL Inj Susp-5x3mL Pk | NOO | 48.9900 | 48.9900 | NO | NO | NO |
| 02024225 | INSULIN (ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge NPH 1000U/10mL Inj Susp-10mL Pk | NOO | 25.7800 | 25.7800 | NO | NO | NO |
| 09853782 | INSULIN (ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge NPH Penfill 100U/mL Inj Susp-5x3mL Pk | NOO | 50.6900 | 50.6900 | NO | NO | NO |
| 00587737 | INSULIN (ISOPHANE) HUMAN BIOSYNTHETIC (RDNA ORIGIN) | Humulin NPH 1000U/10mL Inj Susp-10mL Pk | LIL | 29.9800 | 29.9800 | NO | NO | NO |
| 09853804 | INSULIN (ISOPHANE) HUMAN BIOSYNTHETIC (RDNA ORIGIN) | Humulin N 100U/mL Inj Susp-5x3mL Pk | LIL | 56.0200 | 56.0200 | NO | NO | NO |
| 00586714 | INSULIN (ZINC CRYSTALLINE) HUMAN BIOSYNTHETIC (RDNA ORIGIN) | Humulin Regular 1000U/10mL Inj Sol-10mL Pk | LIL | 29.9800 | 29.9800 | NO | NO | NO |
| 09853766 | INSULIN (ZINC CRYSTALLINE) HUMAN BIOSYNTHETIC (RDNA ORIGIN) | Humulin R 100U/mL Inj Sol-5x3mL Pk | LIL | 56.0200 | 56.0200 | NO | NO | NO |
| 02245397 | INSULIN ASPART | NovoRapid 100U/mL Inj Sol-10mL Pk | NOO | 31.9500 | 31.9500 | NO | YES | NO |
| 02529254 | INSULIN ASPART | Trurapi 100U/mL Inj Sol-10mL Vial Pk | SAC | 22.6430 | 22.6430 | NO | NO | NO |
| 02520974 | INSULIN ASPART | Kirsty 100U/mL Inj Sol-5X3mL Pref Pen Pk | BGP | 42.7125 | 42.7125 | NO | NO | NO |
| 02506564 | INSULIN ASPART | Trurapi 100U/mL Inj Sol-5x3mL Cart Pk | SAC | 45.0000 | 45.0000 | NO | NO | NO |
| 02506572 | INSULIN ASPART | Trurapi 100U/mL Inj Sol-5x3mL SoloSTAR Pref Pen Pk | SAC | 45.0000 | 45.0000 | NO | NO | NO |
| 02265435 | INSULIN ASPART 30% & INSULIN ASPART PROTAMINE 70% | NovoMix 30 Penfill 100U/mL Inj Susp-5x3mL Pk | NOO | 59.4300 | 59.4300 | NO | NO | NO |
| 02467860 | INSULIN DEGLUDEC | Tresiba 100U/mL Inj Sol-3X5mL Cart Pk | NOO | 114.1700 | 114.1700 | NO | NO | NO |
| 02467887 | INSULIN DEGLUDEC | Tresiba 200U/mL Inj Sol-Flextouch Pref Pen 3x3mL Pk | NOO | 137.0100 | 137.0100 | NO | NO | NO |
| 02467879 | INSULIN DEGLUDEC | Tresiba 100U/mL Inj Sol-Flextouch Pref Pen 5x3mL Pk | NOO | 114.1700 | 114.1700 | NO | NO | NO |
| 02271842 | INSULIN DETEMIR | Levemir Penfill 100U/mL Inj Sol-5x3mL Pk | NOO | 114.3600 | 114.3600 | NO | NO | NO |
| 02412829 | INSULIN DETEMIR | Levemir Flextouch 100U/mL Inj Sol-Pref Disp Pen 5X3mL Pk | NOO | 115.2900 | 115.2900 | NO | NO | NO |
| 02441829 | INSULIN GLARGINE | TOUJEO SoloSTAR 300U/mL Inj Sol-1.5mL Pref Pen | SAC | 26.4333 | 26.4333 | NO | NO | NO |
| 02245689 | INSULIN GLARGINE | Lantus-(Vial) 100U/mL Inj Sol-10mL Vial Pk | SAV | 61.6900 | 61.6900 | NO | YES | NO |
| 02526441 | INSULIN GLARGINE | Semglee 100U/mL Inj Sol-3mL Pref Pen | BGP | 12.7668 | 12.7668 | NO | NO | NO |
| 02493373 | INSULIN GLARGINE | Toujeo DoubleSTAR 300U/mL Inj Sol-3mL Pref Pen | SAC | 52.8666 | 52.8666 | NO | NO | NO |
| 02444844 | INSULIN GLARGINE | Basaglar 100U/mL Inj Sol-Cartridge 5x3mL Pk | LIL | 83.0400 | 83.0400 | NO | NO | NO |
| 02461528 | INSULIN GLARGINE | Basaglar 100U/mL Inj Sol-KwikPen (80U) Pref Pen 5x3mL Pk | LIL | 83.0400 | 83.0400 | NO | NO | NO |
| 02478293 | INSULIN GLARGINE & LIXISENATIDE | Soliqua 100U/mL & 33mcg/mL Inj Sol-Pref Pen 5x3mL Pk | SAC | 198.3700 | 198.3700 | NO | NO | YES |
| 02279479 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj 5x3mL Cart ClickStar Pen | SAV | 55.9500 | 55.9500 | NO | NO | YES |
| 02279460 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj Sol-10mL Vial | SAV | 28.2400 | 28.2400 | NO | NO | YES |
| 02294346 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj Sol-5x3mL SoloSTAR Pref Pen | SAV | 56.4900 | 56.4900 | NO | NO | YES |
| 02024233 | INSULIN HUMAN BIOSYNTHETIC | Novolin ge Toronto 1000U/10mL Inj Sol-10mL Pk | NOO | 25.2100 | 25.2100 | NO | NO | NO |
| 09853774 | INSULIN HUMAN BIOSYNTHETIC | Novolin ge Toronto Penfill 100U/mL Inj Sol-5x3mL Pk | NOO | 49.5200 | 49.5200 | NO | NO | NO |
| 00795879 | INSULIN HUMAN BIOSYNTHETIC 30% & ISOPHANE 70% | Humulin 30/70 1000U/10mL Inj Susp-10mL Pk | LIL | 29.9800 | 29.9800 | NO | NO | NO |
| 09853855 | INSULIN HUMAN BIOSYNTHETIC 30% & ISOPHANE 70% | Humulin 30/70 100U/mL Inj Susp-5x3mL Pk | LIL | 56.0200 | 56.0200 | NO | NO | NO |
| 02466864 | INSULIN INJECTION, HUMAN BIOSYNTHETIC | Entuzity KwikPen 500U/mL Inj Sol-Pref Pen 2x3mL Pk | LIL | 114.2200 | 114.2200 | NO | NO | NO |
| 02229704 | INSULIN LISPRO | Humalog 100U/mL Inj Sol-10mL Pk | LIL | 36.4200 | 36.4200 | NO | YES | NO |
| 02469901 | INSULIN LISPRO | Admelog 100U/mL Inj Sol-10mL Vial Pk | SAC | 22.7000 | 22.7000 | NO | NO | NO |
| 02469898 | INSULIN LISPRO | Admelog 100U/mL Inj Sol-5x3mL Cart Pk | SAC | 45.0000 | 45.0000 | NO | NO | NO |
| 02469871 | INSULIN LISPRO | Admelog 100U/mL Inj Sol-5x3mL SoloSTAR Pref Pen Pk | SAC | 45.0000 | 45.0000 | NO | NO | NO |
| 02439611 | INSULIN LISPRO | Humalog 200 units/mL KwikPen 200U/mL Inj Sol-Pref Pen 5x3mL Pk | LIL | 133.7600 | 133.7600 | NO | NO | YES |
| 02240294 | INSULIN LISPRO & INSULIN LISPRO PROTAMINE | Humalog Mix25 25% & 75% Inj Susp-5x3mL Pk | LIL | 73.2300 | 73.2300 | NO | NO | NO |
| 02403420 | INSULIN LISPRO & INSULIN LISPRO PROTAMINE | Humalog Mix25 Kwikpen 25% & 75% Inj Susp-5x3mL Pk | LIL | 72.6900 | 72.6900 | NO | NO | NO |
| 02240297 | INSULIN LISPRO & INSULIN LISPRO PROTAMINE | Humalog Mix50 50% & 50% Inj Susp-5x3mL Pk | LIL | 72.1100 | 72.1100 | NO | NO | NO |
| 02403439 | INSULIN LISPRO & INSULIN LISPRO PROTAMINE | Humalog Mix50 Kwikpen 50% & 50% Inj Susp-5x3mL Pk | LIL | 71.4700 | 71.4700 | NO | NO | NO |
| 02126222 | IPRATROPIUM BROMIDE | AA-Ipravent 250mcg/mL Inh Sol-20mL Pk | AAP | 6.3140 | 6.3140 | YES | YES | NO |
| 00731439 | IPRATROPIUM BROMIDE | Atrovent (Not a Benefit) 250mcg/mL Inh Sol-20mL Pk | BOE | N/A | N/A | YES | NO | NO |
| 02210479 | IPRATROPIUM BROMIDE | Novo-Ipramide 250mcg/mL Inh Sol-20mL Pk | NOP | 6.3140 | 6.3140 | YES | YES | NO |
| 02231136 | IPRATROPIUM BROMIDE | PMS-Ipratropium 250mcg/mL Inh Sol-20mL Pk | PMS | 6.3140 | 6.3140 | YES | YES | NO |
| 02026759 | IPRATROPIUM BROMIDE | Atrovent UDV (Not a Benefit) 125mcg/mL Inh Sol-2mL UDV Pk | BOE | N/A | N/A | YES | NO | NO |
| 01950681 | IPRATROPIUM BROMIDE | Atrovent UDV (Not a Benefit) 250mcg/mL Inh Sol-2mL UDV Pk | BOE | N/A | N/A | YES | NO | NO |
| 02231135 | IPRATROPIUM BROMIDE | PMS-Ipratropium 125mcg/mL Inh Sol-2mL UDV Pk | PMS | 1.1505 | 1.1505 | YES | YES | NO |
| 02231245 | IPRATROPIUM BROMIDE | PMS-Ipratropium 250mcg/mL Inh Sol-2mL UDV Pk | PMS | 1.3180 | 1.3180 | YES | YES | NO |
| 02097168 | IPRATROPIUM BROMIDE | Ratio-Ipratropium UDV 250mcg/mL Inh Sol-2mL UDV Pk | RPH | 1.3180 | 1.3180 | YES | YES | NO |
| 02216221 | IPRATROPIUM BROMIDE | Teva-Ipratropium Sterinebs 250mcg/mL Inh Sol-2mL UDV Pk | TEV | 1.3180 | 1.3180 | YES | YES | NO |
| 02247686 | IPRATROPIUM BROMIDE | Atrovent HFA 20mcg/Metered Dose Inh-200 Dose Pk | BOE | 20.4600 | 11.2530 | YES | NO | NO |
| 02542587 | IPRATROPIUM BROMIDE | Jamp Ipratropium HFA 20mcg/Metered Dose Inh-200 Dose Pk | JPC | 11.2530 | 11.2530 | YES | NO | NO |
| 02163713 | IPRATROPIUM BROMIDE | Atrovent (Off-Formulary Interchangeable) 0.06% Nasal Spray | BOE | N/A | N/A | YES | NO | NO |
| 02163705 | IPRATROPIUM BROMIDE | Atrovent (Not a Benefit) 0.03% Nasal Spray | BOE | N/A | N/A | YES | NO | NO |
| 02246084 | IPRATROPIUM BROMIDE | Ipravent (Off-Formulary Interchangeable) 0.06% Nasal Spray | AAP | 2.9700 | N/A | YES | NO | NO |
| 02239627 | IPRATROPIUM BROMIDE | PMS-Ipratropium 0.03% Nasal Spray | PMS | 0.9127 | 0.9127 | YES | YES | NO |
| 02231675 | IPRATROPIUM BROMIDE/SALBUTAMOL | Combivent UDV (Not a Benefit) 500mcg/2.5mg/2.5mL Inh Sol-2.5mL Amp Pk | BOE | N/A | N/A | YES | NO | NO |
| 02483394 | IPRATROPIUM BROMIDE/SALBUTAMOL | Ipratropium Bromide and Salbutamol Sulph 500mcg/2.5mg/2.5mL Inh Sol-2.5mL Amp Pk | MDI | 0.8066 | 0.8066 | YES | YES | NO |
| 02272695 | IPRATROPIUM BROMIDE/SALBUTAMOL | Teva-Combo Sterinebs 500mcg/2.5mg/2.5mL Inh Sol-2.5mL Amp Pk | TEV | 0.8066 | 0.8066 | YES | YES | NO |
| 02386968 | IRBESARTAN | Apo-Irbesartan 75mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02386984 | IRBESARTAN | Apo-Irbesartan 300mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02386976 | IRBESARTAN | Apo-Irbesartan 150mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02406098 | IRBESARTAN | Auro-Irbesartan 75mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02406128 | IRBESARTAN | Auro-Irbesartan 300mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02406101 | IRBESARTAN | Auro-Irbesartan 150mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02237924 | IRBESARTAN | Avapro 150mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
| 02237923 | IRBESARTAN | Avapro 75mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
| 02237925 | IRBESARTAN | Avapro 300mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
| 02328100 | IRBESARTAN | Co Irbesartan 300mg Tab | COB | 0.2281 | 0.2281 | YES | NO | NO |
| 02328089 | IRBESARTAN | Co Irbesartan 150mg Tab | COB | 0.2281 | 0.2281 | YES | NO | NO |
| 02372398 | IRBESARTAN | Irbesartan 300mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02385309 | IRBESARTAN | Irbesartan 300mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02372371 | IRBESARTAN | Irbesartan 150mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02385287 | IRBESARTAN | Irbesartan 75mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02385295 | IRBESARTAN | Irbesartan 150mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02372347 | IRBESARTAN | Irbesartan 75mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02545225 | IRBESARTAN | Jamp Irbesartan 75mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02545241 | IRBESARTAN | Jamp Irbesartan 300mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02545233 | IRBESARTAN | Jamp Irbesartan 150mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02418207 | IRBESARTAN | Jamp-Irbesartan 150mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02418193 | IRBESARTAN | Jamp-Irbesartan 75mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02418215 | IRBESARTAN | Jamp-Irbesartan 300mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02524821 | IRBESARTAN | M-Irbesartan 150mg Tab | MAT | 0.2281 | 0.2281 | YES | NO | NO |
| 02524848 | IRBESARTAN | M-Irbesartan 300mg Tab | MAT | 0.2281 | 0.2281 | YES | NO | NO |
| 02524813 | IRBESARTAN | M-Irbesartan 75mg Tab | MAT | 0.2281 | 0.2281 | YES | NO | NO |
| 02422980 | IRBESARTAN | Mint-Irbesartan 75mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02422999 | IRBESARTAN | Mint-Irbesartan 150mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02423006 | IRBESARTAN | Mint-Irbesartan 300mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02317087 | IRBESARTAN | PMS-Irbesartan 300mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02317079 | IRBESARTAN | PMS-Irbesartan 150mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02317060 | IRBESARTAN | PMS-Irbesartan 75mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02406829 | IRBESARTAN | Ran-Irbesartan 150mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02406810 | IRBESARTAN | Ran-Irbesartan 75mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02406837 | IRBESARTAN | Ran-Irbesartan 300mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02328461 | IRBESARTAN | Sandoz Irbesartan 75mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02328488 | IRBESARTAN | Sandoz Irbesartan 150mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02328496 | IRBESARTAN | Sandoz Irbesartan 300mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02316412 | IRBESARTAN | Teva-Irbesartan 300mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02316404 | IRBESARTAN | Teva-Irbesartan 150mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02316390 | IRBESARTAN | Teva-Irbesartan 75mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02387654 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Apo-Irbesartan/HCTZ 300mg & 12.5mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02387662 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Apo-Irbesartan/HCTZ 300mg & 25mg Tab | APX | 0.2184 | 0.2184 | YES | NO | NO |
| 02387646 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Apo-Irbesartan/HCTZ 150mg & 12.5mg Tab | APX | 0.2281 | 0.2281 | YES | NO | NO |
| 02447886 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Auro-Irbesartan HCT 300mg & 12.5mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02447878 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Auro-Irbesartan HCT 150mg & 12.5mg Tab | AUR | 0.2281 | 0.2281 | YES | NO | NO |
| 02447894 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Auro-Irbesartan HCT 300mg & 25mg Tab | AUR | 0.2184 | 0.2184 | YES | NO | NO |
| 02241818 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide 150mg & 12.5mg Tab | SAV | 1.3166 | 0.2281 | YES | NO | NO |
| 02280213 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide (Not a Benefit) 300mg & 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02241819 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide 300mg & 12.5mg Tab | SAV | 1.3166 | 0.2281 | YES | NO | NO |
| 02357410 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Co Irbesartan/HCT 300mg & 25mg Tab | COB | 0.2184 | 0.2184 | YES | NO | NO |
| 02357402 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Co Irbesartan/HCT 300mg & 12.5mg Tab | COB | 0.2281 | 0.2281 | YES | NO | NO |
| 02357399 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Co Irbesartan/HCT 150mg & 12.5mg Tab | COB | 0.2281 | 0.2281 | YES | NO | NO |
| 02385317 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Irbesartan HCT 150mg & 12.5mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02385333 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Irbesartan HCT 300mg & 25mg Tab | SIV | 0.2184 | 0.2184 | YES | NO | NO |
| 02385325 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Irbesartan HCT 300mg & 12.5mg Tab | SIV | 0.2281 | 0.2281 | YES | NO | NO |
| 02372894 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Irbesartan/HCTZ 300mg & 12.5mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02372886 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Irbesartan/HCTZ 150mg & 12.5mg Tab | SAI | 0.2281 | 0.2281 | YES | NO | NO |
| 02372908 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Irbesartan/HCTZ 300mg & 25mg Tab | SAI | 0.2184 | 0.2184 | YES | NO | NO |
| 02418223 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Jamp-Irbesartan and Hydrochlorothiazide 150mg & 12.5mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02418231 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Jamp-Irbesartan and Hydrochlorothiazide 300mg & 12.5mg Tab | JPC | 0.2281 | 0.2281 | YES | NO | NO |
| 02418258 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Jamp-Irbesartan and Hydrochlorothiazide 300mg & 25mg Tab | JPC | 0.2184 | 0.2184 | YES | NO | NO |
| 02393018 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Mint Irbesartan/HCTZ 300mg & 12.5mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02392992 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Mint Irbesartan/HCTZ 150mg & 12.5mg Tab | MIN | 0.2281 | 0.2281 | YES | NO | NO |
| 02393026 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Mint Irbesartan/HCTZ 300mg & 25mg Tab | MIN | 0.2184 | 0.2184 | YES | NO | NO |
| 02328526 | IRBESARTAN & HYDROCHLOROTHIAZIDE | PMS-Irbesartan-HCTZ 300mg & 12.5mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02328518 | IRBESARTAN & HYDROCHLOROTHIAZIDE | PMS-Irbesartan-HCTZ 150mg & 12.5mg Tab | PMS | 0.2281 | 0.2281 | YES | NO | NO |
| 02328534 | IRBESARTAN & HYDROCHLOROTHIAZIDE | PMS-Irbesartan-HCTZ 300mg & 25mg Tab | PMS | 0.2184 | 0.2184 | YES | NO | NO |
| 02363208 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Ran-Irbesartan HCTZ 150mg & 12.5mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02363224 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Ran-Irbesartan HCTZ 300mg & 25mg Tab | RAN | 0.2184 | 0.2184 | YES | NO | NO |
| 02363216 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Ran-Irbesartan HCTZ 300mg & 12.5mg Tab | RAN | 0.2281 | 0.2281 | YES | NO | NO |
| 02337444 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Sandoz Irbesartan HCT 300mg & 25mg Tab | SDZ | 0.2184 | 0.2184 | YES | NO | NO |
| 02337428 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Sandoz Irbesartan HCT 150mg & 12.5mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02337436 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Sandoz Irbesartan HCT 300mg & 12.5mg Tab | SDZ | 0.2281 | 0.2281 | YES | NO | NO |
| 02330512 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Teva-Irbesartan HCTZ 150mg & 12.5mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02330520 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Teva-Irbesartan HCTZ 300mg & 12.5mg Tab | TEV | 0.2281 | 0.2281 | YES | NO | NO |
| 02330539 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Teva-Irbesartan HCTZ 300mg & 25mg Tab | TEV | 0.2184 | 0.2184 | YES | NO | NO |
| 02502917 | IRON SUCROSE | PMS-Iron Sucrose (Off-Formulary Interchangeable) 20mg/mL Inj Sol-5mL Pk (Preservative-Free) | PMS | 27.5000 | 27.5000 | YES | NO | NO |
| 02243716 | IRON SUCROSE | Venofer (Off-Formulary Interchangeable) 20mg/mL Inj Sol-5mL Pk (Preservative-Free) | LUI | N/A | N/A | YES | NO | NO |
| 09857292 | ISOPROPYL MYRISTATE | Resultz 50% Top Sol-120mL Pk | MEF | 12.6500 | 12.6500 | NO | NO | NO |
| 02279592 | ISOPROPYL MYRISTATE | Resultz 50% Top Sol-240mL Pk | ARZ | 24.6600 | 24.6600 | NO | NO | NO |
| 00670944 | ISOSORBIDE DINITRATE | ISDN 5mg SL Tab | AAP | 0.0633 | 0.0633 | YES | NO | NO |
| 02042606 | ISOSORBIDE DINITRATE | Isordil (Not a Benefit) 5mg SL Tab | WAY | N/A | N/A | YES | NO | NO |
| 00441694 | ISOSORBIDE DINITRATE | ISDN 30mg Tab | AAP | 0.1135 | 0.1135 | YES | NO | NO |
| 00441686 | ISOSORBIDE DINITRATE | ISDN 10mg Tab | AAP | 0.0485 | 0.0485 | YES | NO | NO |
| 02042614 | ISOSORBIDE DINITRATE | Isordil (Not a Benefit) 30mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02042622 | ISOSORBIDE DINITRATE | Isordil (Not a Benefit) 10mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02272830 | ISOSORBIDE-5-MONONITRATE | Apo-ISMN (Off-Formulary Interchangeable) 60mg ER Tab | APX | 0.4950 | 0.4950 | YES | NO | NO |
| 02126559 | ISOSORBIDE-5-MONONITRATE | Imdur (Off-Formulary Interchangeable) 60mg ER Tab | AZC | N/A | N/A | YES | NO | NO |
| 02301288 | ISOSORBIDE-5-MONONITRATE | PMS-ISMN (Off-Formulary Interchangeable) 60mg ER Tab | PMS | 0.4950 | 0.4950 | YES | NO | NO |
| 00582344 | ISOTRETINOIN | Accutane 10mg Cap | HLR | 0.9547 | 0.9313 | YES | NO | YES |
| 00582352 | ISOTRETINOIN | Accutane 40mg Cap | HLR | 1.9480 | 1.9003 | YES | NO | YES |
| 02257963 | ISOTRETINOIN | Clarus 40mg Cap | MYL | 1.9003 | 1.9003 | YES | NO | YES |
| 02257955 | ISOTRETINOIN | Clarus 10mg Cap | MYL | 0.9313 | 0.9313 | YES | NO | YES |
| 02396971 | ISOTRETINOIN | Epuris 10mg Cap | CIP | 1.5134 | 1.5134 | NO | NO | YES |
| 02396998 | ISOTRETINOIN | Epuris 20mg Cap | CIP | 2.0941 | 2.0941 | NO | NO | YES |
| 02397005 | ISOTRETINOIN | Epuris 30mg Cap | CIP | 2.6337 | 2.6337 | NO | NO | YES |
| 02397013 | ISOTRETINOIN | Epuris 40mg Cap | CIP | 3.0877 | 3.0877 | NO | NO | YES |
| 02462559 | ITRACONAZOLE | Mint-Itraconazole 100mg Cap | MIN | 3.9270 | 3.9270 | YES | NO | NO |
| 02047454 | ITRACONAZOLE | Sporanox 100mg Cap | JAN | 6.6750 | 3.9270 | YES | NO | NO |
| 02484315 | ITRACONAZOLE | Jamp Itraconazole Oral Solution 10mg/mL Oral Sol | JPC | 0.4111 | 0.4111 | YES | YES | NO |
| 02495988 | ITRACONAZOLE | Odan-Itraconazole 10mg/mL Oral Sol | ODN | 0.4111 | 0.4111 | YES | YES | NO |
| 02231347 | ITRACONAZOLE | Sporanox (Not a Benefit) 10mg/mL Oral Sol | JAN | N/A | N/A | YES | NO | NO |
| 02459981 | IVABRADINE HCL | Lancora 7.5mg Tab | SEV | 1.6707 | 1.6707 | NO | YES | NO |
| 02459973 | IVABRADINE HCL | Lancora 5mg Tab | SEV | 0.9136 | 0.9136 | NO | YES | NO |
| 02455102 | IXEKIZUMAB | Taltz 80mg/mL Inj Sol-Pref Autoinj | LIL | 1937.8800 | 1937.8800 | NO | YES | NO |
| 02455110 | IXEKIZUMAB | Taltz 80mg/mL Inj Sol-Pref Syr | LIL | 1951.0900 | 1951.0900 | NO | YES | NO |
| 02245662 | KETOCONAZOLE | Ketoderm 2% Cr | TAR | 0.4043 | 0.4043 | YES | NO | YES |
| 00703974 | KETOCONAZOLE | Nizoral (Not a Benefit) 2% Cr | JAN | N/A | N/A | YES | NO | YES |
| 02237235 | KETOCONAZOLE | Apo-Ketoconazole 200mg Tab | APX | 0.9393 | 0.9393 | YES | NO | YES |
| 00633836 | KETOCONAZOLE | Nizoral (Not a Benefit) 200mg Tab | JAN | N/A | N/A | YES | NO | YES |
| 02231061 | KETOCONAZOLE | Teva-Ketoconazole 200mg Tab | TEV | 0.9393 | 0.9393 | YES | NO | YES |
| 00790427 | KETOPROFEN | Ketoprofen 50mg Cap | AAP | 0.3440 | 0.3440 | YES | NO | YES |
| 01926403 | KETOPROFEN | Orudis (Not a Benefit) 50mg Cap | RPP | N/A | N/A | YES | NO | YES |
| 00842664 | KETOPROFEN | Ketoprofen-E 100mg Ent Tab | AAP | 0.6959 | 0.6959 | YES | NO | YES |
| 00790435 | KETOPROFEN | Ketoprofen-E 50mg Ent Tab | AAP | 0.3379 | 0.3379 | YES | NO | YES |
| 01926365 | KETOPROFEN | Orudis E-100 (Not a Benefit) 100mg Ent Tab | RPP | N/A | N/A | YES | NO | YES |
| 01926381 | KETOPROFEN | Orudis E-50 (Not a Benefit) 50mg Ent Tab | RPP | N/A | N/A | YES | NO | YES |
| 00761680 | KETOPROFEN | Rhodis-EC (Not a Benefit) 100mg Ent Tab | SAV | N/A | N/A | YES | NO | YES |
| 02172577 | KETOPROFEN | Ketoprofen SR 200mg LA Tab | AAP | 1.3925 | 1.3925 | YES | NO | YES |
| 01926373 | KETOPROFEN | Orudis SR-200 (Not a Benefit) 200mg LA Tab | RPP | N/A | N/A | YES | NO | YES |
| 01968300 | KETOROLAC TROMETHAMINE | Acular 0.5% Oph Sol | ALL | 3.6780 | 2.8997 | YES | NO | YES |
| 02245821 | KETOROLAC TROMETHAMINE | Ketorolac 0.5% Oph Sol | AAP | 2.8997 | 2.8997 | YES | NO | YES |
| 02369362 | KETOROLAC TROMETHAMINE | Acuvail 0.45% w/v Oph Sol-0.4mL Vial Pk (Preservative-Free) | ABV | 0.2593 | 0.2593 | NO | NO | YES |
| 02229080 | KETOROLAC TROMETHAMINE | Apo-Ketorolac (Off-Formulary Interchangeable) 10mg Tab | APX | 0.6028 | N/A | YES | NO | YES |
| 02510855 | KETOROLAC TROMETHAMINE | Jamp Ketorolac (Off-Formulary Interchangeable) 10mg Tab | JPC | 0.6028 | N/A | YES | NO | YES |
| 02465124 | KETOROLAC TROMETHAMINE | Mar-Ketorolac (Off-Formulary Interchangeable) 10mg Tab | MAR | 0.6028 | N/A | YES | NO | YES |
| 02461455 | KETOROLAC TROMETHAMINE | Mint-Ketorolac (Off-Formulary Interchangeable) 10mg Tab | MIN | 0.6028 | N/A | YES | NO | YES |
| 02162660 | KETOROLAC TROMETHAMINE | Toradol (Off-Formulary Interchangeable) 10mg Tab | AAP | N/A | N/A | YES | NO | YES |
| 02542722 | KETOTIFEN | Jamp Ketotifen Ophthalmic (Off-Formulary Interchangeable) 0.25mg/mL Oph Sol-5mL Pk | JPC | 25.7800 | N/A | YES | NO | NO |
| 02400871 | KETOTIFEN | Ketotifen Ophthalmic Solution (Off-Formulary Interchangeable) 0.25mg/mL Oph Sol-5mL Pk | STE | 21.1700 | N/A | YES | NO | NO |
| 02242324 | KETOTIFEN | Zaditor (Off-Formulary Interchangeable) 0.25mg/mL Oph Sol-5mL Pk | LBT | N/A | N/A | YES | NO | NO |
| 02243539 | LABETALOL HCL | Apo-Labetalol 200mg Tab | APX | 0.3504 | 0.3504 | YES | NO | NO |
| 02243538 | LABETALOL HCL | Apo-Labetalol 100mg Tab | APX | 0.1983 | 0.1983 | YES | NO | NO |
| 02489414 | LABETALOL HCL | Riva-Labetalol 200mg Tab | RIA | 0.3504 | 0.3504 | YES | NO | NO |
| 02489406 | LABETALOL HCL | Riva-Labetalol 100mg Tab | RIA | 0.1983 | 0.1983 | YES | NO | NO |
| 02106272 | LABETALOL HCL | Trandate 100mg Tab | PPI | 0.4044 | 0.1983 | YES | NO | NO |
| 02106280 | LABETALOL HCL | Trandate 200mg Tab | PPI | 0.7148 | 0.3504 | YES | NO | NO |
| 02489317 | LACOSAMIDE | Ach-Lacosamide 200mg Tab | ACH | 1.4500 | 1.4500 | YES | YES | NO |
| 02489309 | LACOSAMIDE | Ach-Lacosamide 150mg Tab | ACH | 1.1763 | 1.1763 | YES | YES | NO |
| 02489287 | LACOSAMIDE | Ach-Lacosamide 50mg Tab | ACH | 0.6313 | 0.6313 | YES | YES | NO |
| 02489295 | LACOSAMIDE | Ach-Lacosamide 100mg Tab | ACH | 0.8750 | 0.8750 | YES | YES | NO |
| 02475340 | LACOSAMIDE | Auro-Lacosamide 100mg Tab | AUR | 0.8750 | 0.8750 | YES | YES | NO |
| 02475332 | LACOSAMIDE | Auro-Lacosamide 50mg Tab | AUR | 0.6313 | 0.6313 | YES | YES | NO |
| 02475367 | LACOSAMIDE | Auro-Lacosamide 200mg Tab | AUR | 1.4500 | 1.4500 | YES | YES | NO |
| 02475359 | LACOSAMIDE | Auro-Lacosamide 150mg Tab | AUR | 1.1763 | 1.1763 | YES | YES | NO |
| 02488396 | LACOSAMIDE | Jamp-Lacosamide 100mg Tab | JPC | 0.8750 | 0.8750 | YES | YES | NO |
| 02488426 | LACOSAMIDE | Jamp-Lacosamide 200mg Tab | JPC | 1.4500 | 1.4500 | YES | YES | NO |
| 02488388 | LACOSAMIDE | Jamp-Lacosamide 50mg Tab | JPC | 0.6313 | 0.6313 | YES | YES | NO |
| 02488418 | LACOSAMIDE | Jamp-Lacosamide 150mg Tab | JPC | 1.1763 | 1.1763 | YES | YES | NO |
| 02512882 | LACOSAMIDE | Lacosamide 100mg Tab | SAI | 0.8750 | 0.8750 | YES | YES | NO |
| 02512874 | LACOSAMIDE | Lacosamide 50mg Tab | SAI | 0.6313 | 0.6313 | YES | YES | NO |
| 02512890 | LACOSAMIDE | Lacosamide 150mg Tab | SAI | 1.1763 | 1.1763 | YES | YES | NO |
| 02512904 | LACOSAMIDE | Lacosamide 200mg Tab | SAI | 1.4500 | 1.4500 | YES | YES | NO |
| 02490552 | LACOSAMIDE | Mint-Lacosamide 100mg Tab | MIN | 0.8750 | 0.8750 | YES | YES | NO |
| 02490544 | LACOSAMIDE | Mint-Lacosamide 50mg Tab | MIN | 0.6313 | 0.6313 | YES | YES | NO |
| 02490579 | LACOSAMIDE | Mint-Lacosamide 200mg Tab | MIN | 1.4500 | 1.4500 | YES | YES | NO |
| 02490560 | LACOSAMIDE | Mint-Lacosamide 150mg Tab | MIN | 1.1763 | 1.1763 | YES | YES | NO |
| 02499592 | LACOSAMIDE | NRA-Lacosamide 200mg Tab | NRA | 1.4500 | 1.4500 | YES | YES | NO |
| 02499584 | LACOSAMIDE | NRA-Lacosamide 150mg Tab | NRA | 1.1763 | 1.1763 | YES | YES | NO |
| 02499576 | LACOSAMIDE | NRA-Lacosamide 100mg Tab | NRA | 0.8750 | 0.8750 | YES | YES | NO |
| 02499568 | LACOSAMIDE | NRA-Lacosamide 50mg Tab | NRA | 0.6313 | 0.6313 | YES | YES | NO |
| 02478234 | LACOSAMIDE | Pharma-Lacosamide 200mg Tab | PMS | 1.4500 | 1.4500 | YES | YES | NO |
| 02478196 | LACOSAMIDE | Pharma-Lacosamide 50mg Tab | PMS | 0.6313 | 0.6313 | YES | YES | NO |
| 02478218 | LACOSAMIDE | Pharma-Lacosamide 100mg Tab | PMS | 0.8750 | 0.8750 | YES | YES | NO |
| 02478226 | LACOSAMIDE | Pharma-Lacosamide 150mg Tab | PMS | 1.1763 | 1.1763 | YES | YES | NO |
| 02474697 | LACOSAMIDE | Sandoz Lacosamide 150mg Tab | SDZ | 1.1763 | 1.1763 | YES | YES | NO |
| 02474670 | LACOSAMIDE | Sandoz Lacosamide 50mg Tab | SDZ | 0.6313 | 0.6313 | YES | YES | NO |
| 02474689 | LACOSAMIDE | Sandoz Lacosamide 100mg Tab | SDZ | 0.8750 | 0.8750 | YES | YES | NO |
| 02474700 | LACOSAMIDE | Sandoz Lacosamide 200mg Tab | SDZ | 1.4500 | 1.4500 | YES | YES | NO |
| 02472929 | LACOSAMIDE | Teva-Lacosamide 150mg Tab | TEV | 1.1763 | 1.1763 | YES | YES | NO |
| 02472902 | LACOSAMIDE | Teva-Lacosamide 50mg Tab | TEV | 0.6313 | 0.6313 | YES | YES | NO |
| 02472910 | LACOSAMIDE | Teva-Lacosamide 100mg Tab | TEV | 0.8750 | 0.8750 | YES | YES | NO |
| 02472937 | LACOSAMIDE | Teva-Lacosamide 200mg Tab | TEV | 1.4500 | 1.4500 | YES | YES | NO |
| 02357615 | LACOSAMIDE | Vimpat 50mg Tab | UCB | 2.5250 | 0.6313 | YES | YES | NO |
| 02357658 | LACOSAMIDE | Vimpat 200mg Tab | UCB | 5.8000 | 1.4500 | YES | YES | NO |
| 02357631 | LACOSAMIDE | Vimpat 150mg Tab | UCB | 4.7050 | 1.1763 | YES | YES | NO |
| 02357623 | LACOSAMIDE | Vimpat 100mg Tab | UCB | 3.5000 | 0.8750 | YES | YES | NO |
| 02487837 | LACOSAMIDE | ZDS-Lacosamide 200mg Tab | ZDS | 1.4500 | 1.4500 | YES | YES | NO |
| 02487829 | LACOSAMIDE | ZDS-Lacosamide 150mg Tab | ZDS | 1.1763 | 1.1763 | YES | YES | NO |
| 02487810 | LACOSAMIDE | ZDS-Lacosamide 100mg Tab | ZDS | 0.8750 | 0.8750 | YES | YES | NO |
| 02487802 | LACOSAMIDE | ZDS-Lacosamide 50mg Tab | ZDS | 0.6313 | 0.6313 | YES | YES | NO |
| 02242814 | LACTULOSE | Apo-Lactulose Solution 667mg/mL O/L | APX | 0.0145 | 0.0145 | YES | NO | NO |
| 02091925 | LACTULOSE | Cephulac (Not a Benefit) 667mg/mL O/L | MRR | N/A | N/A | YES | NO | NO |
| 02295881 | LACTULOSE | Jamp-Lactulose 667mg/mL O/L | JPC | 0.0145 | 0.0145 | YES | NO | NO |
| 02412268 | LACTULOSE | Lactulose 667mg/mL O/L | SAI | 0.0145 | 0.0145 | YES | NO | NO |
| 00703486 | LACTULOSE | PMS-Lactulose 667mg/mL O/L | PMS | 0.0147 | 0.0147 | NO | NO | NO |
| 02469391 | LACTULOSE | PMS-Lactulose-Pharma 667mg/mL O/L | PMS | 0.0145 | 0.0145 | YES | NO | NO |
| 02247383 | LACTULOSE | Pharma-Lactulose 667mg/mL O/L | PMS | 0.0145 | 0.0145 | YES | NO | NO |
| 00854409 | LACTULOSE | Ratio-Lactulose 667mg/mL O/L | RPH | 0.0145 | 0.0145 | YES | NO | NO |
| 02192691 | LAMIVUDINE | 3TC 10mg/mL O/L | VIH | 0.4267 | 0.4267 | NO | NO | YES |
| 02247825 | LAMIVUDINE | 3TC 300mg Tab | VIH | 13.2673 | 5.4857 | YES | NO | YES |
| 02192683 | LAMIVUDINE | 3TC 150mg Tab | VIH | 6.6082 | 2.7323 | YES | NO | YES |
| 02369052 | LAMIVUDINE | Apo-Lamivudine 150mg Tab | APX | 2.7323 | 2.7323 | YES | NO | YES |
| 02369060 | LAMIVUDINE | Apo-Lamivudine 300mg Tab | APX | 5.4857 | 5.4857 | YES | NO | YES |
| 02393239 | LAMIVUDINE | Apo-Lamivudine HBV 100mg Tab | APX | 2.6154 | 2.6154 | YES | YES | NO |
| 02239193 | LAMIVUDINE | Heptovir (Not a Benefit) 100mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02507110 | LAMIVUDINE | Jamp Lamivudine 150mg Tab | JPC | 2.7323 | 2.7323 | YES | NO | YES |
| 02507129 | LAMIVUDINE | Jamp Lamivudine 300mg Tab | JPC | 5.4857 | 5.4857 | YES | NO | YES |
| 02512467 | LAMIVUDINE | Jamp Lamivudine HBV 100mg Tab | JPC | 2.6154 | 2.6154 | YES | YES | NO |
| 02375540 | LAMIVUDINE & ZIDOVUDINE | Apo-Lamivudine-Zidovudine 150mg & 300mg Tab | APX | 2.6103 | 2.6103 | YES | NO | NO |
| 02414414 | LAMIVUDINE & ZIDOVUDINE | Auro-Lamivudine/Zidovudine 150mg & 300mg Tab | AUR | 2.6103 | 2.6103 | YES | NO | NO |
| 02239213 | LAMIVUDINE & ZIDOVUDINE | Combivir 150mg & 300mg Tab | VIH | 13.2262 | 2.6103 | YES | NO | NO |
| 02502801 | LAMIVUDINE & ZIDOVUDINE | Jamp Lamivudine / Zidovudine 150mg & 300mg Tab | JPC | 2.6103 | 2.6103 | YES | NO | NO |
| 02245209 | LAMOTRIGINE | Apo-Lamotrigine 100mg Tab | APX | 0.2787 | 0.2787 | YES | NO | NO |
| 02245208 | LAMOTRIGINE | Apo-Lamotrigine 25mg Tab | APX | 0.0698 | 0.0698 | YES | NO | NO |
| 02245210 | LAMOTRIGINE | Apo-Lamotrigine 150mg Tab | APX | 0.4107 | 0.4107 | YES | NO | NO |
| 02381370 | LAMOTRIGINE | Auro-Lamotrigine 150mg Tab | AUR | 0.4107 | 0.4107 | YES | NO | NO |
| 02381362 | LAMOTRIGINE | Auro-Lamotrigine 100mg Tab | AUR | 0.2787 | 0.2787 | YES | NO | NO |
| 02381354 | LAMOTRIGINE | Auro-Lamotrigine 25mg Tab | AUR | 0.0698 | 0.0698 | YES | NO | NO |
| 02542749 | LAMOTRIGINE | Jamp Lamotrigine 100mg Tab | JPC | 0.2787 | 0.2787 | YES | NO | NO |
| 02542730 | LAMOTRIGINE | Jamp Lamotrigine 25mg Tab | JPC | 0.0698 | 0.0698 | YES | NO | NO |
| 02542757 | LAMOTRIGINE | Jamp Lamotrigine 150mg Tab | JPC | 0.4107 | 0.4107 | YES | NO | NO |
| 02142112 | LAMOTRIGINE | Lamictal 150mg Tab | GSK | 3.1803 | 0.4107 | YES | NO | NO |
| 02142082 | LAMOTRIGINE | Lamictal 25mg Tab | GSK | 0.5402 | 0.0698 | YES | NO | NO |
| 02142104 | LAMOTRIGINE | Lamictal 100mg Tab | GSK | 2.1580 | 0.2787 | YES | NO | NO |
| 02428202 | LAMOTRIGINE | Lamotrigine 25mg Tab | SIV | 0.0698 | 0.0698 | YES | NO | NO |
| 02343037 | LAMOTRIGINE | Lamotrigine 150mg Tab | SAI | 0.4107 | 0.4107 | YES | NO | NO |
| 02428229 | LAMOTRIGINE | Lamotrigine 150mg Tab | SIV | 0.4107 | 0.4107 | YES | NO | NO |
| 02343010 | LAMOTRIGINE | Lamotrigine 25mg Tab | SAI | 0.0698 | 0.0698 | YES | NO | NO |
| 02343029 | LAMOTRIGINE | Lamotrigine 100mg Tab | SAI | 0.2787 | 0.2787 | YES | NO | NO |
| 02428210 | LAMOTRIGINE | Lamotrigine 100mg Tab | SIV | 0.2787 | 0.2787 | YES | NO | NO |
| 02265508 | LAMOTRIGINE | Mylan-Lamotrigine 100mg Tab | MYL | 0.2787 | 0.2787 | YES | NO | NO |
| 02265516 | LAMOTRIGINE | Mylan-Lamotrigine 150mg Tab | MYL | 0.4107 | 0.4107 | YES | NO | NO |
| 02265494 | LAMOTRIGINE | Mylan-Lamotrigine 25mg Tab | MYL | 0.0698 | 0.0698 | YES | NO | NO |
| 02246897 | LAMOTRIGINE | PMS-Lamotrigine 25mg Tab | PMS | 0.0698 | 0.0698 | YES | NO | NO |
| 02246898 | LAMOTRIGINE | PMS-Lamotrigine 100mg Tab | PMS | 0.2787 | 0.2787 | YES | NO | NO |
| 02246899 | LAMOTRIGINE | PMS-Lamotrigine 150mg Tab | PMS | 0.4107 | 0.4107 | YES | NO | NO |
| 02243352 | LAMOTRIGINE | Ratio-Lamotrigine 25mg Tab | RPH | 0.0698 | 0.0698 | YES | NO | NO |
| 02248233 | LAMOTRIGINE | Teva-Lamotrigine 100mg Tab | TEV | 0.2787 | 0.2787 | YES | NO | NO |
| 02248234 | LAMOTRIGINE | Teva-Lamotrigine 150mg Tab | TEV | 0.4107 | 0.4107 | YES | NO | NO |
| 02248232 | LAMOTRIGINE | Teva-Lamotrigine 25mg Tab | TEV | 0.0698 | 0.0698 | YES | NO | NO |
| 02283409 | LANREOTIDE ACETATE | Somatuline Autogel 90mg/0.3mL ER Pref Syr-0.3mL Pk | IPS | 1843.2658 | 1843.2658 | NO | NO | NO |
| 02283395 | LANREOTIDE ACETATE | Somatuline Autogel 60mg/0.3mL ER Pref Syr-0.3mL Pk | IPS | 1381.8284 | 1381.8284 | NO | NO | NO |
| 02283417 | LANREOTIDE ACETATE | Somatuline Autogel 120mg/0.5mL ER Pref Syr-0.5mL Pk | IPS | 2307.2221 | 2307.2221 | NO | NO | NO |
| 02293838 | LANSOPRAZOLE | Apo-Lansoprazole 30mg DR Cap | APX | 0.5000 | 0.5000 | YES | YES | NO |
| 02293811 | LANSOPRAZOLE | Apo-Lansoprazole 15mg DR Cap | APX | 0.5000 | 0.5000 | YES | YES | NO |
| 02410389 | LANSOPRAZOLE | Lansoprazole 30mg DR Cap | SIV | 0.5000 | 0.5000 | YES | YES | NO |
| 02357690 | LANSOPRAZOLE | Lansoprazole 30mg DR Cap | SAI | 0.5000 | 0.5000 | YES | YES | NO |
| 02385767 | LANSOPRAZOLE | Lansoprazole 15mg DR Cap | SIV | 0.5000 | 0.5000 | YES | YES | NO |
| 02357682 | LANSOPRAZOLE | Lansoprazole 15mg DR Cap | SAI | 0.5000 | 0.5000 | YES | YES | NO |
| 02353830 | LANSOPRAZOLE | Mylan-Lansoprazole 15mg DR Cap | MYL | 0.5000 | 0.5000 | YES | YES | NO |
| 02353849 | LANSOPRAZOLE | Mylan-Lansoprazole 30mg DR Cap | MYL | 0.5000 | 0.5000 | YES | YES | NO |
| 02165503 | LANSOPRAZOLE | Prevacid 15mg DR Cap | TPA | 2.4338 | 0.5000 | YES | YES | NO |
| 02165511 | LANSOPRAZOLE | Prevacid 30mg DR Cap | TPA | 2.4338 | 0.5000 | YES | YES | NO |
| 02385643 | LANSOPRAZOLE | Sandoz Lansoprazole 15mg DR Cap | SDZ | 0.5000 | 0.5000 | YES | YES | NO |
| 02385651 | LANSOPRAZOLE | Sandoz Lansoprazole 30mg DR Cap | SDZ | 0.5000 | 0.5000 | YES | YES | NO |
| 02402629 | LANSOPRAZOLE | Taro-Lansoprazole 30mg DR Cap | SPC | 0.5000 | 0.5000 | YES | YES | NO |
| 02402610 | LANSOPRAZOLE | Taro-Lansoprazole 15mg DR Cap | SPC | 0.5000 | 0.5000 | YES | YES | NO |
| 02280523 | LANSOPRAZOLE | Teva-Lansoprazole 30mg DR Cap | TEV | 0.5000 | 0.5000 | YES | YES | NO |
| 02280515 | LANSOPRAZOLE | Teva-Lansoprazole 15mg DR Cap | TEV | 0.5000 | 0.5000 | YES | YES | NO |
| 02470780 | LANSOPRAZOLE & CLARITHROMYCIN & AMOXICILLIN | AA-LansoprazoleAmoxicillinClarithromycin 30mg & 500mg & 500mg Tab/Cap Pk | AAP | 67.9100 | 67.9100 | YES | YES | NO |
| 02238525 | LANSOPRAZOLE & CLARITHROMYCIN & AMOXICILLIN | Hp-PAC (Not a Benefit) 30mg & 500mg & 500mg Tab/Cap Pk | TPA | N/A | N/A | YES | NO | NO |
| 02287188 | LANTHANUM | Fosrenol (Not a Benefit) 1000mg Chew Tab | TAK | N/A | N/A | YES | NO | NO |
| 02287161 | LANTHANUM | Fosrenol (Not a Benefit) 750mg Chew Tab | TAK | N/A | N/A | YES | NO | NO |
| 02287145 | LANTHANUM | Fosrenol (Not a Benefit) 250mg Chew Tab | TAK | N/A | N/A | YES | NO | NO |
| 02287153 | LANTHANUM | Fosrenol (Not a Benefit) 500mg Chew Tab | TAK | N/A | N/A | YES | NO | NO |
| 02498766 | LANTHANUM | Nat-Lanthanum (Off-Formulary Interchangeable) 750mg Chew Tab | NAT | 3.6219 | 3.6219 | YES | NO | NO |
| 02498758 | LANTHANUM | Nat-Lanthanum (Off-Formulary Interchangeable) 500mg Chew Tab | NAT | 2.4069 | 2.4069 | YES | NO | NO |
| 02498731 | LANTHANUM | Nat-Lanthanum (Off-Formulary Interchangeable) 250mg Chew Tab | NAT | 1.2034 | 1.2034 | YES | NO | NO |
| 02498774 | LANTHANUM | Nat-Lanthanum (Off-Formulary Interchangeable) 1000mg Chew Tab | NAT | 4.8018 | 4.8018 | YES | NO | NO |
| 02296527 | LATANOPROST | Apo-Latanoprost 0.005% Oph Sol-2.5mL Pk | APX | 9.5830 | 9.5830 | YES | YES | NO |
| 02254786 | LATANOPROST | Co Latanoprost 0.005% Oph Sol-2.5mL Pk | COB | 9.5830 | 9.5830 | YES | YES | NO |
| 02373041 | LATANOPROST | Gd-Latanoprost 0.005% Oph Sol-2.5mL Pk | UJC | 9.5830 | 9.5830 | YES | YES | NO |
| 02453355 | LATANOPROST | Jamp Latanoprost 0.005% Oph Sol-2.5mL Pk | JPC | 9.5830 | 9.5830 | YES | YES | NO |
| 02489570 | LATANOPROST | Latanoprost Ophthalmic Solution 0.005% Oph Sol-2.5mL Pk | TCI | 9.5830 | 9.5830 | YES | YES | NO |
| 02513285 | LATANOPROST | M-Latanoprost 0.005% Oph Sol-2.5mL Pk | MAT | 9.5830 | 9.5830 | YES | YES | NO |
| 02426935 | LATANOPROST | Med-Latanoprost 0.005% Oph Sol-2.5mL Pk | GMP | 9.5830 | 9.5830 | YES | YES | NO |
| 02341085 | LATANOPROST | Riva-Latanoprost 0.005% Oph Sol-2.5mL Pk | RIA | 9.5830 | 9.5830 | YES | YES | NO |
| 02367335 | LATANOPROST | Sandoz Latanoprost 0.005% Oph Sol-2.5mL Pk | SDZ | 9.5830 | 9.5830 | YES | YES | NO |
| 02231493 | LATANOPROST | Xalatan 0.005% Oph Sol-2.5mL Pk | UJC | 35.4927 | 9.5830 | YES | YES | NO |
| 02436256 | LATANOPROST & TIMOLOL MALEATE | Act Latanoprost/Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | ACV | 11.0700 | 11.0670 | YES | YES | NO |
| 02414155 | LATANOPROST & TIMOLOL MALEATE | Apo-Latanoprost-Timop 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | APX | 11.0700 | 11.0670 | YES | YES | NO |
| 02373068 | LATANOPROST & TIMOLOL MALEATE | Gd-Latanoprost/Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | UJC | 11.0700 | 11.0670 | YES | YES | NO |
| 02453770 | LATANOPROST & TIMOLOL MALEATE | Jamp-Latanoprost/Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | JPC | 11.0700 | 11.0670 | YES | YES | NO |
| 02514516 | LATANOPROST & TIMOLOL MALEATE | M-Latanoprost-Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | MAT | 11.0670 | 11.0670 | YES | YES | NO |
| 02454505 | LATANOPROST & TIMOLOL MALEATE | Med-Latanoprost-Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | GMP | 11.0700 | 11.0670 | YES | YES | NO |
| 02394685 | LATANOPROST & TIMOLOL MALEATE | Sandoz Latanoprost/Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | SDZ | 11.0700 | 11.0670 | YES | YES | NO |
| 02246619 | LATANOPROST & TIMOLOL MALEATE | Xalacom 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk | UJC | 40.1739 | 11.0670 | YES | YES | NO |
| 02484218 | LATANOPROSTENE BUNOD | Vyzulta 0.024%w/v Oph Sol | BSH | 5.2500 | 5.2500 | NO | YES | NO |
| 02432226 | LEDIPASVIR & SOFOSBUVIR | Harvoni 90mg & 400mg Tab | GIL | 797.6190 | 797.6190 | NO | YES | NO |
| 02478870 | LEFLUNOMIDE | Accel-Leflunomide 20mg Tab | ACC | 2.0000 | 2.0000 | YES | NO | NO |
| 02478862 | LEFLUNOMIDE | Accel-Leflunomide 10mg Tab | ACC | 2.0000 | 2.0000 | YES | NO | NO |
| 02256495 | LEFLUNOMIDE | Apo-Leflunomide 10mg Tab | APX | 2.6433 | 2.0000 | YES | NO | NO |
| 02256509 | LEFLUNOMIDE | Apo-Leflunomide 20mg Tab | APX | 2.6433 | 2.0000 | YES | NO | NO |
| 02241889 | LEFLUNOMIDE | Arava 20mg Tab | SAV | 11.4443 | 2.0000 | YES | NO | NO |
| 02241888 | LEFLUNOMIDE | Arava 10mg Tab | SAV | 11.4440 | 2.0000 | YES | NO | NO |
| 02543575 | LEFLUNOMIDE | Leflunomide 10mg Tab | SIV | 2.6433 | 2.0000 | YES | NO | NO |
| 02351668 | LEFLUNOMIDE | Leflunomide 10mg Tab | SAI | 2.6433 | 2.0000 | YES | NO | NO |
| 02543583 | LEFLUNOMIDE | Leflunomide 20mg Tab | SIV | 2.6433 | 2.0000 | YES | NO | NO |
| 02351676 | LEFLUNOMIDE | Leflunomide 20mg Tab | SAI | 2.6433 | 2.0000 | YES | NO | NO |
| 02551926 | LEFLUNOMIDE | Mar-Leflunomide 20mg Tab | MAR | 2.6433 | 2.0000 | YES | NO | NO |
| 02551918 | LEFLUNOMIDE | Mar-Leflunomide 10mg Tab | MAR | 2.6433 | 2.0000 | YES | NO | NO |
| 02283972 | LEFLUNOMIDE | Sandoz Leflunomide 20mg Tab | SDZ | 2.6433 | 2.0000 | YES | NO | NO |
| 02283964 | LEFLUNOMIDE | Sandoz Leflunomide 10mg Tab | SDZ | 2.6433 | 2.0000 | YES | NO | NO |
| 02261278 | LEFLUNOMIDE | Teva-Leflunomide 20mg Tab | TEV | 2.6433 | 2.0000 | YES | NO | NO |
| 02261251 | LEFLUNOMIDE | Teva-Leflunomide 10mg Tab | TEV | 2.6433 | 2.0000 | YES | NO | NO |
| 02507927 | LENALIDOMIDE | Apo-Lenalidomide 2.5mg Cap | APX | 82.3750 | 82.3750 | YES | YES | NO |
| 02507978 | LENALIDOMIDE | Apo-Lenalidomide 20mg Cap | APX | 100.7500 | 100.7500 | YES | YES | NO |
| 02507943 | LENALIDOMIDE | Apo-Lenalidomide 10mg Cap | APX | 90.2500 | 90.2500 | YES | YES | NO |
| 02507935 | LENALIDOMIDE | Apo-Lenalidomide 5mg Cap | APX | 85.0000 | 85.0000 | YES | YES | NO |
| 02507951 | LENALIDOMIDE | Apo-Lenalidomide 15mg Cap | APX | 95.5000 | 95.5000 | YES | YES | NO |
| 02507986 | LENALIDOMIDE | Apo-Lenalidomide 25mg Cap | APX | 106.0000 | 106.0000 | YES | YES | NO |
| 02506130 | LENALIDOMIDE | Jamp Lenalidomide 2.5mg Cap | JPC | 82.3750 | 82.3750 | YES | YES | NO |
| 02506149 | LENALIDOMIDE | Jamp Lenalidomide 5mg Cap | JPC | 85.0000 | 85.0000 | YES | YES | NO |
| 02506165 | LENALIDOMIDE | Jamp Lenalidomide 15mg Cap | JPC | 95.5000 | 95.5000 | YES | YES | NO |
| 02506181 | LENALIDOMIDE | Jamp Lenalidomide 25mg Cap | JPC | 106.0000 | 106.0000 | YES | YES | NO |
| 02506157 | LENALIDOMIDE | Jamp Lenalidomide 10mg Cap | JPC | 90.2500 | 90.2500 | YES | YES | NO |
| 02506173 | LENALIDOMIDE | Jamp Lenalidomide 20mg Cap | JPC | 100.7500 | 100.7500 | YES | YES | NO |
| 02493896 | LENALIDOMIDE | Nat-Lenalidomide 20mg Cap | NAT | 100.7500 | 100.7500 | YES | YES | NO |
| 02493845 | LENALIDOMIDE | Nat-Lenalidomide 5mg Cap | NAT | 85.0000 | 85.0000 | YES | YES | NO |
| 02493888 | LENALIDOMIDE | Nat-Lenalidomide 15mg Cap | NAT | 95.5000 | 95.5000 | YES | YES | NO |
| 02493861 | LENALIDOMIDE | Nat-Lenalidomide 10mg Cap | NAT | 90.2500 | 90.2500 | YES | YES | NO |
| 02493837 | LENALIDOMIDE | Nat-Lenalidomide 2.5mg Cap | NAT | 82.3750 | 82.3750 | YES | YES | NO |
| 02493918 | LENALIDOMIDE | Nat-Lenalidomide 25mg Cap | NAT | 106.0000 | 106.0000 | YES | YES | NO |
| 02483041 | LENALIDOMIDE | Reddy-Lenalidomide 20mg Cap | DRR | 100.7500 | 100.7500 | YES | YES | NO |
| 02483033 | LENALIDOMIDE | Reddy-Lenalidomide 15mg Cap | DRR | 95.5000 | 95.5000 | YES | YES | NO |
| 02484714 | LENALIDOMIDE | Reddy-Lenalidomide 2.5mg Cap | DRR | 82.3750 | 82.3750 | YES | YES | NO |
| 02483025 | LENALIDOMIDE | Reddy-Lenalidomide 10mg Cap | DRR | 90.2500 | 90.2500 | YES | YES | NO |
| 02483017 | LENALIDOMIDE | Reddy-Lenalidomide 5mg Cap | DRR | 85.0000 | 85.0000 | YES | YES | NO |
| 02483068 | LENALIDOMIDE | Reddy-Lenalidomide 25mg Cap | DRR | 106.0000 | 106.0000 | YES | YES | NO |
| 02317710 | LENALIDOMIDE | Revlimid 25mg Cap | BQU | 424.0000 | 106.0000 | YES | YES | NO |
| 02440601 | LENALIDOMIDE | Revlimid 20mg Cap | BQU | 403.0000 | 100.7500 | YES | YES | NO |
| 02317699 | LENALIDOMIDE | Revlimid 15mg Cap | BQU | 382.0000 | 95.5000 | YES | YES | NO |
| 02304902 | LENALIDOMIDE | Revlimid 10mg Cap | BQU | 361.0000 | 90.2500 | YES | YES | NO |
| 02459418 | LENALIDOMIDE | Revlimid 2.5mg Cap | BQU | 329.5000 | 82.3750 | YES | YES | NO |
| 02304899 | LENALIDOMIDE | Revlimid 5mg Cap | BQU | 340.0000 | 85.0000 | YES | YES | NO |
| 02518600 | LENALIDOMIDE | Sandoz Lenalidomide 20mg Cap | SDZ | 100.7500 | 100.7500 | YES | YES | NO |
| 02518562 | LENALIDOMIDE | Sandoz Lenalidomide 2.5mg Cap | SDZ | 82.3750 | 82.3750 | YES | YES | NO |
| 02518597 | LENALIDOMIDE | Sandoz Lenalidomide 15mg Cap | SDZ | 95.5000 | 95.5000 | YES | YES | NO |
| 02518619 | LENALIDOMIDE | Sandoz Lenalidomide 25mg Cap | SDZ | 106.0000 | 106.0000 | YES | YES | NO |
| 02518570 | LENALIDOMIDE | Sandoz Lenalidomide 5mg Cap | SDZ | 85.0000 | 85.0000 | YES | YES | NO |
| 02518589 | LENALIDOMIDE | Sandoz Lenalidomide 10mg Cap | SDZ | 90.2500 | 90.2500 | YES | YES | NO |
| 02507900 | LENALIDOMIDE | Taro-Lenalidomide 20mg Cap | TAR | 100.7500 | 100.7500 | YES | YES | NO |
| 02507862 | LENALIDOMIDE | Taro-Lenalidomide 2.5mg Cap | TAR | 82.3750 | 82.3750 | YES | YES | NO |
| 02507870 | LENALIDOMIDE | Taro-Lenalidomide 5mg Cap | TAR | 85.0000 | 85.0000 | YES | YES | NO |
| 02507897 | LENALIDOMIDE | Taro-Lenalidomide 15mg Cap | TAR | 95.5000 | 95.5000 | YES | YES | NO |
| 02507889 | LENALIDOMIDE | Taro-Lenalidomide 10mg Cap | TAR | 90.2500 | 90.2500 | YES | YES | NO |
| 02507919 | LENALIDOMIDE | Taro-Lenalidomide 25mg Cap | TAR | 106.0000 | 106.0000 | YES | YES | NO |
| 02358514 | LETROZOLE | Apo-Letrozole 2.5mg Tab | APX | 1.3780 | 1.3780 | YES | NO | NO |
| 02459884 | LETROZOLE | CCP-Letrozole 2.5mg Tab | CCP | 1.3780 | 1.3780 | YES | NO | NO |
| 02231384 | LETROZOLE | Femara 2.5mg Tab | NOV | 8.7543 | 1.3780 | YES | NO | NO |
| 02541912 | LETROZOLE | Jamp Letrozole Tablets 2.5mg Tab | JPC | 1.3780 | 1.3780 | YES | NO | NO |
| 02373009 | LETROZOLE | Jamp-Letrozole 2.5mg Tab | JPC | 1.3780 | 1.3780 | YES | NO | NO |
| 02348969 | LETROZOLE | Letrozole 2.5mg Tab | COB | 1.3780 | 1.3780 | YES | NO | NO |
| 02504472 | LETROZOLE | Letrozole 2.5mg Tab | SAI | 1.3780 | 1.3780 | YES | NO | NO |
| 02524244 | LETROZOLE | Letrozole 2.5mg Tab | SIV | 1.3780 | 1.3780 | YES | NO | NO |
| 02338459 | LETROZOLE | Letrozole Tablets USP 2.5mg Tab | ACH | 1.3780 | 1.3780 | YES | NO | NO |
| 02373424 | LETROZOLE | Mar-Letrozole 2.5mg Tab | MAR | 1.3780 | 1.3780 | YES | NO | NO |
| 02322315 | LETROZOLE | Med-Letrozole 2.5mg Tab | GMP | 1.3780 | 1.3780 | YES | NO | NO |
| 02508109 | LETROZOLE | Mint-Letrozole 2.5mg Tab | MIN | 1.3780 | 1.3780 | YES | NO | NO |
| 02520486 | LETROZOLE | NRA-Letrozole 2.5mg Tab | NRA | 1.3780 | 1.3780 | YES | NO | NO |
| 02421585 | LETROZOLE | Nat-Letrozole 2.5mg Tab | NAT | 1.3780 | 1.3780 | YES | NO | NO |
| 02309114 | LETROZOLE | PMS-Letrozole 2.5mg Tab | PMS | 1.3780 | 1.3780 | YES | NO | NO |
| 02372282 | LETROZOLE | Ran-Letrozole 2.5mg Tab | RAN | 1.3780 | 1.3780 | YES | NO | NO |
| 02398656 | LETROZOLE | Riva-Letrozole 2.5mg Tab | RIA | 1.3780 | 1.3780 | YES | NO | NO |
| 02344815 | LETROZOLE | Sandoz Letrozole 2.5mg Tab | SDZ | 1.3780 | 1.3780 | YES | NO | NO |
| 02343657 | LETROZOLE | Teva-Letrozole 2.5mg Tab | TEV | 1.3780 | 1.3780 | YES | NO | NO |
| 02378213 | LETROZOLE | Zinda-Letrozole 2.5mg Tab | STA | 1.3780 | 1.3780 | YES | NO | NO |
| 02548208 | LEUCOVORIN CALCIUM | Jamp Leucovorin 5mg Tab | JPC | 1.8388 | 1.8388 | YES | NO | NO |
| 02170493 | LEUCOVORIN CALCIUM | Leucovorin Calcium 5mg Tab | WAY | 7.3552 | 1.8388 | YES | NO | NO |
| 02496828 | LEUCOVORIN CALCIUM | Mint-Leucovorin 5mg Tab | MIN | 1.8388 | 1.8388 | YES | NO | NO |
| 02493357 | LEUCOVORIN CALCIUM | Riva Leucovorin 5mg Tab | RIA | 1.8388 | 1.8388 | YES | NO | NO |
| 00884502 | LEUPROLIDE ACETATE | Lupron Depot PDS 3.75mg Inj-Kit | ABB | 389.1300 | 389.1300 | NO | NO | NO |
| 00836273 | LEUPROLIDE ACETATE | Lupron Depot PDS 7.5mg Inj-Kit | ABB | 387.9700 | 387.9700 | NO | NO | NO |
| 02239833 | LEUPROLIDE ACETATE | Lupron Depot PDS 30mg Inj-Kit | ABB | 1428.0000 | 1428.0000 | NO | NO | NO |
| 02230248 | LEUPROLIDE ACETATE | Lupron Depot PDS 22.5mg Inj-Kit | ABB | 1071.0000 | 1071.0000 | NO | NO | NO |
| 02239834 | LEUPROLIDE ACETATE | Lupron Depot PDS 11.25mg Inj-Kit | ABB | 1159.5200 | 1159.5200 | NO | NO | NO |
| 02248999 | LEUPROLIDE ACETATE | Eligard 30mg Pd Susp Inj-Pref Syr Kit | TOL | 1285.2000 | 1285.2000 | NO | NO | NO |
| 02248240 | LEUPROLIDE ACETATE | Eligard 22.5mg Pd Susp Inj-Pref Syr Kit | TOL | 891.0000 | 891.0000 | NO | NO | NO |
| 02248239 | LEUPROLIDE ACETATE | Eligard 7.5mg Pd Susp Inj-Pref Syr Kit | TOL | 310.7200 | 310.7200 | NO | NO | NO |
| 02268892 | LEUPROLIDE ACETATE | Eligard 45mg Pd Susp Inj-Pref Syr Kit | TOL | 1659.9000 | 1659.9000 | NO | NO | NO |
| 02429977 | LEUPROLIDE ACETATE | Zeulide Depot 3.75mg/Vial Pd for Inj - Vial Pk | VET | 304.0000 | 304.0000 | NO | NO | NO |
| 02462699 | LEUPROLIDE ACETATE | Zeulide Depot 22.5mg/Vial Pd for Inj - Vial Pk | VET | 873.0000 | 873.0000 | NO | NO | NO |
| 02558416 | LEVETIRACETAM | Mint-Levetiracetam Solution 100mg/mL Oral Sol | MIN | 0.4071 | 0.4071 | YES | YES | NO |
| 02490447 | LEVETIRACETAM | PDP-Levetiracetam 100mg/mL Oral Sol | PEN | 0.8142 | 0.4071 | YES | YES | NO |
| 02515318 | LEVETIRACETAM | Pharma-Levetiracetam 100mg/mL Oral Sol | PMS | 0.4071 | 0.4071 | YES | YES | NO |
| 02399784 | LEVETIRACETAM | Ach-Levetiracetam 500mg Tab | ACH | 0.3911 | 0.3911 | YES | YES | NO |
| 02399792 | LEVETIRACETAM | Ach-Levetiracetam 750mg Tab | ACH | 0.5416 | 0.5416 | YES | YES | NO |
| 02399776 | LEVETIRACETAM | Ach-Levetiracetam 250mg Tab | ACH | 0.3210 | 0.3210 | YES | YES | NO |
| 02274205 | LEVETIRACETAM | Act Levetiracetam 750mg Tab | ACV | 0.5416 | 0.5416 | YES | YES | NO |
| 02274183 | LEVETIRACETAM | Act Levetiracetam 250mg Tab | ACV | 0.3210 | 0.3210 | YES | YES | NO |
| 02274191 | LEVETIRACETAM | Act Levetiracetam 500mg Tab | ACV | 0.3911 | 0.3911 | YES | YES | NO |
| 02285924 | LEVETIRACETAM | Apo-Levetiracetam 250mg Tab | APX | 0.3210 | 0.3210 | YES | YES | NO |
| 02285940 | LEVETIRACETAM | Apo-Levetiracetam 750mg Tab | APX | 0.5416 | 0.5416 | YES | YES | NO |
| 02285932 | LEVETIRACETAM | Apo-Levetiracetam 500mg Tab | APX | 0.3911 | 0.3911 | YES | YES | NO |
| 02375257 | LEVETIRACETAM | Auro-Levetiracetam 500mg Tab | AUR | 0.3911 | 0.3911 | YES | YES | NO |
| 02375265 | LEVETIRACETAM | Auro-Levetiracetam 750mg Tab | AUR | 0.5416 | 0.5416 | YES | YES | NO |
| 02375249 | LEVETIRACETAM | Auro-Levetiracetam 250mg Tab | AUR | 0.3210 | 0.3210 | YES | YES | NO |
| 02504553 | LEVETIRACETAM | Jamp Levetiracetam Tablets 250mg Tab | JPC | 0.3210 | 0.3210 | YES | YES | NO |
| 02504588 | LEVETIRACETAM | Jamp Levetiracetam Tablets 750mg Tab | JPC | 0.5416 | 0.5416 | YES | YES | NO |
| 02504561 | LEVETIRACETAM | Jamp Levetiracetam Tablets 500mg Tab | JPC | 0.3911 | 0.3911 | YES | YES | NO |
| 02403021 | LEVETIRACETAM | Jamp-Levetiracetam 500mg Tab | JPC | 0.3911 | 0.3911 | YES | YES | NO |
| 02403048 | LEVETIRACETAM | Jamp-Levetiracetam 750mg Tab | JPC | 0.5416 | 0.5416 | YES | YES | NO |
| 02403005 | LEVETIRACETAM | Jamp-Levetiracetam 250mg Tab | JPC | 0.3210 | 0.3210 | YES | YES | NO |
| 02247027 | LEVETIRACETAM | Keppra 250mg Tab | UCB | 1.7836 | 0.3210 | YES | YES | NO |
| 02247029 | LEVETIRACETAM | Keppra 750mg Tab | UCB | 3.0089 | 0.5416 | YES | YES | NO |
| 02247028 | LEVETIRACETAM | Keppra 500mg Tab | UCB | 2.1725 | 0.3911 | YES | YES | NO |
| 02442531 | LEVETIRACETAM | Levetiracetam 250mg Tab | SIV | 0.3210 | 0.3210 | YES | YES | NO |
| 02442566 | LEVETIRACETAM | Levetiracetam 750mg Tab | SIV | 0.5416 | 0.5416 | YES | YES | NO |
| 02353369 | LEVETIRACETAM | Levetiracetam 750mg Tab | SAI | 0.5416 | 0.5416 | YES | YES | NO |
| 02353342 | LEVETIRACETAM | Levetiracetam 250mg Tab | SAI | 0.3210 | 0.3210 | YES | YES | NO |
| 02353350 | LEVETIRACETAM | Levetiracetam 500mg Tab | SAI | 0.3911 | 0.3911 | YES | YES | NO |
| 02442558 | LEVETIRACETAM | Levetiracetam 500mg Tab | SIV | 0.3911 | 0.3911 | YES | YES | NO |
| 02524562 | LEVETIRACETAM | M-Levetiracetam 250mg Tab | MAT | 0.3210 | 0.3210 | YES | YES | NO |
| 02524589 | LEVETIRACETAM | M-Levetiracetam 750mg Tab | MAT | 0.5416 | 0.5416 | YES | YES | NO |
| 02524570 | LEVETIRACETAM | M-Levetiracetam 500mg Tab | MAT | 0.3911 | 0.3911 | YES | YES | NO |
| 02442418 | LEVETIRACETAM | Mint-Levetiracetam 750mg Tab | MIN | 0.5416 | 0.5416 | YES | YES | NO |
| 02442388 | LEVETIRACETAM | Mint-Levetiracetam 250mg Tab | MIN | 0.3210 | 0.3210 | YES | YES | NO |
| 02442396 | LEVETIRACETAM | Mint-Levetiracetam 500mg Tab | MIN | 0.3911 | 0.3911 | YES | YES | NO |
| 02499207 | LEVETIRACETAM | NRA-Levetiracetam 500mg Tab | NRA | 0.3911 | 0.3911 | YES | YES | NO |
| 02499193 | LEVETIRACETAM | NRA-Levetiracetam 250mg Tab | NRA | 0.3210 | 0.3210 | YES | YES | NO |
| 02499215 | LEVETIRACETAM | NRA-Levetiracetam 750mg Tab | NRA | 0.5416 | 0.5416 | YES | YES | NO |
| 02440229 | LEVETIRACETAM | Nat-Levetiracetam 750mg Tab | NAT | 0.5416 | 0.5416 | YES | YES | NO |
| 02440210 | LEVETIRACETAM | Nat-Levetiracetam 500mg Tab | NAT | 0.3911 | 0.3911 | YES | YES | NO |
| 02440202 | LEVETIRACETAM | Nat-Levetiracetam 250mg Tab | NAT | 0.3210 | 0.3210 | YES | YES | NO |
| 02296136 | LEVETIRACETAM | PMS-Levetiracetam 750mg Tab | PMS | 0.5416 | 0.5416 | YES | YES | NO |
| 02296128 | LEVETIRACETAM | PMS-Levetiracetam 500mg Tab | PMS | 0.3911 | 0.3911 | YES | YES | NO |
| 02296101 | LEVETIRACETAM | PMS-Levetiracetam 250mg Tab | PMS | 0.3210 | 0.3210 | YES | YES | NO |
| 02482290 | LEVETIRACETAM | Riva-Levetiracetam 750mg Tab | RIA | 0.5416 | 0.5416 | YES | YES | NO |
| 02482282 | LEVETIRACETAM | Riva-Levetiracetam 500mg Tab | RIA | 0.3911 | 0.3911 | YES | YES | NO |
| 02482274 | LEVETIRACETAM | Riva-Levetiracetam 250mg Tab | RIA | 0.3210 | 0.3210 | YES | YES | NO |
| 02461986 | LEVETIRACETAM | Sandoz Levetiracetam 250mg Tab | SDZ | 0.3210 | 0.3210 | YES | YES | NO |
| 02462028 | LEVETIRACETAM | Sandoz Levetiracetam 1000mg Tab | SDZ | 0.7221 | 0.7221 | NO | YES | NO |
| 02461994 | LEVETIRACETAM | Sandoz Levetiracetam 500mg Tab | SDZ | 0.3911 | 0.3911 | YES | YES | NO |
| 02462001 | LEVETIRACETAM | Sandoz Levetiracetam 750mg Tab | SDZ | 0.5416 | 0.5416 | YES | YES | NO |
| 00637661 | LEVOBUNOLOL HCL | Betagan 0.5% Oph Sol | ALL | 3.8153 | 3.8153 | NO | NO | NO |
| 02144336 | LEVOCARNITINE | Carnitor (Off-Formulary Interchangeable) 100mg/mL Oral Sol (with preservative) | LBI | 0.3809 | 0.3809 | YES | NO | NO |
| 02492105 | LEVOCARNITINE | Odan Levocarnitine (Off-Formulary Interchangeable) 100mg/mL Oral Sol (with preservative) | ODN | 0.3809 | 0.3809 | YES | NO | NO |
| 00386464 | LEVODOPA & BENSERAZIDE | Prolopa 100-25 100mg & 25mg Cap | HLR | 0.5660 | 0.5660 | NO | NO | NO |
| 00386472 | LEVODOPA & BENSERAZIDE | Prolopa 200-50 200mg & 50mg Cap | HLR | 0.9503 | 0.9503 | NO | NO | NO |
| 00522597 | LEVODOPA & BENSERAZIDE | Prolopa 50-12.5 50mg & 12.5mg Cap | HLR | 0.3437 | 0.3437 | NO | NO | NO |
| 02272873 | LEVODOPA & CARBIDOPA | AA-Levocarb CR 100mg & 25mg CR Tab | AAP | 0.7974 | 0.7974 | YES | YES | NO |
| 02245211 | LEVODOPA & CARBIDOPA | AA-Levocarb CR 200mg & 50mg CR Tab | AAP | 1.4282 | 1.4282 | YES | YES | NO |
| 00870935 | LEVODOPA & CARBIDOPA | Sinemet CR (Not a Benefit) 200mg & 50mg CR Tab | MFC | N/A | N/A | YES | NO | NO |
| 02028786 | LEVODOPA & CARBIDOPA | Sinemet CR (Not a Benefit) 100mg & 25mg CR Tab | MFC | N/A | N/A | YES | NO | NO |
| 02195933 | LEVODOPA & CARBIDOPA | Apo-Levocarb 100mg & 10mg Tab | APX | 0.1479 | 0.1479 | YES | NO | NO |
| 02195941 | LEVODOPA & CARBIDOPA | Apo-Levocarb 100mg & 25mg Tab | APX | 0.2209 | 0.2209 | YES | NO | NO |
| 02195968 | LEVODOPA & CARBIDOPA | Apo-Levocarb 250mg & 25mg Tab | APX | 0.2466 | 0.2466 | YES | NO | NO |
| 02531593 | LEVODOPA & CARBIDOPA | Auro-Levocarb 100mg & 10mg Tab | AUR | 0.1479 | 0.1479 | YES | NO | NO |
| 02531615 | LEVODOPA & CARBIDOPA | Auro-Levocarb 250mg & 25mg Tab | AUR | 0.2466 | 0.2466 | YES | NO | NO |
| 02531607 | LEVODOPA & CARBIDOPA | Auro-Levocarb 100mg & 25mg Tab | AUR | 0.2209 | 0.2209 | YES | NO | NO |
| 02546396 | LEVODOPA & CARBIDOPA | Jamp Levocarb 100mg & 10mg Tab | JPC | 0.1479 | 0.1479 | YES | NO | NO |
| 02546426 | LEVODOPA & CARBIDOPA | Jamp Levocarb 250mg & 25mg Tab | JPC | 0.2466 | 0.2466 | YES | NO | NO |
| 02546418 | LEVODOPA & CARBIDOPA | Jamp Levocarb 100mg & 25mg Tab | JPC | 0.2209 | 0.2209 | YES | NO | NO |
| 02457970 | LEVODOPA & CARBIDOPA | Mint-Levocarb 250mg & 25mg Tab | MIN | 0.2466 | 0.2466 | YES | NO | NO |
| 02457954 | LEVODOPA & CARBIDOPA | Mint-Levocarb 100mg & 10mg Tab | MIN | 0.1479 | 0.1479 | YES | NO | NO |
| 02457962 | LEVODOPA & CARBIDOPA | Mint-Levocarb 100mg & 25mg Tab | MIN | 0.2209 | 0.2209 | YES | NO | NO |
| 02549719 | LEVODOPA & CARBIDOPA | PMS-Levodopa-Carbidopa 100mg & 10mg Tab | PMS | 0.1479 | 0.1479 | YES | NO | NO |
| 02549727 | LEVODOPA & CARBIDOPA | PMS-Levodopa-Carbidopa 100mg & 25mg Tab | PMS | 0.2209 | 0.2209 | YES | NO | NO |
| 02549735 | LEVODOPA & CARBIDOPA | PMS-Levodopa-Carbidopa 250mg & 25mg Tab | PMS | 0.2466 | 0.2466 | YES | NO | NO |
| 00513997 | LEVODOPA & CARBIDOPA | Sinemet (Not a Benefit) 100mg & 25mg Tab | OCI | N/A | N/A | YES | NO | NO |
| 00355658 | LEVODOPA & CARBIDOPA | Sinemet (Not a Benefit) 100mg & 10mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 00328219 | LEVODOPA & CARBIDOPA | Sinemet (Not a Benefit) 250mg & 25mg Tab | OCI | N/A | N/A | YES | NO | NO |
| 02244496 | LEVODOPA & CARBIDOPA | Teva-Levocarbidopa 250mg & 25mg Tab | TEV | 0.2466 | 0.2466 | YES | NO | NO |
| 02244494 | LEVODOPA & CARBIDOPA | Teva-Levocarbidopa 100mg & 10mg Tab | TEV | 0.1479 | 0.1479 | YES | NO | NO |
| 02244495 | LEVODOPA & CARBIDOPA | Teva-Levocarbidopa 100mg & 25mg Tab | TEV | 0.2209 | 0.2209 | YES | NO | NO |
| 02337827 | LEVODOPA & CARBIDOPA & ENTACAPONE | Stalevo 75 & 18.75 & 200mg Tab | SDZ | 1.7471 | 1.7471 | NO | YES | NO |
| 02305968 | LEVODOPA & CARBIDOPA & ENTACAPONE | Stalevo 150 & 37.5 & 200mg Tab | SDZ | 1.7471 | 1.7471 | NO | YES | NO |
| 02337835 | LEVODOPA & CARBIDOPA & ENTACAPONE | Stalevo 125 & 31.25 & 200mg Tab | SDZ | 1.7471 | 1.7471 | NO | YES | NO |
| 02305933 | LEVODOPA & CARBIDOPA & ENTACAPONE | Stalevo 50 & 12.5 & 200mg Tab | SDZ | 1.7471 | 1.7471 | NO | YES | NO |
| 02305941 | LEVODOPA & CARBIDOPA & ENTACAPONE | Stalevo 100 & 25 & 200mg Tab | SDZ | 1.7471 | 1.7471 | NO | YES | NO |
| 02315424 | LEVOFLOXACIN | Act Levofloxacin 250mg Tab | TEV | 1.2038 | 1.2038 | YES | NO | NO |
| 02315432 | LEVOFLOXACIN | Act Levofloxacin 500mg Tab | TEV | 1.3718 | 1.3718 | YES | NO | NO |
| 02315440 | LEVOFLOXACIN | Act Levofloxacin (Off-Formulary Interchangeable) 750mg Tab | TEV | 6.5484 | N/A | YES | NO | NO |
| 02284715 | LEVOFLOXACIN | Apo-Levofloxacin 500mg Tab | APX | 1.3718 | 1.3718 | YES | NO | NO |
| 02325942 | LEVOFLOXACIN | Apo-Levofloxacin (Off-Formulary Interchangeable) 750mg Tab | APX | 6.5484 | N/A | YES | NO | NO |
| 02284707 | LEVOFLOXACIN | Apo-Levofloxacin 250mg Tab | APX | 1.2038 | 1.2038 | YES | NO | NO |
| 02508451 | LEVOFLOXACIN | Jamp Levofloxacin 500mg Tab | JPC | 1.3718 | 1.3718 | YES | NO | NO |
| 02508478 | LEVOFLOXACIN | Jamp Levofloxacin (Off-Formulary Interchangeable) 750mg Tab | JPC | 6.5484 | N/A | YES | NO | NO |
| 02508443 | LEVOFLOXACIN | Jamp Levofloxacin 250mg Tab | JPC | 1.2038 | 1.2038 | YES | NO | NO |
| 02246804 | LEVOFLOXACIN | Levaquin (Off-Formulary Interchangeable) 750mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02236841 | LEVOFLOXACIN | Levaquin (Not a Benefit) 250mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02236842 | LEVOFLOXACIN | Levaquin (Not a Benefit) 500mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02505797 | LEVOFLOXACIN | Mint-Levofloxacin 250mg Tab | MIN | 1.2038 | 1.2038 | YES | NO | NO |
| 02505819 | LEVOFLOXACIN | Mint-Levofloxacin 500mg Tab | MIN | 1.3718 | 1.3718 | YES | NO | NO |
| 02505800 | LEVOFLOXACIN | Mint-Levofloxacin (Off-Formulary Interchangeable) 750mg Tab | MIN | 6.5484 | N/A | YES | NO | NO |
| 02248262 | LEVOFLOXACIN | Novo-Levofloxacin 250mg Tab | NOP | 1.2038 | 1.2038 | YES | NO | NO |
| 02285649 | LEVOFLOXACIN | Novo-Levofloxacin (Off-Formulary Interchangeable) 750mg Tab | NOP | 6.5484 | N/A | YES | NO | NO |
| 02248263 | LEVOFLOXACIN | Novo-Levofloxacin 500mg Tab | NOP | 1.3718 | 1.3718 | YES | NO | NO |
| 02492741 | LEVOFLOXACIN | Riva-Levofloxacin (Off-Formulary Interchangeable) 750mg Tab | RIA | 6.5484 | N/A | YES | NO | NO |
| 02492733 | LEVOFLOXACIN | Riva-Levofloxacin 500mg Tab | RIA | 1.3718 | 1.3718 | YES | NO | NO |
| 02492725 | LEVOFLOXACIN | Riva-Levofloxacin 250mg Tab | RIA | 1.2038 | 1.2038 | YES | NO | NO |
| 02298635 | LEVOFLOXACIN | Sandoz Levofloxacin 250mg Tab | SDZ | 1.2038 | 1.2038 | YES | NO | NO |
| 02298643 | LEVOFLOXACIN | Sandoz Levofloxacin 500mg Tab | SDZ | 1.3718 | 1.3718 | YES | NO | NO |
| 02298651 | LEVOFLOXACIN | Sandoz Levofloxacin (Off-Formulary Interchangeable) 750mg Tab | SDZ | 6.5484 | N/A | YES | NO | NO |
| 02459523 | LEVONORGESTREL | Kyleena 19.5mg Insert | BAY | 348.6100 | 348.6100 | NO | NO | NO |
| 02243005 | LEVONORGESTREL | Mirena 52mg Insert | BAY | 372.5500 | 372.5500 | NO | NO | NO |
| 02433532 | LEVONORGESTREL | Backup Plan Onestep 1.5mg Tab-1 Tab Pk | APX | 4.3000 | 4.3000 | YES | NO | NO |
| 02425009 | LEVONORGESTREL | Contingency One 1.5mg Tab-1 Tab Pk | MYL | 4.3000 | 4.3000 | YES | NO | NO |
| 02548461 | LEVONORGESTREL | MyStep 1.5mg Tab-1 Tab Pk | JPC | 4.3000 | 4.3000 | YES | NO | NO |
| 02293854 | LEVONORGESTREL | Plan B 1.5mg Tab-1 Tab Pk | TBP | 17.2000 | 4.3000 | YES | NO | NO |
| 02550776 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine (Off-Formulary Interchangeable) 0.137mg Tab | APX | 0.1906 | N/A | YES | NO | NO |
| 02550806 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.2mg Tab | APX | 0.0526 | 0.0526 | YES | NO | NO |
| 02550792 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.175mg Tab | APX | 0.0740 | 0.0740 | YES | NO | NO |
| 02550784 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.15mg Tab | APX | 0.0495 | 0.0495 | YES | NO | NO |
| 02550768 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.125mg Tab | APX | 0.0690 | 0.0690 | YES | NO | NO |
| 02550741 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.112mg Tab | APX | 0.0682 | 0.0682 | YES | NO | NO |
| 02534681 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.1mg Tab | APX | 0.0460 | 0.0460 | YES | NO | NO |
| 02550733 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.088mg Tab | APX | 0.0646 | 0.0646 | YES | NO | NO |
| 02550725 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.075mg Tab | APX | 0.0646 | 0.0646 | YES | NO | NO |
| 02550717 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.05mg Tab | APX | 0.0373 | 0.0373 | YES | NO | NO |
| 02550709 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.025mg Tab | APX | 0.0597 | 0.0597 | YES | NO | NO |
| 02534703 | LEVOTHYROXINE (SODIUM) | Apo-Levothyroxine 0.3mg Tab | APX | 0.0797 | 0.0797 | YES | NO | NO |
| 02213192 | LEVOTHYROXINE (SODIUM) | Eltroxin 0.05mg Tab | ASN | 0.0373 | 0.0373 | YES | NO | NO |
| 02213206 | LEVOTHYROXINE (SODIUM) | Eltroxin 0.1mg Tab | ASN | 0.0460 | 0.0460 | YES | NO | NO |
| 02213222 | LEVOTHYROXINE (SODIUM) | Eltroxin 0.2mg Tab | ASN | 0.0526 | 0.0526 | YES | NO | NO |
| 02213214 | LEVOTHYROXINE (SODIUM) | Eltroxin 0.15mg Tab | ASN | 0.0495 | 0.0495 | YES | NO | NO |
| 02172097 | LEVOTHYROXINE (SODIUM) | Synthroid 0.088mg Tab | ABB | 0.1220 | 0.0646 | YES | NO | NO |
| 02172089 | LEVOTHYROXINE (SODIUM) | Synthroid 0.075mg Tab | ABB | 0.1220 | 0.0646 | YES | NO | NO |
| 02172127 | LEVOTHYROXINE (SODIUM) | Synthroid 0.15mg Tab | ABB | 0.1028 | 0.0495 | YES | NO | NO |
| 02172070 | LEVOTHYROXINE (SODIUM) | Synthroid 0.05mg Tab | ABB | 0.0775 | 0.0373 | YES | NO | NO |
| 02172143 | LEVOTHYROXINE (SODIUM) | Synthroid 0.2mg Tab | ABB | 0.1092 | 0.0526 | YES | NO | NO |
| 02172062 | LEVOTHYROXINE (SODIUM) | Synthroid 0.025mg Tab | ABB | 0.1129 | 0.0597 | YES | NO | NO |
| 02172119 | LEVOTHYROXINE (SODIUM) | Synthroid 0.125mg Tab | ABB | 0.1304 | 0.0690 | YES | NO | NO |
| 02172100 | LEVOTHYROXINE (SODIUM) | Synthroid 0.1mg Tab | ABB | 0.0956 | 0.0460 | YES | NO | NO |
| 02172151 | LEVOTHYROXINE (SODIUM) | Synthroid 0.3mg Tab | ABB | 0.1506 | 0.0797 | YES | NO | NO |
| 02171228 | LEVOTHYROXINE (SODIUM) | Synthroid 0.112mg Tab | ABB | 0.1289 | 0.0682 | YES | NO | NO |
| 02233852 | LEVOTHYROXINE (SODIUM) | Synthroid (Off-Formulary Interchangeable) 0.137mg Tab | BGP | N/A | N/A | YES | NO | NO |
| 02172135 | LEVOTHYROXINE (SODIUM) | Synthroid 0.175mg Tab | ABB | 0.1398 | 0.0740 | YES | NO | NO |
| 02370921 | LINAGLIPTIN | Trajenta 5mg Tab | BOE | 2.6954 | 2.6954 | NO | NO | YES |
| 02403269 | LINAGLIPTIN & METFORMIN | Jentadueto 2.5mg & 850mg Tab | BOE | 1.4132 | 1.4132 | NO | NO | YES |
| 02403250 | LINAGLIPTIN & METFORMIN | Jentadueto 2.5mg & 500mg Tab | BOE | 1.4132 | 1.4132 | NO | NO | YES |
| 02403277 | LINAGLIPTIN & METFORMIN | Jentadueto 2.5mg & 1000mg Tab | BOE | 1.4132 | 1.4132 | NO | NO | YES |
| 02481278 | LINEZOLID | Linezolid Injection (Off-Formulary Interchangeable) 2mg/mL Inj-300mL Pk | JPC | 88.7400 | 88.7400 | YES | NO | NO |
| 02243685 | LINEZOLID | Zyvoxam (Off-Formulary Interchangeable) 2mg/mL Inj-300mL Pk | PFI | N/A | N/A | YES | NO | NO |
| 02426552 | LINEZOLID | Apo-Linezolid 600mg Tab | APX | 19.3041 | 19.3041 | YES | YES | NO |
| 02520354 | LINEZOLID | Jamp Linezolid 600mg Tab | JPC | 19.3041 | 19.3041 | YES | YES | NO |
| 02422689 | LINEZOLID | Sandoz Linezolid 600mg Tab | SDZ | 19.3041 | 19.3041 | YES | YES | NO |
| 02243684 | LINEZOLID | Zyvoxam (Not a Benefit) 600mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02549999 | LIOTHYRONINE (SODIUM) | Auro-Liothyronine (Off-Formulary Interchangeable) 5mcg Tab | AUR | 1.1587 | 1.1587 | YES | NO | NO |
| 02550008 | LIOTHYRONINE (SODIUM) | Auro-Liothyronine (Off-Formulary Interchangeable) 25mcg Tab | AUR | 1.2595 | 1.2595 | YES | NO | NO |
| 01919458 | LIOTHYRONINE (SODIUM) | Cytomel (Off-Formulary Interchangeable) 5mcg Tab | SKB | N/A | N/A | YES | NO | NO |
| 01919466 | LIOTHYRONINE (SODIUM) | Cytomel (Off-Formulary Interchangeable) 25mcg Tab | SKB | N/A | N/A | YES | NO | NO |
| 02494337 | LIOTHYRONINE (SODIUM) | Teva-Liothyronine (Off-Formulary Interchangeable) 5mcg Tab | TEV | 1.1587 | 1.1587 | YES | NO | NO |
| 02494345 | LIOTHYRONINE (SODIUM) | Teva-Liothyronine (Off-Formulary Interchangeable) 25mcg Tab | TEV | 1.2595 | 1.2595 | YES | NO | NO |
| 02494639 | LIPASE & AMYLASE & PROTEASE | Creon Minimicrospheres 35 35000 & 35700 & 2240 Units | BGP | 0.9531 | 0.9531 | NO | YES | NO |
| 02546663 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Capsules 30mg Cap | APX | 0.8469 | 0.8469 | YES | NO | YES |
| 02546671 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Capsules 40mg Cap | APX | 0.9857 | 0.9857 | YES | NO | YES |
| 02546655 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Capsules 20mg Cap | APX | 0.7081 | 0.7081 | YES | NO | YES |
| 02546728 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Capsules (Off-Formulary Interchangeable) 70mg Cap | APX | 4.6968 | N/A | YES | NO | YES |
| 02546698 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Capsules 50mg Cap | APX | 1.1246 | 1.1246 | YES | NO | YES |
| 02546647 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Capsules 10mg Cap | APX | 0.5692 | 0.5692 | YES | NO | YES |
| 02546701 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Capsules 60mg Cap | APX | 1.2634 | 1.2634 | YES | NO | YES |
| 02535130 | LISDEXAMFETAMINE DIMESYLATE | Jamp Lisdexamfetamine 20mg Cap | JPC | 0.7081 | 0.7081 | YES | NO | YES |
| 02535173 | LISDEXAMFETAMINE DIMESYLATE | Jamp Lisdexamfetamine 60mg Cap | JPC | 1.2634 | 1.2634 | YES | NO | YES |
| 02535165 | LISDEXAMFETAMINE DIMESYLATE | Jamp Lisdexamfetamine 50mg Cap | JPC | 1.1246 | 1.1246 | YES | NO | YES |
| 02535157 | LISDEXAMFETAMINE DIMESYLATE | Jamp Lisdexamfetamine 40mg Cap | JPC | 0.9857 | 0.9857 | YES | NO | YES |
| 02535149 | LISDEXAMFETAMINE DIMESYLATE | Jamp Lisdexamfetamine 30mg Cap | JPC | 0.8469 | 0.8469 | YES | NO | YES |
| 02535122 | LISDEXAMFETAMINE DIMESYLATE | Jamp Lisdexamfetamine 10mg Cap | JPC | 0.5692 | 0.5692 | YES | NO | YES |
| 02535181 | LISDEXAMFETAMINE DIMESYLATE | Jamp Lisdexamfetamine (Off-Formulary Interchangeable) 70mg Cap | JPC | 4.6968 | N/A | YES | NO | YES |
| 02546264 | LISDEXAMFETAMINE DIMESYLATE | Sandoz Lisdexamfetamine Capsules 30mg Cap | SDZ | 0.8469 | 0.8469 | YES | NO | YES |
| 02546248 | LISDEXAMFETAMINE DIMESYLATE | Sandoz Lisdexamfetamine Capsules 10mg Cap | SDZ | 0.5692 | 0.5692 | YES | NO | YES |
| 02546256 | LISDEXAMFETAMINE DIMESYLATE | Sandoz Lisdexamfetamine Capsules 20mg Cap | SDZ | 0.7081 | 0.7081 | YES | NO | YES |
| 02546302 | LISDEXAMFETAMINE DIMESYLATE | Sandoz Lisdexamfetamine Capsules (Off-Formulary Interchangeable) 70mg Cap | SDZ | 4.6968 | N/A | YES | NO | YES |
| 02546299 | LISDEXAMFETAMINE DIMESYLATE | Sandoz Lisdexamfetamine Capsules 60mg Cap | SDZ | 1.2634 | 1.2634 | YES | NO | YES |
| 02546280 | LISDEXAMFETAMINE DIMESYLATE | Sandoz Lisdexamfetamine Capsules 50mg Cap | SDZ | 1.1246 | 1.1246 | YES | NO | YES |
| 02546272 | LISDEXAMFETAMINE DIMESYLATE | Sandoz Lisdexamfetamine Capsules 40mg Cap | SDZ | 0.9857 | 0.9857 | YES | NO | YES |
| 02545942 | LISDEXAMFETAMINE DIMESYLATE | Teva Lisdexamfetamine (Off-Formulary Interchangeable) 70mg Cap | TEV | 4.6968 | N/A | YES | NO | YES |
| 02545926 | LISDEXAMFETAMINE DIMESYLATE | Teva-Lisdexamfetamine 50mg Cap | TEV | 1.1246 | 1.1246 | YES | NO | YES |
| 02545934 | LISDEXAMFETAMINE DIMESYLATE | Teva-Lisdexamfetamine 60mg Cap | TEV | 1.2634 | 1.2634 | YES | NO | YES |
| 02545918 | LISDEXAMFETAMINE DIMESYLATE | Teva-Lisdexamfetamine 40mg Cap | TEV | 0.9857 | 0.9857 | YES | NO | YES |
| 02545896 | LISDEXAMFETAMINE DIMESYLATE | Teva-Lisdexamfetamine 30mg Cap | TEV | 0.8469 | 0.8469 | YES | NO | YES |
| 02545861 | LISDEXAMFETAMINE DIMESYLATE | Teva-Lisdexamfetamine 10mg Cap | TEV | 0.5692 | 0.5692 | YES | NO | YES |
| 02545888 | LISDEXAMFETAMINE DIMESYLATE | Teva-Lisdexamfetamine 20mg Cap | TEV | 0.7081 | 0.7081 | YES | NO | YES |
| 02322951 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 30mg Cap | TAK | 3.5196 | 0.8469 | YES | NO | YES |
| 02458071 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse (Off-Formulary Interchangeable) 70mg Cap | TAK | N/A | N/A | YES | NO | YES |
| 02347164 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 40mg Cap | TAK | 4.0966 | 0.9857 | YES | NO | YES |
| 02347156 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 20mg Cap | TAK | 2.9426 | 0.7081 | YES | NO | YES |
| 02347172 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 60mg Cap | TAK | 5.2505 | 1.2634 | YES | NO | YES |
| 02322978 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 50mg Cap | TAK | 4.6736 | 1.1246 | YES | NO | YES |
| 02439603 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 10mg Cap | TAK | 2.3656 | 0.5692 | YES | NO | YES |
| 02534460 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Chewable Tablets 30mg Chew Tab | APX | 1.6938 | 1.6938 | YES | NO | YES |
| 02534479 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Chewable Tablets 40mg Chew Tab | APX | 1.9715 | 1.9715 | YES | NO | YES |
| 02534487 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Chewable Tablets 50mg Chew Tab | APX | 2.2491 | 2.2491 | YES | NO | YES |
| 02534495 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Chewable Tablets 60mg Chew Tab | APX | 2.5268 | 2.5268 | YES | NO | YES |
| 02534444 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Chewable Tablets 10mg Chew Tab | APX | 1.1385 | 1.1385 | YES | NO | YES |
| 02534452 | LISDEXAMFETAMINE DIMESYLATE | Apo-Lisdexamfetamine Chewable Tablets 20mg Chew Tab | APX | 1.4161 | 1.4161 | YES | NO | YES |
| 02533391 | LISDEXAMFETAMINE DIMESYLATE | Taro-Lisdexamfetamine Chewable Tablets 60mg Chew Tab | TAR | 2.5268 | 2.5268 | YES | NO | YES |
| 02533340 | LISDEXAMFETAMINE DIMESYLATE | Taro-Lisdexamfetamine Chewable Tablets 10mg Chew Tab | TAR | 1.1385 | 1.1385 | YES | NO | YES |
| 02533383 | LISDEXAMFETAMINE DIMESYLATE | Taro-Lisdexamfetamine Chewable Tablets 50mg Chew Tab | TAR | 2.2491 | 2.2491 | YES | NO | YES |
| 02533367 | LISDEXAMFETAMINE DIMESYLATE | Taro-Lisdexamfetamine Chewable Tablets 30mg Chew Tab | TAR | 1.6938 | 1.6938 | YES | NO | YES |
| 02533375 | LISDEXAMFETAMINE DIMESYLATE | Taro-Lisdexamfetamine Chewable Tablets 40mg Chew Tab | TAR | 1.9715 | 1.9715 | YES | NO | YES |
| 02533359 | LISDEXAMFETAMINE DIMESYLATE | Taro-Lisdexamfetamine Chewable Tablets 20mg Chew Tab | TAR | 1.4161 | 1.4161 | YES | NO | YES |
| 02490277 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 60mg Chew Tab | TAK | 5.2505 | 2.5268 | YES | NO | YES |
| 02490269 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 50mg Chew Tab | TAK | 4.6736 | 2.2491 | YES | NO | YES |
| 02490242 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 30mg Chew Tab | TAK | 3.5196 | 1.6938 | YES | NO | YES |
| 02490234 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 20mg Chew Tab | TAK | 2.9426 | 1.4161 | YES | NO | YES |
| 02490226 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 10mg Chew Tab | TAK | 2.3656 | 1.1385 | YES | NO | YES |
| 02490250 | LISDEXAMFETAMINE DIMESYLATE | Vyvanse 40mg Chew Tab | TAK | 4.0966 | 1.9715 | YES | NO | YES |
| 02217503 | LISINOPRIL | Apo-Lisinopril 10mg Tab | APX | 0.1619 | 0.1619 | YES | NO | NO |
| 02217481 | LISINOPRIL | Apo-Lisinopril 5mg Tab | APX | 0.1347 | 0.1347 | YES | NO | NO |
| 09853685 | LISINOPRIL | Apo-Lisinopril 5mg Tab | APX | 0.1428 | 0.1428 | YES | NO | NO |
| 09853960 | LISINOPRIL | Apo-Lisinopril 10mg Tab | APX | 0.1716 | 0.1716 | YES | NO | NO |
| 09854010 | LISINOPRIL | Apo-Lisinopril 20mg Tab | APX | 0.2063 | 0.2063 | YES | NO | NO |
| 02217511 | LISINOPRIL | Apo-Lisinopril 20mg Tab | APX | 0.1945 | 0.1945 | YES | NO | NO |
| 02394480 | LISINOPRIL | Auro-Lisinopril 10mg Tab | AUR | 0.1619 | 0.1619 | YES | NO | NO |
| 02394472 | LISINOPRIL | Auro-Lisinopril 5mg Tab | AUR | 0.1347 | 0.1347 | YES | NO | NO |
| 02394499 | LISINOPRIL | Auro-Lisinopril 20mg Tab | AUR | 0.1945 | 0.1945 | YES | NO | NO |
| 02271451 | LISINOPRIL | Co Lisinopril 10mg Tab | COB | 0.1619 | 0.1619 | YES | NO | NO |
| 02271478 | LISINOPRIL | Co Lisinopril 20mg Tab | COB | 0.1945 | 0.1945 | YES | NO | NO |
| 02271443 | LISINOPRIL | Co Lisinopril 5mg Tab | COB | 0.1347 | 0.1347 | YES | NO | NO |
| 02361566 | LISINOPRIL | Jamp-Lisinopril 20mg Tab | JPC | 0.1945 | 0.1945 | YES | NO | NO |
| 02361558 | LISINOPRIL | Jamp-Lisinopril 10mg Tab | JPC | 0.1619 | 0.1619 | YES | NO | NO |
| 02361531 | LISINOPRIL | Jamp-Lisinopril 5mg Tab | JPC | 0.1347 | 0.1347 | YES | NO | NO |
| 02386240 | LISINOPRIL | Lisinopril 10mg Tab | SIV | 0.1619 | 0.1619 | YES | NO | NO |
| 02386232 | LISINOPRIL | Lisinopril 5mg Tab | SIV | 0.1347 | 0.1347 | YES | NO | NO |
| 02525186 | LISINOPRIL | Lisinopril 5mg Tab | SAI | 0.1347 | 0.1347 | YES | NO | NO |
| 02525208 | LISINOPRIL | Lisinopril 20mg Tab | SAI | 0.1945 | 0.1945 | YES | NO | NO |
| 02386259 | LISINOPRIL | Lisinopril 20mg Tab | SIV | 0.1945 | 0.1945 | YES | NO | NO |
| 02525194 | LISINOPRIL | Lisinopril 10mg Tab | SAI | 0.1619 | 0.1619 | YES | NO | NO |
| 00839418 | LISINOPRIL | Prinivil 20mg Tab | MFC | 1.1408 | 0.2063 | YES | NO | NO |
| 00839388 | LISINOPRIL | Prinivil (Not a Benefit) 5mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 00839396 | LISINOPRIL | Prinivil 10mg Tab | MFC | 0.9489 | 0.1716 | YES | NO | NO |
| 02294230 | LISINOPRIL | Ran-Lisinopril 5mg Tab | RAN | 0.1347 | 0.1347 | YES | NO | NO |
| 02294249 | LISINOPRIL | Ran-Lisinopril 10mg Tab | RAN | 0.1619 | 0.1619 | YES | NO | NO |
| 02294257 | LISINOPRIL | Ran-Lisinopril 20mg Tab | RAN | 0.1945 | 0.1945 | YES | NO | NO |
| 02289229 | LISINOPRIL | Sandoz Lisinopril 20mg Tab | SDZ | 0.1945 | 0.1945 | YES | NO | NO |
| 02289199 | LISINOPRIL | Sandoz Lisinopril 5mg Tab | SDZ | 0.1347 | 0.1347 | YES | NO | NO |
| 09857287 | LISINOPRIL | Sandoz Lisinopril 20mg Tab | SDZ | 0.2063 | 0.2063 | YES | NO | NO |
| 09857286 | LISINOPRIL | Sandoz Lisinopril 10mg Tab | SDZ | 0.1716 | 0.1716 | YES | NO | NO |
| 02289202 | LISINOPRIL | Sandoz Lisinopril 10mg Tab | SDZ | 0.1619 | 0.1619 | YES | NO | NO |
| 09857272 | LISINOPRIL | Sandoz Lisinopril 5mg Tab | SDZ | 0.1428 | 0.1428 | YES | NO | NO |
| 02285096 | LISINOPRIL | Teva-Lisinopril (Type P) 20mg Tab | TEV | 0.2063 | 0.2063 | YES | NO | NO |
| 02285088 | LISINOPRIL | Teva-Lisinopril (Type P) 10mg Tab | TEV | 0.1716 | 0.1716 | YES | NO | NO |
| 02285061 | LISINOPRIL | Teva-Lisinopril (Type P) 5mg Tab | TEV | 0.1428 | 0.1428 | YES | NO | NO |
| 02285126 | LISINOPRIL | Teva-Lisinopril (Type Z) 10mg Tab | TEV | 0.1619 | 0.1619 | YES | NO | NO |
| 02285118 | LISINOPRIL | Teva-Lisinopril (Type Z) 5mg Tab | TEV | 0.1347 | 0.1347 | YES | NO | NO |
| 02285134 | LISINOPRIL | Teva-Lisinopril (Type Z) 20mg Tab | TEV | 0.1945 | 0.1945 | YES | NO | NO |
| 02049376 | LISINOPRIL | Zestril 10mg Tab | AZC | 0.6935 | 0.1619 | YES | NO | NO |
| 02049384 | LISINOPRIL | Zestril 20mg Tab | AZC | 0.8330 | 0.1945 | YES | NO | NO |
| 02049333 | LISINOPRIL | Zestril 5mg Tab | AZC | 0.5770 | 0.1347 | YES | NO | NO |
| 02362945 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Lisinopril/HCTZ (Type Z) 10mg & 12.5mg Tab | SAI | 0.2084 | 0.2084 | YES | NO | NO |
| 02362953 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Lisinopril/HCTZ (Type Z) 20mg & 12.5mg Tab | SAI | 0.2504 | 0.2504 | YES | NO | NO |
| 02362961 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Lisinopril/HCTZ (Type Z) (Off-Formulary Interchangeable) 20mg & 25mg Tab | SAI | 0.7011 | N/A | YES | NO | NO |
| 00884413 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Prinzide (Not a Benefit) 20mg & 12.5mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 02108194 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Prinzide (Not a Benefit) 10mg & 12.5mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 00884421 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Prinzide (Off-Formulary Interchangeable) 20mg/25mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 02302365 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Sandoz Lisinopril HCT 10mg & 12.5mg Tab | SDZ | 0.2084 | 0.2084 | YES | NO | NO |
| 02302381 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Sandoz Lisinopril HCT (Off-Formulary Interchangeable) 20mg & 25mg Tab | SDZ | 0.7011 | N/A | YES | NO | NO |
| 02302373 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Sandoz Lisinopril HCT 20mg & 12.5mg Tab | SDZ | 0.2504 | 0.2504 | YES | NO | NO |
| 02302136 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Teva-Lisinopril/HCTZ (Type P) 10mg & 12.5mg Tab | TEV | 0.3334 | 0.3334 | YES | NO | NO |
| 02302144 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Teva-Lisinopril/HCTZ (Type P) 20mg & 12.5mg Tab | TEV | 0.4006 | 0.4006 | YES | NO | NO |
| 02302152 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Teva-Lisinopril/HCTZ (Type P) (Off-Formulary Interchangeable) 20mg/25mg Tab | TEV | 0.7011 | N/A | YES | NO | NO |
| 02301784 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Teva-Lisinopril/HCTZ (Type Z) (Off-Formulary Interchangeable) 20mg & 25mg Tab | TEV | 0.7011 | N/A | YES | NO | NO |
| 02301768 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Teva-Lisinopril/HCTZ (Type Z) 10mg & 12.5mg Tab | TEV | 0.2084 | 0.2084 | YES | NO | NO |
| 02301776 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Teva-Lisinopril/HCTZ (Type Z) 20mg & 12.5mg Tab | TEV | 0.2504 | 0.2504 | YES | NO | NO |
| 02045729 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Zestoretic (Off-Formulary Interchangeable) 20mg & 25mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02045737 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Zestoretic 20mg & 12.5mg Tab | AZC | 1.1159 | 0.2504 | YES | NO | NO |
| 02103729 | LISINOPRIL & HYDROCHLOROTHIAZIDE | Zestoretic 10mg & 12.5mg Tab | AZC | 0.9286 | 0.2084 | YES | NO | NO |
| 02242837 | LITHIUM CARBONATE | Apo-Lithium Carbonate 150mg Cap | APX | 0.0667 | 0.0667 | YES | NO | NO |
| 02242838 | LITHIUM CARBONATE | Apo-Lithium Carbonate 300mg Cap | APX | 0.0657 | 0.0657 | YES | NO | NO |
| 09857540 | LITHIUM CARBONATE | Apo-Lithium Carbonate 300mg Cap | APX | 0.0657 | 0.0657 | YES | NO | NO |
| 09857532 | LITHIUM CARBONATE | Apo-Lithium Carbonate 150mg Cap | APX | 0.0667 | 0.0667 | YES | NO | NO |
| 00461733 | LITHIUM CARBONATE | Carbolith 150mg Cap | VAL | 0.1560 | 0.0667 | YES | NO | NO |
| 00236683 | LITHIUM CARBONATE | Carbolith 300mg Cap | VAL | 0.1212 | 0.0657 | YES | NO | NO |
| 00406775 | LITHIUM CARBONATE | Lithane 300mg Cap | SLP | 0.1892 | 0.0657 | YES | NO | NO |
| 02013231 | LITHIUM CARBONATE | Lithane 150mg Cap | SLP | 0.1892 | 0.0667 | YES | NO | NO |
| 02216140 | LITHIUM CARBONATE | PMS-Lithium Carbonate 300mg Cap | PMS | 0.0657 | 0.0657 | YES | NO | NO |
| 02216132 | LITHIUM CARBONATE | PMS-Lithium Carbonate 150mg Cap | PMS | 0.0667 | 0.0667 | YES | NO | NO |
| 00590665 | LITHIUM CARBONATE | Duralith (Off-Formulary Interchangeable) 300mg ER Tab | JNO | N/A | N/A | YES | NO | NO |
| 02266695 | LITHIUM CARBONATE | Lithmax (Off-Formulary Interchangeable) 300mg ER Tab | AAP | 0.2880 | 0.2880 | YES | NO | NO |
| 00893560 | LODOXAMIDE TROMETHAMINE | Alomide 0.1% Oph Sol | NOV | 1.4890 | 1.4890 | NO | NO | YES |
| 00360414 | LOMUSTINE (CCNU) | CeeNU 100mg Cap | BQU | 22.4550 | 22.4550 | NO | NO | NO |
| 00360422 | LOMUSTINE (CCNU) | CeeNU 40mg Cap | BQU | 13.6025 | 13.6025 | NO | NO | NO |
| 00360430 | LOMUSTINE (CCNU) | CeeNU 10mg Cap | BQU | 7.8900 | 7.8900 | NO | NO | NO |
| 09858359 | LOMUSTINE (CCNU) | Gleostine (Temporary Benefit) 10mg Cap | SET | 211.2400 | 211.2400 | NO | NO | NO |
| 09858382 | LOMUSTINE (CCNU) | Lomustine (Temporary Benefit) 40mg Cap | SET | 336.9200 | 336.9200 | NO | NO | NO |
| 02212005 | LOPERAMIDE HCL | Apo-Loperamide 2mg Caplet | APX | 0.0952 | 0.0952 | YES | YES | NO |
| 00860743 | LOPERAMIDE HCL | Imodium (Not a Benefit) 2mg Caplet | JAN | N/A | N/A | YES | NO | NO |
| 02228351 | LOPERAMIDE HCL | PMS-Loperamide 2mg Caplet | PMS | 0.0952 | 0.0952 | YES | YES | NO |
| 02132591 | LOPERAMIDE HCL | Teva-Loperamide 2mg Caplet | TEV | 0.0952 | 0.0952 | YES | YES | NO |
| 02243644 | LOPINAVIR & RITONAVIR | Kaletra 80mg/mL & 20mg/mL O/L | ABV | 2.3688 | 2.3688 | NO | NO | NO |
| 02285533 | LOPINAVIR & RITONAVIR | Kaletra 200mg & 50mg Tab | ABV | 5.8633 | 5.8633 | NO | NO | NO |
| 02312301 | LOPINAVIR & RITONAVIR | Kaletra 100mg & 25mg Tab | ABV | 2.9317 | 2.9317 | NO | NO | NO |
| 02243880 | LORATADINE | Apo-Loratadine (Off-Formulary Interchangeable) 10mg Tab | APX | 0.6267 | 0.6267 | YES | NO | NO |
| 00782696 | LORATADINE | Claritin (Off-Formulary Interchangeable) 10mg Tab | SCP | N/A | N/A | YES | NO | NO |
| 02041405 | LORAZEPAM | Ativan (Not a Benefit) 4mg/mL Inj Sol (with preservative) | WAY | N/A | N/A | YES | NO | NO |
| 02243278 | LORAZEPAM | Lorazepam Injection USP 4mg/mL Inj Sol (with preservative) | SDZ | 21.2000 | 21.2000 | YES | YES | NO |
| 02041464 | LORAZEPAM | Ativan (Off-Formulary Interchangeable) 1mg SL Tab | PFI | N/A | N/A | YES | NO | NO |
| 02041472 | LORAZEPAM | Ativan (Off-Formulary Interchangeable) 2mg SL Tab | PFI | N/A | N/A | YES | NO | NO |
| 02041456 | LORAZEPAM | Ativan (Off-Formulary Interchangeable) 0.5mg SL Tab | PFI | N/A | N/A | YES | NO | NO |
| 02410745 | LORAZEPAM | Lorazepam Sublingual (Off-Formulary Interchangeable) 0.5mg SL Tab | AAP | 0.1099 | N/A | YES | NO | NO |
| 02410761 | LORAZEPAM | Lorazepam Sublingual (Off-Formulary Interchangeable) 2mg SL Tab | AAP | 0.2152 | N/A | YES | NO | NO |
| 02410753 | LORAZEPAM | Lorazepam Sublingual (Off-Formulary Interchangeable) 1mg SL Tab | AAP | 0.1385 | N/A | YES | NO | NO |
| 00655767 | LORAZEPAM | Apo-Lorazepam 2mg Tab | APX | 0.0699 | 0.0699 | YES | NO | NO |
| 00655759 | LORAZEPAM | Apo-Lorazepam 1mg Tab | APX | 0.0447 | 0.0447 | YES | NO | NO |
| 00655740 | LORAZEPAM | Apo-Lorazepam 0.5mg Tab | APX | 0.0359 | 0.0359 | YES | NO | NO |
| 02041413 | LORAZEPAM | Ativan 0.5mg Tab | PFI | 0.0479 | 0.0359 | YES | NO | NO |
| 02041448 | LORAZEPAM | Ativan 2mg Tab | PFI | 0.0885 | 0.0699 | YES | NO | NO |
| 02041421 | LORAZEPAM | Ativan 1mg Tab | PFI | 0.0565 | 0.0447 | YES | NO | NO |
| 00728187 | LORAZEPAM | PMS-Lorazepam 0.5mg Tab | PMS | 0.0359 | 0.0359 | YES | NO | NO |
| 00728209 | LORAZEPAM | PMS-Lorazepam 2mg Tab | PMS | 0.0699 | 0.0699 | YES | NO | NO |
| 00728195 | LORAZEPAM | PMS-Lorazepam 1mg Tab | PMS | 0.0447 | 0.0447 | YES | NO | NO |
| 00637750 | LORAZEPAM | Teva-Lorazepam 2mg Tab | TEV | 0.0699 | 0.0699 | YES | NO | NO |
| 00711101 | LORAZEPAM | Teva-Lorazepam 0.5mg Tab | TEV | 0.0359 | 0.0359 | YES | NO | NO |
| 00637742 | LORAZEPAM | Teva-Lorazepam 1mg Tab | TEV | 0.0447 | 0.0447 | YES | NO | NO |
| 02353512 | LOSARTAN POTASSIUM | Apo-Losartan 100mg Tab | APX | 0.3148 | 0.3147 | YES | NO | NO |
| 02353504 | LOSARTAN POTASSIUM | Apo-Losartan 50mg Tab | APX | 0.3148 | 0.3147 | YES | NO | NO |
| 02379058 | LOSARTAN POTASSIUM | Apo-Losartan 25mg Tab | APX | 0.3148 | 0.3147 | YES | NO | NO |
| 02403331 | LOSARTAN POTASSIUM | Auro-Losartan 50mg Tab | AUR | 0.3147 | 0.3147 | YES | NO | NO |
| 02403358 | LOSARTAN POTASSIUM | Auro-Losartan 100mg Tab | AUR | 0.3147 | 0.3147 | YES | NO | NO |
| 02403323 | LOSARTAN POTASSIUM | Auro-Losartan 25mg Tab | AUR | 0.3147 | 0.3147 | YES | NO | NO |
| 02445964 | LOSARTAN POTASSIUM | Bio-Losartan 25mg Tab | BMP | 0.3147 | 0.3147 | YES | NO | NO |
| 02445972 | LOSARTAN POTASSIUM | Bio-Losartan 50mg Tab | BMP | 0.3147 | 0.3147 | YES | NO | NO |
| 02445980 | LOSARTAN POTASSIUM | Bio-Losartan 100mg Tab | BMP | 0.3147 | 0.3147 | YES | NO | NO |
| 02354829 | LOSARTAN POTASSIUM | Co Losartan 25mg Tab | COB | 0.3148 | 0.3147 | YES | NO | NO |
| 02354837 | LOSARTAN POTASSIUM | Co Losartan 50mg Tab | COB | 0.3148 | 0.3147 | YES | NO | NO |
| 02354845 | LOSARTAN POTASSIUM | Co Losartan 100mg Tab | COB | 0.3148 | 0.3147 | YES | NO | NO |
| 02182815 | LOSARTAN POTASSIUM | Cozaar 25mg Tab | OCI | 1.9924 | 0.3147 | YES | NO | NO |
| 02182882 | LOSARTAN POTASSIUM | Cozaar 100mg Tab | OCI | 1.9924 | 0.3147 | YES | NO | NO |
| 02182874 | LOSARTAN POTASSIUM | Cozaar 50mg Tab | OCI | 1.9924 | 0.3147 | YES | NO | NO |
| 02398842 | LOSARTAN POTASSIUM | Jamp-Losartan 50mg Tab | JPC | 0.3147 | 0.3147 | YES | NO | NO |
| 02398850 | LOSARTAN POTASSIUM | Jamp-Losartan 100mg Tab | JPC | 0.3147 | 0.3147 | YES | NO | NO |
| 02398834 | LOSARTAN POTASSIUM | Jamp-Losartan 25mg Tab | JPC | 0.3147 | 0.3147 | YES | NO | NO |
| 02388898 | LOSARTAN POTASSIUM | Losartan 100mg Tab | SAI | 0.3147 | 0.3147 | YES | NO | NO |
| 02388812 | LOSARTAN POTASSIUM | Losartan 100mg Tab | SIV | 0.3147 | 0.3147 | YES | NO | NO |
| 02388871 | LOSARTAN POTASSIUM | Losartan 50mg Tab | SAI | 0.3147 | 0.3147 | YES | NO | NO |
| 02388804 | LOSARTAN POTASSIUM | Losartan 50mg Tab | SIV | 0.3147 | 0.3147 | YES | NO | NO |
| 02388863 | LOSARTAN POTASSIUM | Losartan 25mg Tab | SAI | 0.3147 | 0.3147 | YES | NO | NO |
| 02388790 | LOSARTAN POTASSIUM | Losartan 25mg Tab | SIV | 0.3147 | 0.3147 | YES | NO | NO |
| 02405741 | LOSARTAN POTASSIUM | Mint-Losartan 50mg Tab | MIN | 0.3147 | 0.3147 | YES | NO | NO |
| 02405768 | LOSARTAN POTASSIUM | Mint-Losartan 100mg Tab | MIN | 0.3147 | 0.3147 | YES | NO | NO |
| 02405733 | LOSARTAN POTASSIUM | Mint-Losartan 25mg Tab | MIN | 0.3147 | 0.3147 | YES | NO | NO |
| 02309777 | LOSARTAN POTASSIUM | PMS-Losartan 100mg Tab | PMS | 0.3147 | 0.3147 | YES | NO | NO |
| 02309750 | LOSARTAN POTASSIUM | PMS-Losartan 25mg Tab | PMS | 0.3147 | 0.3147 | YES | NO | NO |
| 02309769 | LOSARTAN POTASSIUM | PMS-Losartan 50mg Tab | PMS | 0.3147 | 0.3147 | YES | NO | NO |
| 02404486 | LOSARTAN POTASSIUM | Ran-Losartan 100mg Tab | RAN | 0.3147 | 0.3147 | YES | NO | NO |
| 02404478 | LOSARTAN POTASSIUM | Ran-Losartan 50mg Tab | RAN | 0.3147 | 0.3147 | YES | NO | NO |
| 02404451 | LOSARTAN POTASSIUM | Ran-Losartan 25mg Tab | RAN | 0.3147 | 0.3147 | YES | NO | NO |
| 02313340 | LOSARTAN POTASSIUM | Sandoz Losartan 50mg Tab | SDZ | 0.3147 | 0.3147 | YES | NO | NO |
| 02313359 | LOSARTAN POTASSIUM | Sandoz Losartan 100mg Tab | SDZ | 0.3147 | 0.3147 | YES | NO | NO |
| 02313332 | LOSARTAN POTASSIUM | Sandoz Losartan 25mg Tab | SDZ | 0.3147 | 0.3147 | YES | NO | NO |
| 02424967 | LOSARTAN POTASSIUM | Septa-Losartan 25mg Tab | SET | 0.3147 | 0.3147 | YES | NO | NO |
| 02424975 | LOSARTAN POTASSIUM | Septa-Losartan 50mg Tab | SET | 0.3147 | 0.3147 | YES | NO | NO |
| 02424983 | LOSARTAN POTASSIUM | Septa-Losartan 100mg Tab | SET | 0.3147 | 0.3147 | YES | NO | NO |
| 02380838 | LOSARTAN POTASSIUM | Teva-Losartan 25mg Tab | TEV | 0.3148 | 0.3147 | YES | NO | NO |
| 02357968 | LOSARTAN POTASSIUM | Teva-Losartan 50mg Tab | TEV | 0.3148 | 0.3147 | YES | NO | NO |
| 02357976 | LOSARTAN POTASSIUM | Teva-Losartan 100mg Tab | TEV | 0.3148 | 0.3147 | YES | NO | NO |
| 02371251 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Apo-Losartan/HCTZ 100mg & 25mg Tab | APX | 0.3148 | 0.3147 | YES | NO | NO |
| 02371235 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Apo-Losartan/HCTZ 50mg & 12.5mg Tab | APX | 0.3148 | 0.3147 | YES | NO | NO |
| 02371243 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Apo-Losartan/HCTZ 100mg & 12.5mg Tab | APX | 0.3082 | 0.3082 | YES | NO | NO |
| 02423669 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Auro-Losartan HCT 100mg & 25mg Tab | AUR | 0.3147 | 0.3147 | YES | NO | NO |
| 02423642 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Auro-Losartan HCT 50mg & 12.5mg Tab | AUR | 0.3147 | 0.3147 | YES | NO | NO |
| 02423650 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Auro-Losartan HCT 100mg & 12.5mg Tab | AUR | 0.3082 | 0.3082 | YES | NO | NO |
| 02388286 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Co Losartan/HCT 100mg & 25mg Tab | COB | 0.3147 | 0.3147 | YES | NO | NO |
| 02388251 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Co Losartan/HCT 50mg & 12.5mg Tab | COB | 0.3147 | 0.3147 | YES | NO | NO |
| 02388278 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Co Losartan/HCT 100mg & 12.5mg Tab | COB | 0.3082 | 0.3082 | YES | NO | NO |
| 02297841 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Hyzaar 100mg & 12.5mg Tab | OCI | 1.9508 | 0.3082 | YES | NO | NO |
| 02230047 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Hyzaar 50mg & 12.5mg Tab | OCI | 1.9924 | 0.3147 | YES | NO | NO |
| 02241007 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Hyzaar DS 100mg & 25mg Tab | OCI | 1.9924 | 0.3147 | YES | NO | NO |
| 02408252 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Jamp-Losartan HCTZ 100mg & 25mg Tab | JPC | 0.3147 | 0.3147 | YES | NO | NO |
| 02408244 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Jamp-Losartan HCTZ 50mg & 12.5mg Tab | JPC | 0.3147 | 0.3147 | YES | NO | NO |
| 02388987 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Losartan HCT 100mg & 25mg Tab | SIV | 0.3147 | 0.3147 | YES | NO | NO |
| 02388979 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Losartan HCT 100mg & 12.5mg Tab | SIV | 0.3082 | 0.3082 | YES | NO | NO |
| 02388960 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Losartan HCT 50mg & 12.5mg Tab | SIV | 0.3147 | 0.3147 | YES | NO | NO |
| 02427656 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Losartan/HCTZ 100mg & 12.5mg Tab | SAI | 0.3082 | 0.3082 | YES | NO | NO |
| 02427664 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Losartan/HCTZ 100mg & 25mg Tab | SAI | 0.3147 | 0.3147 | YES | NO | NO |
| 02427648 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Losartan/HCTZ 50mg & 12.5mg Tab | SAI | 0.3147 | 0.3147 | YES | NO | NO |
| 02389657 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Mint-Losartan/HCTZ 50mg & 12.5mg Tab | MIN | 0.3147 | 0.3147 | YES | NO | NO |
| 02389665 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Mint-Losartan/HCTZ 100mg & 12.5mg Tab | MIN | 0.3082 | 0.3082 | YES | NO | NO |
| 02389673 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Mint-Losartan/HCTZ DS 100mg & 25mg Tab | MIN | 0.3147 | 0.3147 | YES | NO | NO |
| 02392232 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | PMS-Losartan-HCTZ 100mg & 12.5mg Tab | PMS | 0.3082 | 0.3082 | YES | NO | NO |
| 02392240 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | PMS-Losartan-HCTZ 100mg & 25mg Tab | PMS | 0.3147 | 0.3147 | YES | NO | NO |
| 02392224 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | PMS-Losartan-HCTZ 50mg & 12.5mg Tab | PMS | 0.3147 | 0.3147 | YES | NO | NO |
| 02362449 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Sandoz Losartan HCT 100mg & 12.5mg Tab | SDZ | 0.3082 | 0.3082 | YES | NO | NO |
| 02313375 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Sandoz Losartan HCT 50mg & 12.5mg Tab | SDZ | 0.3147 | 0.3147 | YES | NO | NO |
| 02313383 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Sandoz Losartan HCT DS 100mg & 25mg Tab | SDZ | 0.3147 | 0.3147 | YES | NO | NO |
| 02428539 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Septa-Losartan HCTZ 50mg & 12.5mg Tab | SET | 0.3147 | 0.3147 | YES | NO | NO |
| 02428547 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Septa-Losartan HCTZ 100mg & 25mg Tab | SET | 0.3147 | 0.3147 | YES | NO | NO |
| 02358263 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Teva-Losartan/HCTZ 50mg & 12.5mg Tab | TEV | 0.3148 | 0.3147 | YES | NO | NO |
| 02377152 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Teva-Losartan/HCTZ 100mg & 25mg Tab | TEV | 0.3148 | 0.3147 | YES | NO | NO |
| 02377144 | LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE | Teva-Losartan/HCTZ 100mg & 12.5mg Tab | TEV | 0.3082 | 0.3082 | YES | NO | NO |
| 02220180 | LOVASTATIN | Lovastatin 40mg Tab | AAP | 2.1793 | 2.1793 | YES | NO | NO |
| 02220172 | LOVASTATIN | Lovastatin 20mg Tab | AAP | 1.1931 | 1.1931 | YES | NO | NO |
| 00795860 | LOVASTATIN | Mevacor (Not a Benefit) 20mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 00795852 | LOVASTATIN | Mevacor (Not a Benefit) 40mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 02170035 | LOXAPINE SUCCINATE | Loxapac (Not a Benefit) 50mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02170027 | LOXAPINE SUCCINATE | Loxapac (Not a Benefit) 10mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02170132 | LOXAPINE SUCCINATE | Loxapac (Not a Benefit) 25mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02170019 | LOXAPINE SUCCINATE | Loxapac (Not a Benefit) 5mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02230839 | LOXAPINE SUCCINATE | Xylac 25mg Tab | PEN | 0.5012 | 0.5012 | YES | NO | NO |
| 02230837 | LOXAPINE SUCCINATE | Xylac 5mg Tab | PEN | 0.1801 | 0.1801 | YES | NO | NO |
| 02230838 | LOXAPINE SUCCINATE | Xylac 10mg Tab | PEN | 0.3233 | 0.3233 | YES | NO | NO |
| 02230840 | LOXAPINE SUCCINATE | Xylac 50mg Tab | PEN | 0.6197 | 0.6197 | YES | NO | NO |
| 02514028 | LURASIDONE HYDROCHLORIDE | Auro-Lurasidone 80mg Tab | AUR | 1.2250 | 1.2250 | YES | NO | YES |
| 02513994 | LURASIDONE HYDROCHLORIDE | Auro-Lurasidone 40mg Tab | AUR | 1.2250 | 1.2250 | YES | NO | YES |
| 02513986 | LURASIDONE HYDROCHLORIDE | Auro-Lurasidone 20mg Tab | AUR | 1.2250 | 1.2250 | YES | NO | YES |
| 02514001 | LURASIDONE HYDROCHLORIDE | Auro-Lurasidone 60mg Tab | AUR | 1.2250 | 1.2250 | YES | NO | YES |
| 02514036 | LURASIDONE HYDROCHLORIDE | Auro-Lurasidone 120mg Tab | AUR | 1.2250 | 1.2250 | YES | NO | YES |
| 02516446 | LURASIDONE HYDROCHLORIDE | Jamp Lurasidone 40mg Tab | JPC | 1.2250 | 1.2250 | YES | NO | YES |
| 02516438 | LURASIDONE HYDROCHLORIDE | Jamp Lurasidone 20mg Tab | JPC | 1.2250 | 1.2250 | YES | NO | YES |
| 02516470 | LURASIDONE HYDROCHLORIDE | Jamp Lurasidone 120mg Tab | JPC | 1.2250 | 1.2250 | YES | NO | YES |
| 02516454 | LURASIDONE HYDROCHLORIDE | Jamp Lurasidone 60mg Tab | JPC | 1.2250 | 1.2250 | YES | NO | YES |
| 02516462 | LURASIDONE HYDROCHLORIDE | Jamp Lurasidone 80mg Tab | JPC | 1.2250 | 1.2250 | YES | NO | YES |
| 02387751 | LURASIDONE HYDROCHLORIDE | Latuda 40mg Tab | SUO | 4.9000 | 1.2250 | YES | NO | YES |
| 02387786 | LURASIDONE HYDROCHLORIDE | Latuda (Not a Benefit) 120mg Tab | SUO | N/A | N/A | YES | NO | YES |
| 02387778 | LURASIDONE HYDROCHLORIDE | Latuda 80mg Tab | SUO | 4.5000 | 1.2250 | YES | NO | YES |
| 02422050 | LURASIDONE HYDROCHLORIDE | Latuda 20mg Tab | SUO | 4.2500 | 1.2250 | YES | NO | YES |
| 02413361 | LURASIDONE HYDROCHLORIDE | Latuda 60mg Tab | SUO | 4.9000 | 1.2250 | YES | NO | YES |
| 02548585 | LURASIDONE HYDROCHLORIDE | Lurasidone 20mg Tab | SAI | 1.2250 | 1.2250 | YES | NO | YES |
| 02548615 | LURASIDONE HYDROCHLORIDE | Lurasidone 80mg Tab | SAI | 1.2250 | 1.2250 | YES | NO | YES |
| 02548607 | LURASIDONE HYDROCHLORIDE | Lurasidone 60mg Tab | SAI | 1.2250 | 1.2250 | YES | NO | YES |
| 02548593 | LURASIDONE HYDROCHLORIDE | Lurasidone 40mg Tab | SAI | 1.2250 | 1.2250 | YES | NO | YES |
| 02522349 | LURASIDONE HYDROCHLORIDE | NRA-Lurasidone 80mg Tab | NRA | 1.2250 | 1.2250 | YES | NO | YES |
| 02522314 | LURASIDONE HYDROCHLORIDE | NRA-Lurasidone 20mg Tab | NRA | 1.2250 | 1.2250 | YES | NO | YES |
| 02522330 | LURASIDONE HYDROCHLORIDE | NRA-Lurasidone 60mg Tab | NRA | 1.2250 | 1.2250 | YES | NO | YES |
| 02522322 | LURASIDONE HYDROCHLORIDE | NRA-Lurasidone 40mg Tab | NRA | 1.2250 | 1.2250 | YES | NO | YES |
| 02505878 | LURASIDONE HYDROCHLORIDE | PMS-Lurasidone 20mg Tab | PMS | 1.2250 | 1.2250 | YES | NO | YES |
| 02505886 | LURASIDONE HYDROCHLORIDE | PMS-Lurasidone 40mg Tab | PMS | 1.2250 | 1.2250 | YES | NO | YES |
| 02505908 | LURASIDONE HYDROCHLORIDE | PMS-Lurasidone 80mg Tab | PMS | 1.2250 | 1.2250 | YES | NO | YES |
| 02505916 | LURASIDONE HYDROCHLORIDE | PMS-Lurasidone 120mg Tab | PMS | 1.2250 | 1.2250 | YES | NO | YES |
| 02505894 | LURASIDONE HYDROCHLORIDE | PMS-Lurasidone 60mg Tab | PMS | 1.2250 | 1.2250 | YES | NO | YES |
| 02521075 | LURASIDONE HYDROCHLORIDE | Sandoz Lurasidone 20mg Tab | SDZ | 1.2250 | 1.2250 | YES | NO | YES |
| 02521091 | LURASIDONE HYDROCHLORIDE | Sandoz Lurasidone 40mg Tab | SDZ | 1.2250 | 1.2250 | YES | NO | YES |
| 02521105 | LURASIDONE HYDROCHLORIDE | Sandoz Lurasidone 60mg Tab | SDZ | 1.2250 | 1.2250 | YES | NO | YES |
| 02521121 | LURASIDONE HYDROCHLORIDE | Sandoz Lurasidone 120mg Tab | SDZ | 1.2250 | 1.2250 | YES | NO | YES |
| 02521113 | LURASIDONE HYDROCHLORIDE | Sandoz Lurasidone 80mg Tab | SDZ | 1.2250 | 1.2250 | YES | NO | YES |
| 02504499 | LURASIDONE HYDROCHLORIDE | Taro-Lurasidone 20mg Tab | TAR | 1.2250 | 1.2250 | YES | NO | YES |
| 02504510 | LURASIDONE HYDROCHLORIDE | Taro-Lurasidone 60mg Tab | TAR | 1.2250 | 1.2250 | YES | NO | YES |
| 02504529 | LURASIDONE HYDROCHLORIDE | Taro-Lurasidone 80mg Tab | TAR | 1.2250 | 1.2250 | YES | NO | YES |
| 02504502 | LURASIDONE HYDROCHLORIDE | Taro-Lurasidone 40mg Tab | TAR | 1.2250 | 1.2250 | YES | NO | YES |
| 02504537 | LURASIDONE HYDROCHLORIDE | Taro-Lurasidone 120mg Tab | TAR | 1.2250 | 1.2250 | YES | NO | YES |
| 02254794 | MAGNESIUM OXIDE & CITRIC ACID & SODIUM PICOSULFATE | Pico-Salax 3.5g & 12g & 10mg Pd for Sol-12g Sachet | FEI | 14.5808 | 12.3500 | YES | NO | NO |
| 02317966 | MAGNESIUM OXIDE & CITRIC ACID & SODIUM PICOSULFATE | Purg-Odan 3.5g & 12g & 10mg Pd for Sol-12g Sachet | ODN | 12.3500 | 12.3500 | YES | NO | NO |
| 02299844 | MARAVIROC | Celsentri 150mg Tab | VIH | 21.6208 | 21.6208 | NO | NO | NO |
| 02299852 | MARAVIROC | Celsentri 300mg Tab | VIH | 21.6208 | 21.6208 | NO | NO | NO |
| 00556734 | MEBENDAZOLE | Vermox 100mg Tab | JAN | 10.3400 | 10.3400 | NO | NO | NO |
| 00220442 | MECLIZINE HCL | Bonamine 25mg Tab | PFI | 0.2919 | 0.2919 | NO | NO | NO |
| 09858134 | MEDROXYPROGESTERONE ACETATE | Depo-Provera (Temporary Benefit) 150mg/mL Inj Sol-1mL Pref Syr | PFI | 31.6900 | 31.6900 | NO | NO | NO |
| 02523493 | MEDROXYPROGESTERONE ACETATE | Depo-Provera (Temporary Benefit) 150mg/mL Inj Sol-1mL Pref Syr | PFI | 34.1400 | 34.1400 | NO | NO | NO |
| 02277298 | MEDROXYPROGESTERONE ACETATE | AA-Medroxy 10mg Tab | AAP | 0.5649 | 0.5649 | YES | NO | NO |
| 02244726 | MEDROXYPROGESTERONE ACETATE | AA-Medroxy 2.5mg Tab | AAP | 0.1301 | 0.1301 | YES | NO | NO |
| 02267640 | MEDROXYPROGESTERONE ACETATE | AA-Medroxy 100mg Tab | AAP | 1.2057 | 1.2057 | YES | NO | NO |
| 02244727 | MEDROXYPROGESTERONE ACETATE | AA-Medroxy 5mg Tab | AAP | 0.2602 | 0.2602 | YES | NO | NO |
| 00030945 | MEDROXYPROGESTERONE ACETATE | Provera (Not a Benefit) 100mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 00729973 | MEDROXYPROGESTERONE ACETATE | Provera 10mg Tab | PFI | 1.0271 | 0.5649 | YES | NO | NO |
| 00708917 | MEDROXYPROGESTERONE ACETATE | Provera 2.5mg Tab | PFI | 0.2567 | 0.1301 | YES | NO | NO |
| 00030937 | MEDROXYPROGESTERONE ACETATE | Provera 5mg Tab | PFI | 0.5274 | 0.2602 | YES | NO | NO |
| 02229452 | MEFENAMIC ACID | Mefenamic 250mg Cap | AAP | 0.4988 | 0.4988 | YES | NO | YES |
| 00155225 | MEFENAMIC ACID | Ponstan (Not a Benefit) 250mg Cap | AAP | N/A | N/A | YES | NO | YES |
| 02018055 | MEFLOQUINE HCL | Lariam (Off-Formulary Interchangeable) 250mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02244366 | MEFLOQUINE HCL | Mefloquine (Off-Formulary Interchangeable) 250mg Tab | AAP | 3.6950 | 3.6950 | YES | NO | NO |
| 00731323 | MEGESTROL ACETATE | Megace (Not a Benefit) 160mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00386391 | MEGESTROL ACETATE | Megace (Not a Benefit) 40mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02195925 | MEGESTROL ACETATE | Megestrol 160mg Tab | AAP | 5.8151 | 5.8151 | YES | NO | NO |
| 02195917 | MEGESTROL ACETATE | Megestrol 40mg Tab | AAP | 1.3340 | 1.3340 | YES | NO | NO |
| 02248974 | MELOXICAM | Apo-Meloxicam 15mg Tab | APX | 0.2311 | 0.2311 | YES | NO | YES |
| 02248973 | MELOXICAM | Apo-Meloxicam 7.5mg Tab | APX | 0.2003 | 0.2003 | YES | NO | YES |
| 02390892 | MELOXICAM | Auro-Meloxicam 15mg Tab | AUR | 0.2311 | 0.2311 | YES | NO | YES |
| 02390884 | MELOXICAM | Auro-Meloxicam 7.5mg Tab | AUR | 0.2003 | 0.2003 | YES | NO | YES |
| 02250020 | MELOXICAM | Co Meloxicam 15mg Tab | COB | 0.2311 | 0.2311 | YES | NO | YES |
| 02250012 | MELOXICAM | Co Meloxicam 7.5mg Tab | COB | 0.2003 | 0.2003 | YES | NO | YES |
| 02353148 | MELOXICAM | Meloxicam 7.5mg Tab | SAI | 0.2003 | 0.2003 | YES | NO | YES |
| 02353156 | MELOXICAM | Meloxicam 15mg Tab | SAI | 0.2311 | 0.2311 | YES | NO | YES |
| 02242786 | MELOXICAM | Mobicox (Not a Benefit) 15mg Tab | BOE | N/A | N/A | YES | NO | YES |
| 02242785 | MELOXICAM | Mobicox (Not a Benefit) 7.5mg Tab | BOE | N/A | N/A | YES | NO | YES |
| 02248268 | MELOXICAM | PMS-Meloxicam 15mg Tab | PMS | 0.2311 | 0.2311 | YES | NO | YES |
| 02248267 | MELOXICAM | PMS-Meloxicam 7.5mg Tab | PMS | 0.2003 | 0.2003 | YES | NO | YES |
| 02258323 | MELOXICAM | Teva-Meloxicam 15mg Tab | TEV | 0.2311 | 0.2311 | YES | NO | YES |
| 02258315 | MELOXICAM | Teva-Meloxicam 7.5mg Tab | TEV | 0.2003 | 0.2003 | YES | NO | YES |
| 00004715 | MELPHALAN | Alkeran 2mg Tab | ASN | 2.4112 | 2.4112 | NO | NO | NO |
| 02366487 | MEMANTINE HCL | Apo-Memantine (Off-Formulary Interchangeable) 10mg Tab | APX | 1.6357 | N/A | YES | NO | NO |
| 02324067 | MEMANTINE HCL | Co Memantine (Off-Formulary Interchangeable) 10mg Tab | COB | 1.6357 | N/A | YES | NO | NO |
| 02260638 | MEMANTINE HCL | Ebixa (Off-Formulary Interchangeable) 10mg Tab | VLH | N/A | N/A | YES | NO | NO |
| 02409895 | MEMANTINE HCL | Med-Memantine (Off-Formulary Interchangeable) 10mg Tab | GMP | 1.6357 | N/A | YES | NO | NO |
| 02443082 | MEMANTINE HCL | Memantine (Off-Formulary Interchangeable) 10mg Tab | SAI | 1.6357 | N/A | YES | NO | NO |
| 02446049 | MEMANTINE HCL | Memantine (Off-Formulary Interchangeable) 10mg Tab | SIV | 1.6357 | N/A | YES | NO | NO |
| 02531887 | MEMANTINE HCL | Mint-Memantine (Off-Formulary Interchangeable) 10mg Tab | MIN | 1.6357 | N/A | YES | NO | NO |
| 02321130 | MEMANTINE HCL | PMS-Memantine (Off-Formulary Interchangeable) 10mg Tab | PMS | 1.6357 | N/A | YES | NO | NO |
| 02421364 | MEMANTINE HCL | Ran-Memantine (Off-Formulary Interchangeable) 10mg Tab | RAN | 1.6357 | N/A | YES | NO | NO |
| 02320908 | MEMANTINE HCL | Ratio-Memantine (Off-Formulary Interchangeable) 10mg Tab | RPH | 1.6357 | N/A | YES | NO | NO |
| 02375532 | MEMANTINE HCL | Sandoz Memantine FCT (Off-Formulary Interchangeable) 10mg Tab | SDZ | 1.6357 | N/A | YES | NO | NO |
| 02415275 | MERCAPTOPURINE | Mercaptopurine Tablets USP 50mg Tab | STE | 2.8610 | 2.8610 | YES | NO | YES |
| 00004723 | MERCAPTOPURINE | Purinethol 50mg Tab | NOP | 2.8610 | 2.8610 | YES | NO | YES |
| 02378795 | MEROPENEM | Meropenem for Injection (Off-Formulary Interchangeable) 1g/Vial Pd for Inj Sol | SDZ | 47.9900 | 47.9900 | YES | NO | NO |
| 02493330 | MEROPENEM | Meropenem for Injection (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol | STE | 23.9950 | 23.9950 | YES | NO | NO |
| 02493349 | MEROPENEM | Meropenem for Injection (Off-Formulary Interchangeable) 1g/Vial Pd for Inj Sol | STE | 47.9900 | 47.9900 | YES | NO | NO |
| 02378787 | MEROPENEM | Meropenem for Injection (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol | SDZ | 23.9950 | 23.9950 | YES | NO | NO |
| 02536374 | MEROPENEM | Meropenem for Injection (Off-Formulary Interchangeable) 1g/Vial Pd for Inj Sol | JPC | 47.9900 | 47.9900 | YES | NO | NO |
| 02415224 | MEROPENEM | Meropenem for Injection, USP (Off-Formulary Interchangeable) 1g/Vial Pd for Inj Sol | FKC | 47.9900 | 47.9900 | YES | NO | NO |
| 02415216 | MEROPENEM | Meropenem for Injection, USP (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol | FKC | 23.9950 | 23.9950 | YES | NO | NO |
| 02218496 | MEROPENEM | Merrem (Off-Formulary Interchangeable) 1g/Vial Pd for Inj Sol | PFI | N/A | N/A | YES | NO | NO |
| 02218488 | MEROPENEM | Merrem (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol | PFI | N/A | N/A | YES | NO | NO |
| 02421526 | MEROPENEM | Taro-Meropenem (Off-Formulary Interchangeable) 1g/Vial Pd for Inj Sol | SPC | 47.9900 | 47.9900 | YES | NO | NO |
| 02421518 | MEROPENEM | Taro-Meropenem (Off-Formulary Interchangeable) 500mg/Vial Pd for Inj Sol | SPC | 23.9950 | 23.9950 | YES | NO | NO |
| 02545012 | MESALAZINE | Mezera 1g DR Tab | AVP | 1.2756 | 1.2756 | NO | NO | NO |
| 02529610 | MESALAZINE | Octasa 1600mg DR Tab | TIP | 2.3740 | 2.3740 | NO | NO | NO |
| 02465752 | MESALAZINE | Octasa 800mg DR Tab | TIP | 1.1358 | 1.1358 | NO | NO | NO |
| 02305062 | METFORMIN HCL | Apo-Metformin ER (Off-Formulary Interchangeable) 500mg ER Tab | APX | 0.6584 | N/A | YES | NO | NO |
| 02460653 | METFORMIN HCL | Apo-Metformin ER (Off-Formulary Interchangeable) 1000mg ER Tab | APX | 1.3233 | N/A | YES | NO | NO |
| 02300451 | METFORMIN HCL | Glumetza (Off-Formulary Interchangeable) 1000mg ER Tab | VAL | N/A | N/A | YES | NO | NO |
| 02268493 | METFORMIN HCL | Glumetza (Off-Formulary Interchangeable) 500mg ER Tab | BIO | N/A | N/A | YES | NO | NO |
| 02550504 | METFORMIN HCL | Mar-Metformin XR (Off-Formulary Interchangeable) 500mg ER Tab | MAR | 0.6584 | N/A | YES | NO | NO |
| 02550512 | METFORMIN HCL | Mar-Metformin XR (Off-Formulary Interchangeable) 1000mg ER Tab | MAR | 1.3233 | N/A | YES | NO | NO |
| 02547309 | METFORMIN HCL | Mint-Metformin XR (Off-Formulary Interchangeable) 500mg ER Tab | MIN | 0.6584 | N/A | YES | NO | NO |
| 02547317 | METFORMIN HCL | Mint-Metformin XR (Off-Formulary Interchangeable) 1000mg ER Tab | MIN | 1.3233 | N/A | YES | NO | NO |
| 02552027 | METFORMIN HCL | Taro-Metformin XR (Off-Formulary Interchangeable) 500mg ER Tab | TAR | 0.6584 | N/A | YES | NO | NO |
| 02167786 | METFORMIN HCL | Apo-Metformin 500mg Tab | APX | 0.0247 | 0.0247 | YES | NO | NO |
| 02229785 | METFORMIN HCL | Apo-Metformin (Off-Formulary Interchangeable) 850mg Tab | APX | 0.2090 | N/A | YES | NO | NO |
| 02438283 | METFORMIN HCL | Auro-Metformin (Off-Formulary Interchangeable) 850mg Tab | AUR | 0.2090 | N/A | YES | NO | NO |
| 02438275 | METFORMIN HCL | Auro-Metformin 500mg Tab | AUR | 0.0247 | 0.0247 | YES | NO | NO |
| 02421836 | METFORMIN HCL | Ecl-Metformin (Off-Formulary Interchangeable) 850mg Tab | ECL | 0.2090 | N/A | YES | NO | NO |
| 02446065 | METFORMIN HCL | Glucophage (Off-Formulary Interchangeable) 1000mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02099233 | METFORMIN HCL | Glucophage 500mg Tab | SAV | 0.2821 | 0.0247 | YES | NO | NO |
| 02162849 | METFORMIN HCL | Glucophage (Off-Formulary Interchangeable) 850mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02380218 | METFORMIN HCL | Jamp-Metformin (Off-Formulary Interchangeable) 850mg Tab | JPC | 0.2090 | N/A | YES | NO | NO |
| 02380196 | METFORMIN HCL | Jamp-Metformin 500mg Tab | JPC | 0.0247 | 0.0247 | YES | NO | NO |
| 02380730 | METFORMIN HCL | Jamp-Metformin Blackberry (Off-Formulary Interchangeable) 850mg Tab | JPC | 0.2090 | N/A | YES | NO | NO |
| 02547767 | METFORMIN HCL | M-Metformin 500mg Tab | MAT | 0.0247 | 0.0247 | YES | NO | NO |
| 02547775 | METFORMIN HCL | M-Metformin (Off-Formulary Interchangeable) 850mg Tab | MAT | 0.2090 | N/A | YES | NO | NO |
| 02548275 | METFORMIN HCL | M-Metformin (Off-Formulary Interchangeable) 1000mg Tab | MAT | 0.0399 | N/A | YES | NO | NO |
| 02378639 | METFORMIN HCL | Mar-Metformin (Off-Formulary Interchangeable) 850mg Tab | MAR | 0.2090 | N/A | YES | NO | NO |
| 02378620 | METFORMIN HCL | Mar-Metformin 500mg Tab | MAR | 0.0247 | 0.0247 | YES | NO | NO |
| 02353377 | METFORMIN HCL | Metformin 500mg Tab | SAI | 0.0247 | 0.0247 | YES | NO | NO |
| 02353385 | METFORMIN HCL | Metformin (Off-Formulary Interchangeable) 850mg Tab | SAI | 0.2090 | N/A | YES | NO | NO |
| 02385368 | METFORMIN HCL | Metformin FC (Off-Formulary Interchangeable) 850mg Tab | SIV | 0.2090 | N/A | YES | NO | NO |
| 02385341 | METFORMIN HCL | Metformin FC 500mg Tab | SIV | 0.0247 | 0.0247 | YES | NO | NO |
| 02388774 | METFORMIN HCL | Mint-Metformin (Off-Formulary Interchangeable) 850mg Tab | MIN | 0.2090 | N/A | YES | NO | NO |
| 02388766 | METFORMIN HCL | Mint-Metformin 500mg Tab | MIN | 0.0247 | 0.0247 | YES | NO | NO |
| 02536447 | METFORMIN HCL | NRA-Metformin (Off-Formulary Interchangeable) 850mg Tab | NRA | 0.2090 | N/A | YES | NO | NO |
| 02536439 | METFORMIN HCL | NRA-Metformin 500mg Tab | NRA | 0.0247 | 0.0247 | YES | NO | NO |
| 02045710 | METFORMIN HCL | Novo-Metformin 500mg Tab | NOP | 0.0247 | 0.0247 | YES | NO | NO |
| 02223562 | METFORMIN HCL | PMS-Metformin 500mg Tab | PMS | 0.0247 | 0.0247 | YES | NO | NO |
| 02242589 | METFORMIN HCL | PMS-Metformin (Off-Formulary Interchangeable) 850mg Tab | PMS | 0.2090 | N/A | YES | NO | NO |
| 02520303 | METFORMIN HCL | PMSC-Metformin 500mg Tab | PMS | 0.0247 | 0.0247 | YES | NO | NO |
| 02520311 | METFORMIN HCL | PMSC-Metformin (Off-Formulary Interchangeable) 850mg Tab | PMS | 0.2090 | N/A | YES | NO | NO |
| 02531895 | METFORMIN HCL | PRZ-Metformin 500mg Tab | PRZ | 0.0247 | 0.0247 | YES | NO | NO |
| 02531909 | METFORMIN HCL | PRZ-Metformin (Off-Formulary Interchangeable) 850mg Tab | PRZ | 0.2090 | N/A | YES | NO | NO |
| 02534673 | METFORMIN HCL | PRZ-Metformin (Off-Formulary Interchangeable) 1000mg Tab | PRZ | 0.0399 | N/A | YES | NO | NO |
| 02269058 | METFORMIN HCL | Ran-Metformin (Off-Formulary Interchangeable) 850mg Tab | RAN | 0.2090 | N/A | YES | NO | NO |
| 02269031 | METFORMIN HCL | Ran-Metformin 500mg Tab | RAN | 0.0247 | 0.0247 | YES | NO | NO |
| 02242931 | METFORMIN HCL | Ratio-Metformin (Off-Formulary Interchangeable) 850mg Tab | RPH | 0.2090 | N/A | YES | NO | NO |
| 02242974 | METFORMIN HCL | Ratio-Metformin 500mg Tab | RPH | 0.0247 | 0.0247 | YES | NO | NO |
| 02246820 | METFORMIN HCL | Sandoz Metformin FC 500mg Tab | SDZ | 0.0247 | 0.0247 | YES | NO | NO |
| 02246821 | METFORMIN HCL | Sandoz Metformin FC (Off-Formulary Interchangeable) 850mg Tab | SDZ | 0.2090 | N/A | YES | NO | NO |
| 02379767 | METFORMIN HCL | Septa-Metformin 500mg Tab | SET | 0.0247 | 0.0247 | YES | NO | NO |
| 02257726 | METFORMIN HCL | Teva-Metformin 500mg Tab | TEV | 0.0247 | 0.0247 | YES | NO | NO |
| 02257734 | METFORMIN HCL | Teva-Metformin (Off-Formulary Interchangeable) 850mg Tab | TEV | 0.2090 | N/A | YES | NO | NO |
| 02244290 | METHADONE HCL | Metadol-D 10mg/mL Oral Concentrate | PAL | 0.1607 | 0.1607 | NO | NO | YES |
| 02394596 | METHADONE HCL | Methadose 10mg/mL Oral Concentrate (Cherry Flavour) | MAL | 0.0525 | 0.0525 | YES | NO | YES |
| 02495872 | METHADONE HCL | Odan-Methadone 10mg/mL Oral Concentrate (Cherry Flavour) | ODN | 0.0525 | 0.0525 | YES | NO | YES |
| 02552736 | METHADONE HCL | PMS-Methadone HCl Oral Concentrate 10mg/mL Oral Concentrate (Cherry Flavour) | PMS | 0.0525 | 0.0525 | YES | NO | YES |
| 02495783 | METHADONE HCL | Jamp Methadone Oral Concentrate 10mg/mL Oral Concentrate (Unflavoured) | JPC | 0.0525 | 0.0525 | YES | NO | YES |
| 02394618 | METHADONE HCL | Methadose 10mg/mL Oral Concentrate (Unflavoured) | MAL | 0.0525 | 0.0525 | YES | NO | YES |
| 02495880 | METHADONE HCL | Odan-Methadone 10mg/mL Oral Concentrate (Unflavoured) | ODN | 0.0525 | 0.0525 | YES | NO | YES |
| 02552728 | METHADONE HCL | PMS-Methadone HCl Oral Concentrate 10mg/mL Oral Concentrate (Unflavoured) | PMS | 0.0525 | 0.0525 | YES | NO | YES |
| 02533669 | METHADONE HCL | Apo-Methadone (Off-Formulary Interchangeable) 10mg Tab | APX | 0.5466 | 0.5466 | YES | NO | YES |
| 02533677 | METHADONE HCL | Apo-Methadone (Off-Formulary Interchangeable) 25mg Tab | APX | 1.0157 | 1.0157 | YES | NO | YES |
| 02533650 | METHADONE HCL | Apo-Methadone (Off-Formulary Interchangeable) 5mg Tab | APX | 0.3417 | 0.3417 | YES | NO | YES |
| 02533642 | METHADONE HCL | Apo-Methadone (Off-Formulary Interchangeable) 1mg Tab | APX | 0.1026 | 0.1026 | YES | NO | YES |
| 02247698 | METHADONE HCL | Metadol (Off-Formulary Interchangeable) 1mg Tab | PMS | 0.1399 | 0.1026 | YES | NO | YES |
| 02247699 | METHADONE HCL | Metadol (Off-Formulary Interchangeable) 5mg Tab | PMS | 0.4659 | 0.3417 | YES | NO | YES |
| 02247700 | METHADONE HCL | Metadol (Off-Formulary Interchangeable) 10mg Tab | PMS | 0.7454 | 0.5466 | YES | NO | YES |
| 02247701 | METHADONE HCL | Metadol (Off-Formulary Interchangeable) 25mg Tab | PMS | 1.3850 | 1.0157 | YES | NO | YES |
| 02245882 | METHAZOLAMIDE | Methazolamide 50mg Tab | AAP | 0.4913 | 0.4913 | YES | NO | NO |
| 02238071 | METHAZOLAMIDE | Neptazane (Not a Benefit) 50mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02490625 | METHIMAZOLE | Jamp Methimazole 5mg Tab | JPC | 0.1531 | 0.1531 | YES | NO | NO |
| 02490633 | METHIMAZOLE | Jamp Methimazole (Off-Formulary Interchangeable) 10mg Tab | JPC | 0.5181 | N/A | YES | NO | NO |
| 02480115 | METHIMAZOLE | Mar-Methimazole (Off-Formulary Interchangeable) 10mg Tab | MAR | 0.5181 | N/A | YES | NO | NO |
| 02480107 | METHIMAZOLE | Mar-Methimazole 5mg Tab | MAR | 0.1531 | 0.1531 | YES | NO | NO |
| 02296039 | METHIMAZOLE | Tapazole (Off-Formulary Interchangeable) 10mg Tab | PAL | N/A | N/A | YES | NO | NO |
| 00015741 | METHIMAZOLE | Tapazole 5mg Tab | PAL | 0.3696 | 0.1531 | YES | NO | NO |
| 02182777 | METHOTREXATE | Methotrexate 50mg/2mL Inj Sol-2mL Pk | MAY | 8.9200 | 8.9200 | YES | NO | NO |
| 02170671 | METHOTREXATE | Methotrexate (Not a Benefit) 50mg/2mL Inj Sol-2mL Pk | WAY | N/A | N/A | YES | NO | NO |
| 02464365 | METHOTREXATE | Methotrexate Injection BP 50mg/2mL Inj Sol-2mL Pk | ACH | 8.9200 | 8.9200 | YES | NO | NO |
| 02182947 | METHOTREXATE | Methotrexate Sodium 20mg/2mL Inj Sol-2mL Pk | MAY | 12.5000 | 12.5000 | NO | NO | NO |
| 02491281 | METHOTREXATE | Methotrexate Subcutaneous 10mg/0.2mL Inj Sol-Pref Syr | ACH | 14.8200 | 14.8200 | YES | NO | NO |
| 02491303 | METHOTREXATE | Methotrexate Subcutaneous 12.5mg/0.25mL Inj Sol-Pref Syr | ACH | 15.6000 | 15.6000 | YES | NO | NO |
| 02491362 | METHOTREXATE | Methotrexate Subcutaneous 25mg/0.5mL Inj Sol-Pref Syr | ACH | 19.5000 | 19.5000 | YES | NO | NO |
| 02491338 | METHOTREXATE | Methotrexate Subcutaneous 17.5mg/0.35mL Inj Sol-Pref Syr | ACH | 16.0000 | 16.0000 | YES | NO | NO |
| 02491346 | METHOTREXATE | Methotrexate Subcutaneous 20mg/0.4mL Inj Sol-Pref Syr | ACH | 17.5000 | 17.5000 | YES | NO | NO |
| 02491354 | METHOTREXATE | Methotrexate Subcutaneous 22.5mg/0.45mL Inj Sol-Pref Syr | ACH | 17.5000 | 17.5000 | YES | NO | NO |
| 02491311 | METHOTREXATE | Methotrexate Subcutaneous 15mg/0.3mL Inj Sol-Pref Syr | ACH | 16.3800 | 16.3800 | YES | NO | NO |
| 02454777 | METHOTREXATE | Metoject Subcutaneous 22.5mg/0.45mL Inj Sol-Pref Syr | MDX | 17.5000 | 17.5000 | YES | NO | NO |
| 02454866 | METHOTREXATE | Metoject Subcutaneous 20mg/0.4mL Inj Sol-Pref Syr | MDX | 17.5000 | 17.5000 | YES | NO | NO |
| 02454769 | METHOTREXATE | Metoject Subcutaneous 17.5mg/0.35mL Inj Sol-Pref Syr | MDX | 16.0000 | 16.0000 | YES | NO | NO |
| 02454858 | METHOTREXATE | Metoject Subcutaneous 15mg/0.3mL Inj Sol-Pref Syr | MDX | 16.3800 | 16.3800 | YES | NO | NO |
| 02454874 | METHOTREXATE | Metoject Subcutaneous 25mg/0.5mL Inj Sol-Pref Syr | MDX | 19.5000 | 19.5000 | YES | NO | NO |
| 02454831 | METHOTREXATE | Metoject Subcutaneous 10mg/0.2mL Inj Sol-Pref Syr | MDX | 16.3000 | 14.8200 | YES | NO | NO |
| 02454750 | METHOTREXATE | Metoject Subcutaneous 12.5mg/0.25mL Inj Sol-Pref Syr | MDX | 17.1600 | 15.6000 | YES | NO | NO |
| 02539667 | METHOTREXATE | PMS-Methotrexate Injection 25mg/0.5mL Inj Sol-Pref Syr | PMS | 19.5000 | 19.5000 | YES | NO | NO |
| 02539608 | METHOTREXATE | PMS-Methotrexate Injection 10mg/0.2mL Inj Sol-Pref Syr | PMS | 14.8200 | 14.8200 | YES | NO | NO |
| 02539616 | METHOTREXATE | PMS-Methotrexate Injection 12.5mg/0.25mL Inj Sol-Pref Syr | PMS | 15.6000 | 15.6000 | YES | NO | NO |
| 02539624 | METHOTREXATE | PMS-Methotrexate Injection 15mg/0.3mL Inj Sol-Pref Syr | PMS | 16.3800 | 16.3800 | YES | NO | NO |
| 02539632 | METHOTREXATE | PMS-Methotrexate Injection 17.5mg/0.35mL Inj Sol-Pref Syr | PMS | 16.0000 | 16.0000 | YES | NO | NO |
| 02539640 | METHOTREXATE | PMS-Methotrexate Injection 20mg/0.4mL Inj Sol-Pref Syr | PMS | 17.5000 | 17.5000 | YES | NO | NO |
| 02539659 | METHOTREXATE | PMS-Methotrexate Injection 22.5mg/0.45mL Inj Sol-Pref Syr | PMS | 17.5000 | 17.5000 | YES | NO | NO |
| 02509067 | METHOTREXATE | Ach-Methotrexate 2.5mg Tab | ACH | 0.2513 | 0.2513 | YES | NO | NO |
| 02182963 | METHOTREXATE | Apo-Methotrexate 2.5mg Tab | APX | 0.2513 | 0.2513 | YES | NO | NO |
| 02524023 | METHOTREXATE | Auro-Methotrexate 2.5mg Tab | AUR | 0.2513 | 0.2513 | YES | NO | NO |
| 02553740 | METHOTREXATE | Jamp Methotrexate Tablets (Off-Formulary Interchangeable) 10mg Tab | JPC | 2.6588 | N/A | YES | NO | NO |
| 02534916 | METHOTREXATE | M-Methotrexate 2.5mg Tab | MAT | 0.2513 | 0.2513 | YES | NO | NO |
| 02182750 | METHOTREXATE | Methotrexate Tablets, USP (Off-Formulary Interchangeable) 10mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02170698 | METHOTREXATE | PMS-Methotrexate 2.5mg Tab | PMS | 0.2513 | 0.2513 | YES | NO | NO |
| 01927698 | METHOTRIMEPRAZINE | Nozinan 25mg/mL Inj Sol-1mL Pk | NEU | 4.1626 | 4.1626 | NO | NO | NO |
| 02238405 | METHOTRIMEPRAZINE | Methoprazine 25mg Tab | AAP | 0.2681 | 0.2681 | YES | NO | NO |
| 02238404 | METHOTRIMEPRAZINE | Methoprazine 5mg Tab | AAP | 0.1043 | 0.1043 | YES | NO | NO |
| 02238403 | METHOTRIMEPRAZINE | Methoprazine 2mg Tab | AAP | 0.0721 | 0.0721 | YES | NO | NO |
| 02238406 | METHOTRIMEPRAZINE | Methoprazine 50mg Tab | AAP | 0.4060 | 0.4060 | YES | NO | NO |
| 01927647 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 2mg Tab | AVE | N/A | N/A | YES | NO | NO |
| 01927655 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 5mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 01927671 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 50mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 01927663 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 00000817 | METHYLCELLULOSE | Isopto Tears 1% Oph-Sol | ALC | 0.5147 | 0.5147 | NO | YES | NO |
| 00000809 | METHYLCELLULOSE | Isopto Tears 0.5% Oph-Sol | ALC | 0.5147 | 0.5147 | NO | YES | NO |
| 00016586 | METHYLDOPA | Aldomet (Not a Benefit) 500mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 00016578 | METHYLDOPA | Aldomet (Not a Benefit) 250mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 00016551 | METHYLDOPA | Aldomet (Not a Benefit) 125mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 00360252 | METHYLDOPA | Methyldopa 125mg Tab | AAP | 0.1009 | 0.1009 | YES | NO | NO |
| 00360260 | METHYLDOPA | Methyldopa 250mg Tab | AAP | 0.1579 | 0.1579 | YES | NO | NO |
| 00426830 | METHYLDOPA | Methyldopa 500mg Tab | AAP | 0.2588 | 0.2588 | YES | NO | NO |
| 02470292 | METHYLPHENIDATE HCL | Foquest 25mg CR Cap | ELV | 2.9050 | 2.9050 | NO | NO | YES |
| 02470306 | METHYLPHENIDATE HCL | Foquest 35mg CR Cap | ELV | 3.1950 | 3.1950 | NO | NO | YES |
| 02470314 | METHYLPHENIDATE HCL | Foquest 45mg CR Cap | ELV | 3.4725 | 3.4725 | NO | NO | YES |
| 02470322 | METHYLPHENIDATE HCL | Foquest 55mg CR Cap | ELV | 3.7580 | 3.7580 | NO | NO | YES |
| 02470330 | METHYLPHENIDATE HCL | Foquest 70mg CR Cap | ELV | 4.1880 | 4.1880 | NO | NO | YES |
| 02470349 | METHYLPHENIDATE HCL | Foquest 85mg CR Cap | ELV | 4.6080 | 4.6080 | NO | NO | YES |
| 02470357 | METHYLPHENIDATE HCL | Foquest 100mg CR Cap | ELV | 5.0230 | 5.0230 | NO | NO | YES |
| 02277131 | METHYLPHENIDATE HCL | Biphentin 15mg ER Cap | ELV | 1.4447 | 0.7354 | YES | NO | YES |
| 02277158 | METHYLPHENIDATE HCL | Biphentin 20mg ER Cap | ELV | 1.8615 | 0.9477 | YES | NO | YES |
| 02277174 | METHYLPHENIDATE HCL | Biphentin 30mg ER Cap | ELV | 2.5581 | 1.3021 | YES | NO | YES |
| 02277182 | METHYLPHENIDATE HCL | Biphentin 40mg ER Cap | ELV | 3.2588 | 1.6588 | YES | NO | YES |
| 02277190 | METHYLPHENIDATE HCL | Biphentin 50mg ER Cap | ELV | 3.9544 | 2.0130 | YES | NO | YES |
| 02277204 | METHYLPHENIDATE HCL | Biphentin 60mg ER Cap | ELV | 4.6017 | 2.3425 | YES | NO | YES |
| 02277212 | METHYLPHENIDATE HCL | Biphentin 80mg ER Cap | ELV | 6.0670 | 3.0883 | YES | NO | YES |
| 02277166 | METHYLPHENIDATE HCL | Biphentin 10mg ER Cap | ELV | 1.0074 | 0.5128 | YES | NO | YES |
| 02536951 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 15mg ER Cap | PMS | 0.7354 | 0.7354 | YES | NO | YES |
| 02536978 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 20mg ER Cap | PMS | 0.9477 | 0.9477 | YES | NO | YES |
| 02536943 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 10mg ER Cap | PMS | 0.5128 | 0.5128 | YES | NO | YES |
| 02537036 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 80mg ER Cap | PMS | 3.0883 | 3.0883 | YES | NO | YES |
| 02537028 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 60mg ER Cap | PMS | 2.3425 | 2.3425 | YES | NO | YES |
| 02537001 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 50mg ER Cap | PMS | 2.0130 | 2.0130 | YES | NO | YES |
| 02536994 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 40mg ER Cap | PMS | 1.6588 | 1.6588 | YES | NO | YES |
| 02536986 | METHYLPHENIDATE HCL | PMS-Methylphenidate CR 30mg ER Cap | PMS | 1.3021 | 1.3021 | YES | NO | YES |
| 02266687 | METHYLPHENIDATE HCL | Apo-Methylphenidate SR 20mg ER Tab | APX | 0.6796 | 0.6796 | YES | NO | YES |
| 00632775 | METHYLPHENIDATE HCL | Ritalin SR (Not a Benefit) 20mg ER Tab | NOV | N/A | N/A | YES | NO | YES |
| 02441934 | METHYLPHENIDATE HCL | Act Methylphenidate ER 18mg SR Tab | TEV | 1.0493 | 1.0493 | YES | NO | YES |
| 02441942 | METHYLPHENIDATE HCL | Act Methylphenidate ER 27mg SR Tab | TEV | 1.2109 | 1.2109 | YES | NO | YES |
| 02441950 | METHYLPHENIDATE HCL | Act Methylphenidate ER 36mg SR Tab | TEV | 1.3726 | 1.3726 | YES | NO | YES |
| 02441969 | METHYLPHENIDATE HCL | Act Methylphenidate ER 54mg SR Tab | TEV | 1.6958 | 1.6958 | YES | NO | YES |
| 02452758 | METHYLPHENIDATE HCL | Apo-Methylphenidate ER 27mg SR Tab | APX | 1.2109 | 1.2109 | YES | NO | YES |
| 02330377 | METHYLPHENIDATE HCL | Apo-Methylphenidate ER 54mg SR Tab | APX | 1.6958 | 1.6958 | YES | NO | YES |
| 02452766 | METHYLPHENIDATE HCL | Apo-Methylphenidate ER 36mg SR Tab | APX | 1.3726 | 1.3726 | YES | NO | YES |
| 02452731 | METHYLPHENIDATE HCL | Apo-Methylphenidate ER 18mg SR Tab | APX | 1.0493 | 1.0493 | YES | NO | YES |
| 02247734 | METHYLPHENIDATE HCL | Concerta 54mg SR Tab | JAN | 5.3326 | 1.6958 | YES | NO | YES |
| 02247733 | METHYLPHENIDATE HCL | Concerta 36mg SR Tab | JAN | 4.3163 | 1.3726 | YES | NO | YES |
| 02250241 | METHYLPHENIDATE HCL | Concerta 27mg SR Tab | JAN | 3.8076 | 1.2109 | YES | NO | YES |
| 02247732 | METHYLPHENIDATE HCL | Concerta 18mg SR Tab | JAN | 3.2995 | 1.0493 | YES | NO | YES |
| 02249324 | METHYLPHENIDATE HCL | Apo-Methylphenidate 10mg Tab | APX | 0.2216 | 0.2216 | YES | NO | YES |
| 02249332 | METHYLPHENIDATE HCL | Apo-Methylphenidate (Off-Formulary Interchangeable) 20mg Tab | APX | 0.3536 | N/A | YES | NO | YES |
| 00585009 | METHYLPHENIDATE HCL | PMS-Methylphenidate (Off-Formulary Interchangeable) 20mg Tab | PMS | 0.3536 | N/A | YES | NO | YES |
| 00584991 | METHYLPHENIDATE HCL | PMS-Methylphenidate 10mg Tab | PMS | 0.2216 | 0.2216 | YES | NO | YES |
| 00005614 | METHYLPHENIDATE HCL | Ritalin (Off-Formulary Interchangeable) 20mg Tab | NOV | N/A | N/A | YES | NO | YES |
| 00005606 | METHYLPHENIDATE HCL | Ritalin 10mg Tab | NOV | 0.4556 | 0.2216 | YES | NO | YES |
| 00030988 | METHYLPREDNISOLONE | Medrol 4mg Tab | PFI | 0.5364 | 0.5364 | NO | NO | NO |
| 00030759 | METHYLPREDNISOLONE ACETATE | Depo-Medrol 40mg/mL Inj Susp-1mL Pk | PFI | 6.7480 | 6.7480 | NO | NO | NO |
| 00030767 | METHYLPREDNISOLONE ACETATE | Depo-Medrol 80mg/mL Inj Susp-1mL Pk | PFI | 12.9359 | 12.9359 | NO | NO | NO |
| 01934325 | METHYLPREDNISOLONE ACETATE | Depo-Medrol 100mg/5mL Inj Susp-5mL Pk | PFI | 15.0900 | 15.0900 | NO | NO | NO |
| 02185431 | METOCLOPRAMIDE HCL | Metoclopramide HCL Injection 5mg/mL Inj Sol (Preservative Free) | SDZ | 2.3748 | 2.3748 | YES | YES | NO |
| 02537397 | METOCLOPRAMIDE HCL | Metoclopramide Hydrochloride Injection 5mg/mL Inj Sol (Preservative Free) | JPC | 2.3748 | 2.3748 | YES | YES | NO |
| 02517795 | METOCLOPRAMIDE HCL | Mar-Metoclopramide 5mg Tab | MAR | 0.0257 | 0.0257 | YES | NO | NO |
| 02099209 | METOCLOPRAMIDE HCL | Maxeran (Not a Benefit) 10mg Tab | HMR | N/A | N/A | YES | NO | NO |
| 02099195 | METOCLOPRAMIDE HCL | Maxeran (Not a Benefit) 5mg Tab | HMR | N/A | N/A | YES | NO | NO |
| 02230431 | METOCLOPRAMIDE HCL | PMS-Metoclopramide Tablets 5mg Tab | PMS | 0.0257 | 0.0257 | YES | NO | NO |
| 02548747 | METOCLOPRAMIDE HCL | PRZ-Metoclopramide 5mg Tab | PRZ | 0.0257 | 0.0257 | YES | NO | NO |
| 02548755 | METOCLOPRAMIDE HCL | PRZ-Metoclopramide 10mg Tab | PRZ | 0.1513 | 0.1513 | YES | NO | NO |
| 00888400 | METOLAZONE | Zaroxolyn 2.5mg Tab | SAV | 0.2294 | 0.2294 | NO | NO | NO |
| 02285169 | METOPROLOL TARTRATE | AA-Metoprolol SR 100mg LA Tab | AAP | 0.1415 | 0.1415 | YES | NO | NO |
| 02285177 | METOPROLOL TARTRATE | AA-Metoprolol SR 200mg LA Tab | AAP | 0.2568 | 0.2568 | YES | NO | NO |
| 00534560 | METOPROLOL TARTRATE | Lopresor SR (Not a Benefit) 200mg LA Tab | NOV | N/A | N/A | YES | NO | NO |
| 00658855 | METOPROLOL TARTRATE | Lopresor SR (Not a Benefit) 100mg LA Tab | NOV | N/A | N/A | YES | NO | NO |
| 02481316 | METOPROLOL TARTRATE | AG-Metoprolol-L 50mg Tab | ANG | 0.0624 | 0.0624 | YES | NO | NO |
| 02481324 | METOPROLOL TARTRATE | AG-Metoprolol-L 100mg Tab | ANG | 0.1361 | 0.1361 | YES | NO | NO |
| 00618640 | METOPROLOL TARTRATE | Apo-Metoprolol 100mg Tab | APX | 0.1361 | 0.1361 | YES | NO | NO |
| 00618632 | METOPROLOL TARTRATE | Apo-Metoprolol 50mg Tab | APX | 0.0624 | 0.0624 | YES | NO | NO |
| 00749354 | METOPROLOL TARTRATE | Apo-Metoprolol (Type L) 50mg Tab | APX | 0.0624 | 0.0624 | YES | NO | NO |
| 00751170 | METOPROLOL TARTRATE | Apo-Metoprolol (Type L) 100mg Tab | APX | 0.1361 | 0.1361 | YES | NO | NO |
| 00402605 | METOPROLOL TARTRATE | Betaloc (Not a Benefit) 50mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 00402540 | METOPROLOL TARTRATE | Betaloc (Not a Benefit) 100mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02356821 | METOPROLOL TARTRATE | Jamp-Metoprolol-L 50mg Tab | JPC | 0.0624 | 0.0624 | YES | NO | NO |
| 02356848 | METOPROLOL TARTRATE | Jamp-Metoprolol-L 100mg Tab | JPC | 0.1361 | 0.1361 | YES | NO | NO |
| 00397423 | METOPROLOL TARTRATE | Lopresor (Not a Benefit) 50mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00397431 | METOPROLOL TARTRATE | Lopresor (Not a Benefit) 100mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02350394 | METOPROLOL TARTRATE | Metoprolol 50mg Tab | SAI | 0.0624 | 0.0624 | YES | NO | NO |
| 02350408 | METOPROLOL TARTRATE | Metoprolol 100mg Tab | SAI | 0.1361 | 0.1361 | YES | NO | NO |
| 02442124 | METOPROLOL TARTRATE | Metoprolol-L 50mg Tab | SIV | 0.0624 | 0.0624 | YES | NO | NO |
| 02442132 | METOPROLOL TARTRATE | Metoprolol-L 100mg Tab | SIV | 0.1361 | 0.1361 | YES | NO | NO |
| 02230804 | METOPROLOL TARTRATE | PMS-Metoprolol-L 100mg Tab | PMS | 0.1361 | 0.1361 | YES | NO | NO |
| 02230803 | METOPROLOL TARTRATE | PMS-Metoprolol-L 50mg Tab | PMS | 0.0624 | 0.0624 | YES | NO | NO |
| 02354195 | METOPROLOL TARTRATE | Sandoz Metoprolol (Type L) 100mg Tab | SDZ | 0.1361 | 0.1361 | YES | NO | NO |
| 02354187 | METOPROLOL TARTRATE | Sandoz Metoprolol (Type L) 50mg Tab | SDZ | 0.0624 | 0.0624 | YES | NO | NO |
| 00648043 | METOPROLOL TARTRATE | Teva-Metoprolol 100mg Tab | TEV | 0.1361 | 0.1361 | YES | NO | NO |
| 00648035 | METOPROLOL TARTRATE | Teva-Metoprolol 50mg Tab | TEV | 0.0624 | 0.0624 | YES | NO | NO |
| 00842656 | METOPROLOL TARTRATE | Teva-Metoprolol (Uncoated) 100mg Tab | TEV | 0.1361 | 0.1361 | YES | NO | NO |
| 00842648 | METOPROLOL TARTRATE | Teva-Metoprolol (Uncoated) 50mg Tab | TEV | 0.0624 | 0.0624 | YES | NO | NO |
| 02248562 | METRONIDAZOLE | Apo-Metronidazole 500mg Cap | APX | 0.2739 | 0.2739 | YES | NO | NO |
| 02470284 | METRONIDAZOLE | Auro-Metronidazole 500mg Cap | AUR | 0.2739 | 0.2739 | YES | NO | NO |
| 01926853 | METRONIDAZOLE | Flagyl (Not a Benefit) 500mg Cap | SAC | N/A | N/A | YES | NO | NO |
| 02519755 | METRONIDAZOLE | M-Metronidazole 500mg Cap | MAT | 0.2739 | 0.2739 | YES | NO | NO |
| 02534592 | METRONIDAZOLE | Metronidazole 500mg Cap | SAI | 0.2739 | 0.2739 | YES | NO | NO |
| 02518767 | METRONIDAZOLE | Metronidazole 500mg Cap | JPC | 0.2739 | 0.2739 | YES | NO | NO |
| 00783137 | METRONIDAZOLE | PMS-Metronidazole 500mg Cap | PMS | 0.2739 | 0.2739 | YES | NO | NO |
| 00545066 | METRONIDAZOLE | Apo-Metronidazole Tablets 250mg Tab | APX | 0.0572 | 0.0572 | YES | NO | NO |
| 01926896 | METRONIDAZOLE | Flagyl (Not a Benefit) 250mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 02535807 | METRONIDAZOLE | Mint-Metronidazole 250mg Tab | MIN | 0.0572 | 0.0572 | YES | NO | NO |
| 02156091 | METRONIDAZOLE | Noritate 1% Top Cr | VAL | 0.7989 | 0.7989 | NO | NO | NO |
| 02297809 | METRONIDAZOLE | Metrogel 1% Top Gel | GAC | 0.7235 | 0.7235 | NO | NO | NO |
| 01926861 | METRONIDAZOLE | Flagyl 10% Vag Cr-App | SAV | 0.2740 | 0.2740 | NO | NO | NO |
| 01926845 | METRONIDAZOLE & NYSTATIN | Flagystatin 500mg & 100000U/g Vag Cr-App | SAV | 0.6076 | 0.6076 | NO | NO | NO |
| 01926829 | METRONIDAZOLE & NYSTATIN | Flagystatin 500mg & 100000U Vag Sup | SAV | 3.6980 | 3.6980 | NO | NO | NO |
| 00599956 | MEXILETINE HCL | Mexitil (Not a Benefit) 100mg Cap | BOE | N/A | N/A | YES | NO | NO |
| 00599964 | MEXILETINE HCL | Mexitil (Not a Benefit) 200mg Cap | BOE | N/A | N/A | YES | NO | NO |
| 02536854 | MEXILETINE HCL | Mint-Mexiletine 200mg Cap | MIN | 0.9837 | 0.9837 | YES | NO | NO |
| 02536846 | MEXILETINE HCL | Mint-Mexiletine 100mg Cap | MIN | 0.7346 | 0.7346 | YES | NO | NO |
| 02230360 | MEXILETINE HCL | Teva-Mexiletine 200mg Cap | TEV | 0.9837 | 0.9837 | YES | NO | NO |
| 02230359 | MEXILETINE HCL | Teva-Mexiletine 100mg Cap | TEV | 0.7346 | 0.7346 | YES | NO | NO |
| 02547236 | MICAFUNGIN SODIUM | Micafungin Sodium for Injection (Off-Formulary Interchangeable) 100mg/Vial Inj Pd-10mL Vial Pk | OMG | 186.2000 | 186.2000 | YES | NO | NO |
| 02524953 | MICAFUNGIN SODIUM | Micafungin Sodium for Injection (Off-Formulary Interchangeable) 50mg/Vial Inj Pd-10mL Vial Pk | JUN | 93.1000 | 93.1000 | YES | NO | NO |
| 02547228 | MICAFUNGIN SODIUM | Micafungin Sodium for Injection (Off-Formulary Interchangeable) 50mg/Vial Inj Pd-10mL Vial Pk | OMG | 93.1000 | 93.1000 | YES | NO | NO |
| 02524961 | MICAFUNGIN SODIUM | Micafungin Sodium for Injection (Off-Formulary Interchangeable) 100mg/Vial Inj Pd-10mL Vial Pk | JUN | 186.2000 | 186.2000 | YES | NO | NO |
| 02294222 | MICAFUNGIN SODIUM | Mycamine (Off-Formulary Interchangeable) 50mg/Vial Inj Pd-10mL Vial Pk | SDZ | N/A | N/A | YES | NO | NO |
| 02311054 | MICAFUNGIN SODIUM | Mycamine (Off-Formulary Interchangeable) 100mg/Vial Inj Pd-10mL Vial Pk | SDZ | N/A | N/A | YES | NO | NO |
| 02085852 | MICONAZOLE NITRATE | Micatin 2% Cr | WEL | 0.2970 | 0.2970 | NO | NO | YES |
| 02242905 | MIDAZOLAM | Midazolam Injection 5mg/mL Inj Sol (with Preservative) | FKC | 4.1000 | 4.1000 | YES | YES | NO |
| 02240286 | MIDAZOLAM | Midazolam Injection 5mg/mL Inj Sol (with Preservative) | SDZ | 4.1000 | 4.1000 | YES | YES | NO |
| 00766011 | MIDAZOLAM | Versed (Not a Benefit) 5mg/mL Inj Sol (with Preservative) | HLR | N/A | N/A | YES | NO | NO |
| 01934406 | MIDODRINE HCL | Amatine (Not a Benefit) 5mg Tab | SHI | N/A | N/A | YES | NO | NO |
| 01934392 | MIDODRINE HCL | Amatine (Not a Benefit) 2.5mg Tab | SHI | N/A | N/A | YES | NO | NO |
| 02278685 | MIDODRINE HCL | Apo-Midodrine 5mg Tab | APX | 0.1921 | 0.1921 | YES | YES | NO |
| 02278677 | MIDODRINE HCL | Apo-Midodrine 2.5mg Tab | APX | 0.1153 | 0.1153 | YES | YES | NO |
| 02517728 | MIDODRINE HCL | Jamp Midodrine 5mg Tab | JPC | 0.1921 | 0.1921 | YES | YES | NO |
| 02517701 | MIDODRINE HCL | Jamp Midodrine 2.5mg Tab | JPC | 0.1153 | 0.1153 | YES | YES | NO |
| 02473984 | MIDODRINE HCL | Mar-Midodrine 2.5mg Tab | MAR | 0.1153 | 0.1153 | YES | YES | NO |
| 02473992 | MIDODRINE HCL | Mar-Midodrine 5mg Tab | MAR | 0.1921 | 0.1921 | YES | YES | NO |
| 02533219 | MIDODRINE HCL | Midodrine 5mg Tab | SAI | 0.1921 | 0.1921 | YES | YES | NO |
| 02533200 | MIDODRINE HCL | Midodrine 2.5mg Tab | SAI | 0.1153 | 0.1153 | YES | YES | NO |
| 02456257 | MIGLUSTAT | Sandoz Miglustat (Off-Formulary Interchangeable) 100mg Cap | SDZ | 81.4125 | 81.4125 | YES | NO | NO |
| 02250519 | MIGLUSTAT | Zavesca (Off-Formulary Interchangeable) 100mg Cap | ACT | 128.9600 | 81.4125 | YES | NO | NO |
| 00107875 | MINERAL OIL | Fleet Enema Mineral Oil 100% Enema | CBF | 0.0452 | 0.0452 | NO | NO | NO |
| 02173506 | MINOCYCLINE HCL | Minocin (Not a Benefit) 100mg Cap | STI | N/A | N/A | YES | NO | NO |
| 02173514 | MINOCYCLINE HCL | Minocin (Not a Benefit) 50mg Cap | STI | N/A | N/A | YES | NO | NO |
| 02084090 | MINOCYCLINE HCL | Minocycline 50mg Cap | AAP | 0.5616 | 0.5616 | YES | NO | NO |
| 02084104 | MINOCYCLINE HCL | Minocycline 100mg Cap | AAP | 1.0836 | 1.0836 | YES | NO | NO |
| 00514497 | MINOXIDIL | Loniten 2.5mg Tab | PFI | 0.5387 | 0.5387 | NO | NO | NO |
| 00514500 | MINOXIDIL | Loniten 10mg Tab | PFI | 1.1884 | 1.1884 | NO | NO | NO |
| 02402874 | MIRABEGRON | Myrbetriq 25mg ER Tab | ASE | 1.4600 | 1.4600 | NO | YES | NO |
| 02402882 | MIRABEGRON | Myrbetriq 50mg ER Tab | ASE | 1.4600 | 1.4600 | NO | YES | NO |
| 02299828 | MIRTAZAPINE | Auro-Mirtazapine OD 30mg Orally Disintegrating Tab | AUR | 0.8087 | 0.8087 | YES | NO | NO |
| 02299836 | MIRTAZAPINE | Auro-Mirtazapine OD 45mg Orally Disintegrating Tab | AUR | 1.2132 | 1.2132 | YES | NO | NO |
| 02299801 | MIRTAZAPINE | Auro-Mirtazapine OD 15mg Orally Disintegrating Tab | AUR | 0.4046 | 0.4046 | YES | NO | NO |
| 02248544 | MIRTAZAPINE | Remeron RD 45mg Orally Disintegrating Tab | OCI | 1.6580 | 1.2132 | YES | NO | NO |
| 02248543 | MIRTAZAPINE | Remeron RD 30mg Orally Disintegrating Tab | OCI | 1.1052 | 0.8087 | YES | NO | NO |
| 02248542 | MIRTAZAPINE | Remeron RD 15mg Orally Disintegrating Tab | OCI | 0.5529 | 0.4046 | YES | NO | NO |
| 02286629 | MIRTAZAPINE | Apo-Mirtazapine 30mg Tab | APX | 0.3100 | 0.3100 | YES | NO | NO |
| 02411709 | MIRTAZAPINE | Auro-Mirtazapine 30mg Tab | AUR | 0.3100 | 0.3100 | YES | NO | NO |
| 02411717 | MIRTAZAPINE | Auro-Mirtazapine (Off-Formulary Interchangeable) 45mg Tab | AUR | 1.1250 | N/A | YES | NO | NO |
| 02411695 | MIRTAZAPINE | Auro-Mirtazapine (Off-Formulary Interchangeable) 15mg Tab | AUR | 0.3750 | N/A | YES | NO | NO |
| 02532689 | MIRTAZAPINE | Mirtazapine (Off-Formulary Interchangeable) 15mg Tab | SAI | 0.3750 | N/A | YES | NO | NO |
| 02496666 | MIRTAZAPINE | Mirtazapine (Off-Formulary Interchangeable) 15mg Tab | SIV | 0.3750 | N/A | YES | NO | NO |
| 02496682 | MIRTAZAPINE | Mirtazapine (Off-Formulary Interchangeable) 45mg Tab | SIV | 1.1250 | N/A | YES | NO | NO |
| 02496674 | MIRTAZAPINE | Mirtazapine 30mg Tab | SIV | 0.3100 | 0.3100 | YES | NO | NO |
| 02370689 | MIRTAZAPINE | Mirtazapine 30mg Tab | SAI | 0.3100 | 0.3100 | YES | NO | NO |
| 02256118 | MIRTAZAPINE | Mylan-Mirtazapine 30mg Tab | MYL | 0.3100 | 0.3100 | YES | NO | NO |
| 02534932 | MIRTAZAPINE | NRA-Mirtazapine 30mg Tab | NRA | 0.3100 | 0.3100 | YES | NO | NO |
| 02248762 | MIRTAZAPINE | PMS-Mirtazapine 30mg Tab | PMS | 0.3100 | 0.3100 | YES | NO | NO |
| 02243911 | MIRTAZAPINE | Remeron (Off-Formulary Interchangeable) 45mg Tab | ORG | N/A | N/A | YES | NO | NO |
| 02243910 | MIRTAZAPINE | Remeron 30mg Tab | OCI | 1.8987 | 0.3100 | YES | NO | NO |
| 02243909 | MIRTAZAPINE | Remeron (Off-Formulary Interchangeable) 15mg Tab | ORG | N/A | N/A | YES | NO | NO |
| 02250608 | MIRTAZAPINE | Sandoz Mirtazapine 30mg Tab | SDZ | 0.3100 | 0.3100 | YES | NO | NO |
| 02541572 | MIRTAZAPINE | Teva-Mirtazapine (Off-Formulary Interchangeable) 15mg Tab | TEV | 0.3750 | N/A | YES | NO | NO |
| 02259354 | MIRTAZAPINE | Teva-Mirtazapine 30mg Tab | TEV | 0.3100 | 0.3100 | YES | NO | NO |
| 02541580 | MIRTAZAPINE | Teva-Mirtazapine (Off-Formulary Interchangeable) 45mg Tab | TEV | 1.1250 | N/A | YES | NO | NO |
| 00813966 | MISOPROSTOL | Cytotec (Not a Benefit) 100mcg Tab | SEA | N/A | N/A | YES | NO | NO |
| 00632600 | MISOPROSTOL | Cytotec (Not a Benefit) 200mcg Tab | SEA | N/A | N/A | YES | NO | NO |
| 02244022 | MISOPROSTOL | Misoprostol 100mcg Tab | AAP | 0.2636 | 0.2636 | YES | NO | NO |
| 02244023 | MISOPROSTOL | Misoprostol 200mcg Tab | AAP | 0.4389 | 0.4389 | YES | NO | NO |
| 00463221 | MITOTANE | Lysodren 500mg Tab | HRA | 9.7900 | 9.7900 | NO | NO | NO |
| 02439255 | MIXED SALT AMPHETAMINE | Act Amphetamine XR 15mg ER Cap | ACV | 0.6838 | 0.6838 | YES | NO | YES |
| 02439247 | MIXED SALT AMPHETAMINE | Act Amphetamine XR 10mg ER Cap | ACV | 0.6105 | 0.6105 | YES | NO | YES |
| 02439263 | MIXED SALT AMPHETAMINE | Act Amphetamine XR 20mg ER Cap | ACV | 0.7572 | 0.7572 | YES | NO | YES |
| 02439271 | MIXED SALT AMPHETAMINE | Act Amphetamine XR 25mg ER Cap | ACV | 0.8305 | 0.8305 | YES | NO | YES |
| 02439298 | MIXED SALT AMPHETAMINE | Act Amphetamine XR 30mg ER Cap | ACV | 0.9038 | 0.9038 | YES | NO | YES |
| 02439239 | MIXED SALT AMPHETAMINE | Act Amphetamine XR 5mg ER Cap | ACV | 0.5372 | 0.5372 | YES | NO | YES |
| 02248813 | MIXED SALT AMPHETAMINE | Adderall XR 30mg ER Cap | TAK | 4.1888 | 0.9038 | YES | NO | YES |
| 02248812 | MIXED SALT AMPHETAMINE | Adderall XR 25mg ER Cap | TAK | 3.8489 | 0.8305 | YES | NO | YES |
| 02248811 | MIXED SALT AMPHETAMINE | Adderall XR 20mg ER Cap | TAK | 3.5092 | 0.7572 | YES | NO | YES |
| 02248809 | MIXED SALT AMPHETAMINE | Adderall XR 10mg ER Cap | TAK | 2.8296 | 0.6105 | YES | NO | YES |
| 02248810 | MIXED SALT AMPHETAMINE | Adderall XR 15mg ER Cap | TAK | 3.1694 | 0.6838 | YES | NO | YES |
| 02248808 | MIXED SALT AMPHETAMINE | Adderall XR 5mg ER Cap | TAK | 2.4898 | 0.5372 | YES | NO | YES |
| 02445530 | MIXED SALT AMPHETAMINE | Apo-Amphetamine XR 25mg ER Cap | APX | 0.8305 | 0.8305 | YES | NO | YES |
| 02445514 | MIXED SALT AMPHETAMINE | Apo-Amphetamine XR 15mg ER Cap | APX | 0.6838 | 0.6838 | YES | NO | YES |
| 02445506 | MIXED SALT AMPHETAMINE | Apo-Amphetamine XR 10mg ER Cap | APX | 0.6105 | 0.6105 | YES | NO | YES |
| 02445492 | MIXED SALT AMPHETAMINE | Apo-Amphetamine XR 5mg ER Cap | APX | 0.5372 | 0.5372 | YES | NO | YES |
| 02445522 | MIXED SALT AMPHETAMINE | Apo-Amphetamine XR 20mg ER Cap | APX | 0.7572 | 0.7572 | YES | NO | YES |
| 02445549 | MIXED SALT AMPHETAMINE | Apo-Amphetamine XR 30mg ER Cap | APX | 0.9038 | 0.9038 | YES | NO | YES |
| 02457342 | MIXED SALT AMPHETAMINE | Sandoz Amphetamine XR 30mg ER Cap | SDZ | 0.9038 | 0.9038 | YES | NO | YES |
| 02457318 | MIXED SALT AMPHETAMINE | Sandoz Amphetamine XR 15mg ER Cap | SDZ | 0.6838 | 0.6838 | YES | NO | YES |
| 02457296 | MIXED SALT AMPHETAMINE | Sandoz Amphetamine XR 10mg ER Cap | SDZ | 0.6105 | 0.6105 | YES | NO | YES |
| 02457288 | MIXED SALT AMPHETAMINE | Sandoz Amphetamine XR 5mg ER Cap | SDZ | 0.5372 | 0.5372 | YES | NO | YES |
| 02457326 | MIXED SALT AMPHETAMINE | Sandoz Amphetamine XR 20mg ER Cap | SDZ | 0.7572 | 0.7572 | YES | NO | YES |
| 02457334 | MIXED SALT AMPHETAMINE | Sandoz Amphetamine XR 25mg ER Cap | SDZ | 0.8305 | 0.8305 | YES | NO | YES |
| 02166747 | MOCLOBEMIDE | Manerix 300mg Tab | MAB | 1.7570 | 1.0399 | YES | NO | NO |
| 00899356 | MOCLOBEMIDE | Manerix 150mg Tab | MAB | 0.8946 | 0.5295 | YES | NO | NO |
| 00899348 | MOCLOBEMIDE | Manerix (Not a Benefit) 100mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02232150 | MOCLOBEMIDE | Moclobemide 150mg Tab | AAP | 0.5295 | 0.5295 | YES | NO | NO |
| 02232148 | MOCLOBEMIDE | Moclobemide 100mg Tab | AAP | 0.3400 | 0.3400 | YES | NO | NO |
| 02240456 | MOCLOBEMIDE | Moclobemide 300mg Tab | AAP | 1.0399 | 1.0399 | YES | NO | NO |
| 02239665 | MODAFINIL | Alertec (Off-Formulary Interchangeable) 100mg Tab | BJH | 1.8270 | 0.9293 | YES | NO | YES |
| 02285398 | MODAFINIL | Apo-Modafinil (Off-Formulary Interchangeable) 100mg Tab | APX | 0.9293 | 0.9293 | YES | NO | YES |
| 02430487 | MODAFINIL | Auro-Modafinil (Off-Formulary Interchangeable) 100mg Tab | AUR | 0.9293 | 0.9293 | YES | NO | YES |
| 02503727 | MODAFINIL | Jamp Modafinil (Off-Formulary Interchangeable) 100mg Tab | JPC | 0.9293 | 0.9293 | YES | NO | YES |
| 02432560 | MODAFINIL | Mar-Modafinil (Off-Formulary Interchangeable) 100mg Tab | MAR | 0.9293 | 0.9293 | YES | NO | YES |
| 02530244 | MODAFINIL | Modafinil (Off-Formulary Interchangeable) 100mg Tab | SAI | 0.9293 | 0.9293 | YES | NO | YES |
| 02420260 | MODAFINIL | Teva-Modafinil (Off-Formulary Interchangeable) 100mg Tab | TEV | 0.9293 | 0.9293 | YES | NO | YES |
| 00851744 | MOMETASONE FUROATE | Elocom 0.1% Cr | OCI | 0.7393 | 0.5542 | YES | NO | NO |
| 02367157 | MOMETASONE FUROATE | Taro-Mometasone 0.1% Cr | TAR | 0.5542 | 0.5542 | YES | NO | NO |
| 00871095 | MOMETASONE FUROATE | Elocom 0.1% Lot | OCI | 0.5255 | 0.3627 | YES | NO | NO |
| 02266385 | MOMETASONE FUROATE | Taro-Mometasone 0.1% Lot | TAR | 0.3627 | 0.3627 | YES | NO | NO |
| 02403587 | MOMETASONE FUROATE | Apo-Mometasone (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose Pk | APX | 21.6900 | N/A | YES | NO | YES |
| 02519127 | MOMETASONE FUROATE | Mometasone (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose Pk | SAI | 21.6900 | N/A | YES | NO | YES |
| 02551756 | MOMETASONE FUROATE | Mometasone (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose Pk | SIV | 21.6860 | N/A | YES | NO | YES |
| 02238465 | MOMETASONE FUROATE | Nasonex (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose Pk | OCI | N/A | N/A | YES | NO | YES |
| 02449811 | MOMETASONE FUROATE | Sandoz Mometasone (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose Pk | SDZ | 21.6860 | N/A | YES | NO | YES |
| 02475863 | MOMETASONE FUROATE | Teva-Mometasone (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose Pk | TEV | 21.6900 | N/A | YES | NO | YES |
| 00851736 | MOMETASONE FUROATE | Elocom 0.1% Oint | OCI | 0.7342 | 0.2252 | YES | NO | NO |
| 02248130 | MOMETASONE FUROATE | Ratio-Mometasone 0.1% Oint | RPH | 0.2252 | 0.2252 | YES | NO | NO |
| 02243596 | MOMETASONE FUROATE | Asmanex Twisthaler 400mcg/Metered Dose Pd Inh-30 Dose Pk | OCI | 42.4320 | 42.4320 | NO | NO | YES |
| 02243595 | MOMETASONE FUROATE | Asmanex Twisthaler 200mcg/Metered Dose Pd Inh-60 Dose Pk | OCI | 42.4320 | 42.4320 | NO | NO | YES |
| 09857431 | MOMETASONE FUROATE | Asmanex Twisthaler 400mcg/Metered Dose Pd Inh-60 Dose Pk | OCI | 84.8280 | 84.8280 | NO | NO | YES |
| 02361752 | MOMETASONE FUROATE & FORMOTEROL FUMARATE DIHYDRATE | Zenhale 100mcg & 5mcg Metered Dose Inh-120 Dose Pk | OCI | 123.2300 | 123.2300 | NO | YES | NO |
| 02361760 | MOMETASONE FUROATE & FORMOTEROL FUMARATE DIHYDRATE | Zenhale 200mcg & 5mcg Metered Dose Inh-120 Dose Pk | OCI | 149.3300 | 149.3300 | NO | YES | NO |
| 02377616 | MONTELUKAST SODIUM | Apo-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | APX | 1.2075 | 1.2075 | YES | NO | NO |
| 02377608 | MONTELUKAST SODIUM | Apo-Montelukast 4mg Chew Tab | APX | 0.2758 | 0.2758 | YES | YES | NO |
| 02422867 | MONTELUKAST SODIUM | Auro-Montelukast Chewable Tablet 4mg Chew Tab | AUR | 0.2758 | 0.2758 | YES | YES | NO |
| 02422875 | MONTELUKAST SODIUM | Auro-Montelukast Chewable Tablet (Off-Formulary Interchangeable) 5mg Chew Tab | AUR | 1.2077 | 1.2077 | YES | NO | NO |
| 02514885 | MONTELUKAST SODIUM | Jamp Montelukast Chewable Tablets (Off-Formulary Interchangeable) 5mg Chew Tab | JPC | 1.2075 | 1.2075 | YES | NO | NO |
| 02514877 | MONTELUKAST SODIUM | Jamp Montelukast Chewable Tablets 4mg Chew Tab | JPC | 0.2758 | 0.2758 | YES | YES | NO |
| 02442353 | MONTELUKAST SODIUM | Jamp-Montelukast 4mg Chew Tab | JPC | 0.2758 | 0.2758 | YES | YES | NO |
| 02442361 | MONTELUKAST SODIUM | Jamp-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | JPC | 1.2075 | 1.2075 | YES | NO | NO |
| 02399865 | MONTELUKAST SODIUM | Mar-Montelukast 4mg Chew Tab | MAR | 0.2758 | 0.2758 | YES | YES | NO |
| 02399873 | MONTELUKAST SODIUM | Mar-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | MAR | 1.2075 | 1.2075 | YES | NO | NO |
| 02408627 | MONTELUKAST SODIUM | Mint-Montelukast 4mg Chew Tab | MIN | 0.2758 | 0.2758 | YES | YES | NO |
| 02408635 | MONTELUKAST SODIUM | Mint-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | MIN | 1.2075 | 1.2075 | YES | NO | NO |
| 02382466 | MONTELUKAST SODIUM | Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | SIV | 1.2075 | 1.2075 | YES | NO | NO |
| 02382458 | MONTELUKAST SODIUM | Montelukast 4mg Chew Tab | SIV | 0.2758 | 0.2758 | YES | YES | NO |
| 02379325 | MONTELUKAST SODIUM | Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | SAI | 1.2075 | 1.2075 | YES | NO | NO |
| 02522101 | MONTELUKAST SODIUM | Nat-Montelukast 4mg Chew Tab | NAT | 0.2758 | 0.2758 | YES | YES | NO |
| 02522128 | MONTELUKAST SODIUM | Nat-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | NAT | 1.2077 | 1.2077 | YES | NO | NO |
| 02354985 | MONTELUKAST SODIUM | PMS-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | PMS | 1.2075 | 1.2075 | YES | NO | NO |
| 02354977 | MONTELUKAST SODIUM | PMS-Montelukast 4mg Chew Tab | PMS | 0.2758 | 0.2758 | YES | YES | NO |
| 02402807 | MONTELUKAST SODIUM | Ran-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | RAN | 1.2075 | 1.2075 | YES | NO | NO |
| 02330385 | MONTELUKAST SODIUM | Sandoz Montelukast 4mg Chew Tab | SDZ | 0.2758 | 0.2758 | YES | YES | NO |
| 02330393 | MONTELUKAST SODIUM | Sandoz Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | SDZ | 1.2075 | 1.2075 | YES | NO | NO |
| 02238216 | MONTELUKAST SODIUM | Singulair (Off-Formulary Interchangeable) 5mg Chew Tab | OCI | N/A | N/A | YES | NO | NO |
| 02243602 | MONTELUKAST SODIUM | Singulair 4mg Chew Tab | OCI | 1.7622 | 0.2758 | YES | YES | NO |
| 02355515 | MONTELUKAST SODIUM | Teva-Montelukast (Off-Formulary Interchangeable) 5mg Chew Tab | TEV | 1.2077 | 1.2077 | YES | NO | NO |
| 02355507 | MONTELUKAST SODIUM | Teva-Montelukast 4mg Chew Tab | TEV | 0.2758 | 0.2758 | YES | YES | NO |
| 02358611 | MONTELUKAST SODIUM | Sandoz Montelukast (Off-Formulary Interchangeable) 4mg Gran Pk | SDZ | 1.3440 | N/A | YES | NO | NO |
| 02247997 | MONTELUKAST SODIUM | Singulair (Off-Formulary Interchangeable) 4mg Gran Pk | OCI | N/A | N/A | YES | NO | NO |
| 02379236 | MONTELUKAST SODIUM | Ach-Montelukast (Off-Formulary Interchangeable) 10mg Tab | ACH | 1.7735 | 1.7735 | YES | NO | NO |
| 02374609 | MONTELUKAST SODIUM | Apo-Montelukast (Off-Formulary Interchangeable) 10mg Tab | APX | 1.7735 | 1.7735 | YES | NO | NO |
| 02401274 | MONTELUKAST SODIUM | Auro-Montelukast (Off-Formulary Interchangeable) 10mg Tab | AUR | 1.7735 | 1.7735 | YES | NO | NO |
| 02391422 | MONTELUKAST SODIUM | Jamp-Montelukast (Off-Formulary Interchangeable) 10mg Tab | JPC | 1.7735 | 1.7735 | YES | NO | NO |
| 02488183 | MONTELUKAST SODIUM | M-Montelukast (Off-Formulary Interchangeable) 10mg Tab | MAT | 1.7735 | 1.7735 | YES | NO | NO |
| 02399997 | MONTELUKAST SODIUM | Mar-Montelukast (Off-Formulary Interchangeable) 10mg Tab | MAR | 1.7735 | 1.7735 | YES | NO | NO |
| 02408643 | MONTELUKAST SODIUM | Mint-Montelukast (Off-Formulary Interchangeable) 10mg Tab | MIN | 1.7735 | 1.7735 | YES | NO | NO |
| 02382474 | MONTELUKAST SODIUM | Montelukast (Off-Formulary Interchangeable) 10mg Tab | SIV | 1.7735 | 1.7735 | YES | NO | NO |
| 02379333 | MONTELUKAST SODIUM | Montelukast (Off-Formulary Interchangeable) 10mg Tab | SAI | 1.7735 | 1.7735 | YES | NO | NO |
| 02489821 | MONTELUKAST SODIUM | NRA-Montelukast (Off-Formulary Interchangeable) 10mg Tab | NRA | 1.7735 | 1.7735 | YES | NO | NO |
| 02522136 | MONTELUKAST SODIUM | Nat-Montelukast (Off-Formulary Interchangeable) 10mg Tab | NAT | 1.7737 | 1.7737 | YES | NO | NO |
| 02373947 | MONTELUKAST SODIUM | PMS-Montelukast FC (Off-Formulary Interchangeable) 10mg Tab | PMS | 1.7735 | 1.7735 | YES | NO | NO |
| 02389517 | MONTELUKAST SODIUM | Ran-Montelukast (Off-Formulary Interchangeable) 10mg Tab | RAN | 1.7735 | 1.7735 | YES | NO | NO |
| 02328593 | MONTELUKAST SODIUM | Sandoz Montelukast (Off-Formulary Interchangeable) 10mg Tab | SDZ | 1.7735 | 1.7735 | YES | NO | NO |
| 02238217 | MONTELUKAST SODIUM | Singulair (Off-Formulary Interchangeable) 10mg Tab | OCI | N/A | N/A | YES | NO | NO |
| 02355523 | MONTELUKAST SODIUM | Teva-Montelukast (Off-Formulary Interchangeable) 10mg Tab | TEV | 1.7737 | 1.7737 | YES | NO | NO |
| 02177749 | MORPHINE SULFATE | M-Eslon 15mg ER Cap | ETH | 0.3941 | 0.3941 | NO | NO | YES |
| 02019930 | MORPHINE SULFATE | M-Eslon 10mg ER Cap | ETH | 0.3416 | 0.3416 | NO | NO | YES |
| 02019949 | MORPHINE SULFATE | M-Eslon 30mg ER Cap | ETH | 0.5875 | 0.5875 | NO | NO | YES |
| 02019957 | MORPHINE SULFATE | M-Eslon 60mg ER Cap | ETH | 1.0457 | 1.0457 | NO | NO | YES |
| 02019965 | MORPHINE SULFATE | M-Eslon 100mg ER Cap | ETH | 2.2554 | 2.2554 | NO | NO | YES |
| 00392588 | MORPHINE SULFATE | Morphine Sulfate 10mg/mL Inj Sol Amp | SDZ | 2.3860 | 2.3860 | NO | NO | YES |
| 00392561 | MORPHINE SULFATE | Morphine Sulfate 15mg/mL Inj Sol Amp | SDZ | 2.0940 | 2.0940 | YES | NO | YES |
| 02242484 | MORPHINE SULFATE | Morphine Sulfate Injection USP 2mg/mL Inj Sol Amp | SDZ | 2.2510 | 2.2510 | NO | NO | YES |
| 00850330 | MORPHINE SULFATE | Morphine Sulfate Injection USP (Not a Benefit) 15mg/mL Inj Sol Amp | HOS | N/A | N/A | YES | NO | YES |
| 00617288 | MORPHINE SULFATE | Morphine HP-50 50mg/mL Inj Sol-1mL Pk | SDZ | 6.8195 | 6.8195 | NO | NO | YES |
| 02242163 | MORPHINE SULFATE | Kadian 10mg SR Cap | BGP | 0.4648 | 0.4648 | NO | NO | YES |
| 02184435 | MORPHINE SULFATE | Kadian 20mg SR Cap | BGP | 0.9029 | 0.9029 | NO | NO | YES |
| 02184443 | MORPHINE SULFATE | Kadian 50mg SR Cap | BGP | 1.7080 | 1.7080 | NO | NO | YES |
| 02184451 | MORPHINE SULFATE | Kadian 100mg SR Cap | BGP | 2.9793 | 2.9793 | NO | NO | YES |
| 02014300 | MORPHINE SULFATE | MS Contin 60mg SR Tab | PFP | 2.6322 | 1.2180 | YES | NO | YES |
| 02014297 | MORPHINE SULFATE | MS Contin 30mg SR Tab | PFP | 1.4931 | 0.6580 | YES | NO | YES |
| 02014327 | MORPHINE SULFATE | MS Contin (Off-Formulary Interchangeable) 200mg SR Tab | PFP | 7.4705 | 4.5738 | YES | NO | YES |
| 02014319 | MORPHINE SULFATE | MS Contin 100mg SR Tab | PFP | 4.0069 | 1.5395 | YES | NO | YES |
| 02015439 | MORPHINE SULFATE | MS Contin 15mg SR Tab | PFP | 0.9878 | 0.4145 | YES | NO | YES |
| 02478897 | MORPHINE SULFATE | Sandoz Morphine SR (Off-Formulary Interchangeable) 200mg SR Tab | SDZ | 4.5738 | 4.5738 | YES | NO | YES |
| 02478889 | MORPHINE SULFATE | Sandoz Morphine SR 100mg SR Tab | SDZ | 1.5395 | 1.5395 | YES | NO | YES |
| 02244792 | MORPHINE SULFATE | Sandoz Morphine SR 60mg SR Tab | SDZ | 1.2180 | 1.2180 | YES | NO | YES |
| 02244791 | MORPHINE SULFATE | Sandoz Morphine SR 30mg SR Tab | SDZ | 0.6580 | 0.6580 | YES | NO | YES |
| 02244790 | MORPHINE SULFATE | Sandoz Morphine SR 15mg SR Tab | SDZ | 0.4145 | 0.4145 | YES | NO | YES |
| 02302802 | MORPHINE SULFATE | Teva-Morphine SR (Off-Formulary Interchangeable) 200mg SR Tab | TEV | 4.5737 | 4.5737 | YES | NO | YES |
| 02302764 | MORPHINE SULFATE | Teva-Morphine SR 15mg SR Tab | TEV | 0.4145 | 0.4145 | YES | NO | YES |
| 02302772 | MORPHINE SULFATE | Teva-Morphine SR 30mg SR Tab | TEV | 0.6580 | 0.6580 | YES | NO | YES |
| 02302780 | MORPHINE SULFATE | Teva-Morphine SR 60mg SR Tab | TEV | 1.2180 | 1.2180 | YES | NO | YES |
| 02302799 | MORPHINE SULFATE | Teva-Morphine SR 100mg SR Tab | TEV | 1.5395 | 1.5395 | YES | NO | YES |
| 02014238 | MORPHINE SULFATE | MS-IR 20mg Tab | PFP | 0.4605 | 0.4605 | NO | NO | YES |
| 02014254 | MORPHINE SULFATE | MS-IR 30mg Tab | PFP | 0.5912 | 0.5912 | NO | NO | YES |
| 02549808 | MORPHINE SULFATE | PMS-Morphine Sulfate 10mg Tab | PMS | 0.1096 | 0.1096 | YES | NO | YES |
| 02549794 | MORPHINE SULFATE | PMS-Morphine Sulfate 5mg Tab | PMS | 0.0709 | 0.0709 | YES | NO | YES |
| 00594652 | MORPHINE SULFATE | Statex 5mg Tab | PPI | 0.0709 | 0.0709 | YES | NO | YES |
| 00594644 | MORPHINE SULFATE | Statex 10mg Tab | PPI | 0.1096 | 0.1096 | YES | NO | YES |
| 02484757 | MOXIFLOXACIN HYDROCHLORIDE | AG-Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | ANG | 11.2700 | N/A | YES | NO | NO |
| 02404656 | MOXIFLOXACIN HYDROCHLORIDE | Act Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | ACV | 11.2700 | N/A | YES | NO | NO |
| 02406373 | MOXIFLOXACIN HYDROCHLORIDE | Apo-Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | APX | 11.2700 | N/A | YES | NO | NO |
| 02472120 | MOXIFLOXACIN HYDROCHLORIDE | Jamp-Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | JPC | 11.2700 | N/A | YES | NO | NO |
| 02529076 | MOXIFLOXACIN HYDROCHLORIDE | Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | SAI | 11.2700 | N/A | YES | NO | NO |
| 02432218 | MOXIFLOXACIN HYDROCHLORIDE | PMS-Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | PMS | 11.2701 | N/A | YES | NO | NO |
| 02411520 | MOXIFLOXACIN HYDROCHLORIDE | Sandoz Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | SDZ | 11.2700 | N/A | YES | NO | NO |
| 02252260 | MOXIFLOXACIN HYDROCHLORIDE | Vigamox (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free) | NOV | N/A | N/A | YES | NO | NO |
| 02478137 | MOXIFLOXACIN HYDROCHLORIDE | AG-Moxifloxacin 400mg Tab | ANG | 1.5230 | 1.5230 | YES | NO | NO |
| 02404923 | MOXIFLOXACIN HYDROCHLORIDE | Apo-Moxifloxacin 400mg Tab | APX | 1.5230 | 1.5230 | YES | NO | NO |
| 02432242 | MOXIFLOXACIN HYDROCHLORIDE | Auro-Moxifloxacin 400mg Tab | AUR | 1.5230 | 1.5230 | YES | NO | NO |
| 02242965 | MOXIFLOXACIN HYDROCHLORIDE | Avelox (Not a Benefit) 400mg Tab | BAY | N/A | N/A | YES | NO | NO |
| 02443929 | MOXIFLOXACIN HYDROCHLORIDE | Jamp-Moxifloxacin 400mg Tab | JPC | 1.5230 | 1.5230 | YES | NO | NO |
| 02447061 | MOXIFLOXACIN HYDROCHLORIDE | Jamp-Moxifloxacin Tablets 400mg Tab | JPC | 1.5230 | 1.5230 | YES | NO | NO |
| 02472791 | MOXIFLOXACIN HYDROCHLORIDE | M-Moxifloxacin 400mg Tab | MAT | 1.5230 | 1.5230 | YES | NO | NO |
| 02447053 | MOXIFLOXACIN HYDROCHLORIDE | Mar-Moxifloxacin 400mg Tab | MAR | 1.5230 | 1.5230 | YES | NO | NO |
| 02457814 | MOXIFLOXACIN HYDROCHLORIDE | Med-Moxifloxacin 400mg Tab | GMP | 1.5230 | 1.5230 | YES | NO | NO |
| 02520710 | MOXIFLOXACIN HYDROCHLORIDE | Moxifloxacin 400mg Tab | SAI | 1.5230 | 1.5230 | YES | NO | NO |
| 02383381 | MOXIFLOXACIN HYDROCHLORIDE | Sandoz Moxifloxacin 400mg Tab | SDZ | 1.5230 | 1.5230 | YES | NO | NO |
| 02375702 | MOXIFLOXACIN HYDROCHLORIDE | Teva-Moxifloxacin 400mg Tab | TEV | 1.5230 | 1.5230 | YES | NO | NO |
| 02535718 | MULTIVITAMINS | Pregnancy Multivitamin (Off-Formulary Interchangeable) Tab | JPC | 0.3125 | N/A | YES | NO | NO |
| 02537478 | MULTIVITAMINS | Pregnancy Multivitamin Folic 5 (Off-Formulary Interchangeable) Tab | JPC | 0.5025 | N/A | YES | NO | NO |
| 02451573 | MULTIVITAMINS | Pregvit (Off-Formulary Interchangeable) Tab | DUI | N/A | N/A | YES | NO | NO |
| 02451581 | MULTIVITAMINS | Pregvit Folic 5 (Off-Formulary Interchangeable) Tab | DUI | N/A | N/A | YES | NO | NO |
| 02100606 | MULTIVITAMINS FOR INFUSION | Multi-12 Inj-2x5mL Vial Pk | SDZ | 23.0000 | 23.0000 | NO | NO | NO |
| 02242529 | MULTIVITAMINS FOR INFUSION | Multi 12/K1 Pediatric Inj-4mL+1mL Vial Pk | SDZ | 41.8000 | 41.8000 | NO | NO | NO |
| 01916947 | MUPIROCIN | Bactroban (Not a Benefit) 2% Oint | GCH | N/A | N/A | YES | NO | NO |
| 02279983 | MUPIROCIN | Taro-Mupirocin 2% Oint | TAR | 0.5069 | 0.5069 | YES | NO | NO |
| 02483459 | MUPIROCIN CALCIUM | Stramucin 2% w/w Cr | GLP | 1.6000 | 1.6000 | NO | NO | NO |
| 02352559 | MYCOPHENOLATE MOFETIL | Apo-Mycophenolate 250mg Cap | APX | 0.3712 | 0.3712 | YES | NO | NO |
| 02192748 | MYCOPHENOLATE MOFETIL | CellCept 250mg Cap | HLR | 2.2370 | 0.3712 | YES | NO | NO |
| 02386399 | MYCOPHENOLATE MOFETIL | Jamp-Mycophenolate Capsules 250mg Cap | JPC | 0.3712 | 0.3712 | YES | NO | NO |
| 02457369 | MYCOPHENOLATE MOFETIL | Mycophenolate Mofetil 250mg Cap | SAI | 0.3712 | 0.3712 | YES | NO | NO |
| 02383780 | MYCOPHENOLATE MOFETIL | Mycophenolate Mofetil Capsules 250mg Cap | ACH | 0.3712 | 0.3712 | YES | NO | NO |
| 02320630 | MYCOPHENOLATE MOFETIL | Sandoz Mycophenolate Mofetil 250mg Cap | SDZ | 0.3712 | 0.3712 | YES | NO | NO |
| 02364883 | MYCOPHENOLATE MOFETIL | Teva-Mycophenolate 250mg Cap | TEV | 0.3712 | 0.3712 | YES | NO | NO |
| 02242145 | MYCOPHENOLATE MOFETIL | CellCept 200mg/mL Pd for Oral Susp-175mL Pk | HLR | 350.8000 | 244.7025 | YES | YES | NO |
| 02522233 | MYCOPHENOLATE MOFETIL | Mar-Mycophenolate Mofetil 200mg/mL Pd for Oral Susp-175mL Pk | MAR | 244.7025 | 244.7025 | YES | YES | NO |
| 02378574 | MYCOPHENOLATE MOFETIL | Ach-Mycophenolate 500mg Tab | ACH | 0.7423 | 0.7423 | YES | NO | NO |
| 02352567 | MYCOPHENOLATE MOFETIL | Apo-Mycophenolate 500mg Tab | APX | 0.7423 | 0.7423 | YES | NO | NO |
| 02237484 | MYCOPHENOLATE MOFETIL | CellCept 500mg Tab | HLR | 4.4740 | 0.7423 | YES | NO | NO |
| 02380382 | MYCOPHENOLATE MOFETIL | Jamp-Mycophenolate 500mg Tab | JPC | 0.7423 | 0.7423 | YES | NO | NO |
| 02457377 | MYCOPHENOLATE MOFETIL | Mycophenolate Mofetil 500mg Tab | SAI | 0.7423 | 0.7423 | YES | NO | NO |
| 02313855 | MYCOPHENOLATE MOFETIL | Sandoz Mycophenolate Mofetil 500mg Tab | SDZ | 0.7423 | 0.7423 | YES | NO | NO |
| 02348675 | MYCOPHENOLATE MOFETIL | Teva-Mycophenolate 500mg Tab | TEV | 0.7423 | 0.7423 | YES | NO | NO |
| 02372738 | MYCOPHENOLATE SODIUM | Apo-Mycophenolic Acid 180mg Ent Tab | APX | 0.4994 | 0.4994 | YES | NO | NO |
| 02372746 | MYCOPHENOLATE SODIUM | Apo-Mycophenolic Acid 360mg Ent Tab | APX | 0.9988 | 0.9988 | YES | NO | NO |
| 02518538 | MYCOPHENOLATE SODIUM | Jamp Mycophenolic Acid 180mg Ent Tab | JPC | 0.4994 | 0.4994 | YES | NO | NO |
| 02518511 | MYCOPHENOLATE SODIUM | Jamp Mycophenolic Acid 360mg Ent Tab | JPC | 0.9988 | 0.9988 | YES | NO | NO |
| 02511673 | MYCOPHENOLATE SODIUM | Mar-Mycophenolic Acid 180mg Ent Tab | MAR | 0.4994 | 0.4994 | YES | NO | NO |
| 02511681 | MYCOPHENOLATE SODIUM | Mar-Mycophenolic Acid 360mg Ent Tab | MAR | 0.9988 | 0.9988 | YES | NO | NO |
| 02264560 | MYCOPHENOLATE SODIUM | Myfortic 180mg Ent Tab | NOV | 1.9977 | 0.4994 | YES | NO | NO |
| 02264579 | MYCOPHENOLATE SODIUM | Myfortic 360mg Ent Tab | NOV | 3.9953 | 0.9988 | YES | NO | NO |
| 00548375 | NABILONE | Cesamet 1mg Cap | VAL | 8.3582 | 3.6669 | YES | NO | NO |
| 02256193 | NABILONE | Cesamet 0.5mg Cap | VAL | 4.1793 | 1.8886 | YES | NO | NO |
| 02312263 | NABILONE | Cesamet (Off-Formulary Interchangeable) 0.25mg Cap | VAL | N/A | N/A | YES | NO | NO |
| 02380919 | NABILONE | PMS-Nabilone 1mg Cap | PMS | 3.6669 | 3.6669 | YES | NO | NO |
| 02380900 | NABILONE | PMS-Nabilone 0.5mg Cap | PMS | 1.8886 | 1.8886 | YES | NO | NO |
| 02380897 | NABILONE | PMS-Nabilone (Off-Formulary Interchangeable) 0.25mg Cap | PMS | 1.4660 | N/A | YES | NO | NO |
| 02358077 | NABILONE | Ran-Nabilone (Off-Formulary Interchangeable) 0.25mg Cap | RAN | 1.3962 | N/A | YES | NO | NO |
| 02384892 | NABILONE | Teva-Nabilone 1mg Cap | TEV | 3.6669 | 3.6669 | YES | NO | NO |
| 02392925 | NABILONE | Teva-Nabilone (Off-Formulary Interchangeable) 0.25mg Cap | TEV | 1.3962 | N/A | YES | NO | NO |
| 02384884 | NABILONE | Teva-Nabilone 0.5mg Cap | TEV | 1.8886 | 1.8886 | YES | NO | NO |
| 02238639 | NABUMETONE | Nabumetone (Off-Formulary Interchangeable) 500mg Tab | AAP | 0.7363 | N/A | YES | NO | YES |
| 02083531 | NABUMETONE | Relafen (Off-Formulary Interchangeable) 500mg Tab | GSK | N/A | N/A | YES | NO | YES |
| 00782467 | NADOLOL | Apo-Nadolol 80mg Tab | APX | 0.3410 | 0.3410 | YES | NO | NO |
| 00782505 | NADOLOL | Apo-Nadolol 40mg Tab | APX | 0.2375 | 0.2375 | YES | NO | NO |
| 00782475 | NADOLOL | Apo-Nadolol 160mg Tab | APX | 1.2046 | 1.2046 | YES | NO | NO |
| 00607126 | NADOLOL | Corgard (Not a Benefit) 40mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00463256 | NADOLOL | Corgard (Not a Benefit) 80mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00523372 | NADOLOL | Corgard (Not a Benefit) 160mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02496399 | NADOLOL | Mint-Nadolol 80mg Tab | MIN | 0.3410 | 0.3410 | YES | NO | NO |
| 02496380 | NADOLOL | Mint-Nadolol 40mg Tab | MIN | 0.2375 | 0.2375 | YES | NO | NO |
| 09853936 | NADROPARIN CALCIUM | Fraxiparine 9500IU/mL Pref Syr-0.3mL Pk | ASN | 5.4150 | 5.4150 | NO | YES | NO |
| 09853944 | NADROPARIN CALCIUM | Fraxiparine 9500IU/mL Pref Syr-0.4mL Pk | ASN | 6.8400 | 6.8400 | NO | YES | NO |
| 09853952 | NADROPARIN CALCIUM | Fraxiparine 9500IU/mL Pref Syr-0.6mL Pk | ASN | 9.0580 | 9.0580 | NO | YES | NO |
| 02240114 | NADROPARIN CALCIUM | Fraxiparine Forte 19000IU/mL Pref Syr-0.6mL Pk | ASN | 18.1170 | 18.1170 | NO | YES | NO |
| 09854100 | NADROPARIN CALCIUM | Fraxiparine Forte 19000IU/mL Pref Syr-0.8mL Pk | ASN | 18.1170 | 18.1170 | NO | YES | NO |
| 09853987 | NADROPARIN CALCIUM | Fraxiparine 9500IU/mL Pref Syr-1.0mL Pk | ASN | 9.0580 | 9.0580 | NO | YES | NO |
| 09854118 | NADROPARIN CALCIUM | Fraxiparine Forte 19000IU/mL Pref Syr-1.0mL Pk | ASN | 18.1170 | 18.1170 | NO | YES | NO |
| 02444275 | NALTREXONE HCL | Apo-Naltrexone 50mg Tab | APX | 2.8075 | 2.8075 | YES | NO | NO |
| 02451883 | NALTREXONE HCL | Naltrexone Hydrochloride Tablets USP 50mg Tab | STN | 2.8075 | 2.8075 | YES | NO | NO |
| 02213826 | NALTREXONE HCL | Revia 50mg Tab | TEV | 2.8075 | 2.8075 | YES | NO | NO |
| 00001147 | NAPHAZOLINE HCL | Albalon (Not a Benefit) 0.1% Oph Sol | ALL | N/A | N/A | YES | NO | NO |
| 00390283 | NAPHAZOLINE HCL | Naphcon Forte (Not a Benefit) 0.1% Oph Sol | ALC | N/A | N/A | YES | NO | NO |
| 00759880 | NAPHAZOLINE HCL | Vasocon (Not a Benefit) 0.1% Oph Sol | IOB | N/A | N/A | YES | NO | NO |
| 02246701 | NAPROXEN | Apo-Naproxen EC (Off-Formulary Interchangeable) 500mg Ent Tab | APX | 0.6894 | N/A | YES | NO | YES |
| 02246699 | NAPROXEN | Apo-Naproxen EC (Off-Formulary Interchangeable) 250mg Ent Tab | APX | 0.2835 | N/A | YES | NO | YES |
| 02246700 | NAPROXEN | Apo-Naproxen EC (Off-Formulary Interchangeable) 375mg Ent Tab | APX | 0.3675 | N/A | YES | NO | YES |
| 02162423 | NAPROXEN | Naprosyn E (Off-Formulary Interchangeable) 500mg Ent Tab | HLR | N/A | N/A | YES | NO | YES |
| 02162792 | NAPROXEN | Naprosyn E (Off-Formulary Interchangeable) 250mg Ent Tab | HLR | N/A | N/A | YES | NO | YES |
| 02162415 | NAPROXEN | Naprosyn E (Off-Formulary Interchangeable) 375mg Ent Tab | HLR | N/A | N/A | YES | NO | YES |
| 02243312 | NAPROXEN | Teva-Naproxen EC (Off-Formulary Interchangeable) 250mg Ent Tab | TEV | 0.2835 | N/A | YES | NO | YES |
| 02243314 | NAPROXEN | Teva-Naproxen EC (Off-Formulary Interchangeable) 500mg Ent Tab | TEV | 0.6894 | N/A | YES | NO | YES |
| 02243313 | NAPROXEN | Teva-Naproxen EC (Off-Formulary Interchangeable) 375mg Ent Tab | TEV | 0.3675 | N/A | YES | NO | YES |
| 02162431 | NAPROXEN | Pediapharm Naproxen Suspension 25mg/mL O/L | MPI | 0.0949 | 0.0949 | NO | NO | YES |
| 00522678 | NAPROXEN | Apo-Naproxen 125mg Tab | APX | 0.0781 | 0.0781 | YES | NO | YES |
| 00522651 | NAPROXEN | Apo-Naproxen 250mg Tab | APX | 0.1068 | 0.1068 | YES | NO | YES |
| 00592277 | NAPROXEN | Apo-Naproxen 500mg Tab | APX | 0.4522 | 0.4522 | YES | NO | YES |
| 00600806 | NAPROXEN | Apo-Naproxen 375mg Tab | APX | 0.1458 | 0.1458 | YES | NO | YES |
| 00299413 | NAPROXEN | Naprosyn (Not a Benefit) 125mg Tab | SYN | N/A | N/A | YES | NO | YES |
| 02162482 | NAPROXEN | Naprosyn (Not a Benefit) 375mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 02162474 | NAPROXEN | Naprosyn (Not a Benefit) 250mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 02162490 | NAPROXEN | Naprosyn (Not a Benefit) 500mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 00589861 | NAPROXEN | Teva-Naproxen 500mg Tab | TEV | 0.4522 | 0.4522 | YES | NO | YES |
| 00627097 | NAPROXEN | Teva-Naproxen 375mg Tab | TEV | 0.1458 | 0.1458 | YES | NO | YES |
| 00565350 | NAPROXEN | Teva-Naproxen 250mg Tab | TEV | 0.1068 | 0.1068 | YES | NO | YES |
| 02443449 | NAPROXEN & ESOMEPRAZOLE MAGNESIUM | Mylan-Naproxen & Esomeprazole MR (Off-Formulary Interchangeable) 500mg & 20mg MR Tab | MYL | 0.9274 | N/A | YES | NO | YES |
| 02458608 | NAPROXEN & ESOMEPRAZOLE MAGNESIUM | Mylan-Naproxen & Esomeprazole MR (Off-Formulary Interchangeable) 375mg & 20mg MR Tab | MYL | 0.9308 | N/A | YES | NO | YES |
| 02361728 | NAPROXEN & ESOMEPRAZOLE MAGNESIUM | Vimovo (Off-Formulary Interchangeable) 500mg & 20mg MR Tab | XED | N/A | N/A | YES | NO | YES |
| 02361701 | NAPROXEN & ESOMEPRAZOLE MAGNESIUM | Vimovo (Off-Formulary Interchangeable) 375mg & 20mg MR Tab | XED | N/A | N/A | YES | NO | YES |
| 02162725 | NAPROXEN SODIUM | Anaprox (Off-Formulary Interchangeable) 275mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 02162717 | NAPROXEN SODIUM | Anaprox DS (Off-Formulary Interchangeable) 550mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 00784354 | NAPROXEN SODIUM | Apo-Napro-Na (Off-Formulary Interchangeable) 275mg Tab | APX | 0.3422 | N/A | YES | NO | YES |
| 01940309 | NAPROXEN SODIUM | Apo-Napro-Na DS (Off-Formulary Interchangeable) 550mg Tab | APX | 0.6667 | N/A | YES | NO | YES |
| 00778389 | NAPROXEN SODIUM | Teva-Naproxen Sodium (Off-Formulary Interchangeable) 275mg Tab | TEV | 0.3422 | N/A | YES | NO | YES |
| 02026600 | NAPROXEN SODIUM | Teva-Naproxen Sodium DS (Off-Formulary Interchangeable) 550mg Tab | TEV | 0.6667 | N/A | YES | NO | YES |
| 02237820 | NARATRIPTAN HYDROCHLORIDE | Amerge (Off-Formulary Interchangeable) 1mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02237821 | NARATRIPTAN HYDROCHLORIDE | Amerge (Off-Formulary Interchangeable) 2.5mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02365502 | NARATRIPTAN HYDROCHLORIDE | Apo-Naratriptan (Off-Formulary Interchangeable) 2.5mg Tab | APX | 8.2125 | 8.2125 | YES | NO | NO |
| 02322323 | NARATRIPTAN HYDROCHLORIDE | Sandoz Naratriptan (Off-Formulary Interchangeable) 2.5mg Tab | SDZ | 8.2125 | 8.2125 | YES | NO | NO |
| 02314304 | NARATRIPTAN HYDROCHLORIDE | Teva-Naratriptan (Off-Formulary Interchangeable) 2.5mg Tab | TEV | 8.2125 | 8.2125 | YES | NO | NO |
| 02314290 | NARATRIPTAN HYDROCHLORIDE | Teva-Naratriptan (Off-Formulary Interchangeable) 1mg Tab | TEV | 12.4990 | 12.4990 | YES | NO | NO |
| 02238617 | NELFINAVIR MESYLATE | Viracept 250mg Tab | PFI | 2.1814 | 2.1814 | NO | NO | NO |
| 02248761 | NELFINAVIR MESYLATE | Viracept 625mg Tab | PFI | 5.4642 | 5.4642 | NO | NO | NO |
| 02468735 | NETUPITANT & PALONOSETRON HYDROCHLORIDE | Akynzeo 300mg & 0.5mg Cap | KNT | 144.0075 | 144.0075 | NO | YES | NO |
| 02427931 | NEVIRAPINE | Apo-Nevirapine XR 400mg ER Tab | APX | 1.8519 | 1.8519 | YES | NO | NO |
| 02367289 | NEVIRAPINE | Viramune XR (Not a Benefit) 400mg ER Tab | BOE | N/A | N/A | YES | NO | NO |
| 02318601 | NEVIRAPINE | Auro-Nevirapine 200mg Tab | AUR | 1.2346 | 1.2346 | YES | NO | NO |
| 02405776 | NEVIRAPINE | Jamp Nevirapine 200mg Tab | JPC | 1.2346 | 1.2346 | YES | NO | NO |
| 02387727 | NEVIRAPINE | Mylan-Nevirapine 200mg Tab | MYL | 1.2346 | 1.2346 | YES | NO | NO |
| 02352893 | NEVIRAPINE | Teva-Nevirapine 200mg Tab | TEV | 1.2346 | 1.2346 | YES | NO | NO |
| 02238748 | NEVIRAPINE | Viramune (Not a Benefit) 200mg Tab | BOE | N/A | N/A | YES | NO | NO |
| 00268593 | NICOTINIC ACID | Niacin-ICN (Not a Benefit) 50mg Tab | VAL | N/A | N/A | YES | NO | YES |
| 00274496 | NICOTINIC ACID | Novo-Niacin (Not a Benefit) 50mg Tab | NOP | N/A | N/A | YES | NO | YES |
| 02155869 | NIFEDIPINE | Adalat (Not a Benefit) 5mg Cap | BAH | N/A | N/A | YES | NO | NO |
| 02155877 | NIFEDIPINE | Adalat (Not a Benefit) 10mg Cap | BAH | N/A | N/A | YES | NO | YES |
| 00725110 | NIFEDIPINE | Nifedipine 5mg Cap | AAP | 0.3679 | 0.3679 | YES | NO | NO |
| 00755907 | NIFEDIPINE | Nifedipine 10mg Cap | AAP | 0.4877 | 0.4877 | YES | NO | YES |
| 02155907 | NIFEDIPINE | Adalat XL 30mg ER Tab | BAY | 0.6171 | 0.6171 | YES | NO | NO |
| 02155990 | NIFEDIPINE | Adalat XL (Not a Benefit) 60mg ER Tab | BAY | N/A | N/A | YES | NO | NO |
| 02349167 | NIFEDIPINE | Mylan-Nifedipine Extended Release 30mg ER Tab | MYL | 0.6171 | 0.6171 | YES | NO | NO |
| 02321149 | NIFEDIPINE | Mylan-Nifedipine Extended Release 60mg ER Tab | MYL | 0.9374 | 0.9374 | YES | NO | NO |
| 02550903 | NILOTINIB | Apo-Nilotinib (Off-Formulary Interchangeable) 200mg Cap | APX | 23.0473 | 23.0473 | YES | NO | NO |
| 02550881 | NILOTINIB | Apo-Nilotinib (Off-Formulary Interchangeable) 150mg Cap | APX | 16.5570 | 16.5570 | YES | NO | NO |
| 02556642 | NILOTINIB | Reddy-Nilotinib (Off-Formulary Interchangeable) 200mg Cap | DRR | 23.0473 | 23.0473 | YES | NO | NO |
| 02556634 | NILOTINIB | Reddy-Nilotinib (Off-Formulary Interchangeable) 150mg Cap | DRR | 16.5570 | 16.5570 | YES | NO | NO |
| 02368250 | NILOTINIB | Tasigna (Off-Formulary Interchangeable) 150mg Cap | NOV | 33.7762 | 16.5570 | YES | NO | NO |
| 02315874 | NILOTINIB | Tasigna (Off-Formulary Interchangeable) 200mg Cap | NOV | 47.0164 | 23.0473 | YES | NO | NO |
| 02325926 | NIMODIPINE | Nimotop 30mg Tab | BAH | 10.3006 | 10.3006 | NO | YES | NO |
| 02527804 | NIRMATRELVIR & RITONAVIR | Paxlovid 150mg & 100mg Tab-20 Pk | PFI | 1288.8800 | 1288.8800 | NO | YES | NO |
| 02524031 | NIRMATRELVIR & RITONAVIR | Paxlovid 150mg & 100mg Tab-30 Pk | PFI | 1288.8800 | 1288.8800 | NO | YES | NO |
| 00511528 | NITRAZEPAM | Mogadon 5mg Tab | AAP | 0.1826 | 0.1826 | NO | NO | NO |
| 00511536 | NITRAZEPAM | Mogadon 10mg Tab | AAP | 0.2732 | 0.2732 | NO | NO | NO |
| 02495511 | NITROFURANTOIN | Jamp Nitrofurantoin 100mg Cap | JPC | 0.5499 | 0.5499 | YES | NO | YES |
| 02495503 | NITROFURANTOIN | Jamp Nitrofurantoin 50mg Cap | JPC | 0.2927 | 0.2927 | YES | NO | YES |
| 01997637 | NITROFURANTOIN | Macrodantin (Not a Benefit) 50mg Cap | PGP | N/A | N/A | YES | NO | YES |
| 01997645 | NITROFURANTOIN | Macrodantin (Not a Benefit) 100mg Cap | PGP | N/A | N/A | YES | NO | YES |
| 02231016 | NITROFURANTOIN | Teva-Nitrofurantoin 100mg Cap | TEV | 0.5499 | 0.5499 | YES | NO | YES |
| 02231015 | NITROFURANTOIN | Teva-Nitrofurantoin 50mg Cap | TEV | 0.2927 | 0.2927 | YES | NO | YES |
| 00017094 | NITROFURANTOIN | Nifuran (Not a Benefit) 100mg Tab | MAN | N/A | N/A | YES | NO | YES |
| 00017086 | NITROFURANTOIN | Nifuran (Not a Benefit) 50mg Tab | MAN | N/A | N/A | YES | NO | YES |
| 00319511 | NITROFURANTOIN | Nitrofurantoin 50mg Tab | AAP | 0.1703 | 0.1703 | YES | NO | YES |
| 00312738 | NITROFURANTOIN | Nitrofurantoin 100mg Tab | AAP | 0.2272 | 0.2272 | YES | NO | YES |
| 02466392 | NITROFURANTOIN MONO/MICRO CRYSTALS | Auro-Nitrofurantoin BID 100mg Cap | AUR | 0.3983 | 0.3983 | YES | NO | NO |
| 02063662 | NITROFURANTOIN MONO/MICRO CRYSTALS | MacroBID (Not a Benefit) 100mg Cap | WAR | N/A | N/A | YES | NO | NO |
| 02455676 | NITROFURANTOIN MONO/MICRO CRYSTALS | PMS-Nitrofurantoin BID 100mg Cap | PMS | 0.3983 | 0.3983 | YES | NO | NO |
| 00852384 | NITROGLYCERIN | Transderm-Nitro 0.4mg/Hr/20 Sq Cm Patch | NOV | 1.0010 | 1.0010 | NO | NO | NO |
| 02046156 | NITROGLYCERIN | Transderm-Nitro 0.6mg/Hr/30 Sq Cm Patch | NOV | 1.0290 | 1.0290 | NO | NO | NO |
| 02230733 | NITROGLYCERIN | Trinipatch 0.4mg/Hr/14 Sq Cm Patch | PPI | 0.8773 | 0.8773 | NO | NO | NO |
| 02230734 | NITROGLYCERIN | Trinipatch 0.6mg/Hr/21 Sq Cm Patch | PPI | 0.8773 | 0.8773 | NO | NO | NO |
| 00037621 | NITROGLYCERIN | Nitrostat 0.6mg SL Tab | UJC | 0.1847 | 0.1847 | NO | NO | NO |
| 00037613 | NITROGLYCERIN | Nitrostat 0.3mg SL Tab | UJC | 0.1847 | 0.1847 | NO | NO | NO |
| 09858317 | NITROGLYCERIN | Nitrolingual Pumpspray (Temporary Benefit) 0.4mg/Metered Dose Sp-180 Dose Pk | JUN | 8.4200 | 8.4200 | NO | NO | NO |
| 09858327 | NITROGLYCERIN | Nitrolingual Pumpspray (Temporary Benefit) 0.4mg/Metered Dose Sp-75 Dose Pk | SAC | 9.4000 | 9.4000 | NO | NO | NO |
| 02243588 | NITROGLYCERIN | Mylan-Nitro Sublingual Spray 0.4mg/Metered Dose Spray-200 Dose Pk | MYL | 8.4600 | 8.4600 | YES | NO | NO |
| 01926721 | NITROGLYCERIN | Nitrolingual (Not a Benefit) 0.4mg/Metered Dose Spray-200 Dose Pk | AVE | N/A | N/A | YES | NO | NO |
| 02231441 | NITROGLYCERIN | Nitrolingual Pump Spray 0.4mg/Metered Dose Spray-200 Dose Pk | SAV | 16.0000 | 8.4200 | YES | NO | NO |
| 02238998 | NITROGLYCERIN | Rho-Nitro Pumpspray 0.4mg/Metered Dose Spray-200 Dose Pk | SDZ | 8.4200 | 8.4200 | YES | NO | NO |
| 02407442 | NITROGLYCERIN | Mylan-Nitro 0.2 (Off-Formulary Interchangeable) 0.2mg/Hr Transdermal Patch | MYL | 0.4463 | N/A | YES | NO | NO |
| 02407450 | NITROGLYCERIN | Mylan-Nitro 0.4 0.4mg/Hr Transdermal Patch | MYL | 0.5040 | 0.5040 | YES | NO | NO |
| 02407469 | NITROGLYCERIN | Mylan-Nitro 0.6 0.6mg/Hr Transdermal Patch | MYL | 0.5040 | 0.5040 | YES | NO | NO |
| 02407477 | NITROGLYCERIN | Mylan-Nitro 0.8 (Off-Formulary Interchangeable) 0.8mg/Hr Transdermal Patch | MYL | 0.8743 | N/A | YES | NO | NO |
| 01911902 | NITROGLYCERIN | Nitro-Dur 0.4mg/Hr Transdermal Patch | DRR | 0.5040 | 0.5040 | YES | NO | NO |
| 01911929 | NITROGLYCERIN | Nitro-Dur 0.6mg/Hr Transdermal Patch | DRR | 0.5040 | 0.5040 | YES | NO | NO |
| 01911910 | NITROGLYCERIN | Nitro-Dur 0.2 (Off-Formulary Interchangeable) 0.2mg/Hr Transdermal Patch | DRR | N/A | N/A | YES | NO | NO |
| 02011271 | NITROGLYCERIN | Nitro-Dur 0.8 (Off-Formulary Interchangeable) 0.8mg/Hr Transdermal Patch | DRR | N/A | N/A | YES | NO | NO |
| 00778338 | NIZATIDINE | Axid 150mg Cap | PEN | 0.9047 | 0.9047 | NO | NO | YES |
| 00778346 | NIZATIDINE | Axid 300mg Cap | PHE | 1.5206 | 1.5206 | NO | NO | YES |
| 02441306 | NORETHINDRONE | Jencycla 0.35mg Tab-28 Pk | LUP | 10.9900 | 10.9900 | YES | NO | NO |
| 00037605 | NORETHINDRONE | Micronor (Not a Benefit) 0.35mg Tab-28 Pk | JAN | N/A | N/A | YES | NO | NO |
| 02410303 | NORETHINDRONE | Movisse 0.35mg Tab-28 Pk | MYL | 10.9900 | 10.9900 | YES | NO | NO |
| 02229524 | NORFLOXACIN | Norfloxacin 400mg Tab | AAP | 1.8586 | 1.8586 | YES | NO | NO |
| 00643025 | NORFLOXACIN | Noroxin (Not a Benefit) 400mg Tab | MSD | N/A | N/A | YES | NO | NO |
| 02508087 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Cira 21 3 Phase Tab-21 Pk | APX | 14.3900 | 14.3900 | YES | NO | NO |
| 02028700 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Cyclen (Not a Benefit) 3 Phase Tab-21 Pk | JAN | N/A | N/A | YES | NO | NO |
| 02258560 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Cyclen Lo (Not a Benefit) 3 Phase Tab-21 Pk | JAN | N/A | N/A | YES | NO | NO |
| 02486296 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Jordyna 21 3 Phase Tab-21 Pk | GLP | 14.3900 | 14.3900 | YES | NO | NO |
| 02401967 | NORGESTIMATE & ETHINYL ESTRADIOL | Tricira Lo (21 Day) 3 Phase Tab-21 Pk | APX | 13.3900 | 13.3900 | YES | NO | NO |
| 02508095 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Cira 28 3 Phase Tab-28 Pk | APX | 14.3900 | 14.3900 | YES | NO | NO |
| 02029421 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Cyclen (Not a Benefit) 3 Phase Tab-28 Pk | JAN | N/A | N/A | YES | NO | NO |
| 02258587 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Cyclen Lo (Not a Benefit) 3 Phase Tab-28 Pk | JAN | N/A | N/A | YES | NO | NO |
| 02486318 | NORGESTIMATE & ETHINYL ESTRADIOL | Tri-Jordyna 28 3 Phase Tab-28 Pk | GLP | 14.3900 | 14.3900 | YES | NO | NO |
| 02401975 | NORGESTIMATE & ETHINYL ESTRADIOL | Tricira Lo (28 Day) 3 Phase Tab-28 Pk | APX | 13.3900 | 13.3900 | YES | NO | NO |
| 00015229 | NORTRIPTYLINE | Aventyl 10mg Cap | AAP | 0.2995 | 0.2995 | NO | NO | NO |
| 00015237 | NORTRIPTYLINE | Aventyl 25mg Cap | AAP | 0.6054 | 0.6054 | NO | NO | NO |
| 09857569 | NUTRITIONAL PRODUCT | Isosource 1.5 1.5kcal/mL 1500mL Ready-to-Hang | NES | N/A | 11.4975 | NO | NO | NO |
| 09857559 | NUTRITIONAL PRODUCT | Isosource Fibre 1.2 1.2kcal/mL 1500mL Ready-to-hang | NES | N/A | 13.8244 | NO | NO | NO |
| 09857561 | NUTRITIONAL PRODUCT | Isosource Fibre 1.5 1.5kcal/mL 1500mL Ready-to-hang | NES | N/A | 17.2564 | NO | NO | NO |
| 09858353 | NUTRITIONAL PRODUCT | Renastep 2kcal/mL 200mL Pk bottle | VIT | N/A | 9.2300 | NO | NO | NO |
| 09857566 | NUTRITIONAL PRODUCT | Isosource 1.2 1.2Kcal/mL 250mL Tetra Pk | NES | N/A | 1.5330 | NO | NO | NO |
| 09857568 | NUTRITIONAL PRODUCT | Isosource 1.5 1.5kcal/mL 250mL Tetra Pk | NES | N/A | 1.9163 | NO | NO | NO |
| 09857558 | NUTRITIONAL PRODUCT | Isosource Fibre 1.2 1.2kcal/mL 250mL Tetra Pk | NES | N/A | 2.3040 | NO | NO | NO |
| 09857560 | NUTRITIONAL PRODUCT | Isosource Fibre 1.5 1.5kcal/mL 250mL Tetra Pk | NES | N/A | 2.8760 | NO | NO | NO |
| 09858355 | NUTRITIONAL PRODUCT | Peptamen 1.5 with Prebio 1.5kcal/mL Liq - 250mL Tetra Pk | NES | N/A | 13.2225 | NO | NO | NO |
| 09857562 | NUTRITIONAL PRODUCT | Peptamen Junior 1.5 1.5Kcal/mL Liq - 250mL Tetra Pk | NES | N/A | 13.2224 | NO | NO | NO |
| 09857109 | NUTRITIONAL PRODUCT | Jevity 1.2 Cal 1.2kcal/mL Liq-1000mL Pk | ABB | N/A | 9.1300 | NO | NO | NO |
| 09857310 | NUTRITIONAL PRODUCT | Jevity 1.5 Cal 1.5kcal/mL Liq-1000mL Pk | ABB | N/A | 11.5200 | NO | NO | NO |
| 09857126 | NUTRITIONAL PRODUCT | Peptamen 1.5 1.5kcal/mL Liq-1000mL Pk | NES | N/A | 52.8900 | NO | NO | NO |
| 09854391 | NUTRITIONAL PRODUCT | Perative Liq-1000mL Pk | ROS | N/A | 11.4800 | NO | NO | NO |
| 09854231 | NUTRITIONAL PRODUCT | Compleat 1.06 Liq-1000mL Ready-To-Hang | NES | N/A | 7.9700 | NO | NO | NO |
| 09854479 | NUTRITIONAL PRODUCT | Jevity 1 Cal 1.06kcal/mL Liq-1500mL Pk | ABB | N/A | 12.2200 | NO | NO | NO |
| 09857117 | NUTRITIONAL PRODUCT | Jevity 1.2 Cal 1.2kcal/mL Liq-1500mL Pk | ABB | N/A | 13.7000 | NO | NO | NO |
| 09857312 | NUTRITIONAL PRODUCT | Jevity 1.5 Cal 1.5kcal/mL Liq-1500mL Pk | ABB | N/A | 17.2800 | NO | NO | NO |
| 09854452 | NUTRITIONAL PRODUCT | Osmolite 1 Cal 1.06kcal/mL Liq-1500mL Pk | ABB | N/A | 8.0100 | NO | NO | NO |
| 09857095 | NUTRITIONAL PRODUCT | Osmolite 1.2 Cal 1.2kcal/mL Liq-1500mL Pk | ABB | N/A | 9.0700 | NO | NO | NO |
| 09857102 | NUTRITIONAL PRODUCT | Peptamen with Prebio 1kcal/mL Liq-1500mL Pk | NES | N/A | 52.8900 | NO | NO | NO |
| 09858356 | NUTRITIONAL PRODUCT | Peptamen 1.5 with Prebio 1.5kcal/mL Liq-1500mL Ready-to-Hang | NES | N/A | 79.3351 | NO | NO | NO |
| 97984060 | NUTRITIONAL PRODUCT | Jevity 1 Cal 1.06kcal/mL Liq-235mL Pk | ABB | N/A | 1.9200 | NO | NO | NO |
| 09854096 | NUTRITIONAL PRODUCT | Jevity 1.2 Cal 1.2kcal/mL Liq-235mL Pk | ABB | N/A | 2.1700 | NO | NO | NO |
| 09857344 | NUTRITIONAL PRODUCT | Jevity 1.5 Cal 1.5kcal/mL Liq-235mL Pk | ABB | N/A | 2.7025 | NO | NO | NO |
| 97973165 | NUTRITIONAL PRODUCT | Osmolite 1 CAL Liq-235mL Pk | ABB | N/A | 1.2600 | NO | NO | NO |
| 09854169 | NUTRITIONAL PRODUCT | Osmolite 1.2 CAL Liq-235mL Pk | ABB | N/A | 1.4400 | NO | NO | NO |
| 97984370 | NUTRITIONAL PRODUCT | PediaSure Liq-235mL Pk | ABB | N/A | 2.4700 | NO | NO | NO |
| 09857419 | NUTRITIONAL PRODUCT | Pediasure Plus with Fibre 1.5kcal/mL Liq-235mL Pk | ROS | N/A | 2.7400 | NO | NO | NO |
| 09854371 | NUTRITIONAL PRODUCT | Pediasure with Fibre 1kcal/mL Liq-235mL Pk | ROS | N/A | 2.4700 | NO | NO | NO |
| 09853731 | NUTRITIONAL PRODUCT | Suplena Liq-235mL Pk | ABB | N/A | 2.0900 | NO | NO | NO |
| 09854380 | NUTRITIONAL PRODUCT | TwoCal HN 2kcal/mL Liq-235mL Pk | ABB | N/A | 2.3688 | NO | NO | NO |
| 97904333 | NUTRITIONAL PRODUCT | Ensure Plus Liq-235mL Pk Cans | ABB | N/A | 1.7900 | NO | NO | NO |
| 97982610 | NUTRITIONAL PRODUCT | Boost 1.5 Plus Calories 1.5kcal/mL Liq-237mL Pk | NES | N/A | 1.7392 | NO | NO | NO |
| 09853154 | NUTRITIONAL PRODUCT | Boost Fruit Flavoured Beverage Liq-237mL Pk | NES | N/A | 1.5300 | NO | NO | NO |
| 09857615 | NUTRITIONAL PRODUCT | Neocate Splash (Grape Flavour) 1kcal/mL Liq-237mL Pk | NUT | N/A | 7.0561 | NO | NO | NO |
| 09857604 | NUTRITIONAL PRODUCT | Neocate Splash (Tropical Fruit Flavour) 1kcal/mL Liq-237mL Pk | NUT | N/A | 7.0561 | NO | NO | NO |
| 09857603 | NUTRITIONAL PRODUCT | Neocate Splash (Unflavoured) 1kcal/mL Liq-237mL Pk | NUT | N/A | 7.0561 | NO | NO | NO |
| 09857616 | NUTRITIONAL PRODUCT | Neocate Splash(Orange-Pineapple Flavour) 1kcal/mL Liq-237mL Pk | NUT | N/A | 7.0561 | NO | NO | NO |
| 09854258 | NUTRITIONAL PRODUCT | NovaSource Renal Liq-237mL Pk | NES | N/A | 2.3940 | NO | NO | NO |
| 09854390 | NUTRITIONAL PRODUCT | Perative Liq-237mL Pk | ROS | N/A | 2.7200 | NO | NO | NO |
| 09853170 | NUTRITIONAL PRODUCT | Resource 2.0 Liq-237mL Pk | NES | N/A | 2.4041 | NO | NO | NO |
| 09857142 | NUTRITIONAL PRODUCT | Resource Kid Essentials 1.5 1.5kcal/mL Liq-237mL Pk | NES | N/A | 3.2978 | NO | NO | NO |
| 09857523 | NUTRITIONAL PRODUCT | PediaSure Peptide 1 Cal 1.0kcal/mL Liq-237mL Pk Reclosable Plastic Bottle | ABB | N/A | 2.6892 | NO | NO | NO |
| 09858383 | NUTRITIONAL PRODUCT | Jevity 1.2 Cal 1.2kcal/mL Liq-237mL Reclosable Carton Pk | ABB | N/A | 2.1842 | NO | NO | NO |
| 09858367 | NUTRITIONAL PRODUCT | Jevity 1.5 Cal 1.5kcal/mL Liq-237mL Reclosable Carton Pk | ABB | N/A | 2.7302 | NO | NO | NO |
| 09858384 | NUTRITIONAL PRODUCT | Osmolite 1.2 CAL 1.2kcal/mL Liq-237mL Reclosable Carton Pk | ABB | N/A | 1.4533 | NO | NO | NO |
| 09858368 | NUTRITIONAL PRODUCT | TwoCal HN 2kcal/mL Liq-237mL Reclosable Carton Pk | ABB | N/A | 2.3890 | NO | NO | NO |
| 09857497 | NUTRITIONAL PRODUCT | KetoCal 4:1 (Unflavoured) 1.5kcal/mL Liq-237mL Tetra Pk | NUT | N/A | 5.7463 | NO | NO | NO |
| 09857388 | NUTRITIONAL PRODUCT | KetoCal 4:1 (Vanilla Flavoured) 1.5kcal/mL Liq-237mL Tetra Pk | NUT | N/A | 5.7463 | NO | NO | NO |
| 09858245 | NUTRITIONAL PRODUCT | KetoVie 4:1 Plant Based Protein(Vanilla) 1.50kcal/mL Liq-250mL Carton | CAM | N/A | 9.2448 | NO | NO | NO |
| 09858161 | NUTRITIONAL PRODUCT | KetoVie 4:1 Unflavoured 1.50kcal/mL Liq-250mL Carton Box | CAM | N/A | 6.5451 | NO | NO | NO |
| 09858166 | NUTRITIONAL PRODUCT | KetoVie 3:1 1.04kcal/mL Liq-250mL Carton Box (Unflavoured) | CAM | N/A | 6.5451 | NO | NO | NO |
| 09857173 | NUTRITIONAL PRODUCT | Compleat Junior 1.0 1kcal/mL Liq-250mL Pk | NES | N/A | 2.5920 | NO | NO | NO |
| 09858139 | NUTRITIONAL PRODUCT | KetoVie Peptide 4:1 1.49kcal/mL Liq-250mL Pk | CAM | N/A | 9.2448 | NO | NO | NO |
| 09854215 | NUTRITIONAL PRODUCT | Nutren Junior 1.0 1kcal/mL Liq-250mL Pk | NES | N/A | 2.6275 | NO | NO | NO |
| 09854223 | NUTRITIONAL PRODUCT | Nutren Junior Fibre 1.0 1kcal/mL Liq-250mL Pk | NES | N/A | 2.6275 | NO | NO | NO |
| 97984779 | NUTRITIONAL PRODUCT | Peptamen Liq-250mL Pk | NES | N/A | 8.8150 | NO | NO | NO |
| 09853090 | NUTRITIONAL PRODUCT | Peptamen 1.5 1.5kcal/mL Liq-250mL Pk | NES | N/A | 13.2225 | NO | NO | NO |
| 09853588 | NUTRITIONAL PRODUCT | Peptamen Junior Liq-250mL Pk | NES | N/A | 8.8150 | NO | NO | NO |
| 09857101 | NUTRITIONAL PRODUCT | Peptamen with Prebio 1kcal/mL Liq-250mL Pk | NES | N/A | 8.8150 | NO | NO | NO |
| 09857427 | NUTRITIONAL PRODUCT | Resource Diabetic 1.05 1.06kcal/mL Liq-250mL Pk | NES | N/A | 2.0352 | NO | NO | NO |
| 97983330 | NUTRITIONAL PRODUCT | Compleat 1.06 Liq-250mL Tetra Pk | NES | N/A | 2.0300 | NO | NO | NO |
| 09858157 | NUTRITIONAL PRODUCT | Nutramigen Liquid Concentrate (Temporary Benefit) 68kcal/100mL Liq-384mL Can | MJC | 8.3200 | 8.3200 | NO | NO | NO |
| 97973084 | NUTRITIONAL PRODUCT | RCF Liq-384mL Pk | ABB | N/A | 6.2700 | NO | NO | NO |
| 97984558 | NUTRITIONAL PRODUCT | Alimentum Liq-4x237mL Pk | ABB | N/A | 6.7152 | NO | NO | NO |
| 97904473 | NUTRITIONAL PRODUCT | MCT Oil 7.7kcal/mL Liq-946mL Pk | NES | N/A | 39.2833 | NO | NO | NO |
| 09858117 | NUTRITIONAL PRODUCT | KetoVie 4:1 1.56kcal/mL Liq-Chocolate Flavour, 250mL Pk | CAM | N/A | 6.5451 | NO | NO | NO |
| 09858101 | NUTRITIONAL PRODUCT | Vital Peptide 1 Cal 1Kcal/mL Liq-Vanilla Flavour, 220mL Pk bottle | ABB | N/A | 5.3721 | NO | NO | NO |
| 09858102 | NUTRITIONAL PRODUCT | Vital Peptide 1.5 Cal 1.5Kcal/mL Liq-Vanilla Flavour, 220mL Pk bottle | ABB | N/A | 7.7472 | NO | NO | NO |
| 09858118 | NUTRITIONAL PRODUCT | KetoVie 4:1 1.44kcal/mL Liq-Vanilla Flavour, 250mL Pk | CAM | N/A | 6.5451 | NO | NO | NO |
| 09858103 | NUTRITIONAL PRODUCT | Vital Peptide 1.5 Cal 1.5Kcal/mL Liq-Vanilla Flavour,1000mL Ready to Hang container | ABB | N/A | 35.2145 | NO | NO | NO |
| 09857172 | NUTRITIONAL PRODUCT | Enfamil EnfaCare A+ 22kcal/30mL Pd for Liq-363g Pk | MJS | N/A | 17.3700 | NO | NO | NO |
| 09857635 | NUTRITIONAL PRODUCT | Beneprotein 810.7143Kcal/227g Pd-227g Pk Canister (Unflavoured) | NES | N/A | 12.8904 | NO | NO | NO |
| 09857599 | NUTRITIONAL PRODUCT | KetoCal 4:1 (Vanilla Flavour) 7.05kcal/g Pd-300g Pk | NUT | N/A | 31.8000 | NO | NO | NO |
| 09857124 | NUTRITIONAL PRODUCT | Similac Advance NeoSure 5.15kcal/g Pd-363g Pk | ABB | N/A | 14.9900 | NO | NO | NO |
| 09858156 | NUTRITIONAL PRODUCT | Gerber Good Start Extensive HA (Temporary Benefit) 4.9301kcal/g Pd-400g Bottle | NEC | 17.6200 | 17.6200 | NO | NO | NO |
| 09858159 | NUTRITIONAL PRODUCT | Alfamino (Temporary Benefit) 1976Kcal/400g Pd-400g Can | NES | 64.0200 | 64.0200 | NO | NO | NO |
| 09858160 | NUTRITIONAL PRODUCT | Althera (Temporary Benefit) 2024Kcal/400g Pd-400g Can | NES | 18.0700 | 18.0700 | NO | NO | NO |
| 09858140 | NUTRITIONAL PRODUCT | Renastart 1976kcal/400g Pd-400g Can | VIT | N/A | 42.2750 | NO | NO | NO |
| 09857627 | NUTRITIONAL PRODUCT | Neocate DHA & ARA 0.2071g/kcal Pd-400g Can Pk | NUT | N/A | 62.5600 | NO | NO | NO |
| 09857564 | NUTRITIONAL PRODUCT | Similac Alimentum 5.17Kcal/g Pd-400g Can Pk | ABB | N/A | 16.4700 | NO | NO | NO |
| 09858280 | NUTRITIONAL PRODUCT | Monogen (Temporary Benefit) 4.41cal/g Pd-400g Can with DHA & ARA (Unflavoured) | NUT | 38.3333 | 38.3333 | NO | NO | NO |
| 09858320 | NUTRITIONAL PRODUCT | Alfamino Junior 1.0kcal/mL Pd-400g Canister | NES | N/A | 64.6759 | NO | NO | NO |
| 09857393 | NUTRITIONAL PRODUCT | Modulen 1kcal/mL Pd-400g Pk | NES | N/A | 34.7964 | NO | NO | NO |
| 09857594 | NUTRITIONAL PRODUCT | Neocate Junior (Tropical Flavour) 1kcal/mL Pd-400g Pk | NUT | N/A | 54.2699 | NO | NO | NO |
| 09854207 | NUTRITIONAL PRODUCT | Neocate Junior (Unflavoured) 1kcal/mL Pd-400g Pk | NUT | N/A | 54.2699 | NO | NO | NO |
| 09857369 | NUTRITIONAL PRODUCT | PurAmino A+ 5kcal/g Pd-400g Pk | MJN | N/A | 55.7900 | NO | NO | NO |
| 09858354 | NUTRITIONAL PRODUCT | Essential Care Junior (Unflavored) 1.0kcal/mL Pd-400g Pouch Pk | CAM | N/A | 57.7800 | NO | NO | NO |
| 09857345 | NUTRITIONAL PRODUCT | Nutramigen A+ 5kcal/g Pd-454g Pk | MJN | N/A | 29.1300 | NO | NO | NO |
| 09854401 | NUTRITIONAL PRODUCT | Portagen 1.02kcal/mL Pd-454g Pk | MJN | N/A | 55.7800 | NO | NO | NO |
| 09857565 | NUTRITIONAL PRODUCT | Nutramigen A+ with LGG 5Kcal/g Pd-561g Can Pk | MJN | N/A | 35.9900 | NO | NO | NO |
| 09858387 | NUTRITIONAL PRODUCT | Nutramigen A+ 5kcal/g Pd-561g Pk | MJN | N/A | 35.9900 | NO | NO | NO |
| 97982830 | NUTRITIONAL PRODUCT | Vivonex Plus Pd-79.5g Pk | NES | N/A | 9.8345 | NO | NO | NO |
| 09857634 | NUTRITIONAL PRODUCT | Beneprotein 25Kcal/7g Pd-7g Pk Sachet (Unflavoured) | NES | N/A | 0.3975 | NO | NO | NO |
| 09853618 | NUTRITIONAL PRODUCT | Vivonex T.E.N. Pd-80.4g Pk | NES | N/A | 9.7843 | NO | NO | NO |
| 97982750 | NUTRITIONAL PRODUCT | Tolerex Pd-80g Pk | NES | N/A | 7.0643 | NO | NO | NO |
| 09858158 | NUTRITIONAL PRODUCT | Similac Alimentum (Temporary Benefit) 0.677kcal/mL Pd-946mL Bottle | ABB | 5.6278 | 5.6278 | NO | NO | NO |
| 09858121 | NUTRITIONAL PRODUCT | Isosource 2.0 2.0kcal/mL Ready-To-Hang 1000mL Pk | NES | N/A | 10.0800 | NO | NO | NO |
| 09858352 | NUTRITIONAL PRODUCT | Pivot 1.5 CAL 1.5Kcal/mL Ready-to-Hang - 1L Pk | ABB | N/A | 52.7999 | NO | NO | NO |
| 09858351 | NUTRITIONAL PRODUCT | Pivot 1.5 CAL 1.5Kcal/mL Tetrapack-237mL Pk | ABB | N/A | 12.5135 | NO | NO | NO |
| 00029092 | NYSTATIN | Mycostatin (Not a Benefit) 100000U/g Cr | BQU | N/A | N/A | YES | NO | YES |
| 00716871 | NYSTATIN | Nyaderm 100000U/g Cr | TAR | 0.2037 | 0.2037 | YES | NO | YES |
| 02433443 | NYSTATIN | Jamp-Nystatin Oral Suspension USP 100000U/mL O/L | JPC | 0.0518 | 0.0518 | YES | NO | NO |
| 00248169 | NYSTATIN | Mycostatin (Not a Benefit) 100000U/mL O/L | BQU | N/A | N/A | YES | NO | NO |
| 02194201 | NYSTATIN | Ratio-Nystatin 100000U/mL O/L | RPH | 0.0518 | 0.0518 | YES | NO | NO |
| 00029556 | NYSTATIN | Mycostatin (Not a Benefit) 100000U/g Oint | BQU | N/A | N/A | YES | NO | YES |
| 02194228 | NYSTATIN | Ratio-Nystatin 100000U/g Oint | RPH | 0.1277 | 0.1277 | YES | NO | YES |
| 00295973 | NYSTATIN | Mycostatin (Not a Benefit) 25000U/g Vag Cr | BQU | N/A | N/A | YES | NO | YES |
| 00716901 | NYSTATIN | Nyaderm 25000U/g Vag Cr | TAR | 0.0834 | 0.0834 | YES | NO | YES |
| 02194163 | NYSTATIN | Ratio-Nystatin 100000U/g Vag Cr | RPH | 0.3191 | 0.3191 | NO | NO | YES |
| 02503786 | OCTREOTIDE | Octreotide for Injectable Suspension 30mg Inj Kit Pk | TEV | 1642.1400 | 1642.1400 | YES | NO | NO |
| 02503778 | OCTREOTIDE | Octreotide for Injectable Suspension 20mg Inj Kit Pk | TEV | 1279.9350 | 1279.9350 | YES | NO | NO |
| 02503751 | OCTREOTIDE | Octreotide for Injectable Suspension 10mg Inj Kit Pk | TEV | 990.6975 | 990.6975 | YES | NO | NO |
| 02239323 | OCTREOTIDE | Sandostatin LAR 10mg Inj Kit Pk | NOV | 1320.9300 | 990.6975 | YES | NO | NO |
| 02239324 | OCTREOTIDE | Sandostatin LAR 20mg Inj Kit Pk | NOV | 1706.5800 | 1279.9350 | YES | NO | NO |
| 02239325 | OCTREOTIDE | Sandostatin LAR 30mg Inj Kit Pk | NOV | 2189.5200 | 1642.1400 | YES | NO | NO |
| 02248641 | OCTREOTIDE | Octreotide Acetate Omega 500mcg/mL Inj Sol - 1mL Amp Pk | OMG | 40.3019 | 40.3019 | YES | NO | NO |
| 02248639 | OCTREOTIDE | Octreotide Acetate Omega 50mcg/mL Inj Sol - 1mL Amp Pk | OMG | 4.0080 | 4.0080 | YES | NO | NO |
| 02248640 | OCTREOTIDE | Octreotide Acetate Omega 100mcg/mL Inj Sol - 1mL Amp Pk | OMG | 7.5660 | 7.5660 | YES | NO | NO |
| 00839213 | OCTREOTIDE | Sandostatin (Not a Benefit) 500mcg/mL Inj Sol - 1mL Amp Pk | NOV | N/A | N/A | YES | NO | NO |
| 00839205 | OCTREOTIDE | Sandostatin 100mcg/mL Inj Sol - 1mL Amp Pk | NOV | 10.0880 | 7.5660 | YES | NO | NO |
| 00839191 | OCTREOTIDE | Sandostatin 50mcg/mL Inj Sol - 1mL Amp Pk | NOV | 5.3440 | 4.0080 | YES | NO | NO |
| 02248642 | OCTREOTIDE | Octreotide Acetate Omega 200mcg/mL Inj Sol - 5mL Vial Pk | OMG | 72.7725 | 72.7725 | YES | NO | NO |
| 02049392 | OCTREOTIDE | Sandostatin 200mcg/mL Inj Sol - 5mL Vial Pk | NOV | 97.0300 | 72.7725 | YES | NO | NO |
| 02143291 | OFLOXACIN | Ocuflox 0.3% Oph Sol | ALL | 2.8720 | 2.8720 | NO | YES | NO |
| 02327597 | OLANZAPINE | Act Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | TEV | 7.5978 | N/A | YES | NO | NO |
| 02327589 | OLANZAPINE | Act Olanzapine ODT 15mg Rapid Dissolve Tab | TEV | 1.0711 | 1.0711 | YES | NO | NO |
| 02327570 | OLANZAPINE | Act Olanzapine ODT 10mg Rapid Dissolve Tab | TEV | 0.7143 | 0.7143 | YES | NO | NO |
| 02327562 | OLANZAPINE | Act Olanzapine ODT 5mg Rapid Dissolve Tab | TEV | 0.3574 | 0.3574 | YES | NO | NO |
| 02360624 | OLANZAPINE | Apo-Olanzapine ODT 10mg Rapid Dissolve Tab | APX | 0.7143 | 0.7143 | YES | NO | NO |
| 02360640 | OLANZAPINE | Apo-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | APX | 7.5977 | N/A | YES | NO | NO |
| 02360632 | OLANZAPINE | Apo-Olanzapine ODT 15mg Rapid Dissolve Tab | APX | 1.0711 | 1.0711 | YES | NO | NO |
| 02360616 | OLANZAPINE | Apo-Olanzapine ODT 5mg Rapid Dissolve Tab | APX | 0.3574 | 0.3574 | YES | NO | NO |
| 02448742 | OLANZAPINE | Auro-Olanzapine ODT 15mg Rapid Dissolve Tab | AUR | 1.0711 | 1.0711 | YES | NO | NO |
| 02448734 | OLANZAPINE | Auro-Olanzapine ODT 10mg Rapid Dissolve Tab | AUR | 0.7143 | 0.7143 | YES | NO | NO |
| 02448726 | OLANZAPINE | Auro-Olanzapine ODT 5mg Rapid Dissolve Tab | AUR | 0.3574 | 0.3574 | YES | NO | NO |
| 02448750 | OLANZAPINE | Auro-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | AUR | 7.5977 | N/A | YES | NO | NO |
| 02406624 | OLANZAPINE | Jamp-Olanzapine ODT 5mg Rapid Dissolve Tab | JPC | 0.3574 | 0.3574 | YES | NO | NO |
| 02406632 | OLANZAPINE | Jamp-Olanzapine ODT 10mg Rapid Dissolve Tab | JPC | 0.7143 | 0.7143 | YES | NO | NO |
| 02406659 | OLANZAPINE | Jamp-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | JPC | 7.5977 | N/A | YES | NO | NO |
| 02406640 | OLANZAPINE | Jamp-Olanzapine ODT 15mg Rapid Dissolve Tab | JPC | 1.0711 | 1.0711 | YES | NO | NO |
| 02436981 | OLANZAPINE | Mint-Olanzapine ODT 15mg Rapid Dissolve Tab | MIN | 1.0711 | 1.0711 | YES | NO | NO |
| 02437007 | OLANZAPINE | Mint-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | MIN | 7.5977 | N/A | YES | NO | NO |
| 02436973 | OLANZAPINE | Mint-Olanzapine ODT 10mg Rapid Dissolve Tab | MIN | 0.7143 | 0.7143 | YES | NO | NO |
| 02436965 | OLANZAPINE | Mint-Olanzapine ODT 5mg Rapid Dissolve Tab | MIN | 0.3574 | 0.3574 | YES | NO | NO |
| 02536188 | OLANZAPINE | NRA-Olanzapine ODT 5mg Rapid Dissolve Tab | NRA | 0.3574 | 0.3574 | YES | NO | NO |
| 02536226 | OLANZAPINE | NRA-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | NRA | 7.5977 | N/A | YES | NO | NO |
| 02536218 | OLANZAPINE | NRA-Olanzapine ODT 15mg Rapid Dissolve Tab | NRA | 1.0711 | 1.0711 | YES | NO | NO |
| 02536196 | OLANZAPINE | NRA-Olanzapine ODT 10mg Rapid Dissolve Tab | NRA | 0.7143 | 0.7143 | YES | NO | NO |
| 02321351 | OLANZAPINE | Novo-Olanzapine OD 10mg Rapid Dissolve Tab | NOP | 0.7143 | 0.7143 | YES | NO | NO |
| 02321378 | OLANZAPINE | Novo-Olanzapine OD 15mg Rapid Dissolve Tab | NOP | 1.0711 | 1.0711 | YES | NO | NO |
| 02352982 | OLANZAPINE | Olanzapine ODT 10mg Rapid Dissolve Tab | SAI | 0.7143 | 0.7143 | YES | NO | NO |
| 02343673 | OLANZAPINE | Olanzapine ODT 10mg Rapid Dissolve Tab | SIV | 0.7143 | 0.7143 | YES | NO | NO |
| 02343665 | OLANZAPINE | Olanzapine ODT 5mg Rapid Dissolve Tab | SIV | 0.3574 | 0.3574 | YES | NO | NO |
| 02352974 | OLANZAPINE | Olanzapine ODT 5mg Rapid Dissolve Tab | SAI | 0.3574 | 0.3574 | YES | NO | NO |
| 02343703 | OLANZAPINE | Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | SIV | 7.5977 | N/A | YES | NO | NO |
| 02352990 | OLANZAPINE | Olanzapine ODT 15mg Rapid Dissolve Tab | SAI | 1.0711 | 1.0711 | YES | NO | NO |
| 02343681 | OLANZAPINE | Olanzapine ODT 15mg Rapid Dissolve Tab | SIV | 1.0711 | 1.0711 | YES | NO | NO |
| 02303213 | OLANZAPINE | PMS-Olanzapine ODT 15mg Rapid Dissolve Tab | PMS | 1.0711 | 1.0711 | YES | NO | NO |
| 02303205 | OLANZAPINE | PMS-Olanzapine ODT 10mg Rapid Dissolve Tab | PMS | 0.7143 | 0.7143 | YES | NO | NO |
| 02303191 | OLANZAPINE | PMS-Olanzapine ODT 5mg Rapid Dissolve Tab | PMS | 0.3574 | 0.3574 | YES | NO | NO |
| 02414090 | OLANZAPINE | Ran-Olanzapine ODT 5mg Rapid Dissolve Tab | RAN | 0.3574 | 0.3574 | YES | NO | NO |
| 02414104 | OLANZAPINE | Ran-Olanzapine ODT 10mg Rapid Dissolve Tab | RAN | 0.7143 | 0.7143 | YES | NO | NO |
| 02414120 | OLANZAPINE | Ran-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | RAN | 7.5979 | N/A | YES | NO | NO |
| 02414112 | OLANZAPINE | Ran-Olanzapine ODT 15mg Rapid Dissolve Tab | RAN | 1.0711 | 1.0711 | YES | NO | NO |
| 02327805 | OLANZAPINE | Sandoz Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | SDZ | 7.5978 | N/A | YES | NO | NO |
| 02327791 | OLANZAPINE | Sandoz Olanzapine ODT 15mg Rapid Dissolve Tab | SDZ | 1.0711 | 1.0711 | YES | NO | NO |
| 02327783 | OLANZAPINE | Sandoz Olanzapine ODT 10mg Rapid Dissolve Tab | SDZ | 0.7143 | 0.7143 | YES | NO | NO |
| 02327775 | OLANZAPINE | Sandoz Olanzapine ODT 5mg Rapid Dissolve Tab | SDZ | 0.3574 | 0.3574 | YES | NO | NO |
| 02243088 | OLANZAPINE | Zyprexa Zydis 15mg Rapid Dissolve Tab | LIL | 13.5861 | 1.0711 | YES | NO | NO |
| 02243089 | OLANZAPINE | Zyprexa Zydis (Off-Formulary Interchangeable) 20mg Rapid Dissolve Tab | LIL | N/A | N/A | YES | NO | NO |
| 02243087 | OLANZAPINE | Zyprexa Zydis 10mg Rapid Dissolve Tab | LIL | 8.9886 | 0.7143 | YES | NO | NO |
| 02243086 | OLANZAPINE | Zyprexa Zydis 5mg Rapid Dissolve Tab | LIL | 4.4982 | 0.3574 | YES | NO | NO |
| 02487608 | OLANZAPINE | AG-Olanzapine FC 2.5mg Tab | ANG | 0.1772 | 0.1772 | YES | NO | NO |
| 02487616 | OLANZAPINE | AG-Olanzapine FC 5mg Tab | ANG | 0.3544 | 0.3544 | YES | NO | NO |
| 02487632 | OLANZAPINE | AG-Olanzapine FC 10mg Tab | ANG | 0.7088 | 0.7088 | YES | NO | NO |
| 02281791 | OLANZAPINE | Apo-Olanzapine 2.5mg Tab | APX | 0.1772 | 0.1772 | YES | NO | NO |
| 02281805 | OLANZAPINE | Apo-Olanzapine 5mg Tab | APX | 0.3544 | 0.3544 | YES | NO | NO |
| 02281821 | OLANZAPINE | Apo-Olanzapine 10mg Tab | APX | 0.7088 | 0.7088 | YES | NO | NO |
| 02333015 | OLANZAPINE | Apo-Olanzapine (Off-Formulary Interchangeable) 20mg Tab | APX | 10.3093 | N/A | YES | NO | NO |
| 02281813 | OLANZAPINE | Apo-Olanzapine 7.5mg Tab | APX | 0.5316 | 0.5316 | YES | NO | NO |
| 02281848 | OLANZAPINE | Apo-Olanzapine 15mg Tab | APX | 1.0631 | 1.0631 | YES | NO | NO |
| 02325659 | OLANZAPINE | Co Olanzapine 2.5mg Tab | COB | 0.1772 | 0.1772 | YES | NO | NO |
| 02325713 | OLANZAPINE | Co Olanzapine (Off-Formulary Interchangeable) 20mg Tab | COB | 10.3093 | N/A | YES | NO | NO |
| 02325675 | OLANZAPINE | Co Olanzapine 7.5mg Tab | COB | 0.5316 | 0.5316 | YES | NO | NO |
| 02325667 | OLANZAPINE | Co Olanzapine 5mg Tab | COB | 0.3544 | 0.3544 | YES | NO | NO |
| 02325683 | OLANZAPINE | Co Olanzapine 10mg Tab | COB | 0.7088 | 0.7088 | YES | NO | NO |
| 02325691 | OLANZAPINE | Co Olanzapine 15mg Tab | COB | 1.0631 | 1.0631 | YES | NO | NO |
| 02417251 | OLANZAPINE | Jamp Olanzapine FC 5mg Tab | JPC | 0.3544 | 0.3544 | YES | NO | NO |
| 02417286 | OLANZAPINE | Jamp Olanzapine FC 10mg Tab | JPC | 0.7088 | 0.7088 | YES | NO | NO |
| 02417308 | OLANZAPINE | Jamp Olanzapine FC (Off-Formulary Interchangeable) 20mg Tab | JPC | 10.3093 | N/A | YES | NO | NO |
| 02417294 | OLANZAPINE | Jamp Olanzapine FC 15mg Tab | JPC | 1.0631 | 1.0631 | YES | NO | NO |
| 02417278 | OLANZAPINE | Jamp Olanzapine FC 7.5mg Tab | JPC | 0.5316 | 0.5316 | YES | NO | NO |
| 02417243 | OLANZAPINE | Jamp Olanzapine FC 2.5mg Tab | JPC | 0.1772 | 0.1772 | YES | NO | NO |
| 02410176 | OLANZAPINE | Mint-Olanzapine 7.5mg Tab | MIN | 0.5316 | 0.5316 | YES | NO | NO |
| 02410168 | OLANZAPINE | Mint-Olanzapine 5mg Tab | MIN | 0.3544 | 0.3544 | YES | NO | NO |
| 02410141 | OLANZAPINE | Mint-Olanzapine 2.5mg Tab | MIN | 0.1772 | 0.1772 | YES | NO | NO |
| 02410192 | OLANZAPINE | Mint-Olanzapine 15mg Tab | MIN | 1.0631 | 1.0631 | YES | NO | NO |
| 02410184 | OLANZAPINE | Mint-Olanzapine 10mg Tab | MIN | 0.7088 | 0.7088 | YES | NO | NO |
| 02545586 | OLANZAPINE | NRA-Olanzapine 2.5mg Tab | NRA | 0.1772 | 0.1772 | YES | NO | NO |
| 02545608 | OLANZAPINE | NRA-Olanzapine 7.5mg Tab | NRA | 0.5316 | 0.5316 | YES | NO | NO |
| 02545594 | OLANZAPINE | NRA-Olanzapine 5mg Tab | NRA | 0.3544 | 0.3544 | YES | NO | NO |
| 02545624 | OLANZAPINE | NRA-Olanzapine 15mg Tab | NRA | 1.0631 | 1.0631 | YES | NO | NO |
| 02545616 | OLANZAPINE | NRA-Olanzapine 10mg Tab | NRA | 0.7088 | 0.7088 | YES | NO | NO |
| 02545632 | OLANZAPINE | NRA-Olanzapine (Off-Formulary Interchangeable) 20mg Tab | NRA | 10.3093 | N/A | YES | NO | NO |
| 02372819 | OLANZAPINE | Olanzapine 2.5mg Tab | SAI | 0.1772 | 0.1772 | YES | NO | NO |
| 02385864 | OLANZAPINE | Olanzapine 2.5mg Tab | SIV | 0.1772 | 0.1772 | YES | NO | NO |
| 02385899 | OLANZAPINE | Olanzapine 10mg Tab | SIV | 0.7088 | 0.7088 | YES | NO | NO |
| 02372851 | OLANZAPINE | Olanzapine 15mg Tab | SAI | 1.0631 | 1.0631 | YES | NO | NO |
| 02385902 | OLANZAPINE | Olanzapine 15mg Tab | SIV | 1.0631 | 1.0631 | YES | NO | NO |
| 02372827 | OLANZAPINE | Olanzapine 5mg Tab | SAI | 0.3544 | 0.3544 | YES | NO | NO |
| 02385872 | OLANZAPINE | Olanzapine 5mg Tab | SIV | 0.3544 | 0.3544 | YES | NO | NO |
| 02372835 | OLANZAPINE | Olanzapine 7.5mg Tab | SAI | 0.5316 | 0.5316 | YES | NO | NO |
| 02385880 | OLANZAPINE | Olanzapine 7.5mg Tab | SIV | 0.5316 | 0.5316 | YES | NO | NO |
| 02385910 | OLANZAPINE | Olanzapine (Off-Formulary Interchangeable) 20mg Tab | SIV | 10.3093 | N/A | YES | NO | NO |
| 02372843 | OLANZAPINE | Olanzapine 10mg Tab | SAI | 0.7088 | 0.7088 | YES | NO | NO |
| 02303159 | OLANZAPINE | PMS-Olanzapine 5mg Tab | PMS | 0.3544 | 0.3544 | YES | NO | NO |
| 02303183 | OLANZAPINE | PMS-Olanzapine 15mg Tab | PMS | 1.0631 | 1.0631 | YES | NO | NO |
| 02303116 | OLANZAPINE | PMS-Olanzapine 2.5mg Tab | PMS | 0.1772 | 0.1772 | YES | NO | NO |
| 02303167 | OLANZAPINE | PMS-Olanzapine 7.5mg Tab | PMS | 0.5316 | 0.5316 | YES | NO | NO |
| 02303175 | OLANZAPINE | PMS-Olanzapine 10mg Tab | PMS | 0.7088 | 0.7088 | YES | NO | NO |
| 02403099 | OLANZAPINE | Ran-Olanzapine 10mg Tab | RAN | 0.7088 | 0.7088 | YES | NO | NO |
| 02403102 | OLANZAPINE | Ran-Olanzapine 15mg Tab | RAN | 1.0631 | 1.0631 | YES | NO | NO |
| 02403072 | OLANZAPINE | Ran-Olanzapine 5mg Tab | RAN | 0.3544 | 0.3544 | YES | NO | NO |
| 02310384 | OLANZAPINE | Sandoz Olanzapine 10mg Tab | SDZ | 0.7088 | 0.7088 | YES | NO | NO |
| 02310368 | OLANZAPINE | Sandoz Olanzapine 5mg Tab | SDZ | 0.3544 | 0.3544 | YES | NO | NO |
| 02310341 | OLANZAPINE | Sandoz Olanzapine 2.5mg Tab | SDZ | 0.1772 | 0.1772 | YES | NO | NO |
| 02310392 | OLANZAPINE | Sandoz Olanzapine 15mg Tab | SDZ | 1.0631 | 1.0631 | YES | NO | NO |
| 02310376 | OLANZAPINE | Sandoz Olanzapine 7.5mg Tab | SDZ | 0.5316 | 0.5316 | YES | NO | NO |
| 02276755 | OLANZAPINE | Teva-Olanzapine 15mg Tab | TEV | 1.0631 | 1.0631 | YES | NO | NO |
| 02276720 | OLANZAPINE | Teva-Olanzapine 5mg Tab | TEV | 0.3544 | 0.3544 | YES | NO | NO |
| 02276712 | OLANZAPINE | Teva-Olanzapine 2.5mg Tab | TEV | 0.1772 | 0.1772 | YES | NO | NO |
| 02276747 | OLANZAPINE | Teva-Olanzapine 10mg Tab | TEV | 0.7088 | 0.7088 | YES | NO | NO |
| 02359707 | OLANZAPINE | Teva-Olanzapine (Off-Formulary Interchangeable) 20mg Tab | TEV | 10.3093 | N/A | YES | NO | NO |
| 02276739 | OLANZAPINE | Teva-Olanzapine 7.5mg Tab | TEV | 0.5316 | 0.5316 | YES | NO | NO |
| 02238850 | OLANZAPINE | Zyprexa 15mg Tab | LIL | 13.8011 | 1.0631 | YES | NO | NO |
| 02229285 | OLANZAPINE | Zyprexa 10mg Tab | LIL | 9.0468 | 0.7088 | YES | NO | NO |
| 02229250 | OLANZAPINE | Zyprexa 2.5mg Tab | LIL | 2.2996 | 0.1772 | YES | NO | NO |
| 02229277 | OLANZAPINE | Zyprexa 7.5mg Tab | LIL | 6.7850 | 0.5316 | YES | NO | NO |
| 02229269 | OLANZAPINE | Zyprexa 5mg Tab | LIL | 4.5232 | 0.3544 | YES | NO | NO |
| 02238851 | OLANZAPINE | Zyprexa (Off-Formulary Interchangeable) 20mg Tab | LIL | N/A | N/A | YES | NO | NO |
| 02344327 | OLIVE OIL & SOYBEAN OIL | Clinoleic 20% 16% & 4% w/w Inj Emuls-250mL Pk | BAX | 25.0000 | 25.0000 | NO | YES | NO |
| 09858109 | OLIVE OIL & SOYBEAN OIL | Clinoleic 20% 16% & 4% w/w Inj Emuls-500mL Pk | BAX | 30.0000 | 30.0000 | NO | YES | NO |
| 02456311 | OLMESARTAN MEDOXOMIL | Ach-Olmesartan 20mg Tab | ACH | 0.3019 | 0.3019 | YES | NO | NO |
| 02456338 | OLMESARTAN MEDOXOMIL | Ach-Olmesartan 40mg Tab | ACH | 0.3019 | 0.3019 | YES | NO | NO |
| 02453452 | OLMESARTAN MEDOXOMIL | Apo-Olmesartan 20mg Tab | APX | 0.3019 | 0.3019 | YES | NO | NO |
| 02453460 | OLMESARTAN MEDOXOMIL | Apo-Olmesartan 40mg Tab | APX | 0.3019 | 0.3019 | YES | NO | NO |
| 02443864 | OLMESARTAN MEDOXOMIL | Auro-Olmesartan 20mg Tab | AUR | 0.3019 | 0.3019 | YES | NO | NO |
| 02443872 | OLMESARTAN MEDOXOMIL | Auro-Olmesartan 40mg Tab | AUR | 0.3019 | 0.3019 | YES | NO | NO |
| 02469812 | OLMESARTAN MEDOXOMIL | GLN-Olmesartan 20mg Tab | GLP | 0.3019 | 0.3019 | YES | NO | NO |
| 02469820 | OLMESARTAN MEDOXOMIL | GLN-Olmesartan 40mg Tab | GLP | 0.3019 | 0.3019 | YES | NO | NO |
| 02461641 | OLMESARTAN MEDOXOMIL | Jamp-Olmesartan 20mg Tab | JPC | 0.3019 | 0.3019 | YES | NO | NO |
| 02461668 | OLMESARTAN MEDOXOMIL | Jamp-Olmesartan 40mg Tab | JPC | 0.3019 | 0.3019 | YES | NO | NO |
| 02499258 | OLMESARTAN MEDOXOMIL | NRA-Olmesartan 20mg Tab | NRA | 0.3019 | 0.3019 | YES | NO | NO |
| 02499266 | OLMESARTAN MEDOXOMIL | NRA-Olmesartan 40mg Tab | NRA | 0.3019 | 0.3019 | YES | NO | NO |
| 02481065 | OLMESARTAN MEDOXOMIL | Olmesartan 40mg Tab | SAI | 0.3019 | 0.3019 | YES | NO | NO |
| 02481057 | OLMESARTAN MEDOXOMIL | Olmesartan 20mg Tab | SAI | 0.3019 | 0.3019 | YES | NO | NO |
| 02318679 | OLMESARTAN MEDOXOMIL | Olmetec 40mg Tab | OCI | 1.3327 | 0.3019 | YES | NO | NO |
| 02318660 | OLMESARTAN MEDOXOMIL | Olmetec 20mg Tab | OCI | 1.3327 | 0.3019 | YES | NO | NO |
| 02461307 | OLMESARTAN MEDOXOMIL | PMS-Olmesartan 20mg Tab | PMS | 0.3019 | 0.3019 | YES | NO | NO |
| 02461315 | OLMESARTAN MEDOXOMIL | PMS-Olmesartan 40mg Tab | PMS | 0.3019 | 0.3019 | YES | NO | NO |
| 02443422 | OLMESARTAN MEDOXOMIL | Sandoz Olmesartan 40mg Tab | SDZ | 0.3019 | 0.3019 | YES | NO | NO |
| 02443414 | OLMESARTAN MEDOXOMIL | Sandoz Olmesartan 20mg Tab | SDZ | 0.3019 | 0.3019 | YES | NO | NO |
| 02442205 | OLMESARTAN MEDOXOMIL | Teva-Olmesartan 40mg Tab | TEV | 0.3019 | 0.3019 | YES | NO | NO |
| 02442191 | OLMESARTAN MEDOXOMIL | Teva-Olmesartan 20mg Tab | TEV | 0.3019 | 0.3019 | YES | NO | NO |
| 02468964 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Ach-Olmesartan HCTZ 40mg & 25mg Tab | ACH | 0.3019 | 0.3019 | YES | NO | NO |
| 02468956 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Ach-Olmesartan HCTZ 40mg & 12.5mg Tab | ACH | 0.3019 | 0.3019 | YES | NO | NO |
| 02468948 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Ach-Olmesartan HCTZ 20mg & 12.5mg Tab | ACH | 0.3019 | 0.3019 | YES | NO | NO |
| 02443112 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Act Olmesartan HCT 20mg & 12.5mg Tab | TEV | 0.3019 | 0.3019 | YES | NO | NO |
| 02443120 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Act Olmesartan HCT 40mg & 12.5mg Tab | TEV | 0.3019 | 0.3019 | YES | NO | NO |
| 02443139 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Act Olmesartan HCT 40mg & 25mg Tab | TEV | 0.3019 | 0.3019 | YES | NO | NO |
| 02453606 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Apo-Olmesartan/HCTZ 20mg & 12.5mg Tab | APX | 0.3019 | 0.3019 | YES | NO | NO |
| 02453614 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Apo-Olmesartan/HCTZ 40mg & 12.5mg Tab | APX | 0.3019 | 0.3019 | YES | NO | NO |
| 02453622 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Apo-Olmesartan/HCTZ 40mg & 25mg Tab | APX | 0.3019 | 0.3019 | YES | NO | NO |
| 02476495 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Auro-Olmesartan HCTZ 40mg & 12.5mg Tab | AUR | 0.3019 | 0.3019 | YES | NO | NO |
| 02476487 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Auro-Olmesartan HCTZ 20mg & 12.5mg Tab | AUR | 0.3019 | 0.3019 | YES | NO | NO |
| 02476509 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Auro-Olmesartan HCTZ 40mg & 25mg Tab | AUR | 0.3019 | 0.3019 | YES | NO | NO |
| 02475715 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | GLN-Olmesartan HCTZ 40mg & 12.5mg Tab | GLP | 0.3019 | 0.3019 | YES | NO | NO |
| 02475723 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | GLN-Olmesartan HCTZ 40mg & 25mg Tab | GLP | 0.3019 | 0.3019 | YES | NO | NO |
| 02475707 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | GLN-Olmesartan HCTZ 20mg & 12.5mg Tab | GLP | 0.3019 | 0.3019 | YES | NO | NO |
| 02508281 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | NRA-Olmesartan HCTZ 40mg & 12.5mg Tab | NRA | 0.3019 | 0.3019 | YES | NO | NO |
| 02508273 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | NRA-Olmesartan HCTZ 20mg & 12.5mg Tab | NRA | 0.3019 | 0.3019 | YES | NO | NO |
| 02508303 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | NRA-Olmesartan HCTZ 40mg & 25mg Tab | NRA | 0.3019 | 0.3019 | YES | NO | NO |
| 02509636 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Olmesartan/HCTZ 40mg & 12.5mg Tab | SAI | 0.3019 | 0.3019 | YES | NO | NO |
| 02509601 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Olmesartan/HCTZ 20mg & 12.5mg Tab | SAI | 0.3019 | 0.3019 | YES | NO | NO |
| 02509628 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Olmesartan/HCTZ 40mg & 25mg Tab | SAI | 0.3019 | 0.3019 | YES | NO | NO |
| 02319616 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Olmetec Plus 20mg & 12.5mg Tab | OCI | 1.3993 | 0.3019 | YES | NO | NO |
| 02319632 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Olmetec Plus 40mg & 25mg Tab | OCI | 1.3993 | 0.3019 | YES | NO | NO |
| 02319624 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | Olmetec Plus 40mg & 12.5mg Tab | OCI | 1.3993 | 0.3019 | YES | NO | NO |
| 02526484 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | PRZ-Olmesartan/HCTZ 40mg & 25mg Tab | PRZ | 0.3019 | 0.3019 | YES | NO | NO |
| 02526468 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | PRZ-Olmesartan/HCTZ 20mg & 12.5mg Tab | PRZ | 0.3019 | 0.3019 | YES | NO | NO |
| 02526476 | OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDE | PRZ-Olmesartan/HCTZ 40mg & 12.5mg Tab | PRZ | 0.3019 | 0.3019 | YES | NO | NO |
| 02404095 | OLOPATADINE HCL | Act Olopatadine 0.2% (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL Pk | ACV | 26.1300 | N/A | YES | NO | NO |
| 02402823 | OLOPATADINE HCL | Apo-Olopatadine (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL Pk | APX | 26.1300 | N/A | YES | NO | NO |
| 02508605 | OLOPATADINE HCL | Mint-Olopatadine 0.2% (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL Pk | MIN | 26.1300 | N/A | YES | NO | NO |
| 02541653 | OLOPATADINE HCL | Olopatadine 0.2% (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL Pk | SAI | 26.1300 | N/A | YES | NO | NO |
| 02362171 | OLOPATADINE HCL | Pataday (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL Pk | NOV | N/A | N/A | YES | NO | NO |
| 02420171 | OLOPATADINE HCL | Sandoz Olopatadine 0.2% (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL Pk | SDZ | 26.1300 | N/A | YES | NO | NO |
| 02305054 | OLOPATADINE HCL | Apo-Olopatadine (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL Pk | APX | 26.1300 | N/A | YES | NO | NO |
| 02403986 | OLOPATADINE HCL | Co Olopatadine 0.1% (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL Pk | COB | 26.1300 | N/A | YES | NO | NO |
| 02458411 | OLOPATADINE HCL | Jamp-Olopatadine (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL Pk | JPC | 26.1300 | N/A | YES | NO | NO |
| 02422727 | OLOPATADINE HCL | Mint-Olopatadine (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL Pk | MIN | 26.1300 | N/A | YES | NO | NO |
| 02521172 | OLOPATADINE HCL | Olopatadine (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL Pk | SAI | 26.1300 | N/A | YES | NO | NO |
| 02233143 | OLOPATADINE HCL | Patanol (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL Pk | NOV | N/A | N/A | YES | NO | NO |
| 02358913 | OLOPATADINE HCL | Sandoz Olopatadine (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL Pk | SDZ | 26.1300 | N/A | YES | NO | NO |
| 02063808 | OLSALAZINE SODIUM | Dipentum 250mg Cap | APU | 0.5330 | 0.5330 | NO | NO | NO |
| 02553805 | OMALIZUMAB | Omlyclo 75mg/0.5mL Inj Sol-0.5mL Pref Syr Pk | CEI | 168.7440 | 168.7440 | NO | YES | NO |
| 02553813 | OMALIZUMAB | Omlyclo 150mg/mL Inj Sol-1mL Pref Syr Pk | CEI | 384.9600 | 384.9600 | NO | YES | NO |
| 02245058 | OMEPRAZOLE | Apo-Omeprazole Cap 20mg | APX | 0.2287 | 0.2287 | YES | YES | NO |
| 09857285 | OMEPRAZOLE | Apo-Omeprazole Cap 20mg | APX | 0.2287 | 0.2287 | YES | YES | NO |
| 02420198 | OMEPRAZOLE | Jamp-Omeprazole DR Tab 20mg | JPC | 0.2287 | 0.2287 | YES | YES | NO |
| 00846503 | OMEPRAZOLE | Losec DR Cap (Not a Benefit) 20mg | CHE | N/A | N/A | YES | NO | NO |
| 02190915 | OMEPRAZOLE | Losec DR Tab (Not a Benefit) 20mg | CHE | N/A | N/A | YES | NO | NO |
| 02230737 | OMEPRAZOLE | Losec DR Tab (Off-Formulary Interchangeable) 10mg | AZC | N/A | N/A | YES | NO | NO |
| 02439549 | OMEPRAZOLE | Nat-Omeprazole DR Tab 20mg | NAT | 0.2287 | 0.2287 | YES | YES | NO |
| 02348691 | OMEPRAZOLE | Omeprazole DR Cap 20mg | SAI | 0.2287 | 0.2287 | YES | YES | NO |
| 02504294 | OMEPRAZOLE | Omeprazole Magnesium Delayed Release Tab 20mg | SAI | 0.2287 | 0.2287 | YES | YES | NO |
| 02416549 | OMEPRAZOLE | Omeprazole Magnesium Delayed Release Tab 20mg | ACH | 0.2287 | 0.2287 | YES | YES | NO |
| 02411857 | OMEPRAZOLE | Omeprazole-20 DR Cap 20mg | SIV | 0.2287 | 0.2287 | YES | YES | NO |
| 09857342 | OMEPRAZOLE | PMS-Omeprazole DR Cap 20mg | PMS | 0.2287 | 0.2287 | YES | YES | NO |
| 02403617 | OMEPRAZOLE | Ran-Omeprazole DR Cap 20mg | RAN | 0.2287 | 0.2287 | YES | YES | NO |
| 02260867 | OMEPRAZOLE | Ratio-Omeprazole DR Tab 20mg | RPH | 0.2287 | 0.2287 | YES | YES | NO |
| 02296446 | OMEPRAZOLE | Sandoz Omeprazole DR Cap 20mg | SDZ | 0.2287 | 0.2287 | YES | YES | NO |
| 09857314 | OMEPRAZOLE | Sandoz Omeprazole DR Cap 20mg | SDZ | 0.2287 | 0.2287 | YES | YES | NO |
| 02295407 | OMEPRAZOLE | Teva-Omeprazole DR Tab (Off-Formulary Interchangeable) 10mg | TEV | 0.8167 | N/A | YES | NO | NO |
| 02295415 | OMEPRAZOLE | Teva-Omeprazole DR Tab 20mg | TEV | 0.2287 | 0.2287 | YES | YES | NO |
| 02119579 | OMEPRAZOLE | Losec (Off-Formulary Interchangeable) 10mg DR Cap | AZC | N/A | N/A | YES | NO | NO |
| 02296438 | OMEPRAZOLE | Sandoz Omeprazole (Off-Formulary Interchangeable) 10mg DR Cap | SDZ | 0.9470 | N/A | YES | NO | NO |
| 09857464 | OMEPRAZOLE MAGNESIUM | Jamp-Omeprazole DR Tab 20mg | JPC | 0.2287 | 0.2287 | YES | YES | NO |
| 09857195 | OMEPRAZOLE MAGNESIUM | Losec DR Tab (Not a Benefit) 20mg | CHE | N/A | N/A | YES | NO | NO |
| 09857536 | OMEPRAZOLE MAGNESIUM | Nat-Omeprazole DR Tab 20mg | NAT | 0.2287 | 0.2287 | YES | YES | NO |
| 09857500 | OMEPRAZOLE MAGNESIUM | Omeprazole Magnesium Delayed Release Tab 20mg | ACH | 0.2287 | 0.2287 | YES | YES | NO |
| 09857656 | OMEPRAZOLE MAGNESIUM | Omeprazole Magnesium Delayed Release Tab 20mg | SAI | 0.2287 | 0.2287 | YES | YES | NO |
| 09857640 | OMEPRAZOLE MAGNESIUM | Omeprazole-20 DR Cap 20mg | SIV | 0.2287 | 0.2287 | YES | YES | NO |
| 09857267 | OMEPRAZOLE MAGNESIUM | Ratio-Omeprazole DR Tab 20mg | RPH | 0.2287 | 0.2287 | YES | YES | NO |
| 02491524 | ONDANSETRON HCL DIHYDRATE | Auro-Ondansetron Injection (Off-Formulary Interchangeable) 2mg/mL Inj Sol-2mL Pk | AUR | 13.2180 | N/A | YES | NO | NO |
| 02464578 | ONDANSETRON HCL DIHYDRATE | Ondansetron Injection USP (Off-Formulary Interchangeable) 2mg/mL Inj Sol-2mL Pk | STE | 13.2180 | N/A | YES | NO | NO |
| 02213745 | ONDANSETRON HCL DIHYDRATE | Zofran (Off-Formulary Interchangeable) 2mg/mL Inj Sol-2mL Pk | NOV | N/A | N/A | YES | NO | NO |
| 02491532 | ONDANSETRON HCL DIHYDRATE | Auro-Ondansetron Injection (Off-Formulary Interchangeable) 2mg/mL Inj Sol-4mL Pk | AUR | 26.4360 | N/A | YES | NO | NO |
| 09857602 | ONDANSETRON HCL DIHYDRATE | Ondansetron Injection USP (Off-Formulary Interchangeable) 2mg/mL Inj Sol-4mL Pk | STE | 26.4360 | N/A | YES | NO | NO |
| 09857324 | ONDANSETRON HCL DIHYDRATE | Zofran (Off-Formulary Interchangeable) 2mg/mL Inj Sol-4mL Pk | NOV | N/A | N/A | YES | NO | NO |
| 02535327 | ONDANSETRON HYDROCHLORIDE | Accel-Ondansetron ODT (Tablet) 8mg | ACC | 3.8840 | 3.8840 | YES | YES | NO |
| 02535319 | ONDANSETRON HYDROCHLORIDE | Accel-Ondansetron ODT (Tablet) 4mg | ACC | 2.5450 | 2.5450 | YES | YES | NO |
| 02511282 | ONDANSETRON HYDROCHLORIDE | Auro-Ondansetron ODT (Tablet) 4mg | AUR | 3.2720 | 2.5450 | YES | YES | NO |
| 02511290 | ONDANSETRON HYDROCHLORIDE | Auro-Ondansetron ODT (Tablet) 8mg | AUR | 4.9930 | 3.8840 | YES | YES | NO |
| 02541378 | ONDANSETRON HYDROCHLORIDE | Jamp Ondansetron ODF (Film) 8mg | JPC | 4.9930 | 3.8840 | YES | YES | NO |
| 02541351 | ONDANSETRON HYDROCHLORIDE | Jamp Ondansetron ODF (Film) 4mg | JPC | 3.2720 | 2.5450 | YES | YES | NO |
| 02514966 | ONDANSETRON HYDROCHLORIDE | Mar-Ondansetron ODT Tablet 4mg | MAR | 3.2720 | 2.5450 | YES | YES | NO |
| 02514974 | ONDANSETRON HYDROCHLORIDE | Mar-Ondansetron ODT Tablet 8mg | MAR | 4.9930 | 3.8840 | YES | YES | NO |
| 02487330 | ONDANSETRON HYDROCHLORIDE | Mint-Ondansetron ODT (Tablet) 4mg | MIN | 3.2720 | 2.5450 | YES | YES | NO |
| 02487349 | ONDANSETRON HYDROCHLORIDE | Mint-Ondansetron ODT (Tablet) 8mg | MIN | 4.9930 | 3.8840 | YES | YES | NO |
| 02519240 | ONDANSETRON HYDROCHLORIDE | Ondansetron ODT (Tablet) 8mg | JPC | 4.9930 | 3.8840 | YES | YES | NO |
| 02481723 | ONDANSETRON HYDROCHLORIDE | Ondansetron ODT (Tablet) 4mg | SDZ | 3.2720 | 2.5450 | YES | YES | NO |
| 02524279 | ONDANSETRON HYDROCHLORIDE | Ondansetron ODT (Tablet) 4mg | SAI | 3.2720 | 2.5450 | YES | YES | NO |
| 02519232 | ONDANSETRON HYDROCHLORIDE | Ondansetron ODT (Tablet) 4mg | JPC | 3.2720 | 2.5450 | YES | YES | NO |
| 02524287 | ONDANSETRON HYDROCHLORIDE | Ondansetron ODT (Tablet) 8mg | SAI | 4.9930 | 3.8840 | YES | YES | NO |
| 02481731 | ONDANSETRON HYDROCHLORIDE | Ondansetron ODT (Tablet) 8mg | SDZ | 4.9930 | 3.8840 | YES | YES | NO |
| 02389983 | ONDANSETRON HYDROCHLORIDE | Ondissolve ODF (Film) 4mg | TAK | 3.2720 | 2.5450 | YES | YES | NO |
| 02389991 | ONDANSETRON HYDROCHLORIDE | Ondissolve ODF (Film) 8mg | TAK | 4.9930 | 3.8840 | YES | YES | NO |
| 02519453 | ONDANSETRON HYDROCHLORIDE | PMS-Ondansetron ODT Tablet 8mg | PMS | 4.9930 | 3.8840 | YES | YES | NO |
| 02519445 | ONDANSETRON HYDROCHLORIDE | PMS-Ondansetron ODT Tablet 4mg | PMS | 3.2720 | 2.5450 | YES | YES | NO |
| 02239372 | ONDANSETRON HYDROCHLORIDE | Zofran ODT (Tablet) (Not a Benefit) 4mg | SDZ | N/A | N/A | YES | NO | NO |
| 02239373 | ONDANSETRON HYDROCHLORIDE | Zofran ODT (Tablet) (Not a Benefit) 8mg | SDZ | N/A | N/A | YES | NO | NO |
| 02291967 | ONDANSETRON HYDROCHLORIDE | Apo-Ondansetron 4mg/5mL O/L | APX | 0.7952 | 0.7952 | YES | YES | NO |
| 02490617 | ONDANSETRON HYDROCHLORIDE | Jamp Ondansetron 4mg/5mL O/L | JPC | 0.7952 | 0.7952 | YES | YES | NO |
| 02524090 | ONDANSETRON HYDROCHLORIDE | Mint-Ondansetron Solution 4mg/5mL O/L | MIN | 0.7952 | 0.7952 | YES | YES | NO |
| 02229639 | ONDANSETRON HYDROCHLORIDE | Zofran (Not a Benefit) 4mg/5mL O/L | NOV | N/A | N/A | YES | NO | NO |
| 02478927 | ONDANSETRON HYDROCHLORIDE | Accel-Ondansetron 4mg Tab | ACC | 2.5450 | 2.5450 | YES | YES | NO |
| 02478935 | ONDANSETRON HYDROCHLORIDE | Accel-Ondansetron 8mg Tab | ACC | 3.8840 | 3.8840 | YES | YES | NO |
| 02288184 | ONDANSETRON HYDROCHLORIDE | Apo-Ondansetron 4mg Tab | APX | 3.3495 | 2.5450 | YES | YES | NO |
| 02288192 | ONDANSETRON HYDROCHLORIDE | Apo-Ondansetron 8mg Tab | APX | 5.1110 | 3.8840 | YES | YES | NO |
| 02313685 | ONDANSETRON HYDROCHLORIDE | Jamp-Ondansetron 4mg Tab | JPC | 3.3495 | 2.5450 | YES | YES | NO |
| 02313693 | ONDANSETRON HYDROCHLORIDE | Jamp-Ondansetron 8mg Tab | JPC | 5.1110 | 3.8840 | YES | YES | NO |
| 02371731 | ONDANSETRON HYDROCHLORIDE | Mar-Ondansetron 4mg Tab | MAR | 3.3495 | 2.5450 | YES | YES | NO |
| 02371758 | ONDANSETRON HYDROCHLORIDE | Mar-Ondansetron 8mg Tab | MAR | 5.1110 | 3.8840 | YES | YES | NO |
| 02305259 | ONDANSETRON HYDROCHLORIDE | Mint-Ondansetron 4mg Tab | MIN | 3.3495 | 2.5450 | YES | YES | NO |
| 02305267 | ONDANSETRON HYDROCHLORIDE | Mint-Ondansetron 8mg Tab | MIN | 5.1110 | 3.8840 | YES | YES | NO |
| 02297868 | ONDANSETRON HYDROCHLORIDE | Mylan-Ondansetron 4mg Tab | MYL | 3.3495 | 2.5450 | YES | YES | NO |
| 02297876 | ONDANSETRON HYDROCHLORIDE | Mylan-Ondansetron 8mg Tab | MYL | 5.1110 | 3.8840 | YES | YES | NO |
| 02417847 | ONDANSETRON HYDROCHLORIDE | Nat-Ondansetron 8mg Tab | NAT | 5.1110 | 3.8840 | YES | YES | NO |
| 02417839 | ONDANSETRON HYDROCHLORIDE | Nat-Ondansetron 4mg Tab | NAT | 3.3495 | 2.5450 | YES | YES | NO |
| 02541424 | ONDANSETRON HYDROCHLORIDE | Ondansetron 4mg Tab | SIV | 3.3495 | 2.5450 | YES | YES | NO |
| 02421410 | ONDANSETRON HYDROCHLORIDE | Ondansetron 8mg Tab | SAI | 4.9930 | 3.8840 | YES | YES | NO |
| 02421402 | ONDANSETRON HYDROCHLORIDE | Ondansetron 4mg Tab | SAI | 3.2720 | 2.5450 | YES | YES | NO |
| 02541432 | ONDANSETRON HYDROCHLORIDE | Ondansetron 8mg Tab | SIV | 5.1110 | 3.8840 | YES | YES | NO |
| 02258188 | ONDANSETRON HYDROCHLORIDE | PMS-Ondansetron 4mg Tab | PMS | 3.3495 | 2.5450 | YES | YES | NO |
| 02258196 | ONDANSETRON HYDROCHLORIDE | PMS-Ondansetron 8mg Tab | PMS | 5.1110 | 3.8840 | YES | YES | NO |
| 02274329 | ONDANSETRON HYDROCHLORIDE | Sandoz Ondansetron 8mg Tab | SDZ | 5.1110 | 3.8840 | YES | YES | NO |
| 02274310 | ONDANSETRON HYDROCHLORIDE | Sandoz Ondansetron 4mg Tab | SDZ | 3.3495 | 2.5450 | YES | YES | NO |
| 02376091 | ONDANSETRON HYDROCHLORIDE | Septa-Ondansetron 4mg Tab | SET | 3.3495 | 2.5450 | YES | YES | NO |
| 02376105 | ONDANSETRON HYDROCHLORIDE | Septa-Ondansetron 8mg Tab | SET | 5.1110 | 3.8840 | YES | YES | NO |
| 02296357 | ONDANSETRON HYDROCHLORIDE | Teva-Ondansetron 8mg Tab | TEV | 5.1110 | 3.8840 | YES | YES | NO |
| 02296349 | ONDANSETRON HYDROCHLORIDE | Teva-Ondansetron 4mg Tab | TEV | 3.3495 | 2.5450 | YES | YES | NO |
| 02213575 | ONDANSETRON HYDROCHLORIDE | Zofran (Not a Benefit) 8mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02213567 | ONDANSETRON HYDROCHLORIDE | Zofran (Not a Benefit) 4mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00249920 | ORCIPRENALINE SULFATE | Alupent (Not a Benefit) 2mg/mL O/L | BOE | N/A | N/A | YES | NO | NO |
| 02236783 | ORCIPRENALINE SULFATE | Orciprenaline 2mg/mL O/L | AAP | 0.0574 | 0.0574 | YES | NO | NO |
| 01966162 | ORPHENADRINE CITRATE | Norflex (Not a Benefit) 60mg/2mL Inj Sol-2mL Pk | MMH | N/A | N/A | YES | NO | YES |
| 02229731 | ORPHENADRINE CITRATE | Orphenadrine (Not a Benefit) 60mg/2mL Inj Sol-2mL Pk | CYI | N/A | N/A | YES | NO | YES |
| 02497409 | OSELTAMIVIR PHOSPHATE | Jamp Oseltamivir 30mg Cap | JPC | 0.5243 | 0.5243 | YES | YES | NO |
| 02497425 | OSELTAMIVIR PHOSPHATE | Jamp Oseltamivir 75mg Cap | JPC | 1.0393 | 1.0393 | YES | YES | NO |
| 02497476 | OSELTAMIVIR PHOSPHATE | Mint-Oseltamivir 75mg Cap | MIN | 1.0393 | 1.0393 | YES | YES | NO |
| 02497441 | OSELTAMIVIR PHOSPHATE | Mint-Oseltamivir 30mg Cap | MIN | 0.5243 | 0.5243 | YES | YES | NO |
| 02472635 | OSELTAMIVIR PHOSPHATE | Nat-Oseltamivir 30mg Cap | NAT | 0.5243 | 0.5243 | YES | YES | NO |
| 02472643 | OSELTAMIVIR PHOSPHATE | Nat-Oseltamivir 45mg Cap | NAT | 1.6135 | 1.6135 | YES | YES | NO |
| 02457989 | OSELTAMIVIR PHOSPHATE | Nat-Oseltamivir 75mg Cap | NAT | 1.0393 | 1.0393 | YES | YES | NO |
| 02504014 | OSELTAMIVIR PHOSPHATE | Sandoz Oseltamivir 45mg Cap | SDZ | 1.6135 | 1.6135 | YES | YES | NO |
| 02504006 | OSELTAMIVIR PHOSPHATE | Sandoz Oseltamivir 30mg Cap | SDZ | 0.5243 | 0.5243 | YES | YES | NO |
| 02504022 | OSELTAMIVIR PHOSPHATE | Sandoz Oseltamivir 75mg Cap | SDZ | 1.0393 | 1.0393 | YES | YES | NO |
| 02241472 | OSELTAMIVIR PHOSPHATE | Tamiflu 75mg Cap | HLR | 4.1940 | 1.0393 | YES | YES | NO |
| 02304848 | OSELTAMIVIR PHOSPHATE | Tamiflu 30mg Cap | HLR | 2.1150 | 0.5243 | YES | YES | NO |
| 02304856 | OSELTAMIVIR PHOSPHATE | Tamiflu 45mg Cap | HLR | 3.2540 | 1.6135 | YES | YES | NO |
| 02499894 | OSELTAMIVIR PHOSPHATE | Nat-Oseltamivir (Off-Formulary Interchangeable) 6mg/mL O/L | NAT | 0.2811 | N/A | YES | NO | NO |
| 02381842 | OSELTAMIVIR PHOSPHATE | Tamiflu (Off-Formulary Interchangeable) 6mg/mL O/L | HLR | N/A | N/A | YES | NO | NO |
| 02243661 | OXAPROZIN. | Apo-Oxaprozin (Off-Formulary Interchangeable) 600mg Tab | APX | 0.6892 | N/A | YES | NO | YES |
| 02027860 | OXAPROZIN. | Daypro (Off-Formulary Interchangeable) 600mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 00402680 | OXAZEPAM | Apo-Oxazepam 10mg Tab | APX | 0.0350 | 0.0350 | YES | NO | NO |
| 00402737 | OXAZEPAM | Apo-Oxazepam 30mg Tab | APX | 0.0750 | 0.0750 | YES | NO | NO |
| 00402745 | OXAZEPAM | Apo-Oxazepam 15mg Tab | APX | 0.0550 | 0.0550 | YES | NO | NO |
| 02043653 | OXAZEPAM | Serax (Not a Benefit) 10mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02043661 | OXAZEPAM | Serax (Not a Benefit) 15mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02043688 | OXAZEPAM | Serax (Not a Benefit) 30mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02284316 | OXCARBAZEPINE | Apo-Oxcarbazepine (Off-Formulary Interchangeable) 600mg Tab | APX | 1.8204 | 1.8204 | YES | NO | NO |
| 02284294 | OXCARBAZEPINE | Apo-Oxcarbazepine (Off-Formulary Interchangeable) 150mg Tab | APX | 0.6209 | 0.6209 | YES | NO | NO |
| 02284308 | OXCARBAZEPINE | Apo-Oxcarbazepine (Off-Formulary Interchangeable) 300mg Tab | APX | 0.9102 | 0.9102 | YES | NO | NO |
| 02440733 | OXCARBAZEPINE | Jamp-Oxcarbazepine (Off-Formulary Interchangeable) 600mg Tab | JPC | 1.8204 | 1.8204 | YES | NO | NO |
| 02440725 | OXCARBAZEPINE | Jamp-Oxcarbazepine (Off-Formulary Interchangeable) 300mg Tab | JPC | 0.9102 | 0.9102 | YES | NO | NO |
| 02440717 | OXCARBAZEPINE | Jamp-Oxcarbazepine (Off-Formulary Interchangeable) 150mg Tab | JPC | 0.6210 | 0.6210 | YES | NO | NO |
| 02242067 | OXCARBAZEPINE | Trileptal (Not a Benefit) 150mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02242068 | OXCARBAZEPINE | Trileptal (Off-Formulary Interchangeable) 300mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02242069 | OXCARBAZEPINE | Trileptal (Off-Formulary Interchangeable) 600mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00476366 | OXTRIPHYLLINE | Choledyl 20mg/mL O/L | SLP | 0.0398 | 0.0398 | NO | NO | NO |
| 01924753 | OXYBUTYNIN CHLORIDE | Ditropan (Not a Benefit) 1mg/mL O/L | JNO | N/A | N/A | YES | NO | NO |
| 02223376 | OXYBUTYNIN CHLORIDE | PMS-Oxybutynin 1mg/mL O/L | PMS | 0.1249 | 0.1249 | YES | NO | NO |
| 02163543 | OXYBUTYNIN CHLORIDE | Apo-Oxybutynin 5mg Tab | APX | 0.0986 | 0.0986 | YES | NO | NO |
| 01924761 | OXYBUTYNIN CHLORIDE | Ditropan (Not a Benefit) 5mg Tab | PGP | N/A | N/A | YES | NO | NO |
| 02230394 | OXYBUTYNIN CHLORIDE | Novo-Oxybutynin 5mg Tab | NOP | 0.0986 | 0.0986 | YES | NO | NO |
| 02350238 | OXYBUTYNIN CHLORIDE | Oxybutynin 5mg Tab | SAI | 0.0986 | 0.0986 | YES | NO | NO |
| 02240550 | OXYBUTYNIN CHLORIDE | PMS-Oxybutynin 5mg Tab | PMS | 0.0986 | 0.0986 | YES | NO | NO |
| 02240131 | OXYCODONE HCL | Oxy.IR (Off-Formulary Interchangeable) 10mg Tab | PFP | N/A | N/A | YES | NO | YES |
| 02240132 | OXYCODONE HCL | Oxy.IR (Off-Formulary Interchangeable) 20mg Tab | PFP | N/A | N/A | YES | NO | YES |
| 02231934 | OXYCODONE HCL | Oxy.IR (Off-Formulary Interchangeable) 5mg Tab | PFP | N/A | N/A | YES | NO | YES |
| 02319993 | OXYCODONE HCL | PMS-Oxycodone (Off-Formulary Interchangeable) 20mg Tab | PMS | 0.6001 | 0.6001 | YES | NO | YES |
| 02319985 | OXYCODONE HCL | PMS-Oxycodone (Off-Formulary Interchangeable) 10mg Tab | PMS | 0.3451 | 0.3451 | YES | NO | YES |
| 02319977 | OXYCODONE HCL | PMS-Oxycodone (Off-Formulary Interchangeable) 5mg Tab | PMS | 0.2333 | 0.2333 | YES | NO | YES |
| 02262983 | OXYCODONE HCL | Supeudol (Off-Formulary Interchangeable) 20mg Tab | SDZ | 0.6001 | 0.6001 | YES | NO | YES |
| 00443948 | OXYCODONE HCL | Supeudol (Off-Formulary Interchangeable) 10mg Tab | SDZ | 0.3451 | 0.3451 | YES | NO | YES |
| 00789739 | OXYCODONE HCL | Supeudol (Off-Formulary Interchangeable) 5mg Tab | SDZ | 0.2333 | 0.2333 | YES | NO | YES |
| 02324628 | OXYCODONE HCL & ACETAMINOPHEN | Apo-Oxycodone/Acet 5mg & 325mg Tab | APX | 0.1285 | 0.1285 | YES | NO | YES |
| 01916548 | OXYCODONE HCL & ACETAMINOPHEN | Endocet 5mg & 325mg Tab | BQU | 0.1285 | 0.1285 | YES | NO | YES |
| 01916475 | OXYCODONE HCL & ACETAMINOPHEN | Percocet (Not a Benefit) 5mg & 325mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 02307898 | OXYCODONE HCL & ACETAMINOPHEN | Sandoz Oxycodone/Acetaminophen 5mg & 325mg Tab | SDZ | 0.1285 | 0.1285 | YES | NO | YES |
| 00608165 | OXYCODONE HCL & ACETAMINOPHEN | Teva-Oxycocet 5mg & 325mg Tab | TEV | 0.1285 | 0.1285 | YES | NO | YES |
| 01916572 | OXYCODONE HCL & ACETYLSALICYLIC ACID | Percodan (Not a Benefit) 5mg & 325mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 00608157 | OXYCODONE HCL & ACETYLSALICYLIC ACID | Ratio-Oxycodan 5mg & 325mg Tab | RPH | 0.4599 | 0.4599 | YES | NO | YES |
| 02493551 | PALBOCICLIB | Ibrance (Off-Formulary Interchangeable) 125mg Tab | PFI | 253.9123 | 126.9562 | YES | NO | NO |
| 02493543 | PALBOCICLIB | Ibrance (Off-Formulary Interchangeable) 100mg Tab | PFI | 253.9123 | 126.9562 | YES | NO | NO |
| 02493535 | PALBOCICLIB | Ibrance (Off-Formulary Interchangeable) 75mg Tab | PFI | 253.9123 | 126.9562 | YES | NO | NO |
| 02552140 | PALBOCICLIB | PMS-Palbociclib (Off-Formulary Interchangeable) 125mg Tab | PMS | 126.9562 | 126.9562 | YES | NO | NO |
| 02552124 | PALBOCICLIB | PMS-Palbociclib (Off-Formulary Interchangeable) 75mg Tab | PMS | 126.9562 | 126.9562 | YES | NO | NO |
| 02552132 | PALBOCICLIB | PMS-Palbociclib (Off-Formulary Interchangeable) 100mg Tab | PMS | 126.9562 | 126.9562 | YES | NO | NO |
| 02547651 | PALBOCICLIB | Taro-Palbociclib (Off-Formulary Interchangeable) 125mg Tab | TAR | 126.9562 | 126.9562 | YES | NO | NO |
| 02547643 | PALBOCICLIB | Taro-Palbociclib (Off-Formulary Interchangeable) 100mg Tab | TAR | 126.9562 | 126.9562 | YES | NO | NO |
| 02547635 | PALBOCICLIB | Taro-Palbociclib (Off-Formulary Interchangeable) 75mg Tab | TAR | 126.9562 | 126.9562 | YES | NO | NO |
| 02300303 | PALIPERIDONE | Invega 9mg ER Tab | JAN | 9.0850 | 9.0850 | NO | NO | NO |
| 02300281 | PALIPERIDONE | Invega 6mg ER Tab | JAN | 6.8160 | 6.8160 | NO | NO | NO |
| 02300273 | PALIPERIDONE | Invega 3mg ER Tab | JAN | 4.5570 | 4.5570 | NO | NO | NO |
| 02354241 | PALIPERIDONE PALMITATE | Invega Sustenna 150mg Inj Pref Syr | JAN | 725.9100 | 725.9100 | NO | NO | YES |
| 02354233 | PALIPERIDONE PALMITATE | Invega Sustenna 100mg Inj Pref Syr | JAN | 544.4400 | 544.4400 | NO | NO | YES |
| 02354225 | PALIPERIDONE PALMITATE | Invega Sustenna 75mg Inj Pref Syr | JAN | 491.1800 | 491.1800 | NO | NO | YES |
| 02354217 | PALIPERIDONE PALMITATE | Invega Sustenna 50mg Inj Pref Syr | JAN | 327.4500 | 327.4500 | NO | NO | YES |
| 02456001 | PALIPERIDONE PALMITATE | Invega Trinza 525mg/2.625mL Inj Susp-Pref Syr | JAN | 1907.4900 | 1907.4900 | NO | NO | YES |
| 02455994 | PALIPERIDONE PALMITATE | Invega Trinza 350mg/1.75mL Inj Susp-Pref Syr | JAN | 1430.6100 | 1430.6100 | NO | NO | YES |
| 02455986 | PALIPERIDONE PALMITATE | Invega Trinza 263mg/1.315mL Inj Susp-Pref Syr | JAN | 1430.6100 | 1430.6100 | NO | NO | YES |
| 02455943 | PALIPERIDONE PALMITATE | Invega Trinza 175mg/0.875mL Inj Susp-Pref Syr | JAN | 953.7300 | 953.7300 | NO | NO | YES |
| 02059789 | PAMIDRONATE DISODIUM | Aredia (Off-Formulary Interchangeable) 9mg/mL Inj Sol-10mL Vial | NOV | N/A | N/A | YES | NO | NO |
| 02059770 | PAMIDRONATE DISODIUM | Aredia (Off-Formulary Interchangeable) 6mg/mL Inj Sol-10mL Vial | NOV | N/A | N/A | YES | NO | NO |
| 02059762 | PAMIDRONATE DISODIUM | Aredia (Off-Formulary Interchangeable) 3mg/mL Inj Sol-10mL Vial | NOV | N/A | N/A | YES | NO | NO |
| 02249677 | PAMIDRONATE DISODIUM | Pamidronate Disodium Omega (Off-Formulary Interchangeable) 6mg/mL Inj Sol-10mL Vial | OMG | 176.7000 | 176.7000 | YES | NO | NO |
| 02249669 | PAMIDRONATE DISODIUM | Pamidronate Disodium Omega (Off-Formulary Interchangeable) 3mg/mL Inj Sol-10mL Vial | OMG | 86.7800 | 86.7800 | YES | NO | NO |
| 02249685 | PAMIDRONATE DISODIUM | Pamidronate Disodium Omega (Off-Formulary Interchangeable) 9mg/mL Inj Sol-10mL Vial | OMG | 260.3300 | 260.3300 | YES | NO | NO |
| 02246598 | PAMIDRONATE DISODIUM | Pamidronate Disodium for Injection (Off-Formulary Interchangeable) 6mg/mL Inj Sol-10mL Vial | FKC | 176.7000 | 176.7000 | YES | NO | NO |
| 02246597 | PAMIDRONATE DISODIUM | Pamidronate Disodium for Injection (Off-Formulary Interchangeable) 3mg/mL Inj Sol-10mL Vial | FKC | 86.7800 | 86.7800 | YES | NO | NO |
| 02246599 | PAMIDRONATE DISODIUM | Pamidronate Disodium for Injection (Off-Formulary Interchangeable) 9mg/mL Inj Sol-10mL Vial | FKC | 260.3300 | 260.3300 | YES | NO | NO |
| 00263818 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Cotazym 10000 & 40000 & 35000 USP Units Cap | ORG | 0.2752 | 0.2752 | NO | YES | NO |
| 00821373 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Cotazym ECS 20 20000 & 55000 & 55000 USP Units Ent Microsph Cap | ORG | 1.3025 | 1.3025 | NO | YES | NO |
| 00502790 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Cotazym ECS 8 8000 & 30000 & 30000 USP Units Ent Microsph Cap | ORG | 0.4968 | 0.4968 | NO | YES | NO |
| 00789445 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Pancrease MT4 4000 & 12000 & 12000 USP Units Ent Microsph Cap | VIU | 0.7274 | 0.7274 | NO | YES | NO |
| 02200104 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Creon 10 10000 & 33200 & 37500 USP Units Ent Minimicrosph Cap | SPH | 0.2891 | 0.2891 | NO | YES | NO |
| 01985205 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Creon 25 25000 & 74000 & 62500 USP Units Ent Minimicrosph Cap | SPH | 0.9031 | 0.9031 | NO | YES | NO |
| 02445158 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Creon Minimicrospheres Micro 5100 & 500 & 320 Units/100mg Gran - 100mg/Scoop | BGP | 0.1871 | 0.1871 | NO | YES | NO |
| 02241933 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Viokace 16mg Tab | NSA | 0.6222 | 0.6222 | NO | YES | NO |
| 02230019 | PANCRELIPASE EQUIVALENT TO LIPASE & AMYLASE & PROTEASE | Viokace 10440 & 56400 & 57100 USP Units Tab | NSA | 0.4054 | 0.4054 | NO | YES | NO |
| 02408570 | PANTOPRAZOLE MAGNESIUM | Mylan-Pantoprazole T 40mg Ent Coated Tab | MYL | 0.1875 | 0.1875 | YES | NO | NO |
| 02441853 | PANTOPRAZOLE MAGNESIUM | Pantoprazole Magnesium 40mg Ent Coated Tab | ALH | 0.1875 | 0.1875 | YES | NO | NO |
| 02466147 | PANTOPRAZOLE MAGNESIUM | Pantoprazole T 40mg Ent Coated Tab | SAI | 0.1875 | 0.1875 | YES | NO | NO |
| 02519534 | PANTOPRAZOLE MAGNESIUM | Pantoprazole T 40mg Ent Coated Tab | SIV | 0.1875 | 0.1875 | YES | NO | NO |
| 02267233 | PANTOPRAZOLE MAGNESIUM | Tecta 40mg Ent Coated Tab | NYC | 0.8260 | 0.1875 | YES | NO | NO |
| 02440628 | PANTOPRAZOLE MAGNESIUM | Teva-Pantoprazole Magnesium 40mg Ent Coated Tab | TEV | 0.1875 | 0.1875 | YES | NO | NO |
| 02481588 | PANTOPRAZOLE SODIUM | AG-Pantoprazole Sodium 40mg Ent Tab | ANG | 0.2016 | 0.2016 | YES | YES | NO |
| 02292912 | PANTOPRAZOLE SODIUM | Apo-Pantoprazole (Off-Formulary Interchangeable) 20mg Ent Tab | APX | 1.2750 | N/A | YES | NO | NO |
| 02292920 | PANTOPRAZOLE SODIUM | Apo-Pantoprazole 40mg Ent Tab | APX | 0.2016 | 0.2016 | YES | YES | NO |
| 02415208 | PANTOPRAZOLE SODIUM | Auro-Pantoprazole 40mg Ent Tab | AUR | 0.2016 | 0.2016 | YES | YES | NO |
| 02300486 | PANTOPRAZOLE SODIUM | Co Pantoprazole 40mg Ent Tab | COB | 0.2016 | 0.2016 | YES | YES | NO |
| 02392615 | PANTOPRAZOLE SODIUM | Jamp Pantoprazole Sodium (Off-Formulary Interchangeable) 20mg Ent Tab | JPC | 1.2750 | N/A | YES | NO | NO |
| 02392623 | PANTOPRAZOLE SODIUM | Jamp Pantoprazole Sodium 40mg Ent Tab | JPC | 0.2016 | 0.2016 | YES | YES | NO |
| 02408414 | PANTOPRAZOLE SODIUM | Jamp-Pantoprazole (Off-Formulary Interchangeable) 20mg Ent Tab | JPC | 1.2750 | N/A | YES | NO | NO |
| 02357054 | PANTOPRAZOLE SODIUM | Jamp-Pantoprazole 40mg Ent Tab | JPC | 0.2016 | 0.2016 | YES | YES | NO |
| 02467372 | PANTOPRAZOLE SODIUM | M-Pantoprazole 40mg Ent Tab | MAT | 0.2016 | 0.2016 | YES | YES | NO |
| 02416565 | PANTOPRAZOLE SODIUM | Mar-Pantoprazole 40mg Ent Tab | MAR | 0.2016 | 0.2016 | YES | YES | NO |
| 02416557 | PANTOPRAZOLE SODIUM | Mar-Pantoprazole (Off-Formulary Interchangeable) 20mg Ent Tab | MAR | 1.2750 | N/A | YES | NO | NO |
| 02417448 | PANTOPRAZOLE SODIUM | Mint-Pantoprazole 40mg Ent Tab | MIN | 0.2016 | 0.2016 | YES | YES | NO |
| 02471825 | PANTOPRAZOLE SODIUM | NRA-Pantoprazole 40mg Ent Tab | NRA | 0.2016 | 0.2016 | YES | YES | NO |
| 02307871 | PANTOPRAZOLE SODIUM | PMS-Pantoprazole 40mg Ent Tab | PMS | 0.2016 | 0.2016 | YES | YES | NO |
| 02241804 | PANTOPRAZOLE SODIUM | Pantoloc (Off-Formulary Interchangeable) 20mg Ent Tab | NYC | N/A | N/A | YES | NO | NO |
| 02229453 | PANTOPRAZOLE SODIUM | Pantoloc 40mg Ent Tab | NYC | 2.0803 | 0.2016 | YES | YES | NO |
| 02370808 | PANTOPRAZOLE SODIUM | Pantoprazole 40mg Ent Tab | SAI | 0.2016 | 0.2016 | YES | YES | NO |
| 02431327 | PANTOPRAZOLE SODIUM | Pantoprazole 40mg Ent Tab | RIA | 0.2016 | 0.2016 | YES | YES | NO |
| 02536137 | PANTOPRAZOLE SODIUM | Pantoprazole (Off-Formulary Interchangeable) 20mg Ent Tab | SAI | 1.2750 | N/A | YES | NO | NO |
| 02428172 | PANTOPRAZOLE SODIUM | Pantoprazole-20 (Off-Formulary Interchangeable) 20mg Ent Tab | SIV | 1.2750 | N/A | YES | NO | NO |
| 02428180 | PANTOPRAZOLE SODIUM | Pantoprazole-40 40mg Ent Tab | SIV | 0.2016 | 0.2016 | YES | YES | NO |
| 02305046 | PANTOPRAZOLE SODIUM | Ran-Pantoprazole 40mg Ent Tab | RAN | 0.2016 | 0.2016 | YES | YES | NO |
| 02305038 | PANTOPRAZOLE SODIUM | Ran-Pantoprazole (Off-Formulary Interchangeable) 20mg Ent Tab | RAN | 1.2750 | N/A | YES | NO | NO |
| 02301083 | PANTOPRAZOLE SODIUM | Sandoz Pantoprazole 40mg Ent Tab | SDZ | 0.2016 | 0.2016 | YES | YES | NO |
| 02301075 | PANTOPRAZOLE SODIUM | Sandoz Pantoprazole (Off-Formulary Interchangeable) 20mg Ent Tab | SDZ | 1.2750 | N/A | YES | NO | NO |
| 02285487 | PANTOPRAZOLE SODIUM | Teva-Pantoprazole 40mg Ent Tab | TEV | 0.2016 | 0.2016 | YES | YES | NO |
| 02285479 | PANTOPRAZOLE SODIUM | Teva-Pantoprazole (Off-Formulary Interchangeable) 20mg Ent Tab | TEV | 1.2750 | N/A | YES | NO | NO |
| 02475553 | PAROXETINE HCL | AG-Paroxetine 30mg Tab | ANG | 0.3453 | 0.3453 | YES | NO | NO |
| 02475545 | PAROXETINE HCL | AG-Paroxetine 20mg Tab | ANG | 0.3250 | 0.3250 | YES | NO | NO |
| 02475537 | PAROXETINE HCL | AG-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | ANG | 1.0430 | N/A | YES | NO | NO |
| 02240907 | PAROXETINE HCL | Apo-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | APX | 1.0430 | N/A | YES | NO | NO |
| 02240909 | PAROXETINE HCL | Apo-Paroxetine 30mg Tab | APX | 0.3453 | 0.3453 | YES | NO | NO |
| 02240908 | PAROXETINE HCL | Apo-Paroxetine 20mg Tab | APX | 0.3250 | 0.3250 | YES | NO | NO |
| 02383284 | PAROXETINE HCL | Auro-Paroxetine 20mg Tab | AUR | 0.3250 | 0.3250 | YES | NO | NO |
| 02383292 | PAROXETINE HCL | Auro-Paroxetine 30mg Tab | AUR | 0.3453 | 0.3453 | YES | NO | NO |
| 02383276 | PAROXETINE HCL | Auro-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | AUR | 1.0430 | N/A | YES | NO | NO |
| 02262754 | PAROXETINE HCL | Co Paroxetine 20mg Tab | COB | 0.3250 | 0.3250 | YES | NO | NO |
| 02262746 | PAROXETINE HCL | Co Paroxetine (Off-Formulary Interchangeable) 10mg Tab | COB | 1.0430 | N/A | YES | NO | NO |
| 02507773 | PAROXETINE HCL | Jamp Paroxetine Tablets (Off-Formulary Interchangeable) 10mg Tab | JPC | 1.0430 | N/A | YES | NO | NO |
| 02507803 | PAROXETINE HCL | Jamp Paroxetine Tablets 30mg Tab | JPC | 0.3453 | 0.3453 | YES | NO | NO |
| 02507781 | PAROXETINE HCL | Jamp Paroxetine Tablets 20mg Tab | JPC | 0.3250 | 0.3250 | YES | NO | NO |
| 02368862 | PAROXETINE HCL | Jamp-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | JPC | 1.0430 | N/A | YES | NO | NO |
| 02368889 | PAROXETINE HCL | Jamp-Paroxetine 30mg Tab | JPC | 0.3453 | 0.3453 | YES | NO | NO |
| 02368870 | PAROXETINE HCL | Jamp-Paroxetine 20mg Tab | JPC | 0.3250 | 0.3250 | YES | NO | NO |
| 02467410 | PAROXETINE HCL | M-Paroxetine 20mg Tab | MAT | 0.3250 | 0.3250 | YES | NO | NO |
| 02467429 | PAROXETINE HCL | M-Paroxetine 30mg Tab | MAT | 0.3453 | 0.3453 | YES | NO | NO |
| 02467402 | PAROXETINE HCL | M-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | MAT | 1.0430 | N/A | YES | NO | NO |
| 02411954 | PAROXETINE HCL | Mar-Paroxetine 20mg Tab | MAR | 0.3250 | 0.3250 | YES | NO | NO |
| 02411962 | PAROXETINE HCL | Mar-Paroxetine 30mg Tab | MAR | 0.3453 | 0.3453 | YES | NO | NO |
| 02411946 | PAROXETINE HCL | Mar-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | MAR | 1.0430 | N/A | YES | NO | NO |
| 02421399 | PAROXETINE HCL | Mint-Paroxetine 30mg Tab | MIN | 0.3453 | 0.3453 | YES | NO | NO |
| 02421380 | PAROXETINE HCL | Mint-Paroxetine 20mg Tab | MIN | 0.3250 | 0.3250 | YES | NO | NO |
| 02421372 | PAROXETINE HCL | Mint-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | MIN | 1.0430 | N/A | YES | NO | NO |
| 02479753 | PAROXETINE HCL | NRA-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | NRA | 1.0430 | N/A | YES | NO | NO |
| 02479788 | PAROXETINE HCL | NRA-Paroxetine 30mg Tab | NRA | 0.3453 | 0.3453 | YES | NO | NO |
| 02479761 | PAROXETINE HCL | NRA-Paroxetine 20mg Tab | NRA | 0.3250 | 0.3250 | YES | NO | NO |
| 02247750 | PAROXETINE HCL | PMS-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | PMS | 1.0430 | N/A | YES | NO | NO |
| 02247752 | PAROXETINE HCL | PMS-Paroxetine 30mg Tab | PMS | 0.3453 | 0.3453 | YES | NO | NO |
| 02247751 | PAROXETINE HCL | PMS-Paroxetine 20mg Tab | PMS | 0.3250 | 0.3250 | YES | NO | NO |
| 02282844 | PAROXETINE HCL | Paroxetine (Off-Formulary Interchangeable) 10mg Tab | SAI | 1.0430 | N/A | YES | NO | NO |
| 02388235 | PAROXETINE HCL | Paroxetine 20mg Tab | SIV | 0.3250 | 0.3250 | YES | NO | NO |
| 02282852 | PAROXETINE HCL | Paroxetine 20mg Tab | SAI | 0.3250 | 0.3250 | YES | NO | NO |
| 02388243 | PAROXETINE HCL | Paroxetine 30mg Tab | SIV | 0.3453 | 0.3453 | YES | NO | NO |
| 02282860 | PAROXETINE HCL | Paroxetine 30mg Tab | SAI | 0.3453 | 0.3453 | YES | NO | NO |
| 02388227 | PAROXETINE HCL | Paroxetine (Off-Formulary Interchangeable) 10mg Tab | SIV | 1.0430 | N/A | YES | NO | NO |
| 01940473 | PAROXETINE HCL | Paxil 30mg Tab | GSK | 2.6577 | 0.3453 | YES | NO | NO |
| 01940481 | PAROXETINE HCL | Paxil 20mg Tab | GSK | 2.5021 | 0.3250 | YES | NO | NO |
| 02027887 | PAROXETINE HCL | Paxil (Off-Formulary Interchangeable) 10mg Tab | SMJ | N/A | N/A | YES | NO | NO |
| 02431793 | PAROXETINE HCL | Sandoz Paroxetine Tablets 30mg Tab | SDZ | 0.3453 | 0.3453 | YES | NO | NO |
| 02431785 | PAROXETINE HCL | Sandoz Paroxetine Tablets 20mg Tab | SDZ | 0.3250 | 0.3250 | YES | NO | NO |
| 02431777 | PAROXETINE HCL | Sandoz Paroxetine Tablets (Off-Formulary Interchangeable) 10mg Tab | SDZ | 1.0430 | N/A | YES | NO | NO |
| 02248556 | PAROXETINE HCL | Teva-Paroxetine (Off-Formulary Interchangeable) 10mg Tab | TEV | 1.0430 | N/A | YES | NO | NO |
| 02248557 | PAROXETINE HCL | Teva-Paroxetine 20mg Tab | TEV | 0.3250 | 0.3250 | YES | NO | NO |
| 02248558 | PAROXETINE HCL | Teva-Paroxetine 30mg Tab | TEV | 0.3453 | 0.3453 | YES | NO | NO |
| 02552957 | PAZOPANIB | Eugia-Pazopanib (Off-Formulary Interchangeable) 200mg Tab | EUP | 30.9655 | 30.9655 | YES | NO | NO |
| 02525666 | PAZOPANIB | PMS-Pazopanib (Off-Formulary Interchangeable) 200mg Tab | PMS | 30.9655 | 30.9655 | YES | NO | NO |
| 02352303 | PAZOPANIB | Votrient (Off-Formulary Interchangeable) 200mg Tab | GSK | 41.3147 | 30.9655 | YES | NO | NO |
| 00677442 | PEG-ELECTROLYTES | Colyte (Not a Benefit) Pd-4L Pk | PEN | N/A | N/A | YES | NO | NO |
| 00777838 | PEG-ELECTROLYTES | PegLyte Powder Pd-4L Pk | PEN | 17.7331 | 17.7331 | YES | NO | NO |
| 02529343 | PEGFILGRASTIM | Lapelga 6mg/0.6mL Inj Sol-0.6mL Pref Autoinj (Preservative-Free) | APX | 1375.0000 | 1375.0000 | NO | NO | NO |
| 02546973 | PEGFILGRASTIM | Niopeg 6mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | NRA | 492.0000 | 492.0000 | NO | NO | NO |
| 02553945 | PEGFILGRASTIM | Pexegra 6mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | JPC | 492.0000 | 492.0000 | NO | NO | NO |
| 02497395 | PEGFILGRASTIM | Ziextenzo 6mg/0.6mL Inj Sol-0.6mL Pref Syr (Preservative-Free) | SDZ | 492.0000 | 492.0000 | NO | NO | NO |
| 02506238 | PEGFILGRASTIM | Nyvepria 6mg/0.6mL Inj Sol-0.6mL Pref Syr Pk (Preservative-Free) | PFI | 1375.0000 | 1375.0000 | NO | NO | NO |
| 02484153 | PEGFILGRASTIM | Fulphila 10mg/mL Inj Sol-Pref Syr | BCL | 492.0000 | 492.0000 | NO | NO | NO |
| 02474565 | PEGFILGRASTIM | Lapelga 10mg/mL Inj Sol-Pref Syr - 0.6mL Pk (Preservative Free) | APX | 492.0000 | 492.0000 | NO | NO | NO |
| 00016055 | PENICILLAMINE | Cuprimine 250mg Cap | ATO | 4.7355 | 4.7355 | NO | NO | NO |
| 00642223 | PENICILLIN V (POTASSIUM) | Apo-Pen V-K 25mg/mL O/L | APX | 0.0535 | 0.0535 | YES | NO | NO |
| 00018635 | PENICILLIN V (POTASSIUM) | Nadopen-V (Not a Benefit) 25mg/mL O/L | NDA | N/A | N/A | YES | NO | NO |
| 00642215 | PENICILLIN V (POTASSIUM) | PEN V-K 300mg Tab | AAP | 0.1873 | 0.1873 | YES | NO | NO |
| 00248843 | PENICILLIN V (POTASSIUM) | PVF-K 500 (Not a Benefit) 300mg Tab | FRS | N/A | N/A | YES | NO | NO |
| 02543087 | PENTOXIFYLLINE | Jamp Pentoxifylline SR 400mg SR Tab | JPC | 0.7238 | 0.7238 | YES | YES | NO |
| 02230090 | PENTOXIFYLLINE | Pentoxifylline SR 400mg SR Tab | AAP | 0.7238 | 0.7238 | YES | YES | NO |
| 02221977 | PENTOXIFYLLINE | Trental (Not a Benefit) 400mg SR Tab | SAV | N/A | N/A | YES | NO | NO |
| 02404532 | PERAMPANEL | Fycompa 6mg Tab | EIS | 10.3869 | 5.7128 | YES | YES | NO |
| 02404524 | PERAMPANEL | Fycompa 4mg Tab | EIS | 10.3869 | 5.7128 | YES | YES | NO |
| 02404516 | PERAMPANEL | Fycompa 2mg Tab | EIS | 10.3869 | 5.7128 | YES | YES | NO |
| 02404567 | PERAMPANEL | Fycompa 12mg Tab | EIS | 10.3869 | 5.7128 | YES | YES | NO |
| 02404540 | PERAMPANEL | Fycompa 8mg Tab | EIS | 10.3869 | 5.7128 | YES | YES | NO |
| 02404559 | PERAMPANEL | Fycompa 10mg Tab | EIS | 10.3869 | 5.7128 | YES | YES | NO |
| 02522675 | PERAMPANEL | Taro-Perampanel 10mg Tab | TAR | 5.7128 | 5.7128 | YES | YES | NO |
| 02522683 | PERAMPANEL | Taro-Perampanel 12mg Tab | TAR | 5.7128 | 5.7128 | YES | YES | NO |
| 02522632 | PERAMPANEL | Taro-Perampanel 2mg Tab | TAR | 5.7128 | 5.7128 | YES | YES | NO |
| 02522640 | PERAMPANEL | Taro-Perampanel 4mg Tab | TAR | 5.7128 | 5.7128 | YES | YES | NO |
| 02522659 | PERAMPANEL | Taro-Perampanel 6mg Tab | TAR | 5.7128 | 5.7128 | YES | YES | NO |
| 02522667 | PERAMPANEL | Taro-Perampanel 8mg Tab | TAR | 5.7128 | 5.7128 | YES | YES | NO |
| 01926772 | PERICYAZINE | Neuleptil 10mg Cap | SLP | 0.4428 | 0.4428 | NO | NO | NO |
| 01926780 | PERICYAZINE | Neuleptil 5mg Cap | SLP | 0.2566 | 0.2566 | NO | NO | NO |
| 01926756 | PERICYAZINE | Neuleptil 10mg/mL O/L | SLP | 0.4450 | 0.4450 | NO | NO | NO |
| 02468581 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | Apo-Perindopril/Amlodipine (Off-Formulary Interchangeable) 14mg & 10mg Tab | APX | 0.9775 | N/A | YES | NO | NO |
| 02468573 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | Apo-Perindopril/Amlodipine (Off-Formulary Interchangeable) 7mg & 5mg Tab | APX | 0.8925 | N/A | YES | NO | NO |
| 02468565 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | Apo-Perindopril/Amlodipine (Off-Formulary Interchangeable) 3.5mg & 2.5mg Tab | APX | 0.8075 | N/A | YES | NO | NO |
| 02541696 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | PMS-Perindopril-Amlodipine (Off-Formulary Interchangeable) 3.5mg & 2.5mg Tab | PMS | 0.8075 | N/A | YES | NO | NO |
| 02541718 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | PMS-Perindopril-Amlodipine (Off-Formulary Interchangeable) 7mg & 5mg Tab | PMS | 0.8925 | N/A | YES | NO | NO |
| 02541726 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | PMS-Perindopril-Amlodipine (Off-Formulary Interchangeable) 14mg & 10mg Tab | PMS | 0.9775 | N/A | YES | NO | NO |
| 02451557 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | Viacoram (Off-Formulary Interchangeable) 14mg & 10mg Tab | SEV | N/A | N/A | YES | NO | NO |
| 02451530 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | Viacoram (Off-Formulary Interchangeable) 3.5mg & 2.5mg Tab | SEV | N/A | N/A | YES | NO | NO |
| 02451549 | PERINDOPRIL ARGININE & AMLODIPINE BESYLATE | Viacoram (Off-Formulary Interchangeable) 7mg & 5mg Tab | SEV | N/A | N/A | YES | NO | NO |
| 02481693 | PERINDOPRIL ERBUMINE | AG-Perindopril 8mg Tab | ANG | 0.2831 | 0.2831 | YES | NO | NO |
| 02481685 | PERINDOPRIL ERBUMINE | AG-Perindopril 4mg Tab | ANG | 0.2042 | 0.2042 | YES | NO | NO |
| 02481677 | PERINDOPRIL ERBUMINE | AG-Perindopril 2mg Tab | ANG | 0.1632 | 0.1632 | YES | NO | NO |
| 02289261 | PERINDOPRIL ERBUMINE | Apo-Perindopril 2mg Tab | APX | 0.1632 | 0.1632 | YES | NO | NO |
| 02289288 | PERINDOPRIL ERBUMINE | Apo-Perindopril 4mg Tab | APX | 0.2042 | 0.2042 | YES | NO | NO |
| 02289296 | PERINDOPRIL ERBUMINE | Apo-Perindopril 8mg Tab | APX | 0.2831 | 0.2831 | YES | NO | NO |
| 02459833 | PERINDOPRIL ERBUMINE | Auro-Perindopril 8mg Tab | AUR | 0.2831 | 0.2831 | YES | NO | NO |
| 02459825 | PERINDOPRIL ERBUMINE | Auro-Perindopril 4mg Tab | AUR | 0.2042 | 0.2042 | YES | NO | NO |
| 02459817 | PERINDOPRIL ERBUMINE | Auro-Perindopril 2mg Tab | AUR | 0.1632 | 0.1632 | YES | NO | NO |
| 02246624 | PERINDOPRIL ERBUMINE | Coversyl 8mg Tab | SEV | 1.3660 | 0.2831 | YES | NO | NO |
| 02123282 | PERINDOPRIL ERBUMINE | Coversyl 4mg Tab | SEV | 0.9753 | 0.2042 | YES | NO | NO |
| 02123274 | PERINDOPRIL ERBUMINE | Coversyl 2mg Tab | SEV | 0.7790 | 0.1632 | YES | NO | NO |
| 02527227 | PERINDOPRIL ERBUMINE | Jamp Perindopril Erbumine 8mg Tab | JPC | 0.2831 | 0.2831 | YES | NO | NO |
| 02527219 | PERINDOPRIL ERBUMINE | Jamp Perindopril Erbumine 4mg Tab | JPC | 0.2042 | 0.2042 | YES | NO | NO |
| 02527200 | PERINDOPRIL ERBUMINE | Jamp Perindopril Erbumine 2mg Tab | JPC | 0.1632 | 0.1632 | YES | NO | NO |
| 02477025 | PERINDOPRIL ERBUMINE | Jamp-Perindopril 8mg Tab | JPC | 0.2831 | 0.2831 | YES | NO | NO |
| 02477009 | PERINDOPRIL ERBUMINE | Jamp-Perindopril 2mg Tab | JPC | 0.1632 | 0.1632 | YES | NO | NO |
| 02477017 | PERINDOPRIL ERBUMINE | Jamp-Perindopril 4mg Tab | JPC | 0.2042 | 0.2042 | YES | NO | NO |
| 02482924 | PERINDOPRIL ERBUMINE | M-Perindopril Erbumine 2mg Tab | MAT | 0.1632 | 0.1632 | YES | NO | NO |
| 02482940 | PERINDOPRIL ERBUMINE | M-Perindopril Erbumine 8mg Tab | MAT | 0.2831 | 0.2831 | YES | NO | NO |
| 02482932 | PERINDOPRIL ERBUMINE | M-Perindopril Erbumine 4mg Tab | MAT | 0.2042 | 0.2042 | YES | NO | NO |
| 02474824 | PERINDOPRIL ERBUMINE | Mar-Perindopril 2mg Tab | MAR | 0.1632 | 0.1632 | YES | NO | NO |
| 02474840 | PERINDOPRIL ERBUMINE | Mar-Perindopril 8mg Tab | MAR | 0.2831 | 0.2831 | YES | NO | NO |
| 02474832 | PERINDOPRIL ERBUMINE | Mar-Perindopril 4mg Tab | MAR | 0.2042 | 0.2042 | YES | NO | NO |
| 02476789 | PERINDOPRIL ERBUMINE | Mint-Perindopril 8mg Tab | MIN | 0.2831 | 0.2831 | YES | NO | NO |
| 02476762 | PERINDOPRIL ERBUMINE | Mint-Perindopril 2mg Tab | MIN | 0.1632 | 0.1632 | YES | NO | NO |
| 02476770 | PERINDOPRIL ERBUMINE | Mint-Perindopril 4mg Tab | MIN | 0.2042 | 0.2042 | YES | NO | NO |
| 02489023 | PERINDOPRIL ERBUMINE | NRA-Perindopril 4mg Tab | NRA | 0.2042 | 0.2042 | YES | NO | NO |
| 02489031 | PERINDOPRIL ERBUMINE | NRA-Perindopril 8mg Tab | NRA | 0.2831 | 0.2831 | YES | NO | NO |
| 02489015 | PERINDOPRIL ERBUMINE | NRA-Perindopril 2mg Tab | NRA | 0.1632 | 0.1632 | YES | NO | NO |
| 02470675 | PERINDOPRIL ERBUMINE | PMS-Perindopril 2mg Tab | PMS | 0.1632 | 0.1632 | YES | NO | NO |
| 02470691 | PERINDOPRIL ERBUMINE | PMS-Perindopril 8mg Tab | PMS | 0.2831 | 0.2831 | YES | NO | NO |
| 02470683 | PERINDOPRIL ERBUMINE | PMS-Perindopril 4mg Tab | PMS | 0.2042 | 0.2042 | YES | NO | NO |
| 02481650 | PERINDOPRIL ERBUMINE | Perindopril Erbumine 8mg Tab | SAI | 0.2831 | 0.2831 | YES | NO | NO |
| 02479877 | PERINDOPRIL ERBUMINE | Perindopril Erbumine 2mg Tab | SIV | 0.1632 | 0.1632 | YES | NO | NO |
| 02481634 | PERINDOPRIL ERBUMINE | Perindopril Erbumine 2mg Tab | SAI | 0.1632 | 0.1632 | YES | NO | NO |
| 02479885 | PERINDOPRIL ERBUMINE | Perindopril Erbumine 4mg Tab | SIV | 0.2042 | 0.2042 | YES | NO | NO |
| 02481642 | PERINDOPRIL ERBUMINE | Perindopril Erbumine 4mg Tab | SAI | 0.2042 | 0.2042 | YES | NO | NO |
| 02479893 | PERINDOPRIL ERBUMINE | Perindopril Erbumine 8mg Tab | SIV | 0.2831 | 0.2831 | YES | NO | NO |
| 02470233 | PERINDOPRIL ERBUMINE | Sandoz Perindopril Erbumine 4mg Tab | SDZ | 0.2042 | 0.2042 | YES | NO | NO |
| 02470225 | PERINDOPRIL ERBUMINE | Sandoz Perindopril Erbumine 2mg Tab | SDZ | 0.1632 | 0.1632 | YES | NO | NO |
| 02470241 | PERINDOPRIL ERBUMINE | Sandoz Perindopril Erbumine 8mg Tab | SDZ | 0.2831 | 0.2831 | YES | NO | NO |
| 02464985 | PERINDOPRIL ERBUMINE | Teva-Perindopril 2mg Tab | TEV | 0.1632 | 0.1632 | YES | NO | NO |
| 02465000 | PERINDOPRIL ERBUMINE | Teva-Perindopril 8mg Tab | TEV | 0.2831 | 0.2831 | YES | NO | NO |
| 02464993 | PERINDOPRIL ERBUMINE | Teva-Perindopril 4mg Tab | TEV | 0.2042 | 0.2042 | YES | NO | NO |
| 02297574 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Apo-Perindopril-Indapamide 4mg & 1.25mg Tab | APX | 0.2556 | 0.2556 | YES | NO | NO |
| 02453061 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Apo-Perindopril-Indapamide 8mg & 2.5mg Tab | APX | 0.2859 | 0.2859 | YES | NO | NO |
| 02246569 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Coversyl Plus 4mg & 1.25mg Tab | SEV | 1.2080 | 0.2556 | YES | NO | NO |
| 02321653 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Coversyl Plus HD 8mg & 2.5mg Tab | SEV | 1.3660 | 0.2859 | YES | NO | NO |
| 02246568 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Coversyl Plus LD 2mg & 0.625mg Tab | SEV | 1.0160 | 0.4227 | YES | NO | NO |
| 02538008 | PERINDOPRIL ERBUMINE & INDAPAMIDE | PMS-Perindopril-Indapamide 4mg & 1.25mg Tab | PMS | 0.2556 | 0.2556 | YES | NO | NO |
| 02537990 | PERINDOPRIL ERBUMINE & INDAPAMIDE | PMS-Perindopril-Indapamide 2mg & 0.625mg Tab | PMS | 0.4227 | 0.4227 | YES | NO | NO |
| 02537982 | PERINDOPRIL ERBUMINE & INDAPAMIDE | PMS-Perindopril-Indapamide 8mg & 2.5mg Tab | PMS | 0.2859 | 0.2859 | YES | NO | NO |
| 02479834 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Perindopril Erbumine/Indapamide 4mg & 1.25mg Tab | SIV | 0.2556 | 0.2556 | YES | NO | NO |
| 02479842 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Perindopril Erbumine/Indapamide HD 8mg & 2.5mg Tab | SIV | 0.2859 | 0.2859 | YES | NO | NO |
| 02519739 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Perindopril/Indapamide 8mg & 2.5mg Tab | SAI | 0.2859 | 0.2859 | YES | NO | NO |
| 02519720 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Perindopril/Indapamide 4mg & 1.25mg Tab | SAI | 0.2556 | 0.2556 | YES | NO | NO |
| 02470438 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Sandoz Perindopril Erbumine/Indapamide 4mg & 1.25mg Tab | SDZ | 0.2556 | 0.2556 | YES | NO | NO |
| 02470446 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Sandoz Perindopril Erbumine/IndapamideHD 8mg & 2.5mg Tab | SDZ | 0.2859 | 0.2859 | YES | NO | NO |
| 02470411 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Sandoz Perindopril Erbumine/IndapamideLD 2mg & 0.625mg Tab | SDZ | 0.4227 | 0.4227 | YES | NO | NO |
| 02464039 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Teva-Perindopril/Indapamide 8mg & 2.5mg Tab | TEV | 0.2859 | 0.2859 | YES | NO | NO |
| 02464020 | PERINDOPRIL ERBUMINE & INDAPAMIDE | Teva-Perindopril/Indapamide 4mg & 1.25mg Tab | TEV | 0.2556 | 0.2556 | YES | NO | NO |
| 02219905 | PERMETHRIN | Nix Dermal Cream 5% Cr | HLN | 0.4977 | 0.4977 | NO | NO | NO |
| 02231480 | PERMETHRIN | Kwellada-P Creme Rinse 1% Cr Rinse | MEP | 0.1749 | 0.1749 | NO | NO | NO |
| 00771368 | PERMETHRIN | Nix Creme Rinse 1% Cr Rinse | IPL | 0.1701 | 0.1701 | NO | NO | NO |
| 02231348 | PERMETHRIN | Kwellada-P Lotion 5% Lot | MEP | 0.5053 | 0.5053 | NO | NO | NO |
| 00335126 | PERPHENAZINE | Perphenazine 4mg Tab | AAP | 0.0808 | 0.0808 | YES | NO | NO |
| 00335118 | PERPHENAZINE | Perphenazine 8mg Tab | AAP | 0.0888 | 0.0888 | YES | NO | NO |
| 00335134 | PERPHENAZINE | Perphenazine 2mg Tab | AAP | 0.0668 | 0.0668 | YES | NO | NO |
| 00335096 | PERPHENAZINE | Perphenazine 16mg Tab | AAP | 0.1359 | 0.1359 | YES | NO | NO |
| 00028290 | PERPHENAZINE | Trilafon (Not a Benefit) 2mg Tab | SCH | N/A | N/A | YES | NO | NO |
| 00028312 | PERPHENAZINE | Trilafon (Not a Benefit) 8mg Tab | SCH | N/A | N/A | YES | NO | NO |
| 00028304 | PERPHENAZINE | Trilafon (Not a Benefit) 4mg Tab | SCH | N/A | N/A | YES | NO | NO |
| 00028320 | PERPHENAZINE | Trilafon (Not a Benefit) 16mg Tab | SCH | N/A | N/A | YES | NO | NO |
| 00210889 | PETROLATUM/MINERAL OIL | Lacri-Lube 55% & 42.5% Oph Oint-3.5g Pk | ALL | 7.9000 | 7.9000 | NO | YES | NO |
| 02125706 | PETROLATUM/MINERAL OIL | Soothe Night Time 80%/20% Oph Oint-3.5g Pk | BLI | 5.4800 | 5.4800 | NO | YES | NO |
| 00476552 | PHENELZINE SULFATE | Nardil 15mg Tab | SLP | 0.4905 | 0.4905 | NO | NO | YES |
| 02304090 | PHENOBARBITAL | Phenobarbital Injection 120mg/mL Inj Sol-1mL Pk | SDZ | 15.7000 | 15.7000 | NO | YES | NO |
| 00645575 | PHENOBARBITAL | Phenobarb Elixir 5mg/mL Oral Elixir | PEN | 0.1535 | 0.1535 | NO | NO | NO |
| 00178810 | PHENOBARBITAL | Phenobarb 60mg Tab | PEN | 0.2433 | 0.2433 | NO | NO | NO |
| 00178829 | PHENOBARBITAL | Phenobarb 100mg Tab | PEN | 0.3329 | 0.3329 | NO | NO | NO |
| 00178802 | PHENOBARBITAL | Phenobarb 30mg Tab | PEN | 0.1795 | 0.1795 | NO | NO | NO |
| 00178799 | PHENOBARBITAL | Phenobarb 15mg Tab | PEN | 0.1508 | 0.1508 | NO | NO | NO |
| 00023450 | PHENYTOIN (DIPHENYLHYDANTOIN) | Dilantin-125 Suspension 25mg/mL O/L | UJC | 0.0697 | 0.0444 | YES | NO | NO |
| 00023442 | PHENYTOIN (DIPHENYLHYDANTOIN) | Dilantin-30 Suspension 6mg/mL O/L | UJC | 0.0588 | 0.0588 | NO | NO | NO |
| 02250896 | PHENYTOIN (DIPHENYLHYDANTOIN) | Taro-Phenytoin 25mg/mL O/L | TAR | 0.0444 | 0.0444 | YES | NO | NO |
| 00023698 | PHENYTOIN (DIPHENYLHYDANTOIN) | Dilantin Infatabs 50mg Tab | UJC | 0.1069 | 0.1069 | NO | NO | NO |
| 00022780 | PHENYTOIN (DIPHENYLHYDANTOIN) SODIUM | Dilantin 100mg Cap | UJC | 0.1083 | 0.0665 | YES | NO | NO |
| 00022772 | PHENYTOIN (DIPHENYLHYDANTOIN) SODIUM | Dilantin 30mg Cap | UJC | 0.1782 | 0.1782 | NO | NO | NO |
| 02460912 | PHENYTOIN (DIPHENYLHYDANTOIN) SODIUM | Phenytoin Sodium 100mg Cap | AAP | 0.0665 | 0.0665 | YES | NO | NO |
| 00780626 | PHENYTOIN (DIPHENYLHYDANTOIN) SODIUM | Phenytoin Sodium Injection USP 50mg/mL Inj Sol (Preservative Free) | SDZ | 6.0785 | 6.0785 | NO | YES | NO |
| 00781878 | PHYTONADIONE | Vitamin K1 Inj 1mg/0.5mL USP 1mg/0.5mL Inj-0.5mL Amp Pk (Preservative Free) | SDZ | 5.2950 | 5.2950 | NO | NO | NO |
| 00804312 | PHYTONADIONE | Vitamin K1 Inj 10mg/mL USP 10mg/mL Inj-1mL Amp Pk (Preservative Free) | SDZ | 6.0000 | 6.0000 | NO | NO | NO |
| 00000868 | PILOCARPINE HCL | Isopto Carpine 2% Oph Sol | NOV | 0.3320 | 0.3320 | YES | NO | NO |
| 00000884 | PILOCARPINE HCL | Isopto Carpine 4% Oph Sol | NOV | 0.3360 | 0.3360 | NO | NO | NO |
| 02023741 | PILOCARPINE HCL | Pilocarpine (Not a Benefit) 2% Oph Sol | PHS | N/A | N/A | YES | NO | NO |
| 02509571 | PILOCARPINE HCL | Jamp Pilocarpine (Off-Formulary Interchangeable) 5mg Tab | JPC | 1.1708 | 1.1708 | YES | NO | NO |
| 02496119 | PILOCARPINE HCL | M-Pilocarpine (Off-Formulary Interchangeable) 5mg Tab | MAT | 1.1708 | 1.1708 | YES | NO | NO |
| 02216345 | PILOCARPINE HCL | Salagen (Off-Formulary Interchangeable) 5mg Tab | AMD | N/A | N/A | YES | NO | NO |
| 02247238 | PIMECROLIMUS | Elidel 1% Cr | VAL | 2.9720 | 2.9720 | NO | YES | NO |
| 00313823 | PIMOZIDE | Orap 4mg Tab | AAP | 0.4136 | 0.4136 | YES | NO | NO |
| 00313815 | PIMOZIDE | Orap 2mg Tab | AAP | 0.2279 | 0.2279 | YES | NO | NO |
| 02245433 | PIMOZIDE | Pimozide 4mg Tab | AAP | 0.4136 | 0.4136 | YES | NO | NO |
| 02245432 | PIMOZIDE | Pimozide 2mg Tab | AAP | 0.3093 | 0.2279 | YES | NO | NO |
| 02230684 | PINAVERIUM BROMIDE | Dicetel (Off-Formulary Interchangeable) 100mg Tab | BGP | N/A | N/A | YES | NO | NO |
| 01950592 | PINAVERIUM BROMIDE | Dicetel (Off-Formulary Interchangeable) 50mg Tab | BGP | N/A | N/A | YES | NO | NO |
| 02469685 | PINAVERIUM BROMIDE | Pinaverium (Off-Formulary Interchangeable) 100mg Tab | AAP | 0.5405 | 0.5405 | YES | NO | NO |
| 02469677 | PINAVERIUM BROMIDE | Pinaverium (Off-Formulary Interchangeable) 50mg Tab | AAP | 0.3100 | 0.3100 | YES | NO | NO |
| 00869023 | PINDOLOL | Teva-Pindolol 15mg Tab | TEV | 0.9783 | 0.9783 | YES | NO | NO |
| 00869015 | PINDOLOL | Teva-Pindolol 10mg Tab | TEV | 0.6947 | 0.6947 | YES | NO | NO |
| 00869007 | PINDOLOL | Teva-Pindolol 5mg Tab | TEV | 0.4068 | 0.4068 | YES | NO | NO |
| 00417270 | PINDOLOL | Visken 5mg Tab | ARZ | 0.8502 | 0.4068 | YES | NO | NO |
| 00417289 | PINDOLOL | Visken (Not a Benefit) 15mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 00443174 | PINDOLOL | Visken 10mg Tab | ARZ | 1.4517 | 0.6947 | YES | NO | NO |
| 00568635 | PINDOLOL & HYDROCHLOROTHIAZIDE | Viskazide 10mg & 50mg Tab | ARZ | 1.3398 | 1.3398 | NO | NO | NO |
| 00568627 | PINDOLOL & HYDROCHLOROTHIAZIDE | Viskazide 10mg & 25mg Tab | ARZ | 1.3398 | 1.3398 | NO | NO | NO |
| 02303469 | PIOGLITAZONE HCL | Accel Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | ACC | 2.9500 | 2.9500 | YES | NO | NO |
| 02303442 | PIOGLITAZONE HCL | Accel Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | ACC | 1.3800 | 1.3800 | YES | NO | NO |
| 02303450 | PIOGLITAZONE HCL | Accel Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | ACC | 1.9600 | 1.9600 | YES | NO | NO |
| 02302896 | PIOGLITAZONE HCL | Act Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | TEV | 3.3105 | 3.3105 | YES | NO | NO |
| 02302888 | PIOGLITAZONE HCL | Act Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | TEV | 2.2017 | 2.2017 | YES | NO | NO |
| 02302861 | PIOGLITAZONE HCL | Act Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | TEV | 1.5716 | 1.5716 | YES | NO | NO |
| 02242574 | PIOGLITAZONE HCL | Actos (Off-Formulary Interchangeable) 45mg Tab | TAK | 5.2710 | 5.2710 | YES | NO | NO |
| 02242572 | PIOGLITAZONE HCL | Actos (Off-Formulary Interchangeable) 15mg Tab | TAK | 2.5070 | 1.5716 | YES | NO | NO |
| 02242573 | PIOGLITAZONE HCL | Actos (Off-Formulary Interchangeable) 30mg Tab | TAK | 3.5124 | 2.2017 | YES | NO | NO |
| 02302942 | PIOGLITAZONE HCL | Apo-Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | APX | 1.5716 | 1.5716 | YES | NO | NO |
| 02302977 | PIOGLITAZONE HCL | Apo-Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | APX | 3.3105 | 3.3105 | YES | NO | NO |
| 02302950 | PIOGLITAZONE HCL | Apo-Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | APX | 2.2017 | 2.2017 | YES | NO | NO |
| 02384922 | PIOGLITAZONE HCL | Auro-Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | AUR | 3.3105 | 3.3105 | YES | NO | NO |
| 02384914 | PIOGLITAZONE HCL | Auro-Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | AUR | 2.2017 | 2.2017 | YES | NO | NO |
| 02384906 | PIOGLITAZONE HCL | Auro-Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | AUR | 1.5716 | 1.5716 | YES | NO | NO |
| 02365529 | PIOGLITAZONE HCL | Jamp-Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | JPC | 2.2017 | 2.2017 | YES | NO | NO |
| 02365537 | PIOGLITAZONE HCL | Jamp-Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | JPC | 3.3105 | 3.3105 | YES | NO | NO |
| 02397307 | PIOGLITAZONE HCL | Jamp-Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | JPC | 1.5716 | 1.5716 | YES | NO | NO |
| 02326477 | PIOGLITAZONE HCL | Mint-Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | MIN | 1.5716 | 1.5716 | YES | NO | NO |
| 02326493 | PIOGLITAZONE HCL | Mint-Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | MIN | 3.3105 | 3.3105 | YES | NO | NO |
| 02326485 | PIOGLITAZONE HCL | Mint-Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | MIN | 2.2017 | 2.2017 | YES | NO | NO |
| 02391600 | PIOGLITAZONE HCL | Pioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 15mg Tab | ACH | 1.5716 | 1.5716 | YES | NO | NO |
| 02339587 | PIOGLITAZONE HCL | Pioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 30mg Tab | ACH | 2.2017 | 2.2017 | YES | NO | NO |
| 02339595 | PIOGLITAZONE HCL | Pioglitazone Hydrochloride Tablets (Off-Formulary Interchangeable) 45mg Tab | ACH | 3.3105 | 3.3105 | YES | NO | NO |
| 02297914 | PIOGLITAZONE HCL | Sandoz Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | SDZ | 2.2017 | 2.2017 | YES | NO | NO |
| 02297922 | PIOGLITAZONE HCL | Sandoz Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | SDZ | 3.3105 | 3.3105 | YES | NO | NO |
| 02297906 | PIOGLITAZONE HCL | Sandoz Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | SDZ | 1.5716 | 1.5716 | YES | NO | NO |
| 02274930 | PIOGLITAZONE HCL | Teva-Pioglitazone (Off-Formulary Interchangeable) 45mg Tab | TEV | 3.3105 | 3.3105 | YES | NO | NO |
| 02274914 | PIOGLITAZONE HCL | Teva-Pioglitazone (Off-Formulary Interchangeable) 15mg Tab | TEV | 1.5716 | 1.5716 | YES | NO | NO |
| 02274922 | PIOGLITAZONE HCL | Teva-Pioglitazone (Off-Formulary Interchangeable) 30mg Tab | TEV | 2.2017 | 2.2017 | YES | NO | NO |
| 02402068 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam For Injection (Off-Formulary Interchangeable) 2g & 250mg Inj Pd-2.25g Vial Pk | AUR | 10.1300 | 10.1300 | YES | NO | NO |
| 02308444 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 2g & 250mg Inj Pd-2.25g Vial Pk | APX | 10.1300 | 10.1300 | YES | NO | NO |
| 02362619 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 2g & 250mg Inj Pd-2.25g Vial Pk | STE | 10.1300 | 10.1300 | YES | NO | NO |
| 02401312 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin and Tazobactam for Inj (Off-Formulary Interchangeable) 2g & 250mg Inj Pd-2.25g Vial Pk | TEL | 10.1300 | 10.1300 | YES | NO | NO |
| 02170817 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Tazocin (Off-Formulary Interchangeable) 2g & 250mg Inj Pd-2.25g Vial Pk | PFI | N/A | N/A | YES | NO | NO |
| 02402076 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam For Injection (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial Pk | AUR | 15.2000 | 15.2000 | YES | NO | NO |
| 02391538 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial Pk | MYL | 15.2000 | 15.2000 | YES | NO | NO |
| 02362627 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial Pk | STE | 15.2000 | 15.2000 | YES | NO | NO |
| 02308452 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial Pk | APX | 15.2000 | 15.2000 | YES | NO | NO |
| 02401320 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin and Tazobactam for Inj (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial Pk | TEL | 15.2000 | 15.2000 | YES | NO | NO |
| 02370166 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin/Tazobactam powder for Inj. (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial Pk | TEV | 15.2000 | 15.2000 | YES | NO | NO |
| 02170795 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Tazocin (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial Pk | WYE | N/A | N/A | YES | NO | NO |
| 02402084 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam For Injection (Off-Formulary Interchangeable) 4g & 500mg Inj Pd-4.5g Vial Pk | AUR | 20.2700 | 20.2700 | YES | NO | NO |
| 02308460 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 4g & 500mg Inj Pd-4.5g Vial Pk | APX | 20.2700 | 20.2700 | YES | NO | NO |
| 02362635 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 4g & 500mg Inj Pd-4.5g Vial Pk | STE | 20.2700 | 20.2700 | YES | NO | NO |
| 02401339 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin and Tazobactam for Inj (Off-Formulary Interchangeable) 4g & 500mg Inj Pd-4.5g Vial Pk | TEL | 20.2700 | 20.2700 | YES | NO | NO |
| 02370174 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Piperacillin/Tazobactam powder for Inj. (Off-Formulary Interchangeable) 4g & 500mg Inj Pd-4.5g Vial Pk | TEV | 20.2700 | 20.2700 | YES | NO | NO |
| 02170809 | PIPERACILLIN SODIUM & TAZOBACTAM SODIUM | Tazocin (Off-Formulary Interchangeable) 4g & 500mg Inj Pd-4.5g Vial Pk | WYE | N/A | N/A | YES | NO | NO |
| 02393751 | PIRFENIDONE | Esbriet (Off-Formulary Interchangeable) 267mg Cap | INT | N/A | N/A | YES | NO | NO |
| 02509938 | PIRFENIDONE | Jamp Pirfenidone (Off-Formulary Interchangeable) 267mg Cap | JPC | 6.7120 | 6.7120 | YES | NO | NO |
| 02488833 | PIRFENIDONE | Sandoz Pirfenidone Capsules (Off-Formulary Interchangeable) 267mg Cap | SDZ | 6.7120 | 6.7120 | YES | NO | NO |
| 02537761 | PIRFENIDONE | Auro-Pirfenidone (Off-Formulary Interchangeable) 801mg Tab | AUR | 20.1361 | 20.1361 | YES | NO | NO |
| 02537753 | PIRFENIDONE | Auro-Pirfenidone (Off-Formulary Interchangeable) 267mg Tab | AUR | 6.7119 | 6.7119 | YES | NO | NO |
| 02464489 | PIRFENIDONE | Esbriet (Off-Formulary Interchangeable) 267mg Tab | HLR | 13.4240 | 6.7120 | YES | NO | NO |
| 02464500 | PIRFENIDONE | Esbriet (Off-Formulary Interchangeable) 801mg Tab | HLR | 40.2720 | 20.1361 | YES | NO | NO |
| 02514702 | PIRFENIDONE | Jamp Pirfenidone (Off-Formulary Interchangeable) 267mg Tab | JPC | 6.7120 | 6.7120 | YES | NO | NO |
| 02514710 | PIRFENIDONE | Jamp Pirfenidone (Off-Formulary Interchangeable) 801mg Tab | JPC | 20.1360 | 20.1360 | YES | NO | NO |
| 02550644 | PIRFENIDONE | M-Pirfenidone (Off-Formulary Interchangeable) 267mg Tab | MAT | 6.7120 | 6.7120 | YES | NO | NO |
| 02550652 | PIRFENIDONE | M-Pirfenidone (Off-Formulary Interchangeable) 801mg Tab | MAT | 20.1360 | 20.1360 | YES | NO | NO |
| 02531534 | PIRFENIDONE | PMS-Pirfenidone (Off-Formulary Interchangeable) 801mg Tab | PMS | 20.1360 | 20.1360 | YES | NO | NO |
| 02531526 | PIRFENIDONE | PMS-Pirfenidone (Off-Formulary Interchangeable) 267mg Tab | PMS | 6.7120 | 6.7120 | YES | NO | NO |
| 02488507 | PIRFENIDONE | Sandoz Pirfenidone Tablets (Off-Formulary Interchangeable) 267mg Tab | SDZ | 6.7120 | 6.7120 | YES | NO | NO |
| 02488515 | PIRFENIDONE | Sandoz Pirfenidone Tablets (Off-Formulary Interchangeable) 801mg Tab | SDZ | 20.1360 | 20.1360 | YES | NO | NO |
| 00642886 | PIROXICAM | Apo-Piroxicam 10mg Cap | APX | 0.4426 | 0.4426 | YES | NO | YES |
| 00642894 | PIROXICAM | Apo-Piroxicam 20mg Cap | APX | 0.7422 | 0.7422 | YES | NO | YES |
| 00525618 | PIROXICAM | Feldene (Not a Benefit) 20mg Cap | PFI | N/A | N/A | YES | NO | YES |
| 00525596 | PIROXICAM | Feldene (Not a Benefit) 10mg Cap | PFI | N/A | N/A | YES | NO | YES |
| 00695718 | PIROXICAM | Teva-Piroxicam 10mg Cap | TEV | 0.4426 | 0.4426 | YES | NO | YES |
| 00695696 | PIROXICAM | Teva-Piroxicam 20mg Cap | TEV | 0.7422 | 0.7422 | YES | NO | YES |
| 00511552 | PIZOTYLINE | Sandomigran DS 1mg Tab | PPI | 1.1698 | 1.1698 | NO | NO | NO |
| 02239157 | POLYMYXIN B SULFATE & BACITRACIN (ZINC) | Polysporin 10000U & 500U/g Oph Oint 3.5g Pk | PFI | 5.5400 | 5.5400 | NO | NO | NO |
| 02239156 | POLYMYXIN B SULFATE & GRAMICIDIN | Polysporin Eye and Ear Drops Sterile 10000U & 0.025mg/mL Oph/Ot Sol | JAJ | 0.9139 | 0.9139 | NO | NO | NO |
| 02473968 | POLYSTYRENE SODIUM SULFONATE | Odan-Sodium Polystyrene Sulfonate (Off-Formulary Interchangeable) 250mg/mL O/L | ODN | 0.1954 | 0.1954 | YES | NO | NO |
| 00769541 | POLYSTYRENE SODIUM SULFONATE | Solystat (Off-Formulary Interchangeable) 250mg/mL O/L | PEN | N/A | N/A | YES | NO | NO |
| 02497557 | POLYSTYRENE SODIUM SULFONATE | Jamp Sodium Polystyrene Sulfonate 1mEq/g Oral Pd-454g Pk | JPC | 29.4175 | 29.4175 | YES | NO | NO |
| 02026961 | POLYSTYRENE SODIUM SULFONATE | Kayexalate 1mEq/g Oral Pd-454g Pk | SAV | 43.6300 | 29.4175 | YES | NO | NO |
| 02473941 | POLYSTYRENE SODIUM SULFONATE | Odan-Sodium Polystyrene Sulfonate 1mEq/g Oral Pd-454g Pk | ODN | 29.4175 | 29.4175 | YES | NO | NO |
| 00755338 | POLYSTYRENE SODIUM SULFONATE | Solystat 1mEq/g Oral Pd-454g Pk | PEN | 29.4175 | 29.4175 | YES | NO | NO |
| 00045616 | POLYVINYL ALCOHOL | Liquifilm Tears 1.4% Oph-Sol | ALL | 0.6373 | 0.6373 | NO | YES | NO |
| 00579408 | POLYVINYL ALCOHOL & POLYVINYLPYRROLIDONE | Tears Plus Oph-Sol | ALL | 0.3840 | 0.3840 | NO | YES | NO |
| 02520443 | POMALIDOMIDE | Apo-Pomalidomide (Off-Formulary Interchangeable) 3mg Cap | APX | 425.0000 | 425.0000 | YES | NO | NO |
| 02520427 | POMALIDOMIDE | Apo-Pomalidomide (Off-Formulary Interchangeable) 1mg Cap | APX | 425.0000 | 425.0000 | YES | NO | NO |
| 02520435 | POMALIDOMIDE | Apo-Pomalidomide (Off-Formulary Interchangeable) 2mg Cap | APX | 425.0000 | 425.0000 | YES | NO | NO |
| 02520451 | POMALIDOMIDE | Apo-Pomalidomide (Off-Formulary Interchangeable) 4mg Cap | APX | 425.0000 | 425.0000 | YES | NO | NO |
| 02538091 | POMALIDOMIDE | Jamp Pomalidomide (Off-Formulary Interchangeable) 4mg Cap | JPC | 425.0000 | 425.0000 | YES | NO | NO |
| 02538059 | POMALIDOMIDE | Jamp Pomalidomide (Off-Formulary Interchangeable) 1mg Cap | JPC | 425.0000 | 425.0000 | YES | NO | NO |
| 02538075 | POMALIDOMIDE | Jamp Pomalidomide (Off-Formulary Interchangeable) 2mg Cap | JPC | 425.0000 | 425.0000 | YES | NO | NO |
| 02538083 | POMALIDOMIDE | Jamp Pomalidomide (Off-Formulary Interchangeable) 3mg Cap | JPC | 425.0000 | 425.0000 | YES | NO | NO |
| 02506394 | POMALIDOMIDE | Nat-Pomalidomide (Off-Formulary Interchangeable) 1mg Cap | NAT | 425.0000 | 425.0000 | YES | NO | NO |
| 02506424 | POMALIDOMIDE | Nat-Pomalidomide (Off-Formulary Interchangeable) 4mg Cap | NAT | 425.0000 | 425.0000 | YES | NO | NO |
| 02506416 | POMALIDOMIDE | Nat-Pomalidomide (Off-Formulary Interchangeable) 3mg Cap | NAT | 425.0000 | 425.0000 | YES | NO | NO |
| 02506408 | POMALIDOMIDE | Nat-Pomalidomide (Off-Formulary Interchangeable) 2mg Cap | NAT | 425.0000 | 425.0000 | YES | NO | NO |
| 02419580 | POMALIDOMIDE | Pomalyst (Off-Formulary Interchangeable) 1mg Cap | BQU | 500.0000 | 425.0000 | YES | NO | NO |
| 02419599 | POMALIDOMIDE | Pomalyst (Off-Formulary Interchangeable) 2mg Cap | BQU | 500.0000 | 425.0000 | YES | NO | NO |
| 02419602 | POMALIDOMIDE | Pomalyst (Off-Formulary Interchangeable) 3mg Cap | BQU | 500.0000 | 425.0000 | YES | NO | NO |
| 02419610 | POMALIDOMIDE | Pomalyst (Off-Formulary Interchangeable) 4mg Cap | BQU | 500.0000 | 425.0000 | YES | NO | NO |
| 02504073 | POMALIDOMIDE | Reddy-Pomalidomide (Off-Formulary Interchangeable) 1mg Cap | DRR | 425.0000 | 425.0000 | YES | NO | NO |
| 02504081 | POMALIDOMIDE | Reddy-Pomalidomide (Off-Formulary Interchangeable) 2mg Cap | DRR | 425.0000 | 425.0000 | YES | NO | NO |
| 02504103 | POMALIDOMIDE | Reddy-Pomalidomide (Off-Formulary Interchangeable) 3mg Cap | DRR | 425.0000 | 425.0000 | YES | NO | NO |
| 02504111 | POMALIDOMIDE | Reddy-Pomalidomide (Off-Formulary Interchangeable) 4mg Cap | DRR | 425.0000 | 425.0000 | YES | NO | NO |
| 02523973 | POMALIDOMIDE | Sandoz Pomalidomide (Off-Formulary Interchangeable) 1mg Cap | SDZ | 425.0000 | 425.0000 | YES | NO | NO |
| 02524015 | POMALIDOMIDE | Sandoz Pomalidomide (Off-Formulary Interchangeable) 4mg Cap | SDZ | 425.0000 | 425.0000 | YES | NO | NO |
| 02523981 | POMALIDOMIDE | Sandoz Pomalidomide (Off-Formulary Interchangeable) 2mg Cap | SDZ | 425.0000 | 425.0000 | YES | NO | NO |
| 02524007 | POMALIDOMIDE | Sandoz Pomalidomide (Off-Formulary Interchangeable) 3mg Cap | SDZ | 425.0000 | 425.0000 | YES | NO | NO |
| 02542021 | POSACONAZOLE | GLN-Posaconazole (Off-Formulary Interchangeable) 100mg DR Tab | GLP | 42.6030 | 42.6030 | YES | NO | NO |
| 02544644 | POSACONAZOLE | Mint-Posaconazole (Off-Formulary Interchangeable) 100mg DR Tab | MIN | 42.6030 | 42.6030 | YES | NO | NO |
| 02424622 | POSACONAZOLE | Posanol (Off-Formulary Interchangeable) 100mg DR Tab | MEK | 53.7642 | 42.6030 | YES | NO | NO |
| 02496259 | POSACONAZOLE | Sandoz Posaconazole (Off-Formulary Interchangeable) 100mg DR Tab | SDZ | 42.6030 | 42.6030 | YES | NO | NO |
| 02543311 | POSACONAZOLE | Taro-Posaconazole (Off-Formulary Interchangeable) 100mg DR Tab | TAR | 42.6030 | 42.6030 | YES | NO | NO |
| 02530333 | POSACONAZOLE | Jamp Posaconazole (Off-Formulary Interchangeable) 40mg/mL O/L | JPC | 8.2765 | 8.2765 | YES | NO | NO |
| 02293404 | POSACONAZOLE | Posanol (Off-Formulary Interchangeable) 40mg/mL O/L | SCP | 10.1801 | 8.2765 | YES | NO | NO |
| 00158348 | POVIDONE - IODINE | Betadine (Not a Benefit) 10% Top Sol | PFP | N/A | N/A | YES | NO | NO |
| 00172944 | POVIDONE - IODINE | Proviodine (Not a Benefit) 10% Top Sol | ROG | N/A | N/A | YES | NO | NO |
| 02297337 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Act Pramipexole 1.5mg Tab | TEV | 0.3901 | 0.3901 | YES | NO | NO |
| 02297310 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Act Pramipexole (Off-Formulary Interchangeable) 0.5mg Tab | TEV | 1.3860 | N/A | YES | NO | NO |
| 02297302 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Act Pramipexole 0.25mg Tab | TEV | 0.1950 | 0.1950 | YES | NO | NO |
| 02297329 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Act Pramipexole 1mg Tab | TEV | 0.3901 | 0.3901 | YES | NO | NO |
| 02292408 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Apo-Pramipexole 1.5mg Tab | APX | 0.3901 | 0.3901 | YES | NO | NO |
| 02292378 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Apo-Pramipexole 0.25mg Tab | APX | 0.1950 | 0.1950 | YES | NO | NO |
| 02292386 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Apo-Pramipexole (Off-Formulary Interchangeable) 0.5mg Tab | APX | 1.3860 | N/A | YES | NO | NO |
| 02292394 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Apo-Pramipexole 1mg Tab | APX | 0.3901 | 0.3901 | YES | NO | NO |
| 02424096 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Auro-Pramipexole 1mg Tab | AUR | 0.3901 | 0.3901 | YES | NO | NO |
| 02424118 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Auro-Pramipexole 1.5mg Tab | AUR | 0.3901 | 0.3901 | YES | NO | NO |
| 02424061 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Auro-Pramipexole 0.25mg Tab | AUR | 0.1950 | 0.1950 | YES | NO | NO |
| 02424088 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Auro-Pramipexole (Off-Formulary Interchangeable) 0.5mg Tab | AUR | 1.3860 | N/A | YES | NO | NO |
| 02237145 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Mirapex 0.25mg Tab | BOE | 1.2915 | 0.1950 | YES | NO | NO |
| 02241594 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Mirapex (Off-Formulary Interchangeable) 0.5mg Tab | BOE | N/A | N/A | YES | NO | NO |
| 09857269 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Mirapex (Not a Benefit) 1mg Tab | BOE | N/A | N/A | YES | NO | NO |
| 09857270 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Mirapex (Not a Benefit) 1.5mg Tab | BOE | N/A | N/A | YES | NO | NO |
| 02309122 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole 0.25mg Tab | SIV | 0.1950 | 0.1950 | YES | NO | NO |
| 02367610 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole (Off-Formulary Interchangeable) 0.5mg Tab | SAI | 1.3860 | N/A | YES | NO | NO |
| 02309157 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole 1.5mg Tab | SIV | 0.3901 | 0.3901 | YES | NO | NO |
| 02367629 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole 1mg Tab | SAI | 0.3901 | 0.3901 | YES | NO | NO |
| 02309149 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole 1mg Tab | SIV | 0.3901 | 0.3901 | YES | NO | NO |
| 02367602 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole 0.25mg Tab | SAI | 0.1950 | 0.1950 | YES | NO | NO |
| 02309130 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole (Off-Formulary Interchangeable) 0.5mg Tab | SIV | 1.3860 | N/A | YES | NO | NO |
| 02367645 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Pramipexole 1.5mg Tab | SAI | 0.3901 | 0.3901 | YES | NO | NO |
| 02315270 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Sandoz Pramipexole (Off-Formulary Interchangeable) 0.5mg Tab | SDZ | 1.3860 | N/A | YES | NO | NO |
| 02315297 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Sandoz Pramipexole 1.5mg Tab | SDZ | 0.3901 | 0.3901 | YES | NO | NO |
| 02315289 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Sandoz Pramipexole 1mg Tab | SDZ | 0.3901 | 0.3901 | YES | NO | NO |
| 02315262 | PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE | Sandoz Pramipexole 0.25mg Tab | SDZ | 0.1950 | 0.1950 | YES | NO | NO |
| 02476150 | PRAVASTATIN SODIUM | AG-Pravastatin 20mg Tab | ANG | 0.3440 | 0.3440 | YES | NO | NO |
| 02476169 | PRAVASTATIN SODIUM | AG-Pravastatin 40mg Tab | ANG | 0.4143 | 0.4143 | YES | NO | NO |
| 02476142 | PRAVASTATIN SODIUM | AG-Pravastatin 10mg Tab | ANG | 0.2916 | 0.2916 | YES | NO | NO |
| 02440652 | PRAVASTATIN SODIUM | Ach-Pravastatin 20mg Tab | ACH | 0.3440 | 0.3440 | YES | NO | NO |
| 02440644 | PRAVASTATIN SODIUM | Ach-Pravastatin 10mg Tab | ACH | 0.2916 | 0.2916 | YES | NO | NO |
| 02440660 | PRAVASTATIN SODIUM | Ach-Pravastatin 40mg Tab | ACH | 0.4143 | 0.4143 | YES | NO | NO |
| 02243506 | PRAVASTATIN SODIUM | Apo-Pravastatin 10mg Tab | APX | 0.2916 | 0.2916 | YES | NO | NO |
| 02243508 | PRAVASTATIN SODIUM | Apo-Pravastatin 40mg Tab | APX | 0.4143 | 0.4143 | YES | NO | NO |
| 02243507 | PRAVASTATIN SODIUM | Apo-Pravastatin 20mg Tab | APX | 0.3440 | 0.3440 | YES | NO | NO |
| 02458985 | PRAVASTATIN SODIUM | Auro-Pravastatin 20mg Tab | AUR | 0.3440 | 0.3440 | YES | NO | NO |
| 02458977 | PRAVASTATIN SODIUM | Auro-Pravastatin 10mg Tab | AUR | 0.2916 | 0.2916 | YES | NO | NO |
| 02458993 | PRAVASTATIN SODIUM | Auro-Pravastatin 40mg Tab | AUR | 0.4143 | 0.4143 | YES | NO | NO |
| 02248182 | PRAVASTATIN SODIUM | Co Pravastatin 10mg Tab | COB | 0.2916 | 0.2916 | YES | NO | NO |
| 02248184 | PRAVASTATIN SODIUM | Co Pravastatin 40mg Tab | COB | 0.4143 | 0.4143 | YES | NO | NO |
| 02248183 | PRAVASTATIN SODIUM | Co Pravastatin 20mg Tab | COB | 0.3440 | 0.3440 | YES | NO | NO |
| 02330962 | PRAVASTATIN SODIUM | Jamp-Pravastatin 20mg Tab | JPC | 0.3440 | 0.3440 | YES | NO | NO |
| 02330970 | PRAVASTATIN SODIUM | Jamp-Pravastatin 40mg Tab | JPC | 0.4143 | 0.4143 | YES | NO | NO |
| 02330954 | PRAVASTATIN SODIUM | Jamp-Pravastatin 10mg Tab | JPC | 0.2916 | 0.2916 | YES | NO | NO |
| 02476282 | PRAVASTATIN SODIUM | M-Pravastatin 20mg Tab | MAT | 0.3440 | 0.3440 | YES | NO | NO |
| 02476274 | PRAVASTATIN SODIUM | M-Pravastatin 10mg Tab | MAT | 0.2916 | 0.2916 | YES | NO | NO |
| 02476290 | PRAVASTATIN SODIUM | M-Pravastatin 40mg Tab | MAT | 0.4143 | 0.4143 | YES | NO | NO |
| 02432064 | PRAVASTATIN SODIUM | Mar-Pravastatin 40mg Tab | MAR | 0.4143 | 0.4143 | YES | NO | NO |
| 02432056 | PRAVASTATIN SODIUM | Mar-Pravastatin 20mg Tab | MAR | 0.3440 | 0.3440 | YES | NO | NO |
| 02432048 | PRAVASTATIN SODIUM | Mar-Pravastatin 10mg Tab | MAR | 0.2916 | 0.2916 | YES | NO | NO |
| 02317486 | PRAVASTATIN SODIUM | Mint-Pravastatin 40mg Tab | MIN | 0.4143 | 0.4143 | YES | NO | NO |
| 02317478 | PRAVASTATIN SODIUM | Mint-Pravastatin 20mg Tab | MIN | 0.3440 | 0.3440 | YES | NO | NO |
| 02317451 | PRAVASTATIN SODIUM | Mint-Pravastatin 10mg Tab | MIN | 0.2916 | 0.2916 | YES | NO | NO |
| 02247657 | PRAVASTATIN SODIUM | PMS-Pravastatin 40mg Tab | PMS | 0.4143 | 0.4143 | YES | NO | NO |
| 02247655 | PRAVASTATIN SODIUM | PMS-Pravastatin 10mg Tab | PMS | 0.2916 | 0.2916 | YES | NO | NO |
| 02247656 | PRAVASTATIN SODIUM | PMS-Pravastatin 20mg Tab | PMS | 0.3440 | 0.3440 | YES | NO | NO |
| 02222051 | PRAVASTATIN SODIUM | Pravachol (Not a Benefit) 40mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00893757 | PRAVASTATIN SODIUM | Pravachol (Not a Benefit) 20mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00893749 | PRAVASTATIN SODIUM | Pravachol (Not a Benefit) 10mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02356554 | PRAVASTATIN SODIUM | Pravastatin 20mg Tab | SAI | 0.3440 | 0.3440 | YES | NO | NO |
| 02356562 | PRAVASTATIN SODIUM | Pravastatin 40mg Tab | SAI | 0.4143 | 0.4143 | YES | NO | NO |
| 02356546 | PRAVASTATIN SODIUM | Pravastatin 10mg Tab | SAI | 0.2916 | 0.2916 | YES | NO | NO |
| 02389746 | PRAVASTATIN SODIUM | Pravastatin 40mg Tab | SIV | 0.4143 | 0.4143 | YES | NO | NO |
| 02389738 | PRAVASTATIN SODIUM | Pravastatin 20mg Tab | SIV | 0.3440 | 0.3440 | YES | NO | NO |
| 02389703 | PRAVASTATIN SODIUM | Pravastatin 10mg Tab | SIV | 0.2916 | 0.2916 | YES | NO | NO |
| 02284421 | PRAVASTATIN SODIUM | Ran-Pravastatin 10mg Tab | RAN | 0.2916 | 0.2916 | YES | NO | NO |
| 02284448 | PRAVASTATIN SODIUM | Ran-Pravastatin 20mg Tab | RAN | 0.3440 | 0.3440 | YES | NO | NO |
| 02284456 | PRAVASTATIN SODIUM | Ran-Pravastatin 40mg Tab | RAN | 0.4143 | 0.4143 | YES | NO | NO |
| 02246932 | PRAVASTATIN SODIUM | Ratio-Pravastatin 40mg Tab | RPH | 0.4143 | 0.4143 | YES | NO | NO |
| 02246930 | PRAVASTATIN SODIUM | Ratio-Pravastatin 10mg Tab | RPH | 0.2916 | 0.2916 | YES | NO | NO |
| 02246931 | PRAVASTATIN SODIUM | Ratio-Pravastatin 20mg Tab | RPH | 0.3440 | 0.3440 | YES | NO | NO |
| 02468700 | PRAVASTATIN SODIUM | Sandoz Pravastatin Tablets 10mg Tab | SDZ | 0.2916 | 0.2916 | YES | NO | NO |
| 02468727 | PRAVASTATIN SODIUM | Sandoz Pravastatin Tablets 40mg Tab | SDZ | 0.4143 | 0.4143 | YES | NO | NO |
| 02468719 | PRAVASTATIN SODIUM | Sandoz Pravastatin Tablets 20mg Tab | SDZ | 0.3440 | 0.3440 | YES | NO | NO |
| 02247010 | PRAVASTATIN SODIUM | Teva-Pravastatin 40mg Tab | TEV | 0.4143 | 0.4143 | YES | NO | NO |
| 02247009 | PRAVASTATIN SODIUM | Teva-Pravastatin 20mg Tab | TEV | 0.3440 | 0.3440 | YES | NO | NO |
| 02247008 | PRAVASTATIN SODIUM | Teva-Pravastatin 10mg Tab | TEV | 0.2916 | 0.2916 | YES | NO | NO |
| 09858281 | PRAZOSIN HCL | Prazosin Hydrochloride Capsules, USP (Temporary Benefit) 1mg Cap | STE | 0.2743 | 0.2743 | NO | NO | NO |
| 09858282 | PRAZOSIN HCL | Prazosin Hydrochloride Capsules, USP (Temporary Benefit) 2mg Cap | STE | 0.3725 | 0.3725 | NO | NO | NO |
| 09858283 | PRAZOSIN HCL | Prazosin Hydrochloride Capsules, USP (Temporary Benefit) 5mg Cap | STE | 0.5121 | 0.5121 | NO | NO | NO |
| 00882801 | PRAZOSIN HCL | Apo-Prazo 1mg Tab | APX | 0.2743 | 0.2743 | YES | NO | NO |
| 00882828 | PRAZOSIN HCL | Apo-Prazo 2mg Tab | APX | 0.3725 | 0.3725 | YES | NO | NO |
| 00882836 | PRAZOSIN HCL | Apo-Prazo 5mg Tab | APX | 0.5121 | 0.5121 | YES | NO | NO |
| 00560952 | PRAZOSIN HCL | Minipress 1mg Tab | PFI | 0.2743 | 0.2743 | YES | NO | NO |
| 00560960 | PRAZOSIN HCL | Minipress 2mg Tab | PFI | 0.3725 | 0.3725 | YES | NO | NO |
| 00560979 | PRAZOSIN HCL | Minipress 5mg Tab | PFI | 0.5121 | 0.5121 | YES | NO | NO |
| 01934198 | PRAZOSIN HCL | Teva-Prazosin 1mg Tab | TEV | 0.2743 | 0.2743 | YES | NO | NO |
| 01934228 | PRAZOSIN HCL | Teva-Prazosin 5mg Tab | TEV | 0.5121 | 0.5121 | YES | NO | NO |
| 01934201 | PRAZOSIN HCL | Teva-Prazosin 2mg Tab | TEV | 0.3725 | 0.3725 | YES | NO | NO |
| 00301175 | PREDNISOLONE ACETATE | Pred Forte (Not a Benefit) 1% Oph Susp | ALL | N/A | N/A | YES | NO | YES |
| 00700401 | PREDNISOLONE ACETATE | Ratio-Prednisolone 1% Oph Susp | RPH | 1.9400 | 1.9400 | YES | NO | YES |
| 02245532 | PREDNISOLONE SODIUM PHOSPHATE | PMS-Prednisolone 6.7mg/5mL O/L | PMS | 0.1259 | 0.1259 | YES | NO | NO |
| 02230619 | PREDNISOLONE SODIUM PHOSPHATE | Pediapred Oral Liquid (Not a Benefit) 6.7mg/5mL O/L | SAV | N/A | N/A | YES | NO | NO |
| 00550957 | PREDNISONE | Apo-Prednisone 50mg Tab | APX | 0.1735 | 0.1735 | YES | NO | NO |
| 00312770 | PREDNISONE | Apo-Prednisone 5mg Tab | APX | 0.0220 | 0.0220 | YES | NO | NO |
| 00252417 | PREDNISONE | Deltasone (Not a Benefit) 50mg Tab | UPJ | N/A | N/A | YES | NO | NO |
| 00210188 | PREDNISONE | Deltasone (Not a Benefit) 5mg Tab | UPJ | N/A | N/A | YES | NO | NO |
| 00232378 | PREDNISONE | Teva-Prednisone 50mg Tab | TEV | 0.1900 | 0.1735 | YES | NO | NO |
| 00021695 | PREDNISONE | Teva-Prednisone 5mg Tab | TEV | 0.0220 | 0.0220 | YES | NO | NO |
| 00271373 | PREDNISONE | Winpred 1mg Tab | AAP | 0.1276 | 0.1276 | NO | NO | NO |
| 02480743 | PREGABALIN | AG-Pregabalin 75mg Cap | ANG | 0.3007 | 0.3007 | YES | NO | NO |
| 02480735 | PREGABALIN | AG-Pregabalin 50mg Cap | ANG | 0.2324 | 0.2324 | YES | NO | NO |
| 02480727 | PREGABALIN | AG-Pregabalin 25mg Cap | ANG | 0.1481 | 0.1481 | YES | NO | NO |
| 02480751 | PREGABALIN | AG-Pregabalin 150mg Cap | ANG | 0.4145 | 0.4145 | YES | NO | NO |
| 02480778 | PREGABALIN | AG-Pregabalin 300mg Cap | ANG | 0.4145 | 0.4145 | YES | NO | NO |
| 02449897 | PREGABALIN | Ach-Pregabalin (Off-Formulary Interchangeable) 225mg Cap | ACH | 1.7270 | N/A | YES | NO | NO |
| 02449870 | PREGABALIN | Ach-Pregabalin 150mg Cap | ACH | 0.4145 | 0.4145 | YES | NO | NO |
| 02449854 | PREGABALIN | Ach-Pregabalin 75mg Cap | ACH | 0.3007 | 0.3007 | YES | NO | NO |
| 02449838 | PREGABALIN | Ach-Pregabalin 25mg Cap | ACH | 0.1481 | 0.1481 | YES | NO | NO |
| 02449900 | PREGABALIN | Ach-Pregabalin 300mg Cap | ACH | 0.4145 | 0.4145 | YES | NO | NO |
| 02449846 | PREGABALIN | Ach-Pregabalin 50mg Cap | ACH | 0.2324 | 0.2324 | YES | NO | NO |
| 02394243 | PREGABALIN | Apo-Pregabalin 50mg Cap | APX | 0.2324 | 0.2324 | YES | NO | NO |
| 02394294 | PREGABALIN | Apo-Pregabalin 300mg Cap | APX | 0.4145 | 0.4145 | YES | NO | NO |
| 02394235 | PREGABALIN | Apo-Pregabalin 25mg Cap | APX | 0.1481 | 0.1481 | YES | NO | NO |
| 02394278 | PREGABALIN | Apo-Pregabalin 150mg Cap | APX | 0.4145 | 0.4145 | YES | NO | NO |
| 02394286 | PREGABALIN | Apo-Pregabalin (Off-Formulary Interchangeable) 225mg Cap | APX | 1.7270 | N/A | YES | NO | NO |
| 02394251 | PREGABALIN | Apo-Pregabalin 75mg Cap | APX | 0.3007 | 0.3007 | YES | NO | NO |
| 02433907 | PREGABALIN | Auro-Pregabalin 150mg Cap | AUR | 0.4145 | 0.4145 | YES | NO | NO |
| 02433877 | PREGABALIN | Auro-Pregabalin 50mg Cap | AUR | 0.2324 | 0.2324 | YES | NO | NO |
| 02433869 | PREGABALIN | Auro-Pregabalin 25mg Cap | AUR | 0.1481 | 0.1481 | YES | NO | NO |
| 02433885 | PREGABALIN | Auro-Pregabalin 75mg Cap | AUR | 0.3007 | 0.3007 | YES | NO | NO |
| 02402939 | PREGABALIN | Co Pregabalin 75mg Cap | COB | 0.3007 | 0.3007 | YES | NO | NO |
| 02402912 | PREGABALIN | Co Pregabalin 25mg Cap | COB | 0.1481 | 0.1481 | YES | NO | NO |
| 02402920 | PREGABALIN | Co Pregabalin 50mg Cap | COB | 0.2324 | 0.2324 | YES | NO | NO |
| 02402998 | PREGABALIN | Co Pregabalin 300mg Cap | COB | 0.4145 | 0.4145 | YES | NO | NO |
| 02402955 | PREGABALIN | Co Pregabalin 150mg Cap | COB | 0.4145 | 0.4145 | YES | NO | NO |
| 02402971 | PREGABALIN | Co Pregabalin (Off-Formulary Interchangeable) 225mg Cap | COB | 1.7270 | N/A | YES | NO | NO |
| 02436000 | PREGABALIN | Jamp-Pregabalin 150mg Cap | JPC | 0.4145 | 0.4145 | YES | NO | NO |
| 02435977 | PREGABALIN | Jamp-Pregabalin 25mg Cap | JPC | 0.1481 | 0.1481 | YES | NO | NO |
| 02435993 | PREGABALIN | Jamp-Pregabalin 75mg Cap | JPC | 0.3007 | 0.3007 | YES | NO | NO |
| 02436019 | PREGABALIN | Jamp-Pregabalin 300mg Cap | JPC | 0.4145 | 0.4145 | YES | NO | NO |
| 02435985 | PREGABALIN | Jamp-Pregabalin 50mg Cap | JPC | 0.2324 | 0.2324 | YES | NO | NO |
| 02268418 | PREGABALIN | Lyrica 25mg Cap | UJC | 1.0002 | 0.1481 | YES | NO | NO |
| 02268477 | PREGABALIN | Lyrica (Off-Formulary Interchangeable) 225mg Cap | UJC | N/A | N/A | YES | NO | NO |
| 02268450 | PREGABALIN | Lyrica 150mg Cap | UJC | 2.7982 | 0.4145 | YES | NO | NO |
| 02268485 | PREGABALIN | Lyrica 300mg Cap | UJC | 2.7982 | 0.4145 | YES | NO | NO |
| 02268426 | PREGABALIN | Lyrica 50mg Cap | UJC | 1.5689 | 0.2324 | YES | NO | NO |
| 02268434 | PREGABALIN | Lyrica 75mg Cap | UJC | 2.0300 | 0.3007 | YES | NO | NO |
| 02467313 | PREGABALIN | M-Pregabalin 75mg Cap | MAT | 0.3007 | 0.3007 | YES | NO | NO |
| 02467291 | PREGABALIN | M-Pregabalin 25mg Cap | MAT | 0.1481 | 0.1481 | YES | NO | NO |
| 02467321 | PREGABALIN | M-Pregabalin 150mg Cap | MAT | 0.4145 | 0.4145 | YES | NO | NO |
| 02467305 | PREGABALIN | M-Pregabalin 50mg Cap | MAT | 0.2324 | 0.2324 | YES | NO | NO |
| 02541963 | PREGABALIN | M-Pregabalin 300mg Cap | MAT | 0.4145 | 0.4145 | YES | NO | NO |
| 02417618 | PREGABALIN | Mar-Pregabalin 300mg Cap | MAR | 0.4145 | 0.4145 | YES | NO | NO |
| 02417537 | PREGABALIN | Mar-Pregabalin 50mg Cap | MAR | 0.2324 | 0.2324 | YES | NO | NO |
| 02417545 | PREGABALIN | Mar-Pregabalin 75mg Cap | MAR | 0.3007 | 0.3007 | YES | NO | NO |
| 02417561 | PREGABALIN | Mar-Pregabalin 150mg Cap | MAR | 0.4145 | 0.4145 | YES | NO | NO |
| 02417529 | PREGABALIN | Mar-Pregabalin 25mg Cap | MAR | 0.1481 | 0.1481 | YES | NO | NO |
| 02417596 | PREGABALIN | Mar-Pregabalin (Off-Formulary Interchangeable) 225mg Cap | MAR | 1.7270 | N/A | YES | NO | NO |
| 02423812 | PREGABALIN | Mint-Pregabalin 50mg Cap | MIN | 0.2324 | 0.2324 | YES | NO | NO |
| 02424185 | PREGABALIN | Mint-Pregabalin 75mg Cap | MIN | 0.3007 | 0.3007 | YES | NO | NO |
| 02423804 | PREGABALIN | Mint-Pregabalin 25mg Cap | MIN | 0.1481 | 0.1481 | YES | NO | NO |
| 02424207 | PREGABALIN | Mint-Pregabalin 150mg Cap | MIN | 0.4145 | 0.4145 | YES | NO | NO |
| 02479125 | PREGABALIN | NRA-Pregabalin 50mg Cap | NRA | 0.2324 | 0.2324 | YES | NO | NO |
| 02479133 | PREGABALIN | NRA-Pregabalin 75mg Cap | NRA | 0.3007 | 0.3007 | YES | NO | NO |
| 02479168 | PREGABALIN | NRA-Pregabalin 150mg Cap | NRA | 0.4145 | 0.4145 | YES | NO | NO |
| 02479192 | PREGABALIN | NRA-Pregabalin 300mg Cap | NRA | 0.4145 | 0.4145 | YES | NO | NO |
| 02479117 | PREGABALIN | NRA-Pregabalin 25mg Cap | NRA | 0.1481 | 0.1481 | YES | NO | NO |
| 02494876 | PREGABALIN | Nat-Pregabalin 75mg Cap | NAT | 0.3007 | 0.3007 | YES | NO | NO |
| 02494884 | PREGABALIN | Nat-Pregabalin 150mg Cap | NAT | 0.4145 | 0.4145 | YES | NO | NO |
| 02494841 | PREGABALIN | Nat-Pregabalin 25mg Cap | NAT | 0.1481 | 0.1481 | YES | NO | NO |
| 02494906 | PREGABALIN | Nat-Pregabalin 300mg Cap | NAT | 0.4145 | 0.4145 | YES | NO | NO |
| 02494892 | PREGABALIN | Nat-Pregabalin (Off-Formulary Interchangeable) 225mg Cap | NAT | 1.7270 | N/A | YES | NO | NO |
| 02494868 | PREGABALIN | Nat-Pregabalin 50mg Cap | NAT | 0.2324 | 0.2324 | YES | NO | NO |
| 02359634 | PREGABALIN | PMS-Pregabalin 150mg Cap | PMS | 0.4145 | 0.4145 | YES | NO | NO |
| 02359626 | PREGABALIN | PMS-Pregabalin 75mg Cap | PMS | 0.3007 | 0.3007 | YES | NO | NO |
| 02359618 | PREGABALIN | PMS-Pregabalin 50mg Cap | PMS | 0.2324 | 0.2324 | YES | NO | NO |
| 02398079 | PREGABALIN | PMS-Pregabalin (Off-Formulary Interchangeable) 225mg Cap | PMS | 1.7270 | N/A | YES | NO | NO |
| 02359642 | PREGABALIN | PMS-Pregabalin 300mg Cap | PMS | 0.4145 | 0.4145 | YES | NO | NO |
| 02359596 | PREGABALIN | PMS-Pregabalin 25mg Cap | PMS | 0.1481 | 0.1481 | YES | NO | NO |
| 02405555 | PREGABALIN | Pregabalin 75mg Cap | SAI | 0.3007 | 0.3007 | YES | NO | NO |
| 02403714 | PREGABALIN | Pregabalin 75mg Cap | SIV | 0.3007 | 0.3007 | YES | NO | NO |
| 02403730 | PREGABALIN | Pregabalin 300mg Cap | SIV | 0.4145 | 0.4145 | YES | NO | NO |
| 02403692 | PREGABALIN | Pregabalin 25mg Cap | SIV | 0.1481 | 0.1481 | YES | NO | NO |
| 02403722 | PREGABALIN | Pregabalin 150mg Cap | SIV | 0.4145 | 0.4145 | YES | NO | NO |
| 02405547 | PREGABALIN | Pregabalin 50mg Cap | SAI | 0.2324 | 0.2324 | YES | NO | NO |
| 02403706 | PREGABALIN | Pregabalin 50mg Cap | SIV | 0.2324 | 0.2324 | YES | NO | NO |
| 02405598 | PREGABALIN | Pregabalin 300mg Cap | SAI | 0.4145 | 0.4145 | YES | NO | NO |
| 02405563 | PREGABALIN | Pregabalin 150mg Cap | SAI | 0.4145 | 0.4145 | YES | NO | NO |
| 02405539 | PREGABALIN | Pregabalin 25mg Cap | SAI | 0.1481 | 0.1481 | YES | NO | NO |
| 02392828 | PREGABALIN | Ran-Pregabalin 50mg Cap | RAN | 0.2324 | 0.2324 | YES | NO | NO |
| 02392836 | PREGABALIN | Ran-Pregabalin 75mg Cap | RAN | 0.3007 | 0.3007 | YES | NO | NO |
| 02392844 | PREGABALIN | Ran-Pregabalin 150mg Cap | RAN | 0.4145 | 0.4145 | YES | NO | NO |
| 02392852 | PREGABALIN | Ran-Pregabalin (Off-Formulary Interchangeable) 225mg Cap | RAN | 1.7270 | N/A | YES | NO | NO |
| 02392801 | PREGABALIN | Ran-Pregabalin 25mg Cap | RAN | 0.1481 | 0.1481 | YES | NO | NO |
| 02392860 | PREGABALIN | Ran-Pregabalin 300mg Cap | RAN | 0.4145 | 0.4145 | YES | NO | NO |
| 02390833 | PREGABALIN | Sandoz Pregabalin 75mg Cap | SDZ | 0.3007 | 0.3007 | YES | NO | NO |
| 02390868 | PREGABALIN | Sandoz Pregabalin 300mg Cap | SDZ | 0.4145 | 0.4145 | YES | NO | NO |
| 02390841 | PREGABALIN | Sandoz Pregabalin 150mg Cap | SDZ | 0.4145 | 0.4145 | YES | NO | NO |
| 02390817 | PREGABALIN | Sandoz Pregabalin 25mg Cap | SDZ | 0.1481 | 0.1481 | YES | NO | NO |
| 02390825 | PREGABALIN | Sandoz Pregabalin 50mg Cap | SDZ | 0.2324 | 0.2324 | YES | NO | NO |
| 02361175 | PREGABALIN | Teva-Pregabalin 50mg Cap | TEV | 0.2324 | 0.2324 | YES | NO | NO |
| 02361248 | PREGABALIN | Teva-Pregabalin 300mg Cap | TEV | 0.4145 | 0.4145 | YES | NO | NO |
| 02361221 | PREGABALIN | Teva-Pregabalin (Off-Formulary Interchangeable) 225mg Cap | TEV | 1.7270 | N/A | YES | NO | NO |
| 02361205 | PREGABALIN | Teva-Pregabalin 150mg Cap | TEV | 0.4145 | 0.4145 | YES | NO | NO |
| 02361183 | PREGABALIN | Teva-Pregabalin 75mg Cap | TEV | 0.3007 | 0.3007 | YES | NO | NO |
| 02361159 | PREGABALIN | Teva-Pregabalin 25mg Cap | TEV | 0.1481 | 0.1481 | YES | NO | NO |
| 02042363 | PRIMIDONE | Mysoline (Not a Benefit) 125mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02042355 | PRIMIDONE | Mysoline (Not a Benefit) 250mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 00396761 | PRIMIDONE | Primidone 250mg Tab | AAP | 0.0887 | 0.0887 | YES | NO | NO |
| 00399310 | PRIMIDONE | Primidone 125mg Tab | AAP | 0.0564 | 0.0564 | YES | NO | NO |
| 00012750 | PROCARBAZINE HCL | Matulane 50mg Cap | LBI | 83.2680 | 83.2680 | NO | NO | YES |
| 00886432 | PROCHLORPERAZINE | Prochlorazine 10mg Tab | AAP | 0.2025 | 0.2025 | YES | NO | NO |
| 00886440 | PROCHLORPERAZINE | Prochlorazine 5mg Tab | AAP | 0.1659 | 0.1659 | YES | NO | NO |
| 01927760 | PROCHLORPERAZINE | Stemetil (Not a Benefit) 10mg Tab | AVE | N/A | N/A | YES | NO | NO |
| 01927752 | PROCHLORPERAZINE | Stemetil (Not a Benefit) 5mg Tab | AVE | N/A | N/A | YES | NO | NO |
| 00649392 | PROCYCLIDINE HCL | Pdp-Procyclidine 2.5mg Tab | PEN | 0.0577 | 0.0577 | NO | NO | NO |
| 02493578 | PROGESTERONE | Auro-Progesterone (Off-Formulary Interchangeable) 100mg Cap | AUR | 1.4358 | 1.4358 | YES | NO | NO |
| 02551268 | PROGESTERONE | M-Progesterone (Off-Formulary Interchangeable) 100mg Cap | MAT | 1.4358 | 1.4358 | YES | NO | NO |
| 02476576 | PROGESTERONE | PMS-Progesterone (Off-Formulary Interchangeable) 100mg Cap | PMS | 1.4358 | 1.4358 | YES | NO | NO |
| 02516187 | PROGESTERONE | Progesterone (Off-Formulary Interchangeable) 100mg Cap | SAI | 1.4358 | 1.4358 | YES | NO | NO |
| 02166704 | PROGESTERONE | Prometrium (Off-Formulary Interchangeable) 100mg Cap | OCI | N/A | N/A | YES | NO | NO |
| 02463113 | PROGESTERONE | Reddy-Progesterone (Off-Formulary Interchangeable) 100mg Cap | DRR | 1.4358 | 1.4358 | YES | NO | NO |
| 02439913 | PROGESTERONE | Teva-Progesterone (Off-Formulary Interchangeable) 100mg Cap | TEV | 1.4358 | 1.4358 | YES | NO | NO |
| 02243325 | PROPAFENONE HCL | Apo-Propafenone 300mg Tab | APX | 1.1116 | 1.1116 | YES | NO | NO |
| 02243324 | PROPAFENONE HCL | Apo-Propafenone 150mg Tab | APX | 0.6306 | 0.6306 | YES | NO | NO |
| 02457172 | PROPAFENONE HCL | Mylan-Propafenone 150mg Tab | MYL | 0.6306 | 0.6306 | YES | NO | NO |
| 02457164 | PROPAFENONE HCL | Mylan-Propafenone 300mg Tab | MYL | 1.1116 | 1.1116 | YES | NO | NO |
| 00603716 | PROPAFENONE HCL | Rythmol 300mg Tab | ABB | 2.6335 | 1.1116 | YES | NO | NO |
| 00603708 | PROPAFENONE HCL | Rythmol 150mg Tab | ABB | 1.4940 | 0.6306 | YES | NO | NO |
| 02460289 | PROPIVERINE HYDROCHLORIDE | Mictoryl Pediatric 5mg Tab | DUI | 0.3889 | 0.3889 | NO | YES | NO |
| 02042274 | PROPRANOLOL | Inderal-LA (Off-Formulary Interchangeable) 160mg LA Cap | WAY | N/A | N/A | YES | NO | NO |
| 02042266 | PROPRANOLOL | Inderal-LA (Off-Formulary Interchangeable) 120mg LA Cap | PFI | N/A | N/A | YES | NO | NO |
| 02042231 | PROPRANOLOL | Inderal-LA (Off-Formulary Interchangeable) 60mg LA Cap | WAY | N/A | N/A | YES | NO | NO |
| 02042258 | PROPRANOLOL | Inderal-LA (Off-Formulary Interchangeable) 80mg LA Cap | WAY | N/A | N/A | YES | NO | NO |
| 02491915 | PROPRANOLOL | Lupin-Propranolol LA (Off-Formulary Interchangeable) 120mg LA Cap | LUP | 1.5313 | N/A | YES | NO | NO |
| 02491907 | PROPRANOLOL | Lupin-Propranolol LA (Off-Formulary Interchangeable) 80mg LA Cap | LUP | 0.9950 | N/A | YES | NO | NO |
| 02491893 | PROPRANOLOL | Lupin-Propranolol LA (Off-Formulary Interchangeable) 60mg LA Cap | LUP | 0.8813 | N/A | YES | NO | NO |
| 02491923 | PROPRANOLOL | Lupin-Propranolol LA (Off-Formulary Interchangeable) 160mg LA Cap | LUP | 1.8113 | N/A | YES | NO | NO |
| 02042215 | PROPRANOLOL | Inderal (Not a Benefit) 80mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02042193 | PROPRANOLOL | Inderal (Not a Benefit) 20mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02042177 | PROPRANOLOL | Inderal (Not a Benefit) 10mg Tab | WAY | N/A | N/A | YES | NO | NO |
| 02042207 | PROPRANOLOL | Inderal-40 (Not a Benefit) 40mg Tab | AYE | N/A | N/A | YES | NO | NO |
| 02550814 | PROPRANOLOL | PRZ-Propranolol 20mg Tab | PRZ | 0.1119 | 0.1119 | YES | NO | NO |
| 02550830 | PROPRANOLOL | PRZ-Propranolol 80mg Tab | PRZ | 0.2057 | 0.2057 | YES | NO | NO |
| 02550822 | PROPRANOLOL | PRZ-Propranolol 40mg Tab | PRZ | 0.1239 | 0.1239 | YES | NO | NO |
| 00496499 | PROPRANOLOL | Teva-Propranolol 40mg Tab | TEV | 0.1239 | 0.1239 | YES | NO | NO |
| 00740675 | PROPRANOLOL | Teva-Propranolol 20mg Tab | TEV | 0.1119 | 0.1119 | YES | NO | NO |
| 00496502 | PROPRANOLOL | Teva-Propranolol 80mg Tab | TEV | 0.2057 | 0.2057 | YES | NO | NO |
| 00496480 | PROPRANOLOL | Teva-Propranolol 10mg Tab | TEV | 0.0813 | 0.0813 | YES | NO | NO |
| 02521059 | PROPYLTHIOURACIL | Halycil (Temporary Benefit) 50mg Tab | HAL | 0.5000 | 0.5000 | NO | NO | NO |
| 09858122 | PROPYLTHIOURACIL | PTU (Temporary Benefit) 50mg Tab | PHB | 0.5000 | 0.5000 | NO | NO | NO |
| 09858135 | PROPYLTHIOURACIL | Propylthiouracil (Temporary Benefit) 50mg Tab | ACP | 0.5000 | 0.5000 | NO | NO | NO |
| 02523019 | PROPYLTHIOURACIL | Propylthiouracil Tablets (Temporary Benefit) 50mg Tab | PHB | 0.5000 | 0.5000 | NO | NO | NO |
| 02491605 | PRUCALOPRIDE | Apo-Prucalopride (Off-Formulary Interchangeable) 2mg Tab | APX | 3.1025 | N/A | YES | NO | NO |
| 02491591 | PRUCALOPRIDE | Apo-Prucalopride (Off-Formulary Interchangeable) 1mg Tab | APX | 2.0145 | N/A | YES | NO | NO |
| 02493489 | PRUCALOPRIDE | Jamp Prucalopride (Off-Formulary Interchangeable) 1mg Tab | JPC | 2.0145 | N/A | YES | NO | NO |
| 02493497 | PRUCALOPRIDE | Jamp Prucalopride (Off-Formulary Interchangeable) 2mg Tab | JPC | 3.1025 | N/A | YES | NO | NO |
| 02550385 | PRUCALOPRIDE | NRA-Prucalopride (Off-Formulary Interchangeable) 2mg Tab | NRA | 3.1025 | N/A | YES | NO | NO |
| 02550377 | PRUCALOPRIDE | NRA-Prucalopride (Off-Formulary Interchangeable) 1mg Tab | NRA | 2.0145 | N/A | YES | NO | NO |
| 02377012 | PRUCALOPRIDE | Resotran (Off-Formulary Interchangeable) 1mg Tab | AMD | N/A | N/A | YES | NO | NO |
| 02377020 | PRUCALOPRIDE | Resotran (Off-Formulary Interchangeable) 2mg Tab | AMD | N/A | N/A | YES | NO | NO |
| 02174812 | PSYLLIUM MUCILLOID | Metamucil Fibre Therapy-Original Texture Oral Pd | PGI | 0.0246 | 0.0246 | NO | NO | NO |
| 02125447 | PYRETHRINS & PIPERONYL BUTOXIDE | R & C Shampoo with Conditioner 0.33% & 3% Topical Shampoo | MEP | 0.1110 | 0.1110 | NO | NO | NO |
| 00869953 | PYRIDOSTIGMINE BROMIDE | Mestinon 180mg LA Tab | VAL | 1.4239 | 1.4239 | NO | NO | NO |
| 02508362 | PYRIDOSTIGMINE BROMIDE | Jamp Pyridostigmine Bromide 60mg Tab | JPC | 0.2673 | 0.2673 | YES | NO | NO |
| 00869961 | PYRIDOSTIGMINE BROMIDE | Mestinon 60mg Tab | VAL | 0.6384 | 0.2673 | YES | NO | NO |
| 02495643 | PYRIDOSTIGMINE BROMIDE | Riva-Pyridostigmine 60mg Tab | RIA | 0.2673 | 0.2673 | YES | NO | NO |
| 02450895 | QUETIAPINE | Ach-Quetiapine Fumarate XR 300mg ER Tab | ACH | 0.9776 | 0.9776 | YES | NO | NO |
| 02450909 | QUETIAPINE | Ach-Quetiapine Fumarate XR 400mg ER Tab | ACH | 1.3270 | 1.3270 | YES | NO | NO |
| 02450879 | QUETIAPINE | Ach-Quetiapine Fumarate XR 150mg ER Tab | ACH | 0.4926 | 0.4926 | YES | NO | NO |
| 02450887 | QUETIAPINE | Ach-Quetiapine Fumarate XR 200mg ER Tab | ACH | 0.6661 | 0.6661 | YES | NO | NO |
| 02450860 | QUETIAPINE | Ach-Quetiapine Fumarate XR 50mg ER Tab | ACH | 0.2501 | 0.2501 | YES | NO | NO |
| 02457253 | QUETIAPINE | Apo-Quetiapine XR 300mg ER Tab | APX | 0.9776 | 0.9776 | YES | NO | NO |
| 02457229 | QUETIAPINE | Apo-Quetiapine XR 50mg ER Tab | APX | 0.2501 | 0.2501 | YES | NO | NO |
| 02457237 | QUETIAPINE | Apo-Quetiapine XR 150mg ER Tab | APX | 0.4926 | 0.4926 | YES | NO | NO |
| 02457261 | QUETIAPINE | Apo-Quetiapine XR 400mg ER Tab | APX | 1.3270 | 1.3270 | YES | NO | NO |
| 02457245 | QUETIAPINE | Apo-Quetiapine XR 200mg ER Tab | APX | 0.6661 | 0.6661 | YES | NO | NO |
| 02527928 | QUETIAPINE | M-Quetiapine Fumarate XR 50mg ER Tab | MAT | 0.2501 | 0.2501 | YES | NO | NO |
| 02527936 | QUETIAPINE | M-Quetiapine Fumarate XR 150mg ER Tab | MAT | 0.4926 | 0.4926 | YES | NO | NO |
| 02527952 | QUETIAPINE | M-Quetiapine Fumarate XR 300mg ER Tab | MAT | 0.9776 | 0.9776 | YES | NO | NO |
| 02527960 | QUETIAPINE | M-Quetiapine Fumarate XR 400mg ER Tab | MAT | 1.3270 | 1.3270 | YES | NO | NO |
| 02527944 | QUETIAPINE | M-Quetiapine Fumarate XR 200mg ER Tab | MAT | 0.6661 | 0.6661 | YES | NO | NO |
| 02522187 | QUETIAPINE | Mint-Quetiapine XR 50mg ER Tab | MIN | 0.2501 | 0.2501 | YES | NO | NO |
| 02522225 | QUETIAPINE | Mint-Quetiapine XR 400mg ER Tab | MIN | 1.3270 | 1.3270 | YES | NO | NO |
| 02522217 | QUETIAPINE | Mint-Quetiapine XR 300mg ER Tab | MIN | 0.9776 | 0.9776 | YES | NO | NO |
| 02522209 | QUETIAPINE | Mint-Quetiapine XR 200mg ER Tab | MIN | 0.6661 | 0.6661 | YES | NO | NO |
| 02522195 | QUETIAPINE | Mint-Quetiapine XR 150mg ER Tab | MIN | 0.4926 | 0.4926 | YES | NO | NO |
| 02510693 | QUETIAPINE | NRA-Quetiapine XR 200mg ER Tab | NRA | 0.6661 | 0.6661 | YES | NO | NO |
| 02510685 | QUETIAPINE | NRA-Quetiapine XR 150mg ER Tab | NRA | 0.4926 | 0.4926 | YES | NO | NO |
| 02510715 | QUETIAPINE | NRA-Quetiapine XR 400mg ER Tab | NRA | 1.3270 | 1.3270 | YES | NO | NO |
| 02510707 | QUETIAPINE | NRA-Quetiapine XR 300mg ER Tab | NRA | 0.9776 | 0.9776 | YES | NO | NO |
| 02510677 | QUETIAPINE | NRA-Quetiapine XR 50mg ER Tab | NRA | 0.2501 | 0.2501 | YES | NO | NO |
| 02516659 | QUETIAPINE | Quetiapine Fumarate XR 400mg ER Tab | SAI | 1.3270 | 1.3270 | YES | NO | NO |
| 02516616 | QUETIAPINE | Quetiapine Fumarate XR 50mg ER Tab | SAI | 0.2501 | 0.2501 | YES | NO | NO |
| 02516624 | QUETIAPINE | Quetiapine Fumarate XR 150mg ER Tab | SAI | 0.4926 | 0.4926 | YES | NO | NO |
| 02516640 | QUETIAPINE | Quetiapine Fumarate XR 300mg ER Tab | SAI | 0.9776 | 0.9776 | YES | NO | NO |
| 02516632 | QUETIAPINE | Quetiapine Fumarate XR 200mg ER Tab | SAI | 0.6661 | 0.6661 | YES | NO | NO |
| 02417391 | QUETIAPINE | Quetiapine XR 400mg ER Tab | SIV | 1.3270 | 1.3270 | YES | NO | NO |
| 02417359 | QUETIAPINE | Quetiapine XR 50mg ER Tab | SIV | 0.2501 | 0.2501 | YES | NO | NO |
| 02519747 | QUETIAPINE | Quetiapine XR 300mg ER Tab | JPC | 0.9776 | 0.9776 | YES | NO | NO |
| 02519615 | QUETIAPINE | Quetiapine XR 150mg ER Tab | JPC | 0.4926 | 0.4926 | YES | NO | NO |
| 02417367 | QUETIAPINE | Quetiapine XR 150mg ER Tab | SIV | 0.4926 | 0.4926 | YES | NO | NO |
| 02519763 | QUETIAPINE | Quetiapine XR 400mg ER Tab | JPC | 1.3270 | 1.3270 | YES | NO | NO |
| 02519607 | QUETIAPINE | Quetiapine XR 50mg ER Tab | JPC | 0.2501 | 0.2501 | YES | NO | NO |
| 02519623 | QUETIAPINE | Quetiapine XR 200mg ER Tab | JPC | 0.6661 | 0.6661 | YES | NO | NO |
| 02417375 | QUETIAPINE | Quetiapine XR 200mg ER Tab | SIV | 0.6661 | 0.6661 | YES | NO | NO |
| 02417383 | QUETIAPINE | Quetiapine XR 300mg ER Tab | SIV | 0.9776 | 0.9776 | YES | NO | NO |
| 02407701 | QUETIAPINE | Sandoz Quetiapine XRT 200mg ER Tab | SDZ | 0.6661 | 0.6661 | YES | NO | NO |
| 02407698 | QUETIAPINE | Sandoz Quetiapine XRT 150mg ER Tab | SDZ | 0.4926 | 0.4926 | YES | NO | NO |
| 02407671 | QUETIAPINE | Sandoz Quetiapine XRT 50mg ER Tab | SDZ | 0.2501 | 0.2501 | YES | NO | NO |
| 02407728 | QUETIAPINE | Sandoz Quetiapine XRT 300mg ER Tab | SDZ | 0.9776 | 0.9776 | YES | NO | NO |
| 02407736 | QUETIAPINE | Sandoz Quetiapine XRT 400mg ER Tab | SDZ | 1.3270 | 1.3270 | YES | NO | NO |
| 02300214 | QUETIAPINE | Seroquel XR 400mg ER Tab | AZC | 5.9951 | 1.3270 | YES | NO | NO |
| 02300206 | QUETIAPINE | Seroquel XR 300mg ER Tab | AZC | 4.4162 | 0.9776 | YES | NO | NO |
| 02300184 | QUETIAPINE | Seroquel XR 50mg ER Tab | AZC | 1.1297 | 0.2501 | YES | NO | NO |
| 02321513 | QUETIAPINE | Seroquel XR 150mg ER Tab | AZC | 2.2253 | 0.4926 | YES | NO | NO |
| 02300192 | QUETIAPINE | Seroquel XR 200mg ER Tab | AZC | 3.0091 | 0.6661 | YES | NO | NO |
| 02395479 | QUETIAPINE | Teva-Quetiapine XR 300mg ER Tab | TEV | 0.9776 | 0.9776 | YES | NO | NO |
| 02395460 | QUETIAPINE | Teva-Quetiapine XR 200mg ER Tab | TEV | 0.6661 | 0.6661 | YES | NO | NO |
| 02395444 | QUETIAPINE | Teva-Quetiapine XR 50mg ER Tab | TEV | 0.2501 | 0.2501 | YES | NO | NO |
| 02395452 | QUETIAPINE | Teva-Quetiapine XR 150mg ER Tab | TEV | 0.4926 | 0.4926 | YES | NO | NO |
| 02395487 | QUETIAPINE | Teva-Quetiapine XR 400mg ER Tab | TEV | 1.3270 | 1.3270 | YES | NO | NO |
| 02475979 | QUETIAPINE | AG-Quetiapine 25mg Tab | ANG | 0.0494 | 0.0494 | YES | NO | NO |
| 02316080 | QUETIAPINE | Act Quetiapine 25mg Tab | TEV | 0.0494 | 0.0494 | YES | NO | NO |
| 02316129 | QUETIAPINE | Act Quetiapine 300mg Tab | TEV | 0.3863 | 0.3863 | YES | NO | NO |
| 02316110 | QUETIAPINE | Act Quetiapine 200mg Tab | TEV | 0.2647 | 0.2647 | YES | NO | NO |
| 02316099 | QUETIAPINE | Act Quetiapine 100mg Tab | TEV | 0.1318 | 0.1318 | YES | NO | NO |
| 02313936 | QUETIAPINE | Apo-Quetiapine 200mg Tab | APX | 0.2647 | 0.2647 | YES | NO | NO |
| 02313901 | QUETIAPINE | Apo-Quetiapine 25mg Tab | APX | 0.0494 | 0.0494 | YES | NO | NO |
| 02313944 | QUETIAPINE | Apo-Quetiapine 300mg Tab | APX | 0.3863 | 0.3863 | YES | NO | NO |
| 02313928 | QUETIAPINE | Apo-Quetiapine 100mg Tab | APX | 0.1318 | 0.1318 | YES | NO | NO |
| 02501643 | QUETIAPINE | Apo-Quetiapine Fumarate 100mg Tab | APX | 0.1318 | 0.1318 | YES | NO | NO |
| 02501678 | QUETIAPINE | Apo-Quetiapine Fumarate 300mg Tab | APX | 0.3863 | 0.3863 | YES | NO | NO |
| 02501635 | QUETIAPINE | Apo-Quetiapine Fumarate 25mg Tab | APX | 0.0494 | 0.0494 | YES | NO | NO |
| 02501651 | QUETIAPINE | Apo-Quetiapine Fumarate 200mg Tab | APX | 0.2647 | 0.2647 | YES | NO | NO |
| 02390213 | QUETIAPINE | Auro-Quetiapine 100mg Tab | AUR | 0.1318 | 0.1318 | YES | NO | NO |
| 02390248 | QUETIAPINE | Auro-Quetiapine 200mg Tab | AUR | 0.2647 | 0.2647 | YES | NO | NO |
| 02390256 | QUETIAPINE | Auro-Quetiapine 300mg Tab | AUR | 0.3863 | 0.3863 | YES | NO | NO |
| 02390205 | QUETIAPINE | Auro-Quetiapine 25mg Tab | AUR | 0.0494 | 0.0494 | YES | NO | NO |
| 02447258 | QUETIAPINE | Bio-Quetiapine 300mg Tab | BMP | 0.3863 | 0.3863 | YES | NO | NO |
| 02447193 | QUETIAPINE | Bio-Quetiapine 25mg Tab | BMP | 0.0494 | 0.0494 | YES | NO | NO |
| 02447223 | QUETIAPINE | Bio-Quetiapine 200mg Tab | BMP | 0.2647 | 0.2647 | YES | NO | NO |
| 02447207 | QUETIAPINE | Bio-Quetiapine 100mg Tab | BMP | 0.1318 | 0.1318 | YES | NO | NO |
| 02390167 | QUETIAPINE | Jamp Quetiapine Fumarate 200mg Tab | JPC | 0.2647 | 0.2647 | YES | NO | NO |
| 02390159 | QUETIAPINE | Jamp Quetiapine Fumarate 100mg Tab | JPC | 0.1318 | 0.1318 | YES | NO | NO |
| 02390140 | QUETIAPINE | Jamp Quetiapine Fumarate 25mg Tab | JPC | 0.0494 | 0.0494 | YES | NO | NO |
| 02390175 | QUETIAPINE | Jamp Quetiapine Fumarate 300mg Tab | JPC | 0.3863 | 0.3863 | YES | NO | NO |
| 02330423 | QUETIAPINE | Jamp-Quetiapine 100mg Tab | JPC | 0.1318 | 0.1318 | YES | NO | NO |
| 02330458 | QUETIAPINE | Jamp-Quetiapine 200mg Tab | JPC | 0.2647 | 0.2647 | YES | NO | NO |
| 02330466 | QUETIAPINE | Jamp-Quetiapine 300mg Tab | JPC | 0.3863 | 0.3863 | YES | NO | NO |
| 02330415 | QUETIAPINE | Jamp-Quetiapine 25mg Tab | JPC | 0.0494 | 0.0494 | YES | NO | NO |
| 02399857 | QUETIAPINE | Mar-Quetiapine 300mg Tab | MAR | 0.3863 | 0.3863 | YES | NO | NO |
| 02399822 | QUETIAPINE | Mar-Quetiapine 25mg Tab | MAR | 0.0494 | 0.0494 | YES | NO | NO |
| 02399830 | QUETIAPINE | Mar-Quetiapine 100mg Tab | MAR | 0.1318 | 0.1318 | YES | NO | NO |
| 02399849 | QUETIAPINE | Mar-Quetiapine 200mg Tab | MAR | 0.2647 | 0.2647 | YES | NO | NO |
| 02438011 | QUETIAPINE | Mint-Quetiapine 100mg Tab | MIN | 0.1318 | 0.1318 | YES | NO | NO |
| 02438054 | QUETIAPINE | Mint-Quetiapine 300mg Tab | MIN | 0.3863 | 0.3863 | YES | NO | NO |
| 02438046 | QUETIAPINE | Mint-Quetiapine 200mg Tab | MIN | 0.2647 | 0.2647 | YES | NO | NO |
| 02438003 | QUETIAPINE | Mint-Quetiapine 25mg Tab | MIN | 0.0494 | 0.0494 | YES | NO | NO |
| 02486237 | QUETIAPINE | NRA-Quetiapine 25mg Tab | NRA | 0.0494 | 0.0494 | YES | NO | NO |
| 02439190 | QUETIAPINE | Nat-Quetiapine 300mg Tab | NAT | 0.3863 | 0.3863 | YES | NO | NO |
| 02439166 | QUETIAPINE | Nat-Quetiapine 100mg Tab | NAT | 0.1318 | 0.1318 | YES | NO | NO |
| 02439182 | QUETIAPINE | Nat-Quetiapine 200mg Tab | NAT | 0.2647 | 0.2647 | YES | NO | NO |
| 02439158 | QUETIAPINE | Nat-Quetiapine 25mg Tab | NAT | 0.0494 | 0.0494 | YES | NO | NO |
| 02439174 | QUETIAPINE | Nat-Quetiapine (Off-Formulary Interchangeable) 150mg Tab | NAT | 1.6222 | N/A | YES | NO | NO |
| 02296594 | QUETIAPINE | PMS-Quetiapine 200mg Tab | PMS | 0.2647 | 0.2647 | YES | NO | NO |
| 02296608 | QUETIAPINE | PMS-Quetiapine 300mg Tab | PMS | 0.3863 | 0.3863 | YES | NO | NO |
| 02296551 | QUETIAPINE | PMS-Quetiapine 25mg Tab | PMS | 0.0494 | 0.0494 | YES | NO | NO |
| 02296578 | QUETIAPINE | PMS-Quetiapine 100mg Tab | PMS | 0.1318 | 0.1318 | YES | NO | NO |
| 02353172 | QUETIAPINE | Quetiapine 100mg Tab | SAI | 0.1318 | 0.1318 | YES | NO | NO |
| 02317907 | QUETIAPINE | Quetiapine 100mg Tab | SIV | 0.1318 | 0.1318 | YES | NO | NO |
| 02317893 | QUETIAPINE | Quetiapine 25mg Tab | SIV | 0.0494 | 0.0494 | YES | NO | NO |
| 02353164 | QUETIAPINE | Quetiapine 25mg Tab | SAI | 0.0494 | 0.0494 | YES | NO | NO |
| 02353202 | QUETIAPINE | Quetiapine 300mg Tab | SAI | 0.3863 | 0.3863 | YES | NO | NO |
| 02317931 | QUETIAPINE | Quetiapine 300mg Tab | SIV | 0.3863 | 0.3863 | YES | NO | NO |
| 02353199 | QUETIAPINE | Quetiapine 200mg Tab | SAI | 0.2647 | 0.2647 | YES | NO | NO |
| 02317923 | QUETIAPINE | Quetiapine 200mg Tab | SIV | 0.2647 | 0.2647 | YES | NO | NO |
| 02387832 | QUETIAPINE | Quetiapine Tablets 300mg Tab | ACH | 0.3863 | 0.3863 | YES | NO | NO |
| 02387816 | QUETIAPINE | Quetiapine Tablets (Off-Formulary Interchangeable) 150mg Tab | ACH | 1.3518 | N/A | YES | NO | NO |
| 02387824 | QUETIAPINE | Quetiapine Tablets 200mg Tab | ACH | 0.2647 | 0.2647 | YES | NO | NO |
| 02387808 | QUETIAPINE | Quetiapine Tablets 100mg Tab | ACH | 0.1318 | 0.1318 | YES | NO | NO |
| 02387794 | QUETIAPINE | Quetiapine Tablets 25mg Tab | ACH | 0.0494 | 0.0494 | YES | NO | NO |
| 02397110 | QUETIAPINE | Ran-Quetiapine 200mg Tab | RAN | 0.2647 | 0.2647 | YES | NO | NO |
| 02397102 | QUETIAPINE | Ran-Quetiapine 100mg Tab | RAN | 0.1318 | 0.1318 | YES | NO | NO |
| 02397099 | QUETIAPINE | Ran-Quetiapine 25mg Tab | RAN | 0.0494 | 0.0494 | YES | NO | NO |
| 02397129 | QUETIAPINE | Ran-Quetiapine 300mg Tab | RAN | 0.3863 | 0.3863 | YES | NO | NO |
| 02314010 | QUETIAPINE | Sandoz Quetiapine 200mg Tab | SDZ | 0.2647 | 0.2647 | YES | NO | NO |
| 02314002 | QUETIAPINE | Sandoz Quetiapine 100mg Tab | SDZ | 0.1318 | 0.1318 | YES | NO | NO |
| 02313995 | QUETIAPINE | Sandoz Quetiapine 25mg Tab | SDZ | 0.0494 | 0.0494 | YES | NO | NO |
| 02314029 | QUETIAPINE | Sandoz Quetiapine 300mg Tab | SDZ | 0.3863 | 0.3863 | YES | NO | NO |
| 02236952 | QUETIAPINE | Seroquel 100mg Tab | AZC | 1.4362 | 0.1318 | YES | NO | NO |
| 02240862 | QUETIAPINE | Seroquel (Off-Formulary Interchangeable) 150mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02236953 | QUETIAPINE | Seroquel 200mg Tab | AZC | 2.8839 | 0.2647 | YES | NO | NO |
| 02244107 | QUETIAPINE | Seroquel 300mg Tab | AZC | 4.2083 | 0.3863 | YES | NO | NO |
| 02236951 | QUETIAPINE | Seroquel 25mg Tab | AZC | 0.5383 | 0.0494 | YES | NO | NO |
| 02284251 | QUETIAPINE | Teva-Quetiapine (Off-Formulary Interchangeable) 150mg Tab | TEV | 1.7288 | N/A | YES | NO | NO |
| 02284278 | QUETIAPINE | Teva-Quetiapine 200mg Tab | TEV | 0.2647 | 0.2647 | YES | NO | NO |
| 02284286 | QUETIAPINE | Teva-Quetiapine 300mg Tab | TEV | 0.3863 | 0.3863 | YES | NO | NO |
| 02284235 | QUETIAPINE | Teva-Quetiapine 25mg Tab | TEV | 0.0494 | 0.0494 | YES | NO | NO |
| 02284243 | QUETIAPINE | Teva-Quetiapine 100mg Tab | TEV | 0.1318 | 0.1318 | YES | NO | NO |
| 02223775 | QUINAGOLIDE HCL | Norprolac 0.15mg Tab | FEI | 1.7294 | 1.7294 | NO | YES | NO |
| 01947672 | QUINAPRIL | Accupril (Not a Benefit) 10mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 01947699 | QUINAPRIL | Accupril (Not a Benefit) 40mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 01947664 | QUINAPRIL | Accupril (Not a Benefit) 5mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 01947680 | QUINAPRIL | Accupril (Not a Benefit) 20mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02248499 | QUINAPRIL | Apo-Quinapril 5mg Tab | APX | 0.4642 | 0.4642 | YES | NO | NO |
| 02248500 | QUINAPRIL | Apo-Quinapril 10mg Tab | APX | 0.2321 | 0.2321 | YES | NO | NO |
| 02517450 | QUINAPRIL | Jamp Quinapril 10mg Tab | JPC | 0.2321 | 0.2321 | YES | NO | NO |
| 02517469 | QUINAPRIL | Jamp Quinapril 20mg Tab | JPC | 0.4642 | 0.4642 | YES | NO | NO |
| 02517477 | QUINAPRIL | Jamp Quinapril 40mg Tab | JPC | 0.4642 | 0.4642 | YES | NO | NO |
| 02340569 | QUINAPRIL | PMS-Quinapril 10mg Tab | PMS | 0.2321 | 0.2321 | YES | NO | NO |
| 02340550 | QUINAPRIL | PMS-Quinapril 5mg Tab | PMS | 0.4642 | 0.4642 | YES | NO | NO |
| 02340577 | QUINAPRIL | PMS-Quinapril 20mg Tab | PMS | 0.4642 | 0.4642 | YES | NO | NO |
| 02340585 | QUINAPRIL | PMS-Quinapril 40mg Tab | PMS | 0.4642 | 0.4642 | YES | NO | NO |
| 02237369 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Accuretic (Not a Benefit) 20mg & 25mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02237368 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Accuretic (Not a Benefit) 20mg & 12.5mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02237367 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Accuretic (Not a Benefit) 10mg & 12.5mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02408767 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Apo-Quinapril/HCTZ 10mg & 12.5mg Tab | APX | 0.2393 | 0.2393 | YES | NO | NO |
| 02408783 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Apo-Quinapril/HCTZ 20mg & 25mg Tab | APX | 0.2301 | 0.2301 | YES | NO | NO |
| 02408775 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Apo-Quinapril/HCTZ 20mg & 12.5mg Tab | APX | 0.4786 | 0.4786 | YES | NO | NO |
| 02473305 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Auro-Quinapril HCTZ 20mg & 12.5mg Tab | AUR | 0.4786 | 0.4786 | YES | NO | NO |
| 02473291 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Auro-Quinapril HCTZ 10mg & 12.5mg Tab | AUR | 0.2393 | 0.2393 | YES | NO | NO |
| 02473321 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Auro-Quinapril HCTZ 20mg & 25mg Tab | AUR | 0.2301 | 0.2301 | YES | NO | NO |
| 02547449 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Jamp Quinapril / HCTZ 20mg & 25mg Tab | JPC | 0.2301 | 0.2301 | YES | NO | NO |
| 02547430 | QUINAPRIL & HYDROCHLOROTHIAZIDE | Jamp Quinapril / HCTZ 10mg & 12.5mg Tab | JPC | 0.2393 | 0.2393 | YES | NO | NO |
| 09857456 | QUINOPROTEIN GLUCOSE DEHYDROGENASE | Accu-Chek Inform II Test Strips Strip | ROD | N/A | 0.6595 | NO | NO | NO |
| 02345579 | RABEPRAZOLE SODIUM | Apo-Rabeprazole 10mg Tab | APX | 0.0669 | 0.0669 | YES | NO | NO |
| 02345587 | RABEPRAZOLE SODIUM | Apo-Rabeprazole 20mg Tab | APX | 0.1338 | 0.1338 | YES | NO | NO |
| 02415283 | RABEPRAZOLE SODIUM | Jamp Rabeprazole 10mg Tab | JPC | 0.0669 | 0.0669 | YES | NO | NO |
| 02415291 | RABEPRAZOLE SODIUM | Jamp Rabeprazole 20mg Tab | JPC | 0.1338 | 0.1338 | YES | NO | NO |
| 02243797 | RABEPRAZOLE SODIUM | Pariet 20mg Tab | JAN | 3.2706 | 0.1338 | YES | NO | NO |
| 02243796 | RABEPRAZOLE SODIUM | Pariet 10mg Tab | JAN | 1.6353 | 0.0669 | YES | NO | NO |
| 02385449 | RABEPRAZOLE SODIUM | Rabeprazole 10mg Tab | SIV | 0.0669 | 0.0669 | YES | NO | NO |
| 02385457 | RABEPRAZOLE SODIUM | Rabeprazole 20mg Tab | SIV | 0.1338 | 0.1338 | YES | NO | NO |
| 02356511 | RABEPRAZOLE SODIUM | Rabeprazole EC 10mg Tab | SAI | 0.0669 | 0.0669 | YES | NO | NO |
| 02356538 | RABEPRAZOLE SODIUM | Rabeprazole EC 20mg Tab | SAI | 0.1338 | 0.1338 | YES | NO | NO |
| 02298074 | RABEPRAZOLE SODIUM | Ran-Rabeprazole 10mg Tab | RAN | 0.0669 | 0.0669 | YES | NO | NO |
| 02298082 | RABEPRAZOLE SODIUM | Ran-Rabeprazole 20mg Tab | RAN | 0.1338 | 0.1338 | YES | NO | NO |
| 02314177 | RABEPRAZOLE SODIUM | Sandoz Rabeprazole 10mg Tab | SDZ | 0.0669 | 0.0669 | YES | NO | NO |
| 02314185 | RABEPRAZOLE SODIUM | Sandoz Rabeprazole 20mg Tab | SDZ | 0.1338 | 0.1338 | YES | NO | NO |
| 02296640 | RABEPRAZOLE SODIUM | Teva-Rabeprazole EC 20mg Tab | TEV | 0.1338 | 0.1338 | YES | NO | NO |
| 02296632 | RABEPRAZOLE SODIUM | Teva-Rabeprazole EC 10mg Tab | TEV | 0.0669 | 0.0669 | YES | NO | NO |
| 02279215 | RALOXIFENE HCL | Apo-Raloxifene 60mg Tab | APX | 0.5134 | 0.5134 | YES | YES | NO |
| 02358840 | RALOXIFENE HCL | Co Raloxifene 60mg Tab | COB | 0.5134 | 0.5134 | YES | YES | NO |
| 02239028 | RALOXIFENE HCL | Evista 60mg Tab | LIL | 2.3757 | 0.5134 | YES | YES | NO |
| 02540681 | RALOXIFENE HCL | Jamp Raloxifene 60mg Tab | JPC | 0.5134 | 0.5134 | YES | YES | NO |
| 02301881 | RALTEGRAVIR POTASSIUM | Isentress 400mg Tab | MFC | 14.0301 | 14.0301 | NO | NO | NO |
| 02465337 | RALTEGRAVIR POTASSIUM | Isentress HD 600mg Tab | MEK | 14.0301 | 14.0301 | NO | NO | NO |
| 02477580 | RAMIPRIL | AG-Ramipril Cap 5mg | ANG | 0.0817 | 0.0817 | YES | NO | NO |
| 02477572 | RAMIPRIL | AG-Ramipril Cap 2.5mg | ANG | 0.0817 | 0.0817 | YES | NO | NO |
| 02477599 | RAMIPRIL | AG-Ramipril Cap 10mg | ANG | 0.1034 | 0.1034 | YES | NO | NO |
| 02221829 | RAMIPRIL | Altace Cap 1.25mg | SAV | 0.9829 | 0.0708 | YES | NO | NO |
| 02221845 | RAMIPRIL | Altace Cap 5mg | SAV | 1.1346 | 0.0817 | YES | NO | NO |
| 02221853 | RAMIPRIL | Altace Cap 10mg | SAV | 1.4577 | 0.1034 | YES | NO | NO |
| 02221837 | RAMIPRIL | Altace Cap 2.5mg | SAV | 1.1058 | 0.0817 | YES | NO | NO |
| 02251531 | RAMIPRIL | Apo-Ramipril Cap 2.5mg | APX | 0.0817 | 0.0817 | YES | NO | NO |
| 02251515 | RAMIPRIL | Apo-Ramipril Cap 1.25mg | APX | 0.0708 | 0.0708 | YES | NO | NO |
| 02251582 | RAMIPRIL | Apo-Ramipril Cap 10mg | APX | 0.1034 | 0.1034 | YES | NO | NO |
| 02251574 | RAMIPRIL | Apo-Ramipril Cap 5mg | APX | 0.0817 | 0.0817 | YES | NO | NO |
| 02387387 | RAMIPRIL | Auro-Ramipril Cap 1.25mg | AUR | 0.0708 | 0.0708 | YES | NO | NO |
| 02387409 | RAMIPRIL | Auro-Ramipril Cap 5mg | AUR | 0.0817 | 0.0817 | YES | NO | NO |
| 02387417 | RAMIPRIL | Auro-Ramipril Cap 10mg | AUR | 0.1034 | 0.1034 | YES | NO | NO |
| 02387395 | RAMIPRIL | Auro-Ramipril Cap 2.5mg | AUR | 0.0817 | 0.0817 | YES | NO | NO |
| 02295512 | RAMIPRIL | Co Ramipril Cap 10mg | COB | 0.1034 | 0.1034 | YES | NO | NO |
| 02295482 | RAMIPRIL | Co Ramipril Cap 1.25mg | COB | 0.0708 | 0.0708 | YES | NO | NO |
| 02295490 | RAMIPRIL | Co Ramipril Cap 2.5mg | COB | 0.0817 | 0.0817 | YES | NO | NO |
| 02295504 | RAMIPRIL | Co Ramipril Cap 5mg | COB | 0.0817 | 0.0817 | YES | NO | NO |
| 02331101 | RAMIPRIL | Jamp-Ramipril Cap 1.25mg | JPC | 0.0708 | 0.0708 | YES | NO | NO |
| 02331144 | RAMIPRIL | Jamp-Ramipril Cap 10mg | JPC | 0.1034 | 0.1034 | YES | NO | NO |
| 02331136 | RAMIPRIL | Jamp-Ramipril Cap 5mg | JPC | 0.0817 | 0.0817 | YES | NO | NO |
| 02331128 | RAMIPRIL | Jamp-Ramipril Cap 2.5mg | JPC | 0.0817 | 0.0817 | YES | NO | NO |
| 02420481 | RAMIPRIL | Mar-Ramipril Cap 10mg | MAR | 0.1034 | 0.1034 | YES | NO | NO |
| 02420473 | RAMIPRIL | Mar-Ramipril Cap 5mg | MAR | 0.0817 | 0.0817 | YES | NO | NO |
| 02420457 | RAMIPRIL | Mar-Ramipril Cap 1.25mg | MAR | 0.0708 | 0.0708 | YES | NO | NO |
| 02420465 | RAMIPRIL | Mar-Ramipril Cap 2.5mg | MAR | 0.0817 | 0.0817 | YES | NO | NO |
| 02421321 | RAMIPRIL | Mint-Ramipril Cap 10mg | MIN | 0.1034 | 0.1034 | YES | NO | NO |
| 02421305 | RAMIPRIL | Mint-Ramipril Cap 2.5mg | MIN | 0.0817 | 0.0817 | YES | NO | NO |
| 02421313 | RAMIPRIL | Mint-Ramipril Cap 5mg | MIN | 0.0817 | 0.0817 | YES | NO | NO |
| 02486172 | RAMIPRIL | NRA-Ramipril Cap 2.5mg | NRA | 0.0817 | 0.0817 | YES | NO | NO |
| 02486180 | RAMIPRIL | NRA-Ramipril Cap 5mg | NRA | 0.0817 | 0.0817 | YES | NO | NO |
| 02486199 | RAMIPRIL | NRA-Ramipril Cap 10mg | NRA | 0.1034 | 0.1034 | YES | NO | NO |
| 02295369 | RAMIPRIL | PMS-Ramipril Cap 1.25mg | PMS | 0.0708 | 0.0708 | YES | NO | NO |
| 02550210 | RAMIPRIL | PMSC-Ramipril Cap 2.5mg | PMS | 0.0817 | 0.0817 | YES | NO | NO |
| 02550229 | RAMIPRIL | PMSC-Ramipril Cap 5mg | PMS | 0.0817 | 0.0817 | YES | NO | NO |
| 02550202 | RAMIPRIL | PMSC-Ramipril Cap 1.25mg | PMS | 0.0708 | 0.0708 | YES | NO | NO |
| 02550237 | RAMIPRIL | PMSC-Ramipril Cap 10mg | PMS | 0.1034 | 0.1034 | YES | NO | NO |
| 02469073 | RAMIPRIL | Pharma-Ramipril 5mg | PMS | 0.0817 | 0.0817 | YES | NO | NO |
| 02469065 | RAMIPRIL | Pharma-Ramipril 2.5mg | PMS | 0.0817 | 0.0817 | YES | NO | NO |
| 02469057 | RAMIPRIL | Pharma-Ramipril 1.25mg | PMS | 0.0708 | 0.0708 | YES | NO | NO |
| 02469081 | RAMIPRIL | Pharma-Ramipril 10mg | PMS | 0.1034 | 0.1034 | YES | NO | NO |
| 02308363 | RAMIPRIL | Ramipril Cap 1.25mg | SIV | 0.0708 | 0.0708 | YES | NO | NO |
| 02255316 | RAMIPRIL | Ramipril Cap (Not a Benefit) 2.5mg | RIA | N/A | N/A | YES | NO | NO |
| 02287927 | RAMIPRIL | Ramipril Cap 2.5mg | SIV | 0.0817 | 0.0817 | YES | NO | NO |
| 02374846 | RAMIPRIL | Ramipril Cap 2.5mg | SAI | 0.0817 | 0.0817 | YES | NO | NO |
| 02255324 | RAMIPRIL | Ramipril Cap (Not a Benefit) 5mg | RIA | N/A | N/A | YES | NO | NO |
| 02287935 | RAMIPRIL | Ramipril Cap 5mg | SIV | 0.0817 | 0.0817 | YES | NO | NO |
| 02374854 | RAMIPRIL | Ramipril Cap 5mg | SAI | 0.0817 | 0.0817 | YES | NO | NO |
| 02374862 | RAMIPRIL | Ramipril Cap 10mg | SAI | 0.1034 | 0.1034 | YES | NO | NO |
| 02287943 | RAMIPRIL | Ramipril Cap 10mg | SIV | 0.1034 | 0.1034 | YES | NO | NO |
| 02299372 | RAMIPRIL | Ramipril Cap (Not a Benefit) 1.25mg | RIA | N/A | N/A | YES | NO | NO |
| 02255332 | RAMIPRIL | Ramipril Cap (Not a Benefit) 10mg | RIA | N/A | N/A | YES | NO | NO |
| 02310546 | RAMIPRIL | Ran-Ramipril Cap 10mg | RAN | 0.1034 | 0.1034 | YES | NO | NO |
| 02310538 | RAMIPRIL | Ran-Ramipril Cap 5mg | RAN | 0.0817 | 0.0817 | YES | NO | NO |
| 02310511 | RAMIPRIL | Ran-Ramipril Cap 2.5mg | RAN | 0.0817 | 0.0817 | YES | NO | NO |
| 02310503 | RAMIPRIL | Ran-Ramipril Cap 1.25mg | RAN | 0.0708 | 0.0708 | YES | NO | NO |
| 02287706 | RAMIPRIL | Ratio-Ramipril Cap 2.5mg | RPH | 0.0817 | 0.0817 | YES | NO | NO |
| 02247947 | RAMIPRIL | Teva-Ramipril Cap 10mg | TEV | 0.1034 | 0.1034 | YES | NO | NO |
| 02247946 | RAMIPRIL | Teva-Ramipril Cap 5mg | TEV | 0.0817 | 0.0817 | YES | NO | NO |
| 02247945 | RAMIPRIL | Teva-Ramipril Cap 2.5mg | TEV | 0.0817 | 0.0817 | YES | NO | NO |
| 02281112 | RAMIPRIL | Altace (Off-Formulary Interchangeable) 15mg Cap | SAV | N/A | N/A | YES | NO | NO |
| 02325381 | RAMIPRIL | Apo-Ramipril (Off-Formulary Interchangeable) 15mg Cap | APX | 0.8550 | N/A | YES | NO | NO |
| 02440334 | RAMIPRIL | Jamp-Ramipril (Off-Formulary Interchangeable) 15mg Cap | JPC | 0.8550 | N/A | YES | NO | NO |
| 02420503 | RAMIPRIL | Mar-Ramipril (Off-Formulary Interchangeable) 15mg Cap | MAR | 0.8550 | N/A | YES | NO | NO |
| 02421348 | RAMIPRIL | Mint-Ramipril (Off-Formulary Interchangeable) 15mg Cap | MIN | 0.8132 | N/A | YES | NO | NO |
| 02425548 | RAMIPRIL | Ran-Ramipril (Off-Formulary Interchangeable) 15mg Cap | RAN | 0.8550 | N/A | YES | NO | NO |
| 02283166 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 10mg & 12.5mg Tab | SAV | 0.6675 | 0.2634 | YES | NO | NO |
| 02283182 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 10mg & 25mg Tab | SAV | 0.6525 | 0.2634 | YES | NO | NO |
| 02283158 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT (Not a Benefit) 5mg & 12.5mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02283131 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT (Not a Benefit) 2.5mg & 12.5mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02283174 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 5mg & 25mg Tab | SAV | 0.4981 | 0.2872 | YES | NO | NO |
| 02342154 | RAMIPRIL & HYDROCHLOROTHIAZIDE | PMS-Ramipril-HCTZ 10mg & 12.5mg Tab | PMS | 0.2634 | 0.2634 | YES | NO | NO |
| 02342170 | RAMIPRIL & HYDROCHLOROTHIAZIDE | PMS-Ramipril-HCTZ 10mg & 25mg Tab | PMS | 0.2634 | 0.2634 | YES | NO | NO |
| 02449447 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Ran-Ramipril HCTZ 5mg & 12.5mg Tab | RAN | 0.3016 | 0.3016 | YES | NO | NO |
| 02449463 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Ran-Ramipril HCTZ 5mg & 25mg Tab | RAN | 0.2872 | 0.2872 | YES | NO | NO |
| 02449455 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Ran-Ramipril HCTZ 10mg & 12.5mg Tab | RAN | 0.2634 | 0.2634 | YES | NO | NO |
| 02449471 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Ran-Ramipril HCTZ 10mg & 25mg Tab | RAN | 0.2634 | 0.2634 | YES | NO | NO |
| 02449439 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Ran-Ramipril HCTZ 2.5mg & 12.5mg Tab | RAN | 0.2242 | 0.2242 | YES | NO | NO |
| 02525852 | RANIBIZUMAB | Byooviz 10mg/mL Inj Sol-0.23mL Vial Pk (Preservative-Free) | SAM | 900.0000 | 900.0000 | NO | YES | NO |
| 02542250 | RANIBIZUMAB | Ranopto 10mg/mL Inj Sol-0.23mL Vial Pk (Preservative-Free) | TEI | 900.0000 | 900.0000 | NO | YES | NO |
| 02280833 | RANITIDINE HCL | Apo-Ranitidine 15mg/mL Oral Sol | APX | 0.1480 | 0.1480 | YES | NO | NO |
| 02242940 | RANITIDINE HCL | Teva-Ranitidine Solution 15mg/mL Oral Sol | TEV | 0.1480 | 0.1480 | YES | NO | NO |
| 02212374 | RANITIDINE HCL | Zantac (Not a Benefit) 15mg/mL Oral Sol | GSK | N/A | N/A | YES | NO | NO |
| 00733059 | RANITIDINE HCL | Apo-Ranitidine 150mg Tab | APX | 0.1197 | 0.1197 | YES | NO | NO |
| 00733067 | RANITIDINE HCL | Apo-Ranitidine 300mg Tab | APX | 0.2253 | 0.2253 | YES | NO | NO |
| 02248570 | RANITIDINE HCL | Co Ranitidine 150mg Tab | COB | 0.1197 | 0.1197 | YES | NO | NO |
| 02248571 | RANITIDINE HCL | Co Ranitidine 300mg Tab | COB | 0.2253 | 0.2253 | YES | NO | NO |
| 02463725 | RANITIDINE HCL | Jamp-Ranitidine 300mg Tab | JPC | 0.2253 | 0.2253 | YES | NO | NO |
| 02463717 | RANITIDINE HCL | Jamp-Ranitidine 150mg Tab | JPC | 0.1197 | 0.1197 | YES | NO | NO |
| 02443708 | RANITIDINE HCL | Mar-Ranitidine 150mg Tab | MAR | 0.1197 | 0.1197 | YES | NO | NO |
| 02443716 | RANITIDINE HCL | Mar-Ranitidine 300mg Tab | MAR | 0.2253 | 0.2253 | YES | NO | NO |
| 02526387 | RANITIDINE HCL | Mint-Ranitidine 300mg Tab | MIN | 0.2253 | 0.2253 | YES | NO | NO |
| 02526379 | RANITIDINE HCL | Mint-Ranitidine 150mg Tab | MIN | 0.1197 | 0.1197 | YES | NO | NO |
| 02242454 | RANITIDINE HCL | PMS-Ranitidine 300mg Tab | PMS | 0.2253 | 0.2253 | YES | NO | NO |
| 02242453 | RANITIDINE HCL | PMS-Ranitidine 150mg Tab | PMS | 0.1197 | 0.1197 | YES | NO | NO |
| 02336502 | RANITIDINE HCL | Ran-Ranitidine 300mg Tab | RAN | 0.2253 | 0.2253 | YES | NO | NO |
| 02336480 | RANITIDINE HCL | Ran-Ranitidine 150mg Tab | RAN | 0.1197 | 0.1197 | YES | NO | NO |
| 02243230 | RANITIDINE HCL | Sandoz Ranitidine 300mg Tab | SDZ | 0.2253 | 0.2253 | YES | NO | NO |
| 02243229 | RANITIDINE HCL | Sandoz Ranitidine 150mg Tab | SDZ | 0.1197 | 0.1197 | YES | NO | NO |
| 00828564 | RANITIDINE HCL | Teva-Ranitidine 150mg Tab | TEV | 0.1197 | 0.1197 | YES | NO | NO |
| 00828556 | RANITIDINE HCL | Teva-Ranitidine 300mg Tab | TEV | 0.2253 | 0.2253 | YES | NO | NO |
| 02212331 | RANITIDINE HCL | Zantac (Not a Benefit) 150mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02212358 | RANITIDINE HCL | Zantac (Not a Benefit) 300mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02404699 | RASAGILINE MESYLATE | Apo-Rasagiline (Off-Formulary Interchangeable) 1mg Tab | APX | 6.1285 | 6.1285 | YES | NO | NO |
| 02404680 | RASAGILINE MESYLATE | Apo-Rasagiline (Off-Formulary Interchangeable) 0.5mg Tab | APX | 6.1285 | 6.1285 | YES | NO | NO |
| 02284650 | RASAGILINE MESYLATE | Azilect (Off-Formulary Interchangeable) 1mg Tab | TEI | 9.5147 | 6.1285 | YES | NO | NO |
| 02284642 | RASAGILINE MESYLATE | Azilect (Off-Formulary Interchangeable) 0.5mg Tab | TEI | 9.5147 | 6.1285 | YES | NO | NO |
| 02491982 | RASAGILINE MESYLATE | Jamp Rasagiline (Off-Formulary Interchangeable) 1mg Tab | JPC | 6.1285 | 6.1285 | YES | NO | NO |
| 02491974 | RASAGILINE MESYLATE | Jamp Rasagiline (Off-Formulary Interchangeable) 0.5mg Tab | JPC | 6.1285 | 6.1285 | YES | NO | NO |
| 02418444 | RASAGILINE MESYLATE | Teva-Rasagiline (Off-Formulary Interchangeable) 1mg Tab | TEV | 6.1285 | 6.1285 | YES | NO | NO |
| 02418436 | RASAGILINE MESYLATE | Teva-Rasagiline (Off-Formulary Interchangeable) 0.5mg Tab | TEV | 6.1285 | 6.1285 | YES | NO | NO |
| 09858148 | READER KIT AND SENSOR KIT | FreeStyle Libre 2 Reader Flash Glucose Monitoring System - Reader | ABD | N/A | 49.0000 | NO | NO | YES |
| 09858147 | READER KIT AND SENSOR KIT | FreeStyle Libre 2 Sensor Flash Glucose Monitoring System - Sensor | ABD | N/A | 91.0000 | NO | NO | YES |
| 02542137 | RELUGOLIX | Orgovyx 120mg Tab | SMT | 9.0000 | 9.0000 | NO | NO | NO |
| 02502143 | REMDESIVIR | Veklury 100mg/vial Pd for Sol-100mg Vial Pk | GIL | 660.5300 | 660.5300 | NO | YES | NO |
| 02355671 | REPAGLINIDE | Apo-Repaglinide (Off-Formulary Interchangeable) 1mg Tab | APX | 0.2165 | 0.2165 | YES | NO | NO |
| 02355663 | REPAGLINIDE | Apo-Repaglinide (Off-Formulary Interchangeable) 0.5mg Tab | APX | 0.2083 | 0.2083 | YES | NO | NO |
| 02355698 | REPAGLINIDE | Apo-Repaglinide (Off-Formulary Interchangeable) 2mg Tab | APX | 0.2441 | 0.2441 | YES | NO | NO |
| 02424274 | REPAGLINIDE | Auro-Repaglinide (Off-Formulary Interchangeable) 2mg Tab | AUR | 0.2441 | 0.2441 | YES | NO | NO |
| 02424266 | REPAGLINIDE | Auro-Repaglinide (Off-Formulary Interchangeable) 1mg Tab | AUR | 0.2165 | 0.2165 | YES | NO | NO |
| 02424258 | REPAGLINIDE | Auro-Repaglinide (Off-Formulary Interchangeable) 0.5mg Tab | AUR | 0.2083 | 0.2083 | YES | NO | NO |
| 02321491 | REPAGLINIDE | Co Repaglinide (Off-Formulary Interchangeable) 2mg Tab | COB | 0.2441 | 0.2441 | YES | NO | NO |
| 02321483 | REPAGLINIDE | Co Repaglinide (Off-Formulary Interchangeable) 1mg Tab | COB | 0.2165 | 0.2165 | YES | NO | NO |
| 02321475 | REPAGLINIDE | Co Repaglinide (Off-Formulary Interchangeable) 0.5mg Tab | COB | 0.2083 | 0.2083 | YES | NO | NO |
| 02239925 | REPAGLINIDE | GlucoNorm (Off-Formulary Interchangeable) 1mg Tab | NOO | N/A | N/A | YES | NO | NO |
| 02239924 | REPAGLINIDE | GlucoNorm (Off-Formulary Interchangeable) 0.5mg Tab | NOO | N/A | N/A | YES | NO | NO |
| 02239926 | REPAGLINIDE | GlucoNorm (Off-Formulary Interchangeable) 2mg Tab | NOO | N/A | N/A | YES | NO | NO |
| 02354926 | REPAGLINIDE | Jamp Repaglinide (Off-Formulary Interchangeable) 0.5mg Tab | JPC | 0.2083 | 0.2083 | YES | NO | NO |
| 02354942 | REPAGLINIDE | Jamp Repaglinide (Off-Formulary Interchangeable) 2mg Tab | JPC | 0.2441 | 0.2441 | YES | NO | NO |
| 02354934 | REPAGLINIDE | Jamp Repaglinide (Off-Formulary Interchangeable) 1mg Tab | JPC | 0.2165 | 0.2165 | YES | NO | NO |
| 02357488 | REPAGLINIDE | Sandoz Repaglinide (Off-Formulary Interchangeable) 2mg Tab | SDZ | 0.2440 | 0.2440 | YES | NO | NO |
| 02357461 | REPAGLINIDE | Sandoz Repaglinide (Off-Formulary Interchangeable) 1mg Tab | SDZ | 0.2165 | 0.2165 | YES | NO | NO |
| 02357453 | REPAGLINIDE | Sandoz Repaglinide (Off-Formulary Interchangeable) 0.5mg Tab | SDZ | 0.2083 | 0.2083 | YES | NO | NO |
| 02063786 | RIFABUTIN | Mycobutin 150mg Cap | PFI | 6.2161 | 6.2161 | NO | YES | NO |
| 00343617 | RIFAMPIN | Rofact 300mg Cap | VAL | 1.4169 | 1.4169 | NO | NO | YES |
| 00393444 | RIFAMPIN | Rofact 150mg Cap | VAL | 0.9001 | 0.9001 | NO | NO | YES |
| 02410702 | RIFAXIMIN | Zaxine 550mg Tab | SAL | 8.3030 | 8.3030 | NO | YES | NO |
| 02370603 | RILPIVIRINE HYDROCHLORIDE | Edurant 25mg Tab | JAN | 17.7500 | 17.7500 | NO | NO | NO |
| 02352583 | RILUZOLE | Apo-Riluzole (Off-Formulary Interchangeable) 50mg Tab | APX | 7.3630 | 7.3630 | YES | NO | NO |
| 02390299 | RILUZOLE | Mylan-Riluzole (Off-Formulary Interchangeable) 50mg Tab | MYL | 7.3630 | 7.3630 | YES | NO | NO |
| 02242763 | RILUZOLE | Rilutek (Off-Formulary Interchangeable) 50mg Tab | SAC | 10.5500 | 7.3630 | YES | NO | NO |
| 02412764 | RIOCIGUAT | Adempas (Off-Formulary Interchangeable) 0.5mg Tab | BAH | 43.7200 | 24.0460 | YES | NO | NO |
| 02412772 | RIOCIGUAT | Adempas (Off-Formulary Interchangeable) 1mg Tab | BAH | 43.7200 | 24.0460 | YES | NO | NO |
| 02412802 | RIOCIGUAT | Adempas (Off-Formulary Interchangeable) 2mg Tab | BAH | 43.7200 | 24.0460 | YES | NO | NO |
| 02412810 | RIOCIGUAT | Adempas (Off-Formulary Interchangeable) 2.5mg Tab | BAH | 43.7200 | 24.0460 | YES | NO | NO |
| 02412799 | RIOCIGUAT | Adempas (Off-Formulary Interchangeable) 1.5mg Tab | BAH | 43.7200 | 24.0460 | YES | NO | NO |
| 02533561 | RIOCIGUAT | Sandoz Riociguat (Off-Formulary Interchangeable) 1mg Tab | SDZ | 24.0460 | 24.0460 | YES | NO | NO |
| 02533596 | RIOCIGUAT | Sandoz Riociguat (Off-Formulary Interchangeable) 2mg Tab | SDZ | 24.0460 | 24.0460 | YES | NO | NO |
| 02533588 | RIOCIGUAT | Sandoz Riociguat (Off-Formulary Interchangeable) 1.5mg Tab | SDZ | 24.0460 | 24.0460 | YES | NO | NO |
| 02533618 | RIOCIGUAT | Sandoz Riociguat (Off-Formulary Interchangeable) 2.5mg Tab | SDZ | 24.0460 | 24.0460 | YES | NO | NO |
| 02533545 | RIOCIGUAT | Sandoz Riociguat (Off-Formulary Interchangeable) 0.5mg Tab | SDZ | 24.0460 | 24.0460 | YES | NO | NO |
| 02487454 | RISANKIZUMAB | Skyrizi 75mg/0.83mL Inj Sol-0.83mL Pref Syr (Preservative-Free) | ABV | 2467.5000 | 2467.5000 | NO | YES | NO |
| 02519291 | RISANKIZUMAB | Skyrizi 150mg/mL Inj Sol-Pref Pen (Preservative-Free) | ABV | 4935.0000 | 4935.0000 | NO | YES | NO |
| 02519283 | RISANKIZUMAB | Skyrizi 150mg/mL Inj Sol-Pref Syr (Preservative-Free) | ABV | 4935.0000 | 4935.0000 | NO | YES | NO |
| 02493268 | RISEDRONATE SODIUM | AA-Risedronate DR 35mg DR Tab | AAP | 2.9663 | 2.9663 | YES | NO | NO |
| 02370417 | RISEDRONATE SODIUM | Actonel DR 35mg DR Tab | WAR | 11.8653 | 2.9663 | YES | NO | NO |
| 02246896 | RISEDRONATE SODIUM | Actonel (Not a Benefit) 35mg Tab | WAR | N/A | N/A | YES | NO | NO |
| 02239146 | RISEDRONATE SODIUM | Actonel (Not a Benefit) 30mg Tab | WAR | N/A | N/A | YES | NO | NO |
| 02242518 | RISEDRONATE SODIUM | Actonel (Not a Benefit) 5mg Tab | WAR | N/A | N/A | YES | NO | NO |
| 02316838 | RISEDRONATE SODIUM | Actonel 150mg Tab | WAR | 47.3370 | 11.1875 | YES | NO | NO |
| 02377721 | RISEDRONATE SODIUM | Apo-Risedronate 150mg Tab | APX | 11.1875 | 11.1875 | YES | NO | NO |
| 02353687 | RISEDRONATE SODIUM | Apo-Risedronate 35mg Tab | APX | 1.6764 | 1.6764 | YES | NO | NO |
| 02406306 | RISEDRONATE SODIUM | Auro-Risedronate 35mg Tab | AUR | 1.6764 | 1.6764 | YES | NO | NO |
| 02442760 | RISEDRONATE SODIUM | Auro-Risedronate 150mg Tab | AUR | 11.1875 | 11.1875 | YES | NO | NO |
| 02368552 | RISEDRONATE SODIUM | Jamp-Risedronate 35mg Tab | JPC | 1.6764 | 1.6764 | YES | NO | NO |
| 02302209 | RISEDRONATE SODIUM | PMS-Risedronate 35mg Tab | PMS | 1.6764 | 1.6764 | YES | NO | NO |
| 02424177 | RISEDRONATE SODIUM | PMS-Risedronate 150mg Tab | PMS | 11.1875 | 11.1875 | YES | NO | NO |
| 02319861 | RISEDRONATE SODIUM | Ratio-Risedronate 35mg Tab | RPH | 1.6764 | 1.6764 | YES | NO | NO |
| 02528460 | RISEDRONATE SODIUM | Risedronate 150mg Tab | SAI | 11.1875 | 11.1875 | YES | NO | NO |
| 02370255 | RISEDRONATE SODIUM | Risedronate 35mg Tab | SAI | 1.6764 | 1.6764 | YES | NO | NO |
| 02411407 | RISEDRONATE SODIUM | Risedronate 35mg Tab | SIV | 1.6764 | 1.6764 | YES | NO | NO |
| 02341077 | RISEDRONATE SODIUM | Riva-Risedronate 35mg Tab | RIA | 1.6764 | 1.6764 | YES | NO | NO |
| 02327295 | RISEDRONATE SODIUM | Sandoz Risedronate 35mg Tab | SDZ | 1.6764 | 1.6764 | YES | NO | NO |
| 02298392 | RISEDRONATE SODIUM | Teva-Risedronate 35mg Tab | TEV | 1.6764 | 1.6764 | YES | NO | NO |
| 02298376 | RISEDRONATE SODIUM | Teva-Risedronate 5mg Tab | TEV | 1.8445 | 1.8445 | YES | NO | NO |
| 02298384 | RISEDRONATE SODIUM | Teva-Risedronate 30mg Tab | TEV | 11.3807 | 11.3807 | YES | NO | NO |
| 02413809 | RISEDRONATE SODIUM | Teva-Risedronate 150mg Tab | TEV | 11.1875 | 11.1875 | YES | NO | NO |
| 02454319 | RISPERIDONE | Jamp-Risperidone 1mg/mL O/L | JPC | 0.7080 | 0.7080 | YES | NO | NO |
| 02279266 | RISPERIDONE | PMS-Risperidone 1mg/mL O/L | PMS | 0.7080 | 0.7080 | YES | NO | NO |
| 02236950 | RISPERIDONE | Risperdal (Not a Benefit) 1mg/mL O/L | JAN | N/A | N/A | YES | NO | NO |
| 02413515 | RISPERIDONE | Mylan-Risperidone ODT 3mg Orally Disintegrating Tab | MYL | 1.5275 | 1.5275 | YES | NO | NO |
| 02413507 | RISPERIDONE | Mylan-Risperidone ODT 2mg Orally Disintegrating Tab | MYL | 1.0188 | 1.0188 | YES | NO | NO |
| 02413493 | RISPERIDONE | Mylan-Risperidone ODT 1mg Orally Disintegrating Tab | MYL | 0.5150 | 0.5150 | YES | NO | NO |
| 02413485 | RISPERIDONE | Mylan-Risperidone ODT 0.5mg Orally Disintegrating Tab | MYL | 0.5588 | 0.5588 | YES | NO | NO |
| 02413523 | RISPERIDONE | Mylan-Risperidone ODT 4mg Orally Disintegrating Tab | MYL | 2.0425 | 2.0425 | YES | NO | NO |
| 02268094 | RISPERIDONE | Risperdal M-Tab (Not a Benefit) 4mg Orally Disintegrating Tab | JAN | N/A | N/A | YES | NO | NO |
| 02247705 | RISPERIDONE | Risperdal M-Tab (Not a Benefit) 1mg Orally Disintegrating Tab | JAN | N/A | N/A | YES | NO | NO |
| 02247706 | RISPERIDONE | Risperdal M-Tab (Not a Benefit) 2mg Orally Disintegrating Tab | JAN | N/A | N/A | YES | NO | NO |
| 02247704 | RISPERIDONE | Risperdal M-Tab (Not a Benefit) 0.5mg Orally Disintegrating Tab | JAN | N/A | N/A | YES | NO | NO |
| 02268086 | RISPERIDONE | Risperdal M-Tab (Not a Benefit) 3mg Orally Disintegrating Tab | JAN | N/A | N/A | YES | NO | NO |
| 02255707 | RISPERIDONE | Risperdal Consta 25mg Pd for Inj-Vial Pk | JAN | 208.3500 | 208.3500 | NO | NO | YES |
| 02255758 | RISPERIDONE | Risperdal Consta 50mg Pd for Inj-Vial Pk | JAN | 416.6800 | 416.6800 | NO | NO | YES |
| 02255723 | RISPERIDONE | Risperdal Consta 37.5mg Pd for Inj-Vial Pk | JAN | 312.5100 | 312.5100 | NO | NO | YES |
| 02282151 | RISPERIDONE | Apo-Risperidone 3mg Tab | APX | 0.6083 | 0.6083 | YES | NO | NO |
| 02282178 | RISPERIDONE | Apo-Risperidone 4mg Tab | APX | 0.8111 | 0.8111 | YES | NO | NO |
| 02282135 | RISPERIDONE | Apo-Risperidone 1mg Tab | APX | 0.2031 | 0.2031 | YES | NO | NO |
| 02282143 | RISPERIDONE | Apo-Risperidone 2mg Tab | APX | 0.4062 | 0.4062 | YES | NO | NO |
| 02282127 | RISPERIDONE | Apo-Risperidone 0.5mg Tab | APX | 0.1470 | 0.1470 | YES | NO | NO |
| 02282119 | RISPERIDONE | Apo-Risperidone 0.25mg Tab | APX | 0.0878 | 0.0878 | YES | NO | NO |
| 02359588 | RISPERIDONE | Jamp-Risperidone 4mg Tab | JPC | 0.8111 | 0.8111 | YES | NO | NO |
| 02359561 | RISPERIDONE | Jamp-Risperidone 3mg Tab | JPC | 0.6083 | 0.6083 | YES | NO | NO |
| 02359545 | RISPERIDONE | Jamp-Risperidone 1mg Tab | JPC | 0.2031 | 0.2031 | YES | NO | NO |
| 02359537 | RISPERIDONE | Jamp-Risperidone 0.5mg Tab | JPC | 0.1470 | 0.1470 | YES | NO | NO |
| 02359553 | RISPERIDONE | Jamp-Risperidone 2mg Tab | JPC | 0.4062 | 0.4062 | YES | NO | NO |
| 02359529 | RISPERIDONE | Jamp-Risperidone 0.25mg Tab | JPC | 0.0878 | 0.0878 | YES | NO | NO |
| 02371782 | RISPERIDONE | Mar-Risperidone 1mg Tab | MAR | 0.2031 | 0.2031 | YES | NO | NO |
| 02371812 | RISPERIDONE | Mar-Risperidone 4mg Tab | MAR | 0.8111 | 0.8111 | YES | NO | NO |
| 02371790 | RISPERIDONE | Mar-Risperidone 2mg Tab | MAR | 0.4062 | 0.4062 | YES | NO | NO |
| 02371804 | RISPERIDONE | Mar-Risperidone 3mg Tab | MAR | 0.6083 | 0.6083 | YES | NO | NO |
| 02371774 | RISPERIDONE | Mar-Risperidone 0.5mg Tab | MAR | 0.1470 | 0.1470 | YES | NO | NO |
| 02371766 | RISPERIDONE | Mar-Risperidone 0.25mg Tab | MAR | 0.0878 | 0.0878 | YES | NO | NO |
| 02359804 | RISPERIDONE | Mint-Risperidon 0.5mg Tab | MIN | 0.1470 | 0.1470 | YES | NO | NO |
| 02359790 | RISPERIDONE | Mint-Risperidon 0.25mg Tab | MIN | 0.0878 | 0.0878 | YES | NO | NO |
| 02359847 | RISPERIDONE | Mint-Risperidon 4mg Tab | MIN | 0.8111 | 0.8111 | YES | NO | NO |
| 02359839 | RISPERIDONE | Mint-Risperidon 3mg Tab | MIN | 0.6083 | 0.6083 | YES | NO | NO |
| 02359820 | RISPERIDONE | Mint-Risperidon 2mg Tab | MIN | 0.4062 | 0.4062 | YES | NO | NO |
| 02359812 | RISPERIDONE | Mint-Risperidon 1mg Tab | MIN | 0.2031 | 0.2031 | YES | NO | NO |
| 02252066 | RISPERIDONE | PMS-Risperidone 4mg Tab | PMS | 0.8111 | 0.8111 | YES | NO | NO |
| 02252023 | RISPERIDONE | PMS-Risperidone 1mg Tab | PMS | 0.2031 | 0.2031 | YES | NO | NO |
| 02252015 | RISPERIDONE | PMS-Risperidone 0.5mg Tab | PMS | 0.1470 | 0.1470 | YES | NO | NO |
| 02252007 | RISPERIDONE | PMS-Risperidone 0.25mg Tab | PMS | 0.0878 | 0.0878 | YES | NO | NO |
| 02252058 | RISPERIDONE | PMS-Risperidone 3mg Tab | PMS | 0.6083 | 0.6083 | YES | NO | NO |
| 02252031 | RISPERIDONE | PMS-Risperidone 2mg Tab | PMS | 0.4062 | 0.4062 | YES | NO | NO |
| 02328372 | RISPERIDONE | Ran-Risperidone 4mg Tab | RAN | 0.8111 | 0.8111 | YES | NO | NO |
| 02328364 | RISPERIDONE | Ran-Risperidone 3mg Tab | RAN | 0.6083 | 0.6083 | YES | NO | NO |
| 02328321 | RISPERIDONE | Ran-Risperidone 1mg Tab | RAN | 0.2031 | 0.2031 | YES | NO | NO |
| 02328348 | RISPERIDONE | Ran-Risperidone 2mg Tab | RAN | 0.4062 | 0.4062 | YES | NO | NO |
| 02328313 | RISPERIDONE | Ran-Risperidone 0.5mg Tab | RAN | 0.1470 | 0.1470 | YES | NO | NO |
| 02328305 | RISPERIDONE | Ran-Risperidone 0.25mg Tab | RAN | 0.0878 | 0.0878 | YES | NO | NO |
| 02240551 | RISPERIDONE | Risperdal (Not a Benefit) 0.25mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02240552 | RISPERIDONE | Risperdal (Not a Benefit) 0.5mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02025280 | RISPERIDONE | Risperdal (Not a Benefit) 1mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02025299 | RISPERIDONE | Risperdal (Not a Benefit) 2mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02025302 | RISPERIDONE | Risperdal (Not a Benefit) 3mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02025310 | RISPERIDONE | Risperdal (Not a Benefit) 4mg Tab | JAN | N/A | N/A | YES | NO | NO |
| 02356929 | RISPERIDONE | Risperidone 3mg Tab | SAI | 0.6083 | 0.6083 | YES | NO | NO |
| 02356937 | RISPERIDONE | Risperidone 4mg Tab | SAI | 0.8111 | 0.8111 | YES | NO | NO |
| 02533960 | RISPERIDONE | Risperidone 4mg Tab | SIV | 0.8111 | 0.8111 | YES | NO | NO |
| 02533952 | RISPERIDONE | Risperidone 3mg Tab | SIV | 0.6083 | 0.6083 | YES | NO | NO |
| 02533944 | RISPERIDONE | Risperidone 2mg Tab | SIV | 0.4062 | 0.4062 | YES | NO | NO |
| 02356910 | RISPERIDONE | Risperidone 2mg Tab | SAI | 0.4062 | 0.4062 | YES | NO | NO |
| 02533936 | RISPERIDONE | Risperidone 1mg Tab | SIV | 0.2031 | 0.2031 | YES | NO | NO |
| 02356902 | RISPERIDONE | Risperidone 1mg Tab | SAI | 0.2031 | 0.2031 | YES | NO | NO |
| 02533928 | RISPERIDONE | Risperidone 0.5mg Tab | SIV | 0.1470 | 0.1470 | YES | NO | NO |
| 02356899 | RISPERIDONE | Risperidone 0.5mg Tab | SAI | 0.1470 | 0.1470 | YES | NO | NO |
| 02533804 | RISPERIDONE | Risperidone 0.25mg Tab | SIV | 0.0878 | 0.0878 | YES | NO | NO |
| 02356880 | RISPERIDONE | Risperidone 0.25mg Tab | SAI | 0.0878 | 0.0878 | YES | NO | NO |
| 02279835 | RISPERIDONE | Sandoz Risperidone 4mg Tab | SDZ | 0.8111 | 0.8111 | YES | NO | NO |
| 02303663 | RISPERIDONE | Sandoz Risperidone 0.5mg Tab | SDZ | 0.1470 | 0.1470 | YES | NO | NO |
| 02279819 | RISPERIDONE | Sandoz Risperidone 2mg Tab | SDZ | 0.4062 | 0.4062 | YES | NO | NO |
| 02279827 | RISPERIDONE | Sandoz Risperidone 3mg Tab | SDZ | 0.6083 | 0.6083 | YES | NO | NO |
| 02303655 | RISPERIDONE | Sandoz Risperidone 0.25mg Tab | SDZ | 0.0878 | 0.0878 | YES | NO | NO |
| 02279800 | RISPERIDONE | Sandoz Risperidone 1mg Tab | SDZ | 0.2031 | 0.2031 | YES | NO | NO |
| 02264196 | RISPERIDONE | Teva-Risperidone 1mg Tab | TEV | 0.2031 | 0.2031 | YES | NO | NO |
| 02264188 | RISPERIDONE | Teva-Risperidone 0.5mg Tab | TEV | 0.1470 | 0.1470 | YES | NO | NO |
| 02264226 | RISPERIDONE | Teva-Risperidone 3mg Tab | TEV | 0.6083 | 0.6083 | YES | NO | NO |
| 02264218 | RISPERIDONE | Teva-Risperidone 2mg Tab | TEV | 0.4062 | 0.4062 | YES | NO | NO |
| 02282690 | RISPERIDONE | Teva-Risperidone 0.25mg Tab | TEV | 0.0878 | 0.0878 | YES | NO | NO |
| 02264234 | RISPERIDONE | Teva-Risperidone 4mg Tab | TEV | 0.8111 | 0.8111 | YES | NO | NO |
| 02523620 | RITONAVIR | Auro-Ritonavir 100mg Tab | AUR | 1.1745 | 1.1745 | YES | NO | NO |
| 02357593 | RITONAVIR | Norvir 100mg Tab | ABB | 1.5660 | 1.1745 | YES | NO | NO |
| 02498316 | RITUXIMAB | Riximyo 10mg/mL Inj Sol (Preservative-Free) | SDZ | 29.7000 | 29.7000 | NO | YES | NO |
| 02495724 | RITUXIMAB | Ruxience 10mg/mL Inj Sol (Preservative-Free) | PFI | 29.7000 | 29.7000 | NO | YES | NO |
| 02478382 | RITUXIMAB | Truxima 100mg/10mL Inj Sol-10mL Vial Pk | CEH | 297.0000 | 297.0000 | NO | YES | NO |
| 02478390 | RITUXIMAB | Truxima 500mg/50mL Inj Sol-50mL Vial Pk | CEH | 1485.0000 | 1485.0000 | NO | YES | NO |
| 02470519 | RIVAROXABAN | Apo-Rivaroxaban 20mg Tab | APX | 0.7175 | 0.7175 | YES | NO | NO |
| 02470497 | RIVAROXABAN | Apo-Rivaroxaban 10mg Tab | APX | 0.7175 | 0.7175 | YES | NO | NO |
| 02470500 | RIVAROXABAN | Apo-Rivaroxaban 15mg Tab | APX | 0.7175 | 0.7175 | YES | NO | NO |
| 02541734 | RIVAROXABAN | Apo-Rivaroxaban 2.5mg Tab | APX | 0.3550 | 0.3550 | YES | NO | NO |
| 02553368 | RIVAROXABAN | Jamp Rivaroxaban 2.5mg Tab | JPC | 0.3550 | 0.3550 | YES | NO | NO |
| 02516292 | RIVAROXABAN | Jamp Rivaroxaban 10mg Tab | JPC | 0.7175 | 0.7175 | YES | NO | NO |
| 02516306 | RIVAROXABAN | Jamp Rivaroxaban 15mg Tab | JPC | 0.7175 | 0.7175 | YES | NO | NO |
| 02516314 | RIVAROXABAN | Jamp Rivaroxaban 20mg Tab | JPC | 0.7175 | 0.7175 | YES | NO | NO |
| 02551624 | RIVAROXABAN | M-Rivaroxaban 15mg Tab | MAT | 0.7175 | 0.7175 | YES | NO | NO |
| 02551632 | RIVAROXABAN | M-Rivaroxaban 20mg Tab | MAT | 0.7175 | 0.7175 | YES | NO | NO |
| 02551616 | RIVAROXABAN | M-Rivaroxaban 10mg Tab | MAT | 0.7175 | 0.7175 | YES | NO | NO |
| 02551608 | RIVAROXABAN | M-Rivaroxaban 2.5mg Tab | MAT | 0.3550 | 0.3550 | YES | NO | NO |
| 02512076 | RIVAROXABAN | PMS-Rivaroxaban 20mg Tab | PMS | 0.7175 | 0.7175 | YES | NO | NO |
| 02512068 | RIVAROXABAN | PMS-Rivaroxaban 15mg Tab | PMS | 0.7175 | 0.7175 | YES | NO | NO |
| 02512041 | RIVAROXABAN | PMS-Rivaroxaban 10mg Tab | PMS | 0.7175 | 0.7175 | YES | NO | NO |
| 02527537 | RIVAROXABAN | PMS-Rivaroxaban 2.5mg Tab | PMS | 0.3550 | 0.3550 | YES | NO | NO |
| 02472422 | RIVAROXABAN | Reddy-Rivaroxaban 20mg Tab | DRR | 0.7175 | 0.7175 | YES | NO | NO |
| 02472430 | RIVAROXABAN | Reddy-Rivaroxaban 15mg Tab | DRR | 0.7175 | 0.7175 | YES | NO | NO |
| 02524503 | RIVAROXABAN | Reddy-Rivaroxaban 2.5mg Tab | DRR | 0.3550 | 0.3550 | YES | NO | NO |
| 02472414 | RIVAROXABAN | Reddy-Rivaroxaban 10mg Tab | DRR | 0.7175 | 0.7175 | YES | NO | NO |
| 02547899 | RIVAROXABAN | Rivaroxaban 2.5mg Tab | SAI | 0.3550 | 0.3550 | YES | NO | NO |
| 02541467 | RIVAROXABAN | Rivaroxaban 2.5mg Tab | SIV | 0.3550 | 0.3550 | YES | NO | NO |
| 02547910 | RIVAROXABAN | Rivaroxaban 15mg Tab | SAI | 0.7175 | 0.7175 | YES | NO | NO |
| 02541483 | RIVAROXABAN | Rivaroxaban 15mg Tab | SIV | 0.7175 | 0.7175 | YES | NO | NO |
| 02541491 | RIVAROXABAN | Rivaroxaban 20mg Tab | SIV | 0.7175 | 0.7175 | YES | NO | NO |
| 02547929 | RIVAROXABAN | Rivaroxaban 20mg Tab | SAI | 0.7175 | 0.7175 | YES | NO | NO |
| 02547902 | RIVAROXABAN | Rivaroxaban 10mg Tab | SAI | 0.7175 | 0.7175 | YES | NO | NO |
| 02541475 | RIVAROXABAN | Rivaroxaban 10mg Tab | SIV | 0.7175 | 0.7175 | YES | NO | NO |
| 02537877 | RIVAROXABAN | Sandoz Rivaroxaban 2.5mg Tab | SDZ | 0.3550 | 0.3550 | YES | NO | NO |
| 02482223 | RIVAROXABAN | Sandoz Rivaroxaban 10mg Tab | SDZ | 0.7175 | 0.7175 | YES | NO | NO |
| 02482258 | RIVAROXABAN | Sandoz Rivaroxaban 20mg Tab | SDZ | 0.7175 | 0.7175 | YES | NO | NO |
| 02482231 | RIVAROXABAN | Sandoz Rivaroxaban 15mg Tab | SDZ | 0.7175 | 0.7175 | YES | NO | NO |
| 02526786 | RIVAROXABAN | Taro-Rivaroxaban 2.5mg Tab | TAR | 0.3550 | 0.3550 | YES | NO | NO |
| 02483815 | RIVAROXABAN | Taro-Rivaroxaban 15mg Tab | TAR | 0.7175 | 0.7175 | YES | NO | NO |
| 02483807 | RIVAROXABAN | Taro-Rivaroxaban 10mg Tab | TAR | 0.7175 | 0.7175 | YES | NO | NO |
| 02483823 | RIVAROXABAN | Taro-Rivaroxaban 20mg Tab | TAR | 0.7175 | 0.7175 | YES | NO | NO |
| 02507196 | RIVAROXABAN | Teva-Rivaroxaban 10mg Tab | TEV | 0.7175 | 0.7175 | YES | NO | NO |
| 02507218 | RIVAROXABAN | Teva-Rivaroxaban 15mg Tab | TEV | 0.7175 | 0.7175 | YES | NO | NO |
| 02547295 | RIVAROXABAN | Teva-Rivaroxaban 2.5mg Tab | TEV | 0.3550 | 0.3550 | YES | NO | NO |
| 02507226 | RIVAROXABAN | Teva-Rivaroxaban 20mg Tab | TEV | 0.7175 | 0.7175 | YES | NO | NO |
| 02480808 | RIVAROXABAN | Xarelto 2.5mg Tab | BAH | 1.4200 | 0.3550 | YES | NO | NO |
| 02378604 | RIVAROXABAN | Xarelto 15mg Tab | BAH | 2.8700 | 0.7175 | YES | NO | NO |
| 02316986 | RIVAROXABAN | Xarelto 10mg Tab | BAH | 2.8700 | 0.7175 | YES | NO | NO |
| 02378612 | RIVAROXABAN | Xarelto 20mg Tab | BAH | 2.8700 | 0.7175 | YES | NO | NO |
| 02336758 | RIVASTIGMINE | Apo-Rivastigmine 6mg Cap | APX | 0.6515 | 0.6514 | YES | YES | NO |
| 02336715 | RIVASTIGMINE | Apo-Rivastigmine 1.5mg Cap | APX | 0.6515 | 0.6514 | YES | YES | NO |
| 02336723 | RIVASTIGMINE | Apo-Rivastigmine 3mg Cap | APX | 0.6515 | 0.6514 | YES | YES | NO |
| 02336731 | RIVASTIGMINE | Apo-Rivastigmine 4.5mg Cap | APX | 0.6515 | 0.6514 | YES | YES | NO |
| 02242115 | RIVASTIGMINE | Exelon 1.5mg Cap | KNT | 3.3050 | 0.6514 | YES | YES | NO |
| 02242118 | RIVASTIGMINE | Exelon 6mg Cap | KNT | 3.3050 | 0.6514 | YES | YES | NO |
| 02242117 | RIVASTIGMINE | Exelon 4.5mg Cap | KNT | 3.3050 | 0.6514 | YES | YES | NO |
| 02242116 | RIVASTIGMINE | Exelon 3mg Cap | KNT | 3.3050 | 0.6514 | YES | YES | NO |
| 02485370 | RIVASTIGMINE | Jamp Rivastigmine 3mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02485397 | RIVASTIGMINE | Jamp Rivastigmine 6mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02485389 | RIVASTIGMINE | Jamp Rivastigmine 4.5mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02485362 | RIVASTIGMINE | Jamp Rivastigmine 1.5mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02552264 | RIVASTIGMINE | Jamp Rivastigmine Capsules 3mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02552280 | RIVASTIGMINE | Jamp Rivastigmine Capsules 6mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02552272 | RIVASTIGMINE | Jamp Rivastigmine Capsules 4.5mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02552256 | RIVASTIGMINE | Jamp Rivastigmine Capsules 1.5mg Cap | JPC | 0.6514 | 0.6514 | YES | YES | NO |
| 02401614 | RIVASTIGMINE | Med-Rivastigmine 1.5mg Cap | GMP | 0.6514 | 0.6514 | YES | YES | NO |
| 02401622 | RIVASTIGMINE | Med-Rivastigmine 3mg Cap | GMP | 0.6514 | 0.6514 | YES | YES | NO |
| 02401630 | RIVASTIGMINE | Med-Rivastigmine 4.5mg Cap | GMP | 0.6514 | 0.6514 | YES | YES | NO |
| 02401649 | RIVASTIGMINE | Med-Rivastigmine 6mg Cap | GMP | 0.6514 | 0.6514 | YES | YES | NO |
| 02407019 | RIVASTIGMINE | Mint-Rivastigmine 6mg Cap | MIN | 0.6515 | 0.6514 | YES | YES | NO |
| 02406993 | RIVASTIGMINE | Mint-Rivastigmine 3mg Cap | MIN | 0.6515 | 0.6514 | YES | YES | NO |
| 02406985 | RIVASTIGMINE | Mint-Rivastigmine 1.5mg Cap | MIN | 0.6515 | 0.6514 | YES | YES | NO |
| 02407000 | RIVASTIGMINE | Mint-Rivastigmine 4.5mg Cap | MIN | 0.6515 | 0.6514 | YES | YES | NO |
| 02324571 | RIVASTIGMINE | Sandoz Rivastigmine 3mg Cap | SDZ | 0.6514 | 0.6514 | YES | YES | NO |
| 02324598 | RIVASTIGMINE | Sandoz Rivastigmine 4.5mg Cap | SDZ | 0.6514 | 0.6514 | YES | YES | NO |
| 02324563 | RIVASTIGMINE | Sandoz Rivastigmine 1.5mg Cap | SDZ | 0.6514 | 0.6514 | YES | YES | NO |
| 02324601 | RIVASTIGMINE | Sandoz Rivastigmine 6mg Cap | SDZ | 0.6514 | 0.6514 | YES | YES | NO |
| 02302853 | RIVASTIGMINE | Exelon Patch 10 (Off-Formulary Interchangeable) 18mg/10 Sq Cm Trans Patch | KNT | N/A | N/A | YES | NO | NO |
| 02302845 | RIVASTIGMINE | Exelon Patch 5 (Off-Formulary Interchangeable) 9mg/5 Sq Cm Trans Patch | KNT | N/A | N/A | YES | NO | NO |
| 02423421 | RIVASTIGMINE | Mylan-Rivastigmine Patch 10 (Off-Formulary Interchangeable) 18mg/10 Sq Cm Trans Patch | MYL | 3.9773 | N/A | YES | NO | NO |
| 02423413 | RIVASTIGMINE | Mylan-Rivastigmine Patch 5 (Off-Formulary Interchangeable) 9mg/5 Sq Cm Trans Patch | MYL | 3.9773 | N/A | YES | NO | NO |
| 02426307 | RIVASTIGMINE | Sandoz Rivastigmine Patch 10 (Off-Formulary Interchangeable) 18mg/10 Sq Cm Trans Patch | SDZ | 3.9773 | N/A | YES | NO | NO |
| 02426293 | RIVASTIGMINE | Sandoz Rivastigmine Patch 5 (Off-Formulary Interchangeable) 9mg/5 Sq Cm Trans Patch | SDZ | 3.9773 | N/A | YES | NO | NO |
| 02492490 | RIZATRIPTAN | AG-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | ANG | 11.1150 | 11.1150 | YES | NO | NO |
| 02483289 | RIZATRIPTAN | Accel-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | ACC | 7.7800 | 7.7800 | YES | NO | NO |
| 02483270 | RIZATRIPTAN | Accel-Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | ACC | 7.7800 | 7.7800 | YES | NO | NO |
| 02393484 | RIZATRIPTAN | Apo-Rizatriptan RPD (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | APX | 11.1150 | 11.1150 | YES | NO | NO |
| 02393492 | RIZATRIPTAN | Apo-Rizatriptan RPD (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | APX | 11.1150 | 11.1150 | YES | NO | NO |
| 02458764 | RIZATRIPTAN | CCP-Rizatriptan (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | CCP | 11.1150 | 11.1150 | YES | NO | NO |
| 02458772 | RIZATRIPTAN | CCP-Rizatriptan (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | CCP | 11.1150 | 11.1150 | YES | NO | NO |
| 02374749 | RIZATRIPTAN | Co Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | COB | 11.1150 | 11.1150 | YES | NO | NO |
| 02374730 | RIZATRIPTAN | Co Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | COB | 11.1150 | 11.1150 | YES | NO | NO |
| 02465086 | RIZATRIPTAN | Jamp-Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | JPC | 11.1150 | 11.1150 | YES | NO | NO |
| 02465094 | RIZATRIPTAN | Jamp-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | JPC | 11.1150 | 11.1150 | YES | NO | NO |
| 02462788 | RIZATRIPTAN | Mar-Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | MAR | 11.1150 | 11.1150 | YES | NO | NO |
| 02462796 | RIZATRIPTAN | Mar-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | MAR | 11.1150 | 11.1150 | YES | NO | NO |
| 02240518 | RIZATRIPTAN | Maxalt RPD (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | OCI | 22.5608 | 11.1650 | YES | NO | NO |
| 02240519 | RIZATRIPTAN | Maxalt RPD (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | OCI | 22.5608 | 11.1650 | YES | NO | NO |
| 02439573 | RIZATRIPTAN | Mint-Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | MIN | 11.1150 | 11.1150 | YES | NO | NO |
| 02439581 | RIZATRIPTAN | Mint-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | MIN | 11.1150 | 11.1150 | YES | NO | NO |
| 02379201 | RIZATRIPTAN | Mylan-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | MYL | 11.1150 | 11.1150 | YES | NO | NO |
| 02379198 | RIZATRIPTAN | Mylan-Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | MYL | 11.1150 | 11.1150 | YES | NO | NO |
| 02489384 | RIZATRIPTAN | NRA-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | NRA | 11.1150 | 11.1150 | YES | NO | NO |
| 02436612 | RIZATRIPTAN | Nat-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | NAT | 11.1650 | 11.1650 | YES | NO | NO |
| 02436604 | RIZATRIPTAN | Nat-Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | NAT | 11.1650 | 11.1650 | YES | NO | NO |
| 02393379 | RIZATRIPTAN | PMS-Rizatriptan RDT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | PMS | 11.1150 | 11.1150 | YES | NO | NO |
| 02393360 | RIZATRIPTAN | PMS-Rizatriptan RDT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | PMS | 11.1150 | 11.1150 | YES | NO | NO |
| 02446138 | RIZATRIPTAN | Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | SIV | 11.1150 | 11.1150 | YES | NO | NO |
| 02446111 | RIZATRIPTAN | Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | SIV | 11.1150 | 11.1150 | YES | NO | NO |
| 02442906 | RIZATRIPTAN | Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | SAI | 11.1150 | 11.1150 | YES | NO | NO |
| 02442914 | RIZATRIPTAN | Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | SAI | 11.1150 | 11.1150 | YES | NO | NO |
| 02351889 | RIZATRIPTAN | Sandoz Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | SDZ | 11.1150 | 11.1150 | YES | NO | NO |
| 02351870 | RIZATRIPTAN | Sandoz Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | SDZ | 11.1150 | 11.1150 | YES | NO | NO |
| 02396688 | RIZATRIPTAN | Teva-Rizatriptan ODT (Off-Formulary Interchangeable) 10mg Orally Disintegrating Tab | TEV | 11.1150 | 11.1150 | YES | NO | NO |
| 02396661 | RIZATRIPTAN | Teva-Rizatriptan ODT (Off-Formulary Interchangeable) 5mg Orally Disintegrating Tab | TEV | 11.1150 | 11.1150 | YES | NO | NO |
| 02381702 | RIZATRIPTAN | Act Rizatriptan (Off-Formulary Interchangeable) 10mg Tab | TEV | 11.1150 | 11.1150 | YES | NO | NO |
| 02393476 | RIZATRIPTAN | Apo-Rizatriptan (Off-Formulary Interchangeable) 10mg Tab | APX | 11.1150 | 11.1150 | YES | NO | NO |
| 02393468 | RIZATRIPTAN | Apo-Rizatriptan (Off-Formulary Interchangeable) 5mg Tab | APX | 12.5970 | 12.5970 | YES | NO | NO |
| 02441144 | RIZATRIPTAN | Auro-Rizatriptan (Off-Formulary Interchangeable) 10mg Tab | AUR | 11.1150 | 11.1150 | YES | NO | NO |
| 02380455 | RIZATRIPTAN | Jamp-Rizatriptan (Off-Formulary Interchangeable) 5mg Tab | JPC | 11.1150 | 11.1150 | YES | NO | NO |
| 02380463 | RIZATRIPTAN | Jamp-Rizatriptan (Off-Formulary Interchangeable) 10mg Tab | JPC | 11.1150 | 11.1150 | YES | NO | NO |
| 02429241 | RIZATRIPTAN | Jamp-Rizatriptan IR (Off-Formulary Interchangeable) 10mg Tab | JPC | 11.1150 | 11.1150 | YES | NO | NO |
| 02429233 | RIZATRIPTAN | Jamp-Rizatriptan IR (Off-Formulary Interchangeable) 5mg Tab | JPC | 11.1150 | 11.1150 | YES | NO | NO |
| 02379678 | RIZATRIPTAN | Mar-Rizatriptan (Off-Formulary Interchangeable) 10mg Tab | MAR | 11.1150 | 11.1150 | YES | NO | NO |
| 02240520 | RIZATRIPTAN | Maxalt (Off-Formulary Interchangeable) 5mg Tab | FRS | N/A | N/A | YES | NO | NO |
| 02240521 | RIZATRIPTAN | Maxalt (Off-Formulary Interchangeable) 10mg Tab | OCI | 22.5608 | 11.1150 | YES | NO | NO |
| 02516756 | RIZATRIPTAN | Rizatriptan (Off-Formulary Interchangeable) 10mg Tab | SAI | 11.1150 | 11.1150 | YES | NO | NO |
| 02314088 | ROPINIROLE | Ran-Ropinirole 5mg Tab | RAN | 1.7450 | 1.7450 | YES | NO | NO |
| 02314061 | ROPINIROLE | Ran-Ropinirole 2mg Tab | RAN | 0.6338 | 0.6338 | YES | NO | NO |
| 02314037 | ROPINIROLE | Ran-Ropinirole 0.25mg Tab | RAN | 0.1441 | 0.1441 | YES | NO | NO |
| 02314053 | ROPINIROLE | Ran-Ropinirole 1mg Tab | RAN | 0.5762 | 0.5762 | YES | NO | NO |
| 02232569 | ROPINIROLE | ReQuip (Not a Benefit) 5mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02232565 | ROPINIROLE | ReQuip (Not a Benefit) 0.25mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02232568 | ROPINIROLE | ReQuip (Not a Benefit) 2mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02232567 | ROPINIROLE | ReQuip (Not a Benefit) 1mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02316846 | ROPINIROLE | Teva-Ropinirole 0.25mg Tab | TEV | 0.1441 | 0.1441 | YES | NO | NO |
| 02316862 | ROPINIROLE | Teva-Ropinirole 2mg Tab | TEV | 0.6338 | 0.6338 | YES | NO | NO |
| 02316870 | ROPINIROLE | Teva-Ropinirole 5mg Tab | TEV | 1.7450 | 1.7450 | YES | NO | NO |
| 02316854 | ROPINIROLE | Teva-Ropinirole 1mg Tab | TEV | 0.5762 | 0.5762 | YES | NO | NO |
| 02241113 | ROSIGLITAZONE | Avandia (Off-Formulary Interchangeable) 4mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02241112 | ROSIGLITAZONE | Avandia (Off-Formulary Interchangeable) 2mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02241114 | ROSIGLITAZONE | Avandia (Off-Formulary Interchangeable) 8mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02403374 | ROSIGLITAZONE | Rosiglitazone (Off-Formulary Interchangeable) 4mg Tab | AAP | 1.9197 | 1.9197 | YES | NO | NO |
| 02403382 | ROSIGLITAZONE | Rosiglitazone (Off-Formulary Interchangeable) 8mg Tab | AAP | 2.7452 | 2.7452 | YES | NO | NO |
| 02403366 | ROSIGLITAZONE | Rosiglitazone (Off-Formulary Interchangeable) 2mg Tab | AAP | 1.2234 | 1.2234 | YES | NO | NO |
| 02438917 | ROSUVASTATIN CALCIUM | Ach-Rosuvastatin 5mg Tab | ACH | 0.1284 | 0.1284 | YES | NO | NO |
| 02438933 | ROSUVASTATIN CALCIUM | Ach-Rosuvastatin 20mg Tab | ACH | 0.1692 | 0.1692 | YES | NO | NO |
| 02438941 | ROSUVASTATIN CALCIUM | Ach-Rosuvastatin 40mg Tab | ACH | 0.1990 | 0.1990 | YES | NO | NO |
| 02438925 | ROSUVASTATIN CALCIUM | Ach-Rosuvastatin 10mg Tab | ACH | 0.1354 | 0.1354 | YES | NO | NO |
| 02337975 | ROSUVASTATIN CALCIUM | Apo-Rosuvastatin 5mg Tab | APX | 0.1284 | 0.1284 | YES | NO | NO |
| 02337991 | ROSUVASTATIN CALCIUM | Apo-Rosuvastatin 20mg Tab | APX | 0.1692 | 0.1692 | YES | NO | NO |
| 02337983 | ROSUVASTATIN CALCIUM | Apo-Rosuvastatin 10mg Tab | APX | 0.1354 | 0.1354 | YES | NO | NO |
| 02338009 | ROSUVASTATIN CALCIUM | Apo-Rosuvastatin 40mg Tab | APX | 0.1990 | 0.1990 | YES | NO | NO |
| 02442590 | ROSUVASTATIN CALCIUM | Auro-Rosuvastatin 20mg Tab | AUR | 0.1692 | 0.1692 | YES | NO | NO |
| 02442574 | ROSUVASTATIN CALCIUM | Auro-Rosuvastatin 5mg Tab | AUR | 0.1284 | 0.1284 | YES | NO | NO |
| 02442604 | ROSUVASTATIN CALCIUM | Auro-Rosuvastatin 40mg Tab | AUR | 0.1990 | 0.1990 | YES | NO | NO |
| 02442582 | ROSUVASTATIN CALCIUM | Auro-Rosuvastatin 10mg Tab | AUR | 0.1354 | 0.1354 | YES | NO | NO |
| 02339773 | ROSUVASTATIN CALCIUM | Co Rosuvastatin 10mg Tab | COB | 0.1354 | 0.1354 | YES | NO | NO |
| 02339781 | ROSUVASTATIN CALCIUM | Co Rosuvastatin 20mg Tab | COB | 0.1692 | 0.1692 | YES | NO | NO |
| 02339803 | ROSUVASTATIN CALCIUM | Co Rosuvastatin 40mg Tab | COB | 0.1990 | 0.1990 | YES | NO | NO |
| 02339765 | ROSUVASTATIN CALCIUM | Co Rosuvastatin 5mg Tab | COB | 0.1284 | 0.1284 | YES | NO | NO |
| 02247164 | ROSUVASTATIN CALCIUM | Crestor 40mg Tab | AZC | 2.3104 | 0.1990 | YES | NO | NO |
| 02247163 | ROSUVASTATIN CALCIUM | Crestor 20mg Tab | AZC | 1.9683 | 0.1692 | YES | NO | NO |
| 02265540 | ROSUVASTATIN CALCIUM | Crestor 5mg Tab | AZC | 1.4893 | 0.1284 | YES | NO | NO |
| 02247162 | ROSUVASTATIN CALCIUM | Crestor 10mg Tab | AZC | 1.5816 | 0.1354 | YES | NO | NO |
| 02498359 | ROSUVASTATIN CALCIUM | Jamp Rosuvastatin Calcium 20mg Tab | JPC | 0.1692 | 0.1692 | YES | NO | NO |
| 02498340 | ROSUVASTATIN CALCIUM | Jamp Rosuvastatin Calcium 10mg Tab | JPC | 0.1354 | 0.1354 | YES | NO | NO |
| 02498332 | ROSUVASTATIN CALCIUM | Jamp Rosuvastatin Calcium 5mg Tab | JPC | 0.1284 | 0.1284 | YES | NO | NO |
| 02498367 | ROSUVASTATIN CALCIUM | Jamp Rosuvastatin Calcium 40mg Tab | JPC | 0.1990 | 0.1990 | YES | NO | NO |
| 02391260 | ROSUVASTATIN CALCIUM | Jamp-Rosuvastatin 10mg Tab | JPC | 0.1354 | 0.1354 | YES | NO | NO |
| 02391279 | ROSUVASTATIN CALCIUM | Jamp-Rosuvastatin 20mg Tab | JPC | 0.1692 | 0.1692 | YES | NO | NO |
| 02391287 | ROSUVASTATIN CALCIUM | Jamp-Rosuvastatin 40mg Tab | JPC | 0.1990 | 0.1990 | YES | NO | NO |
| 02391252 | ROSUVASTATIN CALCIUM | Jamp-Rosuvastatin 5mg Tab | JPC | 0.1284 | 0.1284 | YES | NO | NO |
| 02496534 | ROSUVASTATIN CALCIUM | M-Rosuvastatin 5mg Tab | MAT | 0.1284 | 0.1284 | YES | NO | NO |
| 02496569 | ROSUVASTATIN CALCIUM | M-Rosuvastatin 40mg Tab | MAT | 0.1990 | 0.1990 | YES | NO | NO |
| 02496542 | ROSUVASTATIN CALCIUM | M-Rosuvastatin 10mg Tab | MAT | 0.1354 | 0.1354 | YES | NO | NO |
| 02496550 | ROSUVASTATIN CALCIUM | M-Rosuvastatin 20mg Tab | MAT | 0.1692 | 0.1692 | YES | NO | NO |
| 02413051 | ROSUVASTATIN CALCIUM | Mar-Rosuvastatin 5mg Tab | MAR | 0.1284 | 0.1284 | YES | NO | NO |
| 02413086 | ROSUVASTATIN CALCIUM | Mar-Rosuvastatin 20mg Tab | MAR | 0.1692 | 0.1692 | YES | NO | NO |
| 02413108 | ROSUVASTATIN CALCIUM | Mar-Rosuvastatin 40mg Tab | MAR | 0.1990 | 0.1990 | YES | NO | NO |
| 02413078 | ROSUVASTATIN CALCIUM | Mar-Rosuvastatin 10mg Tab | MAR | 0.1354 | 0.1354 | YES | NO | NO |
| 02399164 | ROSUVASTATIN CALCIUM | Med-Rosuvastatin 5mg Tab | GMP | 0.1284 | 0.1284 | YES | NO | NO |
| 02399172 | ROSUVASTATIN CALCIUM | Med-Rosuvastatin 10mg Tab | GMP | 0.1354 | 0.1354 | YES | NO | NO |
| 02399180 | ROSUVASTATIN CALCIUM | Med-Rosuvastatin 20mg Tab | GMP | 0.1692 | 0.1692 | YES | NO | NO |
| 02399199 | ROSUVASTATIN CALCIUM | Med-Rosuvastatin 40mg Tab | GMP | 0.1990 | 0.1990 | YES | NO | NO |
| 02397803 | ROSUVASTATIN CALCIUM | Mint-Rosuvastatin 10mg Tab | MIN | 0.1354 | 0.1354 | YES | NO | NO |
| 02397781 | ROSUVASTATIN CALCIUM | Mint-Rosuvastatin 5mg Tab | MIN | 0.1284 | 0.1284 | YES | NO | NO |
| 02397811 | ROSUVASTATIN CALCIUM | Mint-Rosuvastatin 20mg Tab | MIN | 0.1692 | 0.1692 | YES | NO | NO |
| 02397838 | ROSUVASTATIN CALCIUM | Mint-Rosuvastatin 40mg Tab | MIN | 0.1990 | 0.1990 | YES | NO | NO |
| 02477491 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin 10mg Tab | NRA | 0.1354 | 0.1354 | YES | NO | NO |
| 02477505 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin 20mg Tab | NRA | 0.1692 | 0.1692 | YES | NO | NO |
| 02477513 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin 40mg Tab | NRA | 0.1990 | 0.1990 | YES | NO | NO |
| 02477483 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin 5mg Tab | NRA | 0.1284 | 0.1284 | YES | NO | NO |
| 02536633 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin Tablets 40mg Tab | NRA | 0.1990 | 0.1990 | YES | NO | NO |
| 02536595 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin Tablets 5mg Tab | NRA | 0.1284 | 0.1284 | YES | NO | NO |
| 02536609 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin Tablets 10mg Tab | NRA | 0.1354 | 0.1354 | YES | NO | NO |
| 02536625 | ROSUVASTATIN CALCIUM | NRA-Rosuvastatin Tablets 20mg Tab | NRA | 0.1692 | 0.1692 | YES | NO | NO |
| 02378566 | ROSUVASTATIN CALCIUM | PMS-Rosuvastatin 40mg Tab | PMS | 0.1990 | 0.1990 | YES | NO | NO |
| 02378531 | ROSUVASTATIN CALCIUM | PMS-Rosuvastatin 10mg Tab | PMS | 0.1354 | 0.1354 | YES | NO | NO |
| 02378558 | ROSUVASTATIN CALCIUM | PMS-Rosuvastatin 20mg Tab | PMS | 0.1692 | 0.1692 | YES | NO | NO |
| 02378523 | ROSUVASTATIN CALCIUM | PMS-Rosuvastatin 5mg Tab | PMS | 0.1284 | 0.1284 | YES | NO | NO |
| 02505606 | ROSUVASTATIN CALCIUM | PRZ-Rosuvastatin 40mg Tab | PRZ | 0.1990 | 0.1990 | YES | NO | NO |
| 02505584 | ROSUVASTATIN CALCIUM | PRZ-Rosuvastatin 10mg Tab | PRZ | 0.1354 | 0.1354 | YES | NO | NO |
| 02505592 | ROSUVASTATIN CALCIUM | PRZ-Rosuvastatin 20mg Tab | PRZ | 0.1692 | 0.1692 | YES | NO | NO |
| 02505576 | ROSUVASTATIN CALCIUM | PRZ-Rosuvastatin 5mg Tab | PRZ | 0.1284 | 0.1284 | YES | NO | NO |
| 02411644 | ROSUVASTATIN CALCIUM | Rosuvastatin 20mg Tab | SIV | 0.1692 | 0.1692 | YES | NO | NO |
| 02405644 | ROSUVASTATIN CALCIUM | Rosuvastatin 20mg Tab | SAI | 0.1692 | 0.1692 | YES | NO | NO |
| 02405636 | ROSUVASTATIN CALCIUM | Rosuvastatin 10mg Tab | SAI | 0.1354 | 0.1354 | YES | NO | NO |
| 02411636 | ROSUVASTATIN CALCIUM | Rosuvastatin 10mg Tab | SIV | 0.1354 | 0.1354 | YES | NO | NO |
| 02411628 | ROSUVASTATIN CALCIUM | Rosuvastatin 5mg Tab | SIV | 0.1284 | 0.1284 | YES | NO | NO |
| 02405628 | ROSUVASTATIN CALCIUM | Rosuvastatin 5mg Tab | SAI | 0.1284 | 0.1284 | YES | NO | NO |
| 02411652 | ROSUVASTATIN CALCIUM | Rosuvastatin 40mg Tab | SIV | 0.1990 | 0.1990 | YES | NO | NO |
| 02405652 | ROSUVASTATIN CALCIUM | Rosuvastatin 40mg Tab | SAI | 0.1990 | 0.1990 | YES | NO | NO |
| 02338726 | ROSUVASTATIN CALCIUM | Sandoz Rosuvastatin 5mg Tab | SDZ | 0.1284 | 0.1284 | YES | NO | NO |
| 02338750 | ROSUVASTATIN CALCIUM | Sandoz Rosuvastatin 40mg Tab | SDZ | 0.1990 | 0.1990 | YES | NO | NO |
| 02338734 | ROSUVASTATIN CALCIUM | Sandoz Rosuvastatin 10mg Tab | SDZ | 0.1354 | 0.1354 | YES | NO | NO |
| 02338742 | ROSUVASTATIN CALCIUM | Sandoz Rosuvastatin 20mg Tab | SDZ | 0.1692 | 0.1692 | YES | NO | NO |
| 02382679 | ROSUVASTATIN CALCIUM | Taro-Rosuvastatin 40mg Tab | SPC | 0.1990 | 0.1990 | YES | NO | NO |
| 02382660 | ROSUVASTATIN CALCIUM | Taro-Rosuvastatin 20mg Tab | SPC | 0.1692 | 0.1692 | YES | NO | NO |
| 02382644 | ROSUVASTATIN CALCIUM | Taro-Rosuvastatin 5mg Tab | SPC | 0.1284 | 0.1284 | YES | NO | NO |
| 02382652 | ROSUVASTATIN CALCIUM | Taro-Rosuvastatin 10mg Tab | SPC | 0.1354 | 0.1354 | YES | NO | NO |
| 02354616 | ROSUVASTATIN CALCIUM | Teva-Rosuvastatin 10mg Tab | TEV | 0.1354 | 0.1354 | YES | NO | NO |
| 02354624 | ROSUVASTATIN CALCIUM | Teva-Rosuvastatin 20mg Tab | TEV | 0.1692 | 0.1692 | YES | NO | NO |
| 02354608 | ROSUVASTATIN CALCIUM | Teva-Rosuvastatin 5mg Tab | TEV | 0.1284 | 0.1284 | YES | NO | NO |
| 02354632 | ROSUVASTATIN CALCIUM | Teva-Rosuvastatin 40mg Tab | TEV | 0.1990 | 0.1990 | YES | NO | NO |
| 02403927 | ROTIGOTINE | Neupro 4mg/24hr Trans Patch | UCB | 6.8250 | 6.8250 | NO | YES | NO |
| 02403943 | ROTIGOTINE | Neupro 8mg/24hr Trans Patch | UCB | 7.6333 | 7.6333 | NO | YES | NO |
| 02403935 | ROTIGOTINE | Neupro 6mg/24hr Trans Patch | UCB | 7.6333 | 7.6333 | NO | YES | NO |
| 02403900 | ROTIGOTINE | Neupro 2mg/24hr Trans Patch | UCB | 3.7170 | 3.7170 | NO | YES | NO |
| 02545993 | RUFINAMIDE | Auro-Rufinamide (Off-Formulary Interchangeable) 400mg Tab | AUR | 2.1970 | 2.1970 | YES | NO | NO |
| 02545985 | RUFINAMIDE | Auro-Rufinamide (Off-Formulary Interchangeable) 200mg Tab | AUR | 1.0083 | 1.0083 | YES | NO | NO |
| 02369648 | RUFINAMIDE | Banzel (Off-Formulary Interchangeable) 400mg Tab | EIS | 4.1503 | 2.1970 | YES | NO | NO |
| 02369621 | RUFINAMIDE | Banzel (Off-Formulary Interchangeable) 200mg Tab | EIS | 1.9047 | 1.0083 | YES | NO | NO |
| 02553155 | RUPATADINE | Apo-Rupatadine (Off-Formulary Interchangeable) 10mg Tab | APX | 0.9993 | N/A | YES | NO | NO |
| 02552604 | RUPATADINE | PMS-Rupatadine (Off-Formulary Interchangeable) 10mg Tab | PMS | 0.9993 | N/A | YES | NO | NO |
| 02560119 | RUPATADINE | Riva-Rupatadine (Off-Formulary Interchangeable) 10mg Tab | RIA | 0.9993 | N/A | YES | NO | NO |
| 02456451 | RUPATADINE | Rupall (Off-Formulary Interchangeable) 10mg Tab | MPI | N/A | N/A | YES | NO | NO |
| 02446936 | SACUBITRIL & VALSARTAN | Entresto 48.6mg & 51.4mg Tab | NOV | 3.7060 | 3.7060 | NO | YES | NO |
| 02446928 | SACUBITRIL & VALSARTAN | Entresto 24.3mg & 25.7mg Tab | NOV | 3.7060 | 3.7060 | NO | YES | NO |
| 02446944 | SACUBITRIL & VALSARTAN | Entresto 97.2mg & 102.8mg Tab | NOV | 3.7060 | 3.7060 | NO | YES | NO |
| 02208229 | SALBUTAMOL | PMS-Salbutamol 1mg/mL Inh Sol- 2.5mL Pk | PMS | 0.3617 | 0.3617 | YES | YES | NO |
| 02208237 | SALBUTAMOL | PMS-Salbutamol 2mg/mL Inh Sol- 2.5mL Pk | PMS | 0.6750 | 0.6750 | YES | YES | NO |
| 02173360 | SALBUTAMOL | Teva-Salbutamol Sterinebs P.F. 2mg/mL Inh Sol- 2.5mL Pk | TEV | 0.6871 | 0.6750 | YES | YES | NO |
| 01926934 | SALBUTAMOL | Teva-Salbutamol Sterinebs P.F. 1mg/mL Inh Sol- 2.5mL Pk | TEV | 0.3617 | 0.3617 | YES | YES | NO |
| 02213427 | SALBUTAMOL | Ventolin Nebules P.F. (Not a Benefit) 2mg/mL Inh Sol- 2.5mL Pk | GSK | N/A | N/A | YES | NO | NO |
| 02213419 | SALBUTAMOL | Ventolin Nebules P.F. (Not a Benefit) 1mg/mL Inh Sol- 2.5mL Pk | GSK | N/A | N/A | YES | NO | NO |
| 02213486 | SALBUTAMOL | Ventolin 5mg/mL Inh Sol-10mL Pk | GSK | 3.1110 | 3.1110 | NO | YES | NO |
| 02232570 | SALBUTAMOL | Airomir HFA 100mcg/Metered Dose Inh-200 dose Pk | GRA | 6.2593 | 5.0000 | YES | NO | NO |
| 02245669 | SALBUTAMOL | Apo-Salbutamol HFA 100mcg/Metered Dose Inh-200 dose Pk | APX | 5.0000 | 5.0000 | YES | NO | NO |
| 00790419 | SALBUTAMOL | Apo-Salvent (Not a Benefit) 100mcg/Metered Dose Inh-200 dose Pk | APX | N/A | N/A | YES | NO | NO |
| 02326450 | SALBUTAMOL | Novo-Salbutamol HFA 100mcg/Metered Dose Inh-200 dose Pk | NOP | 5.0000 | 5.0000 | YES | NO | NO |
| 00874086 | SALBUTAMOL | Novo-Salmol (Not a Benefit) 100mcg/Metered Dose Inh-200 dose Pk | NOP | N/A | N/A | YES | NO | NO |
| 00851841 | SALBUTAMOL | Ratio-Salbutamol Inhaler (Not a Benefit) 100mcg/Metered Dose Inh-200 dose Pk | RPH | N/A | N/A | YES | NO | NO |
| 02419858 | SALBUTAMOL | Salbutamol HFA 100mcg/Metered Dose Inh-200 dose Pk | SAI | 5.0000 | 5.0000 | YES | NO | NO |
| 02213478 | SALBUTAMOL | Ventolin (Not a Benefit) 100mcg/Metered Dose Inh-200 dose Pk | GLW | N/A | N/A | YES | NO | NO |
| 02241497 | SALBUTAMOL | Ventolin HFA 100mcg/Metered Dose Inh-200 dose Pk | GSK | 6.0000 | 5.0000 | YES | NO | NO |
| 02146843 | SALBUTAMOL | Apo-Salvent 2mg Tab | APX | 0.1274 | 0.1274 | YES | NO | NO |
| 02146851 | SALBUTAMOL | Apo-Salvent 4mg Tab | APX | 0.2134 | 0.2134 | YES | NO | NO |
| 01932691 | SALBUTAMOL | Ventolin (Not a Benefit) 4mg Tab | GLA | N/A | N/A | YES | NO | NO |
| 01961039 | SALBUTAMOL | Ventolin (Not a Benefit) 2mg Tab | GLA | N/A | N/A | YES | NO | NO |
| 02231129 | SALMETEROL XINAFOATE | SereVent Diskus 50mcg Pd Inh-60 Dose Pk | GSK | 79.5600 | 79.5600 | NO | YES | NO |
| 02245126 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Advair 125 25/125mcg/Metered Dose Inh-120 Dose Pk | GSK | 135.8700 | 135.8700 | NO | YES | NO |
| 02245127 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Advair 250 25/250mcg/Metered Dose Inh-120 Dose Pk | GSK | 192.8800 | 192.8800 | NO | YES | NO |
| 02240836 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Advair Diskus 50/250mcg Inh-60 Dose Pk | GSK | 135.8700 | 50.7600 | YES | YES | NO |
| 02240835 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Advair Diskus 50/100mcg Inh-60 Dose Pk | GSK | 113.4900 | 42.4050 | YES | YES | NO |
| 02240837 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Advair Diskus 50/500mcg Inh-60 Dose Pk | GSK | 192.8800 | 72.0600 | YES | YES | NO |
| 02494507 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | PMS-FluticasonePropionateSalmeterol DPI 50/100mcg Inh-60 Dose Pk | PMS | 42.4050 | 42.4050 | YES | YES | NO |
| 02494523 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | PMS-FluticasonePropionateSalmeterol DPI 50/500mcg Inh-60 Dose Pk | PMS | 72.0600 | 72.0600 | YES | YES | NO |
| 02494515 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | PMS-FluticasonePropionateSalmeterol DPI 50/250mcg Inh-60 Dose Pk | PMS | 50.7600 | 50.7600 | YES | YES | NO |
| 02495597 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Wixela Inhub 50/100mcg Inh-60 Dose Pk | MYL | 42.4050 | 42.4050 | YES | YES | NO |
| 02495619 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Wixela Inhub 50/500mcg Inh-60 Dose Pk | MYL | 72.0600 | 72.0600 | YES | YES | NO |
| 02495600 | SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE | Wixela Inhub 50/250mcg Inh-60 Dose Pk | MYL | 50.7600 | 50.7600 | YES | YES | NO |
| 02482215 | SAPROPTERIN DIHYDROCHLORIDE | Kuvan (Off-Formulary Interchangeable) 500mg Pd for Sol (Sachet Pk) | BIM | N/A | N/A | YES | NO | NO |
| 02482207 | SAPROPTERIN DIHYDROCHLORIDE | Kuvan (Off-Formulary Interchangeable) 100mg Pd for Sol (Sachet Pk) | BIM | N/A | N/A | YES | NO | NO |
| 02534533 | SAPROPTERIN DIHYDROCHLORIDE | Reddy-Sapropterin (Off-Formulary Interchangeable) 100mg Pd for Sol (Sachet Pk) | DRR | 24.7500 | N/A | YES | NO | NO |
| 02535610 | SAPROPTERIN DIHYDROCHLORIDE | Reddy-Sapropterin (Off-Formulary Interchangeable) 500mg Pd for Sol (Sachet Pk) | DRR | 123.7500 | N/A | YES | NO | NO |
| 02507471 | SAXAGLIPTIN | Apo-Saxagliptin 2.5mg Tab | APX | 1.2650 | 1.2650 | YES | NO | YES |
| 02507498 | SAXAGLIPTIN | Apo-Saxagliptin 5mg Tab | APX | 1.5195 | 1.5195 | YES | NO | YES |
| 02333554 | SAXAGLIPTIN | Onglyza 5mg Tab | AZC | 3.4621 | 1.5195 | YES | NO | YES |
| 02375842 | SAXAGLIPTIN | Onglyza 2.5mg Tab | AZC | 2.8823 | 1.2650 | YES | NO | YES |
| 02468603 | SAXAGLIPTIN | Sandoz Saxagliptin 2.5mg Tab | SDZ | 1.2650 | 1.2650 | YES | NO | YES |
| 02468611 | SAXAGLIPTIN | Sandoz Saxagliptin 5mg Tab | SDZ | 1.5195 | 1.5195 | YES | NO | YES |
| 02389185 | SAXAGLIPTIN & METFORMIN | Komboglyze 2.5mg & 1000mg Tab | AZC | 1.4468 | 1.4468 | NO | NO | YES |
| 02389169 | SAXAGLIPTIN & METFORMIN | Komboglyze 2.5mg & 500mg Tab | AZC | 1.4468 | 1.4468 | NO | NO | YES |
| 02389177 | SAXAGLIPTIN & METFORMIN | Komboglyze 2.5mg & 850mg Tab | AZC | 1.4468 | 1.4468 | NO | NO | YES |
| 00541869 | SCOPOLAMINE HYDROBROMIDE | Scopolamine Hydrobromide Injection (Not a Benefit) 0.4mg/mL Inj Sol (Preservative Free) | HOS | N/A | N/A | YES | NO | NO |
| 02242811 | SCOPOLAMINE HYDROBROMIDE | Scopolamine Hydrobromide Injection 0.6mg/mL Inj Sol (Preservative Free) | OMG | 7.0400 | 7.0400 | YES | YES | NO |
| 00541877 | SCOPOLAMINE HYDROBROMIDE | Scopolamine Hydrobromide Injection (Not a Benefit) 0.6mg/mL Inj Sol (Preservative Free) | HOS | N/A | N/A | YES | NO | NO |
| 02242810 | SCOPOLAMINE HYDROBROMIDE | Scopolamine Hydrobromide Injection 0.4mg/mL Inj Sol (Preservative Free) | OMG | 6.5100 | 6.5100 | YES | YES | NO |
| 09857548 | SECUKINUMAB | Cosentyx 150mg/mL Inj Sol-Pref Pen | NOV | 952.7200 | 952.7200 | NO | YES | NO |
| 02547724 | SECUKINUMAB | Cosentyx 150mg/mL Inj Sol-Pref Syr | NOV | 952.7200 | 952.7200 | NO | YES | NO |
| 02438070 | SECUKINUMAB | Cosentyx 150mg/mL Inj Sol-Pref Syr | NOV | 952.7200 | 952.7200 | NO | YES | NO |
| 02123312 | SELEGILINE HCL | Eldepryl (Not a Benefit) 5mg Tab | BJH | N/A | N/A | YES | NO | NO |
| 02230641 | SELEGILINE HCL | Selegiline 5mg Tab | AAP | 1.7072 | 1.7072 | YES | NO | NO |
| 02540258 | SEMAGLUTIDE | Ozempic 0.68mg/mL Inj Sol - Pref Pen 3mL Pk | NOO | 223.2600 | 223.2600 | NO | YES | NO |
| 02471477 | SEMAGLUTIDE | Ozempic 1.34mg/mL Inj Sol-Pref Pen 1.5mL Pk | NOO | 223.2600 | 223.2600 | NO | YES | NO |
| 02471469 | SEMAGLUTIDE | Ozempic 1.34mg/mL Inj Sol-Pref Pen 3mL Pk | NOO | 223.2600 | 223.2600 | NO | YES | NO |
| 02497611 | SEMAGLUTIDE | Rybelsus 14mg Tab | NOO | 7.3757 | 7.3757 | NO | YES | NO |
| 02497603 | SEMAGLUTIDE | Rybelsus 7mg Tab | NOO | 7.3757 | 7.3757 | NO | YES | NO |
| 02497581 | SEMAGLUTIDE | Rybelsus 3mg Tab | NOO | 7.3757 | 7.3757 | NO | YES | NO |
| 80009595 | SENNOSIDES A & B | Jamp-Senna 8.6mg Tab | JPC | 0.0464 | 0.0464 | YES | NO | NO |
| 00026158 | SENNOSIDES A & B | Senokot 8.6mg Tab | INO | 0.0464 | 0.0464 | YES | NO | NO |
| 02477890 | SERTRALINE HCL | AG-Sertraline 50mg Cap | ANG | 0.3032 | 0.3032 | YES | NO | YES |
| 02477882 | SERTRALINE HCL | AG-Sertraline 25mg Cap | ANG | 0.1516 | 0.1516 | YES | NO | YES |
| 02477904 | SERTRALINE HCL | AG-Sertraline 100mg Cap | ANG | 0.3303 | 0.3303 | YES | NO | YES |
| 02238282 | SERTRALINE HCL | Apo-Sertraline 100mg Cap | APX | 0.3303 | 0.3303 | YES | NO | YES |
| 02238281 | SERTRALINE HCL | Apo-Sertraline 50mg Cap | APX | 0.3032 | 0.3032 | YES | NO | YES |
| 02238280 | SERTRALINE HCL | Apo-Sertraline 25mg Cap | APX | 0.1516 | 0.1516 | YES | NO | YES |
| 02390906 | SERTRALINE HCL | Auro-Sertraline 25mg Cap | AUR | 0.1516 | 0.1516 | YES | NO | YES |
| 02390914 | SERTRALINE HCL | Auro-Sertraline 50mg Cap | AUR | 0.3032 | 0.3032 | YES | NO | YES |
| 02390922 | SERTRALINE HCL | Auro-Sertraline 100mg Cap | AUR | 0.3303 | 0.3303 | YES | NO | YES |
| 02287412 | SERTRALINE HCL | Co Sertraline 100mg Cap | COB | 0.3303 | 0.3303 | YES | NO | YES |
| 02287404 | SERTRALINE HCL | Co Sertraline 50mg Cap | COB | 0.3032 | 0.3032 | YES | NO | YES |
| 02287390 | SERTRALINE HCL | Co Sertraline 25mg Cap | COB | 0.1516 | 0.1516 | YES | NO | YES |
| 02357178 | SERTRALINE HCL | Jamp-Sertraline 100mg Cap | JPC | 0.3303 | 0.3303 | YES | NO | YES |
| 02357143 | SERTRALINE HCL | Jamp-Sertraline 25mg Cap | JPC | 0.1516 | 0.1516 | YES | NO | YES |
| 02357151 | SERTRALINE HCL | Jamp-Sertraline 50mg Cap | JPC | 0.3032 | 0.3032 | YES | NO | YES |
| 02530953 | SERTRALINE HCL | M-Sertraline 100mg Cap | MAT | 0.3303 | 0.3303 | YES | NO | YES |
| 02530945 | SERTRALINE HCL | M-Sertraline 50mg Cap | MAT | 0.3032 | 0.3032 | YES | NO | YES |
| 02530937 | SERTRALINE HCL | M-Sertraline 25mg Cap | MAT | 0.1516 | 0.1516 | YES | NO | YES |
| 02399423 | SERTRALINE HCL | Mar-Sertraline 50mg Cap | MAR | 0.3032 | 0.3032 | YES | NO | YES |
| 02399415 | SERTRALINE HCL | Mar-Sertraline 25mg Cap | MAR | 0.1516 | 0.1516 | YES | NO | YES |
| 02399431 | SERTRALINE HCL | Mar-Sertraline 100mg Cap | MAR | 0.3303 | 0.3303 | YES | NO | YES |
| 02402408 | SERTRALINE HCL | Mint-Sertraline 100mg Cap | MIN | 0.3303 | 0.3303 | YES | NO | YES |
| 02402394 | SERTRALINE HCL | Mint-Sertraline 50mg Cap | MIN | 0.3032 | 0.3032 | YES | NO | YES |
| 02402378 | SERTRALINE HCL | Mint-Sertraline 25mg Cap | MIN | 0.1516 | 0.1516 | YES | NO | YES |
| 02488442 | SERTRALINE HCL | NRA-Sertraline 50mg Cap | NRA | 0.3032 | 0.3032 | YES | NO | YES |
| 02488450 | SERTRALINE HCL | NRA-Sertraline 100mg Cap | NRA | 0.3303 | 0.3303 | YES | NO | YES |
| 02488434 | SERTRALINE HCL | NRA-Sertraline 25mg Cap | NRA | 0.1516 | 0.1516 | YES | NO | YES |
| 02244838 | SERTRALINE HCL | PMS-Sertraline 25mg Cap | PMS | 0.1516 | 0.1516 | YES | NO | YES |
| 02244840 | SERTRALINE HCL | PMS-Sertraline 100mg Cap | PMS | 0.3303 | 0.3303 | YES | NO | YES |
| 02244839 | SERTRALINE HCL | PMS-Sertraline 50mg Cap | PMS | 0.3032 | 0.3032 | YES | NO | YES |
| 02374579 | SERTRALINE HCL | Ran-Sertraline 100mg Cap | RAN | 0.3303 | 0.3303 | YES | NO | YES |
| 02245160 | SERTRALINE HCL | Sandoz Sertraline 50mg Cap | SDZ | 0.3032 | 0.3032 | YES | NO | YES |
| 02245161 | SERTRALINE HCL | Sandoz Sertraline 100mg Cap | SDZ | 0.3303 | 0.3303 | YES | NO | YES |
| 02245159 | SERTRALINE HCL | Sandoz Sertraline 25mg Cap | SDZ | 0.1516 | 0.1516 | YES | NO | YES |
| 02386070 | SERTRALINE HCL | Sertraline 25mg Cap | SIV | 0.1516 | 0.1516 | YES | NO | YES |
| 02353520 | SERTRALINE HCL | Sertraline 25mg Cap | SAI | 0.1516 | 0.1516 | YES | NO | YES |
| 02353539 | SERTRALINE HCL | Sertraline 50mg Cap | SAI | 0.3032 | 0.3032 | YES | NO | YES |
| 02469626 | SERTRALINE HCL | Sertraline 25mg Cap | JPC | 0.1516 | 0.1516 | YES | NO | YES |
| 02386097 | SERTRALINE HCL | Sertraline 100mg Cap | SIV | 0.3303 | 0.3303 | YES | NO | YES |
| 02353547 | SERTRALINE HCL | Sertraline 100mg Cap | SAI | 0.3303 | 0.3303 | YES | NO | YES |
| 02469642 | SERTRALINE HCL | Sertraline 100mg Cap | JPC | 0.3303 | 0.3303 | YES | NO | YES |
| 02386089 | SERTRALINE HCL | Sertraline 50mg Cap | SIV | 0.3032 | 0.3032 | YES | NO | YES |
| 02469634 | SERTRALINE HCL | Sertraline 50mg Cap | JPC | 0.3032 | 0.3032 | YES | NO | YES |
| 02240481 | SERTRALINE HCL | Teva-Sertraline 100mg Cap | TEV | 0.3303 | 0.3303 | YES | NO | YES |
| 02240484 | SERTRALINE HCL | Teva-Sertraline 50mg Cap | TEV | 0.3032 | 0.3032 | YES | NO | YES |
| 02240485 | SERTRALINE HCL | Teva-Sertraline 25mg Cap | TEV | 0.1516 | 0.1516 | YES | NO | YES |
| 01962817 | SERTRALINE HCL | Zoloft 50mg Cap | UJC | 2.0468 | 0.3032 | YES | NO | YES |
| 01962779 | SERTRALINE HCL | Zoloft 100mg Cap | UJC | 2.2301 | 0.3303 | YES | NO | YES |
| 02132702 | SERTRALINE HCL | Zoloft 25mg Cap | UJC | 1.0235 | 0.1516 | YES | NO | YES |
| 02461501 | SEVELAMER CARBONATE | Accel-Sevelamer (Off-Formulary Interchangeable) 800mg Tab | ACC | 1.2634 | 1.2634 | YES | NO | NO |
| 02354586 | SEVELAMER CARBONATE | Renvela (Off-Formulary Interchangeable) 800mg Tab | SAV | 1.3125 | 1.2634 | YES | NO | NO |
| 02479796 | SILDENAFIL | Accel-Sildenafil (Off-Formulary Interchangeable) 25mg Tab | ACC | 3.1850 | 3.1850 | YES | NO | NO |
| 02479826 | SILDENAFIL | Accel-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | ACC | 3.5350 | 3.5350 | YES | NO | NO |
| 02479818 | SILDENAFIL | Accel-Sildenafil (Off-Formulary Interchangeable) 50mg Tab | ACC | 3.4000 | 3.4000 | YES | NO | NO |
| 02248203 | SILDENAFIL | Apo-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | APX | 9.2006 | 9.2006 | YES | NO | NO |
| 02248202 | SILDENAFIL | Apo-Sildenafil (Off-Formulary Interchangeable) 50mg Tab | APX | 8.8481 | 8.8481 | YES | NO | NO |
| 02248201 | SILDENAFIL | Apo-Sildenafil (Off-Formulary Interchangeable) 25mg Tab | APX | 8.2894 | 8.2894 | YES | NO | NO |
| 02418118 | SILDENAFIL | Apo-Sildenafil R (Off-Formulary Interchangeable) 20mg Tab | APX | 7.2940 | 7.2940 | YES | NO | NO |
| 02414384 | SILDENAFIL | Auro-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | AUR | 9.2000 | 9.2000 | YES | NO | NO |
| 02414368 | SILDENAFIL | Auro-Sildenafil (Off-Formulary Interchangeable) 25mg Tab | AUR | 8.2894 | 8.2894 | YES | NO | NO |
| 02414376 | SILDENAFIL | Auro-Sildenafil (Off-Formulary Interchangeable) 50mg Tab | AUR | 8.8475 | 8.8475 | YES | NO | NO |
| 02372088 | SILDENAFIL | Co Sildenafil (Off-Formulary Interchangeable) 100mg Tab | COB | 9.2016 | 9.2016 | YES | NO | NO |
| 02372061 | SILDENAFIL | Co Sildenafil (Off-Formulary Interchangeable) 50mg Tab | COB | 8.8481 | 8.8481 | YES | NO | NO |
| 02372053 | SILDENAFIL | Co Sildenafil (Off-Formulary Interchangeable) 25mg Tab | COB | 8.2894 | 8.2894 | YES | NO | NO |
| 02503506 | SILDENAFIL | Jamp Sildenafil Tablets (Off-Formulary Interchangeable) 100mg Tab | JPC | 9.2000 | 9.2000 | YES | NO | NO |
| 02405687 | SILDENAFIL | Jamp-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | JPC | 9.2000 | 9.2000 | YES | NO | NO |
| 02405660 | SILDENAFIL | Jamp-Sildenafil (Off-Formulary Interchangeable) 25mg Tab | JPC | 8.2900 | 8.2894 | YES | NO | NO |
| 02405679 | SILDENAFIL | Jamp-Sildenafil (Off-Formulary Interchangeable) 50mg Tab | JPC | 8.8475 | 8.8475 | YES | NO | NO |
| 02469669 | SILDENAFIL | Jamp-Sildenafil R (Off-Formulary Interchangeable) 20mg Tab | JPC | 7.2940 | 7.2940 | YES | NO | NO |
| 02430037 | SILDENAFIL | M-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | MAT | 9.2000 | 9.2000 | YES | NO | NO |
| 02402548 | SILDENAFIL | Mar-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | MAR | 9.2006 | 9.2006 | YES | NO | NO |
| 02393077 | SILDENAFIL | Mint-Sildenafil (Off-Formulary Interchangeable) 50mg Tab | MIN | 8.8475 | 8.8475 | YES | NO | NO |
| 02393085 | SILDENAFIL | Mint-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | MIN | 9.2000 | 9.2000 | YES | NO | NO |
| 02393069 | SILDENAFIL | Mint-Sildenafil (Off-Formulary Interchangeable) 25mg Tab | MIN | 8.2900 | 8.2894 | YES | NO | NO |
| 02476819 | SILDENAFIL | NRA-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | NRA | 9.2006 | 9.2006 | YES | NO | NO |
| 02412179 | SILDENAFIL | PMS-Sildenafil R (Off-Formulary Interchangeable) 20mg Tab | PMS | 7.2940 | 7.2940 | YES | NO | NO |
| 02505150 | SILDENAFIL | PRZ-Sildenafil (Off-Formulary Interchangeable) 25mg Tab | PRZ | 8.2894 | 8.2894 | YES | NO | NO |
| 02505169 | SILDENAFIL | PRZ-Sildenafil (Off-Formulary Interchangeable) 50mg Tab | PRZ | 8.8475 | 8.8475 | YES | NO | NO |
| 02468557 | SILDENAFIL | PRZ-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | PRZ | 9.2006 | 9.2006 | YES | NO | NO |
| 02279401 | SILDENAFIL | Revatio (Off-Formulary Interchangeable) 20mg Tab | UJC | 13.2401 | 7.2940 | YES | NO | NO |
| 02452413 | SILDENAFIL | Riva-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | RIA | 9.2006 | 9.2006 | YES | NO | NO |
| 02317559 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 25mg Tab | PMS | 8.2894 | 8.2894 | YES | NO | NO |
| 02400693 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 25mg Tab | SIV | 8.2900 | 8.2894 | YES | NO | NO |
| 02540770 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 25mg Tab | SAI | 8.2894 | 8.2894 | YES | NO | NO |
| 02406160 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 100mg Tab | SAI | 9.2006 | 9.2006 | YES | NO | NO |
| 02400715 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 100mg Tab | SIV | 9.2006 | 9.2006 | YES | NO | NO |
| 02317583 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 100mg Tab | PMS | 9.2006 | 9.2006 | YES | NO | NO |
| 02400707 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 50mg Tab | SIV | 8.8481 | 8.8481 | YES | NO | NO |
| 02317575 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 50mg Tab | PMS | 8.8481 | 8.8481 | YES | NO | NO |
| 02406152 | SILDENAFIL | Sildenafil (Off-Formulary Interchangeable) 50mg Tab | SAI | 8.8475 | 8.8475 | YES | NO | NO |
| 02308754 | SILDENAFIL | Teva-Sildenafil (Off-Formulary Interchangeable) 100mg Tab | TEV | 9.2006 | 9.2006 | YES | NO | NO |
| 02308746 | SILDENAFIL | Teva-Sildenafil (Off-Formulary Interchangeable) 50mg Tab | TEV | 8.8481 | 8.8481 | YES | NO | NO |
| 02308738 | SILDENAFIL | Teva-Sildenafil (Off-Formulary Interchangeable) 25mg Tab | TEV | 8.2900 | 8.2894 | YES | NO | NO |
| 02319500 | SILDENAFIL | Teva-Sildenafil R (Off-Formulary Interchangeable) 20mg Tab | TEV | 7.2940 | 7.2940 | YES | NO | NO |
| 02239767 | SILDENAFIL | Viagra (Off-Formulary Interchangeable) 50mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02239768 | SILDENAFIL | Viagra (Off-Formulary Interchangeable) 100mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02239766 | SILDENAFIL | Viagra (Off-Formulary Interchangeable) 25mg Tab | UJC | N/A | N/A | YES | NO | NO |
| 02478528 | SILODOSIN | Auro-Silodosin 8mg Cap | AUR | 0.4742 | 0.4742 | YES | YES | NO |
| 02478501 | SILODOSIN | Auro-Silodosin 4mg Cap | AUR | 0.4742 | 0.4742 | YES | YES | NO |
| 02539527 | SILODOSIN | Jamp Silodosin 8mg Cap | JPC | 0.4742 | 0.4742 | YES | YES | NO |
| 02539519 | SILODOSIN | Jamp Silodosin 4mg Cap | JPC | 0.4742 | 0.4742 | YES | YES | NO |
| 02517787 | SILODOSIN | PMS-Silodosin 8mg Cap | PMS | 0.4742 | 0.4742 | YES | YES | NO |
| 02517779 | SILODOSIN | PMS-Silodosin 4mg Cap | PMS | 0.4742 | 0.4742 | YES | YES | NO |
| 02361663 | SILODOSIN | Rapaflo (Not a Benefit) 4mg Cap | WAT | N/A | N/A | YES | NO | NO |
| 02361671 | SILODOSIN | Rapaflo (Not a Benefit) 8mg Cap | WAT | N/A | N/A | YES | NO | NO |
| 02475421 | SILODOSIN | Sandoz Silodosin 4mg Cap | SDZ | 0.4742 | 0.4742 | YES | YES | NO |
| 02475448 | SILODOSIN | Sandoz Silodosin 8mg Cap | SDZ | 0.4742 | 0.4742 | YES | YES | NO |
| 00323098 | SILVER SULFADIAZINE | Flamazine 1% Cr | SNE | 0.1320 | 0.1320 | NO | NO | YES |
| 09854037 | SILVER SULFADIAZINE | Flamazine 1% Cr-50g Pk | SNE | 10.9600 | 10.9600 | NO | NO | NO |
| 02480077 | SIMVASTATIN | AG-Simvastatin 20mg Tab | ANG | 0.2501 | 0.2501 | YES | NO | NO |
| 02480050 | SIMVASTATIN | AG-Simvastatin 5mg Tab | ANG | 0.1023 | 0.1023 | YES | NO | NO |
| 02480093 | SIMVASTATIN | AG-Simvastatin 80mg Tab | ANG | 0.2501 | 0.2501 | YES | NO | NO |
| 02480085 | SIMVASTATIN | AG-Simvastatin 40mg Tab | ANG | 0.2501 | 0.2501 | YES | NO | NO |
| 02480069 | SIMVASTATIN | AG-Simvastatin 10mg Tab | ANG | 0.2023 | 0.2023 | YES | NO | NO |
| 02247015 | SIMVASTATIN | Apo-Simvastatin 80mg Tab | APX | 0.2501 | 0.2501 | YES | NO | NO |
| 02247013 | SIMVASTATIN | Apo-Simvastatin 20mg Tab | APX | 0.2501 | 0.2501 | YES | NO | NO |
| 02247011 | SIMVASTATIN | Apo-Simvastatin 5mg Tab | APX | 0.1023 | 0.1023 | YES | NO | NO |
| 02247012 | SIMVASTATIN | Apo-Simvastatin 10mg Tab | APX | 0.2023 | 0.2023 | YES | NO | NO |
| 02247014 | SIMVASTATIN | Apo-Simvastatin 40mg Tab | APX | 0.2501 | 0.2501 | YES | NO | NO |
| 02405148 | SIMVASTATIN | Auro-Simvastatin 5mg Tab | AUR | 0.1023 | 0.1023 | YES | NO | NO |
| 02405156 | SIMVASTATIN | Auro-Simvastatin 10mg Tab | AUR | 0.2023 | 0.2023 | YES | NO | NO |
| 02405180 | SIMVASTATIN | Auro-Simvastatin 80mg Tab | AUR | 0.2501 | 0.2501 | YES | NO | NO |
| 02405172 | SIMVASTATIN | Auro-Simvastatin 40mg Tab | AUR | 0.2501 | 0.2501 | YES | NO | NO |
| 02405164 | SIMVASTATIN | Auro-Simvastatin 20mg Tab | AUR | 0.2501 | 0.2501 | YES | NO | NO |
| 02248103 | SIMVASTATIN | Co Simvastatin 5mg Tab | COB | 0.1023 | 0.1023 | YES | NO | NO |
| 02248107 | SIMVASTATIN | Co Simvastatin 80mg Tab | COB | 0.2501 | 0.2501 | YES | NO | NO |
| 02248106 | SIMVASTATIN | Co Simvastatin 40mg Tab | COB | 0.2501 | 0.2501 | YES | NO | NO |
| 02248105 | SIMVASTATIN | Co Simvastatin 20mg Tab | COB | 0.2501 | 0.2501 | YES | NO | NO |
| 02248104 | SIMVASTATIN | Co Simvastatin 10mg Tab | COB | 0.2023 | 0.2023 | YES | NO | NO |
| 02375605 | SIMVASTATIN | Jamp-Simvastatin 10mg Tab | JPC | 0.2023 | 0.2023 | YES | NO | NO |
| 02375591 | SIMVASTATIN | Jamp-Simvastatin 5mg Tab | JPC | 0.1023 | 0.1023 | YES | NO | NO |
| 02375621 | SIMVASTATIN | Jamp-Simvastatin 40mg Tab | JPC | 0.2501 | 0.2501 | YES | NO | NO |
| 02375648 | SIMVASTATIN | Jamp-Simvastatin 80mg Tab | JPC | 0.2501 | 0.2501 | YES | NO | NO |
| 02375613 | SIMVASTATIN | Jamp-Simvastatin 20mg Tab | JPC | 0.2501 | 0.2501 | YES | NO | NO |
| 02375079 | SIMVASTATIN | Mar-Simvastatin 80mg Tab | MAR | 0.2501 | 0.2501 | YES | NO | NO |
| 02375036 | SIMVASTATIN | Mar-Simvastatin 5mg Tab | MAR | 0.1023 | 0.1023 | YES | NO | NO |
| 02375060 | SIMVASTATIN | Mar-Simvastatin 40mg Tab | MAR | 0.2501 | 0.2501 | YES | NO | NO |
| 02375044 | SIMVASTATIN | Mar-Simvastatin 10mg Tab | MAR | 0.2023 | 0.2023 | YES | NO | NO |
| 02375052 | SIMVASTATIN | Mar-Simvastatin 20mg Tab | MAR | 0.2501 | 0.2501 | YES | NO | NO |
| 02372940 | SIMVASTATIN | Mint-Simvastatin 10mg Tab | MIN | 0.2023 | 0.2023 | YES | NO | NO |
| 02372967 | SIMVASTATIN | Mint-Simvastatin 40mg Tab | MIN | 0.2501 | 0.2501 | YES | NO | NO |
| 02372959 | SIMVASTATIN | Mint-Simvastatin 20mg Tab | MIN | 0.2501 | 0.2501 | YES | NO | NO |
| 02372932 | SIMVASTATIN | Mint-Simvastatin 5mg Tab | MIN | 0.1023 | 0.1023 | YES | NO | NO |
| 02372975 | SIMVASTATIN | Mint-Simvastatin 80mg Tab | MIN | 0.2501 | 0.2501 | YES | NO | NO |
| 02549670 | SIMVASTATIN | PMSC-Simvastatin 80mg Tab | PMS | 0.2501 | 0.2501 | YES | NO | NO |
| 02549646 | SIMVASTATIN | PMSC-Simvastatin 10mg Tab | PMS | 0.2023 | 0.2023 | YES | NO | NO |
| 02549662 | SIMVASTATIN | PMSC-Simvastatin 40mg Tab | PMS | 0.2501 | 0.2501 | YES | NO | NO |
| 02549638 | SIMVASTATIN | PMSC-Simvastatin 5mg Tab | PMS | 0.1023 | 0.1023 | YES | NO | NO |
| 02549654 | SIMVASTATIN | PMSC-Simvastatin 20mg Tab | PMS | 0.2501 | 0.2501 | YES | NO | NO |
| 02470012 | SIMVASTATIN | Pharma-Simvastatin 80mg Tab | PMS | 0.2501 | 0.2501 | YES | NO | NO |
| 02469979 | SIMVASTATIN | Pharma-Simvastatin 5mg Tab | PMS | 0.1023 | 0.1023 | YES | NO | NO |
| 02469987 | SIMVASTATIN | Pharma-Simvastatin 10mg Tab | PMS | 0.2023 | 0.2023 | YES | NO | NO |
| 02469995 | SIMVASTATIN | Pharma-Simvastatin 20mg Tab | PMS | 0.2501 | 0.2501 | YES | NO | NO |
| 02470004 | SIMVASTATIN | Pharma-Simvastatin 40mg Tab | PMS | 0.2501 | 0.2501 | YES | NO | NO |
| 02329166 | SIMVASTATIN | Ran-Simvastatin 20mg Tab | RAN | 0.2501 | 0.2501 | YES | NO | NO |
| 02329131 | SIMVASTATIN | Ran-Simvastatin 5mg Tab | RAN | 0.1023 | 0.1023 | YES | NO | NO |
| 02329182 | SIMVASTATIN | Ran-Simvastatin 80mg Tab | RAN | 0.2501 | 0.2501 | YES | NO | NO |
| 02329174 | SIMVASTATIN | Ran-Simvastatin 40mg Tab | RAN | 0.2501 | 0.2501 | YES | NO | NO |
| 02329158 | SIMVASTATIN | Ran-Simvastatin 10mg Tab | RAN | 0.2023 | 0.2023 | YES | NO | NO |
| 02284723 | SIMVASTATIN | Simvastatin 5mg Tab | SAI | 0.1023 | 0.1023 | YES | NO | NO |
| 02386348 | SIMVASTATIN | Simvastatin 80mg Tab | SIV | 0.2501 | 0.2501 | YES | NO | NO |
| 02284774 | SIMVASTATIN | Simvastatin 80mg Tab | SAI | 0.2501 | 0.2501 | YES | NO | NO |
| 02386321 | SIMVASTATIN | Simvastatin 40mg Tab | SIV | 0.2501 | 0.2501 | YES | NO | NO |
| 02284766 | SIMVASTATIN | Simvastatin 40mg Tab | SAI | 0.2501 | 0.2501 | YES | NO | NO |
| 02386313 | SIMVASTATIN | Simvastatin 20mg Tab | SIV | 0.2501 | 0.2501 | YES | NO | NO |
| 02284758 | SIMVASTATIN | Simvastatin 20mg Tab | SAI | 0.2501 | 0.2501 | YES | NO | NO |
| 02386305 | SIMVASTATIN | Simvastatin 10mg Tab | SIV | 0.2023 | 0.2023 | YES | NO | NO |
| 02284731 | SIMVASTATIN | Simvastatin 10mg Tab | SAI | 0.2023 | 0.2023 | YES | NO | NO |
| 02386291 | SIMVASTATIN | Simvastatin 5mg Tab | SIV | 0.1023 | 0.1023 | YES | NO | NO |
| 02265907 | SIMVASTATIN | Taro-Simvastatin (Not a Benefit) 40mg Tab | TAR | N/A | N/A | YES | NO | NO |
| 02265885 | SIMVASTATIN | Taro-Simvastatin (Not a Benefit) 10mg Tab | TAR | N/A | N/A | YES | NO | NO |
| 02265893 | SIMVASTATIN | Taro-Simvastatin (Not a Benefit) 20mg Tab | TAR | N/A | N/A | YES | NO | NO |
| 02250179 | SIMVASTATIN | Teva-Simvastatin 40mg Tab | TEV | 0.2501 | 0.2501 | YES | NO | NO |
| 02250152 | SIMVASTATIN | Teva-Simvastatin 10mg Tab | TEV | 0.2023 | 0.2023 | YES | NO | NO |
| 02250187 | SIMVASTATIN | Teva-Simvastatin 80mg Tab | TEV | 0.2501 | 0.2501 | YES | NO | NO |
| 02250160 | SIMVASTATIN | Teva-Simvastatin 20mg Tab | TEV | 0.2501 | 0.2501 | YES | NO | NO |
| 02250144 | SIMVASTATIN | Teva-Simvastatin 5mg Tab | TEV | 0.1023 | 0.1023 | YES | NO | NO |
| 00884324 | SIMVASTATIN | Zocor (Not a Benefit) 5mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 00884359 | SIMVASTATIN | Zocor 40mg Tab | OCI | 3.4841 | 0.2501 | YES | NO | NO |
| 00884332 | SIMVASTATIN | Zocor 10mg Tab | OCI | 2.8190 | 0.2023 | YES | NO | NO |
| 02240332 | SIMVASTATIN | Zocor (Not a Benefit) 80mg Tab | MFC | N/A | N/A | YES | NO | NO |
| 00884340 | SIMVASTATIN | Zocor 20mg Tab | OCI | 3.4841 | 0.2501 | YES | NO | NO |
| 02243237 | SIROLIMUS | Rapamune 1mg/mL O/L | WAY | 9.6855 | 9.6855 | NO | YES | NO |
| 02247111 | SIROLIMUS | Rapamune 1mg Tab | WAY | 9.6855 | 9.6855 | NO | YES | NO |
| 02512483 | SITAGLIPTIN | Ach-Sitagliptin 50mg Tab | ACH | 0.8197 | 0.8197 | YES | NO | YES |
| 02512475 | SITAGLIPTIN | Ach-Sitagliptin 25mg Tab | ACH | 0.8197 | 0.8197 | YES | NO | YES |
| 02512491 | SITAGLIPTIN | Ach-Sitagliptin 100mg Tab | ACH | 0.8197 | 0.8197 | YES | NO | YES |
| 02508672 | SITAGLIPTIN | Apo-Sitagliptin Malate 100mg Tab | APX | 0.8197 | 0.8197 | YES | NO | YES |
| 02508664 | SITAGLIPTIN | Apo-Sitagliptin Malate 50mg Tab | APX | 0.8197 | 0.8197 | YES | NO | YES |
| 02508656 | SITAGLIPTIN | Apo-Sitagliptin Malate 25mg Tab | APX | 0.8197 | 0.8197 | YES | NO | YES |
| 02529882 | SITAGLIPTIN | Auro-Sitagliptin 100mg Tab | AUR | 0.8197 | 0.8197 | YES | NO | YES |
| 02529866 | SITAGLIPTIN | Auro-Sitagliptin 25mg Tab | AUR | 0.8197 | 0.8197 | YES | NO | YES |
| 02529874 | SITAGLIPTIN | Auro-Sitagliptin 50mg Tab | AUR | 0.8197 | 0.8197 | YES | NO | YES |
| 02534134 | SITAGLIPTIN | Jamp Sitagliptin 25mg Tab | JPC | 0.8197 | 0.8197 | YES | NO | YES |
| 02534150 | SITAGLIPTIN | Jamp Sitagliptin 100mg Tab | JPC | 0.8197 | 0.8197 | YES | NO | YES |
| 02534142 | SITAGLIPTIN | Jamp Sitagliptin 50mg Tab | JPC | 0.8197 | 0.8197 | YES | NO | YES |
| 02303922 | SITAGLIPTIN | Januvia 100mg Tab | MFC | 3.2787 | 0.8197 | YES | NO | YES |
| 02388847 | SITAGLIPTIN | Januvia 50mg Tab | MFC | 3.2787 | 0.8197 | YES | NO | YES |
| 02388839 | SITAGLIPTIN | Januvia 25mg Tab | MFC | 3.2787 | 0.8197 | YES | NO | YES |
| 02503859 | SITAGLIPTIN | PMS-Sitagliptin 50mg Tab | PMS | 0.8197 | 0.8197 | YES | NO | YES |
| 02503840 | SITAGLIPTIN | PMS-Sitagliptin 25mg Tab | PMS | 0.8197 | 0.8197 | YES | NO | YES |
| 02503867 | SITAGLIPTIN | PMS-Sitagliptin 100mg Tab | PMS | 0.8197 | 0.8197 | YES | NO | YES |
| 02504057 | SITAGLIPTIN | Sandoz Sitagliptin 50mg Tab | SDZ | 0.8197 | 0.8197 | YES | NO | YES |
| 02504049 | SITAGLIPTIN | Sandoz Sitagliptin 25mg Tab | SDZ | 0.8197 | 0.8197 | YES | NO | YES |
| 02504065 | SITAGLIPTIN | Sandoz Sitagliptin 100mg Tab | SDZ | 0.8197 | 0.8197 | YES | NO | YES |
| 02529033 | SITAGLIPTIN | Sitagliptin 25mg Tab | SIV | 0.8197 | 0.8197 | YES | NO | YES |
| 02529068 | SITAGLIPTIN | Sitagliptin 100mg Tab | SIV | 0.8197 | 0.8197 | YES | NO | YES |
| 02548550 | SITAGLIPTIN | Sitagliptin 25mg Tab | SAI | 0.8197 | 0.8197 | YES | NO | YES |
| 02548577 | SITAGLIPTIN | Sitagliptin 100mg Tab | SAI | 0.8197 | 0.8197 | YES | NO | YES |
| 02529041 | SITAGLIPTIN | Sitagliptin 50mg Tab | SIV | 0.8197 | 0.8197 | YES | NO | YES |
| 02548569 | SITAGLIPTIN | Sitagliptin 50mg Tab | SAI | 0.8197 | 0.8197 | YES | NO | YES |
| 02531666 | SITAGLIPTIN | Taro-Sitagliptin Fumarate 100mg Tab | TAR | 0.8197 | 0.8197 | YES | NO | YES |
| 02531631 | SITAGLIPTIN | Taro-Sitagliptin Fumarate 25mg Tab | TAR | 0.8197 | 0.8197 | YES | NO | YES |
| 02531658 | SITAGLIPTIN | Taro-Sitagliptin Fumarate 50mg Tab | TAR | 0.8197 | 0.8197 | YES | NO | YES |
| 02522721 | SITAGLIPTIN | Teva-Sitagliptin Malate 100mg Tab | TEV | 0.8197 | 0.8197 | YES | NO | YES |
| 02522705 | SITAGLIPTIN | Teva-Sitagliptin Malate 25mg Tab | TEV | 0.8197 | 0.8197 | YES | NO | YES |
| 02522713 | SITAGLIPTIN | Teva-Sitagliptin Malate 50mg Tab | TEV | 0.8197 | 0.8197 | YES | NO | YES |
| 02506289 | SITAGLIPTIN & METFORMIN | Apo-Sitagliptin/Metformin XR 50mg & 1000mg ER Tab | APX | 0.8893 | 0.8893 | YES | NO | YES |
| 02506270 | SITAGLIPTIN & METFORMIN | Apo-Sitagliptin/Metformin XR 50mg & 500mg ER Tab | APX | 0.8893 | 0.8893 | YES | NO | YES |
| 02506297 | SITAGLIPTIN & METFORMIN | Apo-Sitagliptin/Metformin XR 100mg & 1000mg ER Tab | APX | 1.7785 | 1.7784 | YES | NO | YES |
| 02416794 | SITAGLIPTIN & METFORMIN | Janumet XR 50mg & 1000mg ER Tab | MEK | 1.7785 | 0.8893 | YES | NO | YES |
| 02416808 | SITAGLIPTIN & METFORMIN | Janumet XR 100mg & 1000mg ER Tab | MEK | 3.5568 | 1.7784 | YES | NO | YES |
| 02416786 | SITAGLIPTIN & METFORMIN | Janumet XR 50mg & 500mg ER Tab | MEK | 1.7785 | 0.8893 | YES | NO | YES |
| 02529114 | SITAGLIPTIN & METFORMIN | Sandoz Sitagliptin-Metformin XR 50mg & 1000mg ER Tab | SDZ | 0.8893 | 0.8893 | YES | NO | YES |
| 02529122 | SITAGLIPTIN & METFORMIN | Sandoz Sitagliptin-Metformin XR 100mg & 1000mg ER Tab | SDZ | 1.7784 | 1.7784 | YES | NO | YES |
| 02529106 | SITAGLIPTIN & METFORMIN | Sandoz Sitagliptin-Metformin XR 50mg & 500mg ER Tab | SDZ | 0.8893 | 0.8893 | YES | NO | YES |
| 02509415 | SITAGLIPTIN & METFORMIN | Apo-Sitagliptin Malate/Metformin HCl 50mg & 500mg Tab | APX | 0.4446 | 0.4446 | YES | NO | YES |
| 02509431 | SITAGLIPTIN & METFORMIN | Apo-Sitagliptin Malate/Metformin HCl 50mg & 1000mg Tab | APX | 0.4446 | 0.4446 | YES | NO | YES |
| 02509423 | SITAGLIPTIN & METFORMIN | Apo-Sitagliptin Malate/Metformin HCl 50mg & 850mg Tab | APX | 0.4446 | 0.4446 | YES | NO | YES |
| 02547821 | SITAGLIPTIN & METFORMIN | Auro-Sitagliptin HCl and Metformin HCl 50mg & 1000mg Tab | AUR | 0.4446 | 0.4446 | YES | NO | YES |
| 02547805 | SITAGLIPTIN & METFORMIN | Auro-Sitagliptin HCl and Metformin HCl 50mg & 500mg Tab | AUR | 0.4446 | 0.4446 | YES | NO | YES |
| 02547813 | SITAGLIPTIN & METFORMIN | Auro-Sitagliptin HCl and Metformin HCl 50mg & 850mg Tab | AUR | 0.4446 | 0.4446 | YES | NO | YES |
| 02556200 | SITAGLIPTIN & METFORMIN | Jamp Sitagliptin HCl / Metformin 50mg & 1000mg Tab | JPC | 0.4446 | 0.4446 | YES | NO | YES |
| 02556197 | SITAGLIPTIN & METFORMIN | Jamp Sitagliptin HCl / Metformin 50mg & 850mg Tab | JPC | 0.4446 | 0.4446 | YES | NO | YES |
| 02556189 | SITAGLIPTIN & METFORMIN | Jamp Sitagliptin HCl / Metformin 50mg & 500mg Tab | JPC | 0.4446 | 0.4446 | YES | NO | YES |
| 02333856 | SITAGLIPTIN & METFORMIN | Janumet 50mg & 500mg Tab | MEK | 1.7785 | 0.4446 | YES | NO | YES |
| 02333864 | SITAGLIPTIN & METFORMIN | Janumet 50mg & 850mg Tab | MEK | 1.7785 | 0.4446 | YES | NO | YES |
| 02333872 | SITAGLIPTIN & METFORMIN | Janumet 50mg & 1000mg Tab | MEK | 1.7785 | 0.4446 | YES | NO | YES |
| 02540134 | SITAGLIPTIN & METFORMIN | Reddy-Sitagliptin and Metformin HCl 50mg & 1000mg Tab | DRR | 0.4446 | 0.4446 | YES | NO | YES |
| 02540126 | SITAGLIPTIN & METFORMIN | Reddy-Sitagliptin and Metformin HCl 50mg & 850mg Tab | DRR | 0.4446 | 0.4446 | YES | NO | YES |
| 02540118 | SITAGLIPTIN & METFORMIN | Reddy-Sitagliptin and Metformin HCl 50mg & 500mg Tab | DRR | 0.4446 | 0.4446 | YES | NO | YES |
| 02503964 | SITAGLIPTIN & METFORMIN | Sandoz Sitagliptin-Metformin 50mg & 850mg Tab | SDZ | 0.4446 | 0.4446 | YES | NO | YES |
| 02503956 | SITAGLIPTIN & METFORMIN | Sandoz Sitagliptin-Metformin 50mg & 500mg Tab | SDZ | 0.4446 | 0.4446 | YES | NO | YES |
| 02503972 | SITAGLIPTIN & METFORMIN | Sandoz Sitagliptin-Metformin 50mg & 1000mg Tab | SDZ | 0.4446 | 0.4446 | YES | NO | YES |
| 02529165 | SITAGLIPTIN & METFORMIN | Sitagliptin-Metformin 50mg & 850mg Tab | SIV | 0.4446 | 0.4446 | YES | NO | YES |
| 02529157 | SITAGLIPTIN & METFORMIN | Sitagliptin-Metformin 50mg & 500mg Tab | SIV | 0.4446 | 0.4446 | YES | NO | YES |
| 02529173 | SITAGLIPTIN & METFORMIN | Sitagliptin-Metformin 50mg & 1000mg Tab | SIV | 0.4446 | 0.4446 | YES | NO | YES |
| 02520508 | SITAGLIPTIN & METFORMIN | Teva-Sitagliptin Malate / Metformin 50mg & 850mg Tab | TEV | 0.4446 | 0.4446 | YES | NO | YES |
| 02520494 | SITAGLIPTIN & METFORMIN | Teva-Sitagliptin Malate / Metformin 50mg & 500mg Tab | TEV | 0.4446 | 0.4446 | YES | NO | YES |
| 02520516 | SITAGLIPTIN & METFORMIN | Teva-Sitagliptin Malate / Metformin 50mg & 1000mg Tab | TEV | 0.4446 | 0.4446 | YES | NO | YES |
| 00108065 | SODIUM BIPHOSPHATE & SODIUM PHOSPHATE | Fleet Enema Pediatric 160mg & 60mg/mL Ped Rect Sol | CBF | 0.0630 | 0.0630 | NO | NO | NO |
| 00009911 | SODIUM BIPHOSPHATE & SODIUM PHOSPHATE | Fleet Enema 160mg & 60mg/mL Rect Sol (with Preservative) | CBF | 0.0313 | 0.0313 | NO | NO | NO |
| 02009277 | SODIUM CROMOGLYCATE | Cromolyn Eye Drops 2% Oph Sol | PEN | 0.9500 | 0.9500 | YES | NO | NO |
| 02230621 | SODIUM CROMOGLYCATE | Opticrom (Not a Benefit) 2% Oph Sol | ALL | N/A | N/A | YES | NO | NO |
| 00586676 | SODIUM FUSIDATE | Fucidin 2% Oint | LEO | 1.1202 | 1.1202 | NO | NO | NO |
| 02418355 | SOFOSBUVIR | Sovaldi 400mg Tab | GIL | 654.7619 | 654.7619 | NO | YES | NO |
| 02456370 | SOFOSBUVIR & VELPATASVIR | Epclusa 400mg & 100mg Tab | GIL | 714.2857 | 714.2857 | NO | YES | NO |
| 02467542 | SOFOSBUVIR & VELPATASVIR & VOXILAPREVIR | Vosevi 400mg & 100mg & 100mg Tab | GIL | 714.2857 | 714.2857 | NO | YES | NO |
| 02439352 | SOLIFENACIN SUCCINATE | Ach-Solifenacin Succinate 10mg Tab | ACH | 0.3041 | 0.3041 | YES | YES | NO |
| 02439344 | SOLIFENACIN SUCCINATE | Ach-Solifenacin Succinate 5mg Tab | ACH | 0.3041 | 0.3041 | YES | YES | NO |
| 02422247 | SOLIFENACIN SUCCINATE | Act Solifenacin 10mg Tab | ACV | 0.3041 | 0.3041 | YES | YES | NO |
| 02422239 | SOLIFENACIN SUCCINATE | Act Solifenacin 5mg Tab | ACV | 0.3041 | 0.3041 | YES | YES | NO |
| 02423383 | SOLIFENACIN SUCCINATE | Apo-Solifenacin 10mg Tab | APX | 0.3041 | 0.3041 | YES | YES | NO |
| 02423375 | SOLIFENACIN SUCCINATE | Apo-Solifenacin 5mg Tab | APX | 0.3041 | 0.3041 | YES | YES | NO |
| 02446375 | SOLIFENACIN SUCCINATE | Auro-Solifenacin 5mg Tab | AUR | 0.3041 | 0.3041 | YES | YES | NO |
| 02446383 | SOLIFENACIN SUCCINATE | Auro-Solifenacin 10mg Tab | AUR | 0.3041 | 0.3041 | YES | YES | NO |
| 02428911 | SOLIFENACIN SUCCINATE | Jamp Solifenacin Succinate 5mg Tab | JPC | 0.3041 | 0.3041 | YES | YES | NO |
| 02428938 | SOLIFENACIN SUCCINATE | Jamp Solifenacin Succinate 10mg Tab | JPC | 0.3041 | 0.3041 | YES | YES | NO |
| 02424339 | SOLIFENACIN SUCCINATE | Jamp-Solifenacin 5mg Tab | JPC | 0.3041 | 0.3041 | YES | YES | NO |
| 02424347 | SOLIFENACIN SUCCINATE | Jamp-Solifenacin 10mg Tab | JPC | 0.3041 | 0.3041 | YES | YES | NO |
| 02529718 | SOLIFENACIN SUCCINATE | M-Solifenacin Succinate 10mg Tab | MAT | 0.3041 | 0.3041 | YES | YES | NO |
| 02529696 | SOLIFENACIN SUCCINATE | M-Solifenacin Succinate 5mg Tab | MAT | 0.3041 | 0.3041 | YES | YES | NO |
| 02417723 | SOLIFENACIN SUCCINATE | PMS-Solifenacin 5mg Tab | PMS | 0.3041 | 0.3041 | YES | YES | NO |
| 02417731 | SOLIFENACIN SUCCINATE | PMS-Solifenacin 10mg Tab | PMS | 0.3041 | 0.3041 | YES | YES | NO |
| 02493047 | SOLIFENACIN SUCCINATE | PRZ-Solifenacin 10mg Tab | PRZ | 0.3041 | 0.3041 | YES | YES | NO |
| 02493039 | SOLIFENACIN SUCCINATE | PRZ-Solifenacin 5mg Tab | PRZ | 0.3041 | 0.3041 | YES | YES | NO |
| 02437988 | SOLIFENACIN SUCCINATE | Ran-Solifenacin 5mg Tab | RAN | 0.3041 | 0.3041 | YES | YES | NO |
| 02437996 | SOLIFENACIN SUCCINATE | Ran-Solifenacin 10mg Tab | RAN | 0.3041 | 0.3041 | YES | YES | NO |
| 02399040 | SOLIFENACIN SUCCINATE | Sandoz Solifenacin 10mg Tab | SDZ | 0.3041 | 0.3041 | YES | YES | NO |
| 02399032 | SOLIFENACIN SUCCINATE | Sandoz Solifenacin 5mg Tab | SDZ | 0.3041 | 0.3041 | YES | YES | NO |
| 02458268 | SOLIFENACIN SUCCINATE | Solifenacin 10mg Tab | SAI | 0.3041 | 0.3041 | YES | YES | NO |
| 02458241 | SOLIFENACIN SUCCINATE | Solifenacin 5mg Tab | SAI | 0.3041 | 0.3041 | YES | YES | NO |
| 02448335 | SOLIFENACIN SUCCINATE | Solifenacin Succinate Tablets 5mg Tab | MDI | 0.3041 | 0.3041 | YES | YES | NO |
| 02448343 | SOLIFENACIN SUCCINATE | Solifenacin Succinate Tablets 10mg Tab | MDI | 0.3041 | 0.3041 | YES | YES | NO |
| 02397919 | SOLIFENACIN SUCCINATE | Teva-Solifenacin 10mg Tab | TEV | 0.3041 | 0.3041 | YES | YES | NO |
| 02397900 | SOLIFENACIN SUCCINATE | Teva-Solifenacin 5mg Tab | TEV | 0.3041 | 0.3041 | YES | YES | NO |
| 02277271 | SOLIFENACIN SUCCINATE | Vesicare 10mg Tab | ASE | 1.6892 | 0.3041 | YES | YES | NO |
| 02277263 | SOLIFENACIN SUCCINATE | Vesicare 5mg Tab | ASE | 1.6892 | 0.3041 | YES | YES | NO |
| 02167794 | SOTALOL HCL | Apo-Sotalol 160mg Tab | APX | 0.1623 | 0.1623 | YES | NO | NO |
| 02210428 | SOTALOL HCL | Apo-Sotalol 80mg Tab | APX | 0.2966 | 0.2966 | YES | NO | NO |
| 02270633 | SOTALOL HCL | Co Sotalol 160mg Tab | COB | 0.1623 | 0.1623 | YES | NO | NO |
| 02368617 | SOTALOL HCL | Jamp-Sotalol 80mg Tab | JPC | 0.2966 | 0.2966 | YES | NO | NO |
| 02368625 | SOTALOL HCL | Jamp-Sotalol 160mg Tab | JPC | 0.1623 | 0.1623 | YES | NO | NO |
| 02231182 | SOTALOL HCL | Novo-Sotalol 160mg Tab | NOP | 0.1623 | 0.1623 | YES | NO | NO |
| 02238326 | SOTALOL HCL | PMS-Sotalol 80mg Tab | PMS | 0.2966 | 0.2966 | YES | NO | NO |
| 02238327 | SOTALOL HCL | PMS-Sotalol 160mg Tab | PMS | 0.1623 | 0.1623 | YES | NO | NO |
| 02084236 | SOTALOL HCL | Ratio-Sotalol 160mg Tab | RPH | 0.1623 | 0.1623 | YES | NO | NO |
| 00483923 | SOTALOL HCL | Sotacor (Not a Benefit) 160mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00897272 | SOTALOL HCL | Sotacor (Not a Benefit) 80mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02396963 | SOYBEAN OIL & MEDIUM CHAIN TRIGLYCERIDES & OLIVE OIL & FISH OIL | SMOFLipid 20% 6% & 6% & 5% & 3% w/v Inj Emuls-250mL Pk | FKC | 27.5000 | 27.5000 | NO | YES | NO |
| 09857595 | SOYBEAN OIL & MEDIUM CHAIN TRIGLYCERIDES & OLIVE OIL & FISH OIL | SMOFLipid 20% 6% & 6% & 5% & 3% w/v Inj Emuls-500mL Pk | FKC | 33.3300 | 33.3300 | NO | YES | NO |
| 00028606 | SPIRONOLACTONE | Aldactone 25mg Tab | PFI | 0.2746 | 0.0405 | YES | NO | YES |
| 00285455 | SPIRONOLACTONE | Aldactone 100mg Tab | PFI | 0.6410 | 0.0955 | YES | NO | YES |
| 02518821 | SPIRONOLACTONE | Jamp Spironolactone 25mg Tab | JPC | 0.0405 | 0.0405 | YES | NO | YES |
| 02518848 | SPIRONOLACTONE | Jamp Spironolactone 100mg Tab | JPC | 0.0955 | 0.0955 | YES | NO | YES |
| 02488159 | SPIRONOLACTONE | Mint-Spironolactone 100mg Tab | MIN | 0.0955 | 0.0955 | YES | NO | YES |
| 02488140 | SPIRONOLACTONE | Mint-Spironolactone 25mg Tab | MIN | 0.0405 | 0.0405 | YES | NO | YES |
| 00613215 | SPIRONOLACTONE | Teva-Spironolactone 25mg Tab | TEV | 0.0405 | 0.0405 | YES | NO | YES |
| 00613223 | SPIRONOLACTONE | Teva-Spironolactone 100mg Tab | TEV | 0.0955 | 0.0955 | YES | NO | YES |
| 02423723 | STANDARDIZED SHORT RAGWEED POLLEN ALLERGENIC EXTRACT | Ragwitek 12U SL Tab | ALK | 4.6533 | 4.6533 | NO | YES | NO |
| 02103567 | SUCRALFATE | Sulcrate Suspension Plus 1g/5mL Oral Susp | BFI | 0.1313 | 0.1313 | NO | NO | NO |
| 02125250 | SUCRALFATE | Apo-Sucralfate 1g Tab | APX | 0.3089 | 0.3089 | YES | NO | NO |
| 02100622 | SUCRALFATE | Sulcrate 1g Tab | BFI | 0.7408 | 0.3089 | YES | NO | NO |
| 02045702 | SUCRALFATE | Teva-Sucralfate 1g Tab | TEV | 0.3089 | 0.3089 | YES | NO | NO |
| 00272485 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Bactrim Sugar Free (Not a Benefit) 40mg & 8mg/mL O/L | HLR | N/A | N/A | YES | NO | YES |
| 00270644 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Septra (Not a Benefit) 40mg & 8mg/mL O/L | BWE | N/A | N/A | YES | NO | YES |
| 00726540 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Teva-Trimel 40mg & 8mg/mL O/L | TEV | 0.1026 | 0.1026 | YES | NO | YES |
| 00272469 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Bactrim (Not a Benefit) 400mg & 80mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 00371823 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Bactrim-DS (Not a Benefit) 800mg & 160mg Tab | HLR | N/A | N/A | YES | NO | YES |
| 00270636 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Septra (Not a Benefit) 400mg & 80mg Tab | BWE | N/A | N/A | YES | NO | YES |
| 00368040 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Septra DS (Not a Benefit) 800mg & 160mg Tab | BWE | N/A | N/A | YES | NO | YES |
| 00445274 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Sulfatrim 400mg & 80mg Tab | AAP | 0.2184 | 0.2184 | YES | NO | YES |
| 00445282 | SULFAMETHOXAZOLE & TRIMETHOPRIM | Sulfatrim-DS 800mg & 160mg Tab | AAP | 0.2074 | 0.2074 | YES | NO | YES |
| 00598488 | SULFASALAZINE | PMS-Sulfasalazine-E.C. 500mg Ent Tab | PMS | 0.3863 | 0.3863 | YES | NO | NO |
| 02064472 | SULFASALAZINE | Salazopyrin EN-TABS 500 MG 500mg Ent Tab | PFI | 0.5512 | 0.3863 | YES | NO | NO |
| 00598461 | SULFASALAZINE | PMS-Sulfasalazine 500mg Tab | PMS | 0.2533 | 0.2533 | YES | NO | NO |
| 02064480 | SULFASALAZINE | Salazopyrin 500mg Tab | PFI | 0.3614 | 0.2533 | YES | NO | NO |
| 00456888 | SULINDAC | Clinoril (Not a Benefit) 150mg Tab | FRS | N/A | N/A | YES | NO | YES |
| 00432369 | SULINDAC | Clinoril (Not a Benefit) 200mg Tab | FRS | N/A | N/A | YES | NO | YES |
| 00745596 | SULINDAC | Teva-Sulindac 200mg Tab | TEV | 0.5253 | 0.5253 | YES | NO | YES |
| 00745588 | SULINDAC | Teva-Sulindac 150mg Tab | TEV | 0.4427 | 0.4427 | YES | NO | YES |
| 02212188 | SUMATRIPTAN SUCCINATE | Imitrex (Off-Formulary Interchangeable) 6mg/0.5mL Inj Sol-Pref Syr 0.5mL Pk | GLW | 52.8600 | 42.4650 | YES | NO | NO |
| 02361698 | SUMATRIPTAN SUCCINATE | Taro-Sumatriptan (Off-Formulary Interchangeable) 6mg/0.5mL Inj Sol-Pref Syr 0.5mL Pk | TAR | 42.4650 | 42.4650 | YES | NO | NO |
| 02268396 | SUMATRIPTAN SUCCINATE | Apo-Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | APX | 9.9867 | 9.9867 | YES | NO | NO |
| 02268388 | SUMATRIPTAN SUCCINATE | Apo-Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | APX | 9.0650 | 9.0650 | YES | NO | NO |
| 02257904 | SUMATRIPTAN SUCCINATE | Co Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | COB | 9.9867 | 9.9867 | YES | NO | NO |
| 02257882 | SUMATRIPTAN SUCCINATE | Co Sumatriptan (Off-Formulary Interchangeable) 25mg Tab | COB | 8.9900 | 8.9900 | YES | NO | NO |
| 02257890 | SUMATRIPTAN SUCCINATE | Co Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | COB | 9.0650 | 9.0650 | YES | NO | NO |
| 01950614 | SUMATRIPTAN SUCCINATE | Imitrex (Off-Formulary Interchangeable) 100mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02163764 | SUMATRIPTAN SUCCINATE | Imitrex (Off-Formulary Interchangeable) 50mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 09857299 | SUMATRIPTAN SUCCINATE | Imitrex (Off-Formulary Interchangeable) 25mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02212161 | SUMATRIPTAN SUCCINATE | Imitrex DF (Off-Formulary Interchangeable) 100mg Tab | GSK | 21.7933 | 9.9866 | YES | NO | NO |
| 02239738 | SUMATRIPTAN SUCCINATE | Imitrex DF (Off-Formulary Interchangeable) 25mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02212153 | SUMATRIPTAN SUCCINATE | Imitrex DF (Off-Formulary Interchangeable) 50mg Tab | GSK | 19.7817 | 9.0650 | YES | NO | NO |
| 02545357 | SUMATRIPTAN SUCCINATE | Jamp Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | JPC | 9.0650 | 9.0650 | YES | NO | NO |
| 02545365 | SUMATRIPTAN SUCCINATE | Jamp Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | JPC | 9.9866 | 9.9866 | YES | NO | NO |
| 02545314 | SUMATRIPTAN SUCCINATE | Jamp Sumatriptan DF (Off-Formulary Interchangeable) 100mg Tab | JPC | 9.9866 | 9.9866 | YES | NO | NO |
| 02545292 | SUMATRIPTAN SUCCINATE | Jamp Sumatriptan DF (Off-Formulary Interchangeable) 25mg Tab | JPC | 8.9900 | N/A | YES | NO | NO |
| 02545306 | SUMATRIPTAN SUCCINATE | Jamp Sumatriptan DF (Off-Formulary Interchangeable) 50mg Tab | JPC | 9.0650 | 9.0650 | YES | NO | NO |
| 02268922 | SUMATRIPTAN SUCCINATE | Mylan-Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | MYL | 9.9867 | 9.9867 | YES | NO | NO |
| 02268914 | SUMATRIPTAN SUCCINATE | Mylan-Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | MYL | 9.0650 | 9.0650 | YES | NO | NO |
| 02268906 | SUMATRIPTAN SUCCINATE | Mylan-Sumatriptan (Off-Formulary Interchangeable) 25mg Tab | MYL | 8.9900 | 8.9900 | YES | NO | NO |
| 02256436 | SUMATRIPTAN SUCCINATE | PMS-Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | PMS | 9.0650 | 9.0650 | YES | NO | NO |
| 02256444 | SUMATRIPTAN SUCCINATE | PMS-Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | PMS | 9.9867 | 9.9867 | YES | NO | NO |
| 02256428 | SUMATRIPTAN SUCCINATE | PMS-Sumatriptan (Off-Formulary Interchangeable) 25mg Tab | PMS | 8.9900 | 8.9900 | YES | NO | NO |
| 02271591 | SUMATRIPTAN SUCCINATE | Ratio-Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | RPH | 9.9867 | 9.9867 | YES | NO | NO |
| 02271583 | SUMATRIPTAN SUCCINATE | Ratio-Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | RPH | 9.0650 | 9.0650 | YES | NO | NO |
| 02263033 | SUMATRIPTAN SUCCINATE | Sandoz Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | SDZ | 9.9867 | 9.9867 | YES | NO | NO |
| 02263025 | SUMATRIPTAN SUCCINATE | Sandoz Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | SDZ | 9.0650 | 9.0650 | YES | NO | NO |
| 02286548 | SUMATRIPTAN SUCCINATE | Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | SAI | 9.9867 | 9.9867 | YES | NO | NO |
| 02286521 | SUMATRIPTAN SUCCINATE | Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | SAI | 9.0650 | 9.0650 | YES | NO | NO |
| 02546043 | SUMATRIPTAN SUCCINATE | Sumatriptan (Off-Formulary Interchangeable) 100mg Tab | SIV | 9.9867 | 9.9867 | YES | NO | NO |
| 02546035 | SUMATRIPTAN SUCCINATE | Sumatriptan (Off-Formulary Interchangeable) 50mg Tab | SIV | 9.0650 | 9.0650 | YES | NO | NO |
| 02385589 | SUMATRIPTAN SUCCINATE | Sumatriptan DF (Off-Formulary Interchangeable) 100mg Tab | SIV | 9.9866 | 9.9866 | YES | NO | NO |
| 02385570 | SUMATRIPTAN SUCCINATE | Sumatriptan DF (Off-Formulary Interchangeable) 50mg Tab | SIV | 9.0650 | 9.0650 | YES | NO | NO |
| 02286815 | SUMATRIPTAN SUCCINATE | Teva-Sumatriptan DF (Off-Formulary Interchangeable) 25mg Tab | TEV | 8.9900 | N/A | YES | NO | NO |
| 02286823 | SUMATRIPTAN SUCCINATE | Teva-Sumatriptan DF (Off-Formulary Interchangeable) 50mg Tab | TEV | 9.0650 | 9.0650 | YES | NO | NO |
| 02286831 | SUMATRIPTAN SUCCINATE | Teva-Sumatriptan DF (Off-Formulary Interchangeable) 100mg Tab | TEV | 9.9866 | 9.9866 | YES | NO | NO |
| 02532204 | SUNITINIB MALATE | Auro-Sunitinib (Off-Formulary Interchangeable) 25mg Cap | AUR | 110.7100 | 110.7100 | YES | NO | NO |
| 02532220 | SUNITINIB MALATE | Auro-Sunitinib (Off-Formulary Interchangeable) 50mg Cap | AUR | 221.4208 | 221.4208 | YES | NO | NO |
| 02532190 | SUNITINIB MALATE | Auro-Sunitinib (Off-Formulary Interchangeable) 12.5mg Cap | AUR | 55.3553 | 55.3553 | YES | NO | NO |
| 02552892 | SUNITINIB MALATE | Nat-Sunitinib (Off-Formulary Interchangeable) 12.5mg Cap | NAT | 55.3553 | 55.3553 | YES | NO | NO |
| 02552906 | SUNITINIB MALATE | Nat-Sunitinib (Off-Formulary Interchangeable) 25mg Cap | NAT | 110.7100 | 110.7100 | YES | NO | NO |
| 02539284 | SUNITINIB MALATE | Nat-Sunitinib (Off-Formulary Interchangeable) 50mg Cap | NAT | 221.4208 | 221.4208 | YES | NO | NO |
| 02532867 | SUNITINIB MALATE | Sandoz Sunitinib (Off-Formulary Interchangeable) 25mg Cap | SDZ | 110.7100 | 110.7100 | YES | NO | NO |
| 02532883 | SUNITINIB MALATE | Sandoz Sunitinib (Off-Formulary Interchangeable) 50mg Cap | SDZ | 221.4208 | 221.4208 | YES | NO | NO |
| 02532840 | SUNITINIB MALATE | Sandoz Sunitinib (Off-Formulary Interchangeable) 12.5mg Cap | SDZ | 55.3553 | 55.3553 | YES | NO | NO |
| 02280817 | SUNITINIB MALATE | Sutent (Off-Formulary Interchangeable) 50mg Cap | PFI | 260.4950 | 221.4208 | YES | NO | NO |
| 02280809 | SUNITINIB MALATE | Sutent (Off-Formulary Interchangeable) 25mg Cap | PFI | 130.2470 | 110.7100 | YES | NO | NO |
| 02280795 | SUNITINIB MALATE | Sutent (Off-Formulary Interchangeable) 12.5mg Cap | PFI | 65.1240 | 55.3553 | YES | NO | NO |
| 02524082 | SUNITINIB MALATE | Taro-Sunitinib (Off-Formulary Interchangeable) 50mg Cap | TAR | 221.4208 | 221.4208 | YES | NO | NO |
| 02524066 | SUNITINIB MALATE | Taro-Sunitinib (Off-Formulary Interchangeable) 25mg Cap | TAR | 110.7100 | 110.7100 | YES | NO | NO |
| 02524058 | SUNITINIB MALATE | Taro-Sunitinib (Off-Formulary Interchangeable) 12.5mg Cap | TAR | 55.3553 | 55.3553 | YES | NO | NO |
| 02526220 | SUNITINIB MALATE | Teva-Sunitinib (Off-Formulary Interchangeable) 50mg Cap | TEV | 221.4208 | 221.4208 | YES | NO | NO |
| 02526212 | SUNITINIB MALATE | Teva-Sunitinib (Off-Formulary Interchangeable) 25mg Cap | TEV | 110.7100 | 110.7100 | YES | NO | NO |
| 02526204 | SUNITINIB MALATE | Teva-Sunitinib (Off-Formulary Interchangeable) 12.5mg Cap | TEV | 55.3553 | 55.3553 | YES | NO | NO |
| 02176009 | TACROLIMUS | Prograf 5mg/mL Amp | ASE | 128.2350 | 128.2350 | NO | YES | NO |
| 02456095 | TACROLIMUS | Ach-Tacrolimus 1mg Cap | ACH | 1.2978 | 1.2978 | YES | YES | NO |
| 02454068 | TACROLIMUS | Ach-Tacrolimus 0.5mg Cap | ACH | 1.0146 | 1.0146 | YES | YES | NO |
| 02456109 | TACROLIMUS | Ach-Tacrolimus 5mg Cap | ACH | 6.4993 | 6.4993 | YES | YES | NO |
| 02175983 | TACROLIMUS | Prograf 5mg Cap | ASE | 12.9986 | 6.4993 | YES | YES | NO |
| 02243144 | TACROLIMUS | Prograf 0.5mg Cap | ASE | 2.0291 | 1.0146 | YES | YES | NO |
| 02175991 | TACROLIMUS | Prograf 1mg Cap | ASE | 2.5956 | 1.2978 | YES | YES | NO |
| 02416824 | TACROLIMUS | Sandoz Tacrolimus 1mg Cap | SDZ | 1.2978 | 1.2978 | YES | YES | NO |
| 02416832 | TACROLIMUS | Sandoz Tacrolimus 5mg Cap | SDZ | 6.4993 | 6.4993 | YES | YES | NO |
| 02416816 | TACROLIMUS | Sandoz Tacrolimus 0.5mg Cap | SDZ | 1.0146 | 1.0146 | YES | YES | NO |
| 02296489 | TACROLIMUS | Advagraf 5mg ER Cap | ASE | 14.2205 | 10.6654 | YES | YES | NO |
| 02331667 | TACROLIMUS | Advagraf 3mg ER Cap | ASE | 8.5188 | 6.3891 | YES | YES | NO |
| 02296470 | TACROLIMUS | Advagraf 1mg ER Cap | ASE | 2.8396 | 2.1297 | YES | YES | NO |
| 02296462 | TACROLIMUS | Advagraf 0.5mg ER Cap | ASE | 2.2199 | 2.2199 | NO | YES | NO |
| 02528622 | TACROLIMUS | Sandoz Tacrolimus XR 3mg ER Cap | SDZ | 6.3891 | 6.3891 | YES | YES | NO |
| 02528606 | TACROLIMUS | Sandoz Tacrolimus XR 1mg ER Cap | SDZ | 2.1297 | 2.1297 | YES | YES | NO |
| 02528630 | TACROLIMUS | Sandoz Tacrolimus XR 5mg ER Cap | SDZ | 10.6654 | 10.6654 | YES | YES | NO |
| 02485877 | TACROLIMUS | Envarsus PA 0.75mg ER Tab | EVL | 2.0999 | 2.0999 | NO | YES | NO |
| 02485885 | TACROLIMUS | Envarsus PA 1mg ER Tab | EVL | 2.7430 | 2.7430 | NO | YES | NO |
| 02485893 | TACROLIMUS | Envarsus PA 4mg ER Tab | EVL | 10.9719 | 10.9719 | NO | YES | NO |
| 02244149 | TACROLIMUS | Protopic 0.03% Oint | LEO | 3.4301 | 3.4301 | NO | YES | NO |
| 02244148 | TACROLIMUS | Protopic 0.1% Oint | LEO | 3.6691 | 3.6691 | NO | YES | NO |
| 02481421 | TADALAFIL | AG-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | ANG | 12.3569 | 12.3569 | YES | NO | NO |
| 02515997 | TADALAFIL | Ach-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | ACH | 11.9250 | 11.9250 | YES | NO | NO |
| 02516004 | TADALAFIL | Ach-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | ACH | 12.3575 | 12.3575 | YES | NO | NO |
| 02515989 | TADALAFIL | Ach-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | ACH | 3.6470 | 3.6470 | YES | NO | NO |
| 02428644 | TADALAFIL | Act Tadalafil (Off-Formulary Interchangeable) 10mg Tab | ACV | 11.9255 | 11.9255 | YES | NO | NO |
| 02428652 | TADALAFIL | Act Tadalafil (Off-Formulary Interchangeable) 20mg Tab | ACV | 12.3569 | 12.3569 | YES | NO | NO |
| 02428636 | TADALAFIL | Act Tadalafil (Off-Formulary Interchangeable) 5mg Tab | ACV | 3.6471 | 3.6471 | YES | NO | NO |
| 02428628 | TADALAFIL | Act Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | ACV | 3.6471 | 3.6471 | YES | NO | NO |
| 02338327 | TADALAFIL | Adcirca (Off-Formulary Interchangeable) 20mg Tab | LIL | 15.0555 | 11.4725 | YES | NO | NO |
| 02422107 | TADALAFIL | Apo-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | APX | 11.9250 | 11.9250 | YES | NO | NO |
| 02422093 | TADALAFIL | Apo-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | APX | 3.6470 | 3.6470 | YES | NO | NO |
| 02422085 | TADALAFIL | Apo-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | APX | 3.6470 | 3.6470 | YES | NO | NO |
| 02422115 | TADALAFIL | Apo-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | APX | 12.3575 | 12.3575 | YES | NO | NO |
| 02421933 | TADALAFIL | Apo-Tadalafil PAH (Off-Formulary Interchangeable) 20mg Tab | APX | 11.4725 | 11.4725 | YES | NO | NO |
| 02435934 | TADALAFIL | Auro-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | AUR | 11.9250 | 11.9250 | YES | NO | NO |
| 02435896 | TADALAFIL | Auro-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | AUR | 3.6470 | 3.6470 | YES | NO | NO |
| 02435942 | TADALAFIL | Auro-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | AUR | 12.3575 | 12.3575 | YES | NO | NO |
| 02435926 | TADALAFIL | Auro-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | AUR | 3.6471 | 3.6471 | YES | NO | NO |
| 02296896 | TADALAFIL | Cialis (Off-Formulary Interchangeable) 5mg Tab | LIL | N/A | N/A | YES | NO | NO |
| 02248088 | TADALAFIL | Cialis (Off-Formulary Interchangeable) 10mg Tab | LIL | N/A | N/A | YES | NO | NO |
| 02248089 | TADALAFIL | Cialis (Off-Formulary Interchangeable) 20mg Tab | LIL | N/A | N/A | YES | NO | NO |
| 02296888 | TADALAFIL | Cialis (Off-Formulary Interchangeable) 2.5mg Tab | LIL | N/A | N/A | YES | NO | NO |
| 02451840 | TADALAFIL | Jamp-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | JPC | 11.9255 | 11.9255 | YES | NO | NO |
| 02451859 | TADALAFIL | Jamp-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | JPC | 12.3569 | 12.3569 | YES | NO | NO |
| 02451824 | TADALAFIL | Jamp-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | JPC | 3.6471 | 3.6471 | YES | NO | NO |
| 02451832 | TADALAFIL | Jamp-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | JPC | 3.6471 | 3.6471 | YES | NO | NO |
| 02512130 | TADALAFIL | M-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | MAT | 12.3575 | 12.3575 | YES | NO | NO |
| 02512122 | TADALAFIL | M-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | MAT | 11.9250 | 11.9250 | YES | NO | NO |
| 02512114 | TADALAFIL | M-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | MAT | 3.6470 | 3.6470 | YES | NO | NO |
| 02452286 | TADALAFIL | Mar-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | MAR | 3.6471 | 3.6471 | YES | NO | NO |
| 02452278 | TADALAFIL | Mar-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | MAR | 3.6471 | 3.6471 | YES | NO | NO |
| 02452243 | TADALAFIL | Mar-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | MAR | 12.3575 | 12.3575 | YES | NO | NO |
| 02452251 | TADALAFIL | Mar-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | MAR | 11.9250 | 11.9250 | YES | NO | NO |
| 02451689 | TADALAFIL | Mint-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | MIN | 11.9255 | 11.9255 | YES | NO | NO |
| 02451697 | TADALAFIL | Mint-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | MIN | 12.3576 | 12.3576 | YES | NO | NO |
| 02451670 | TADALAFIL | Mint-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | MIN | 3.6472 | 3.6472 | YES | NO | NO |
| 02410664 | TADALAFIL | Mylan-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | MYL | 12.3569 | 12.3569 | YES | NO | NO |
| 02410648 | TADALAFIL | Mylan-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | MYL | 3.6471 | 3.6471 | YES | NO | NO |
| 02410656 | TADALAFIL | Mylan-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | MYL | 11.9255 | 11.9255 | YES | NO | NO |
| 02410621 | TADALAFIL | Mylan-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | MYL | 3.6471 | 3.6471 | YES | NO | NO |
| 02520931 | TADALAFIL | NRA-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | NRA | 3.6471 | 3.6471 | YES | NO | NO |
| 02520966 | TADALAFIL | NRA-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | NRA | 12.3575 | 12.3575 | YES | NO | NO |
| 02409429 | TADALAFIL | PMS-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | PMS | 3.6471 | 3.6471 | YES | NO | NO |
| 02409445 | TADALAFIL | PMS-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | PMS | 12.3569 | 12.3569 | YES | NO | NO |
| 02409437 | TADALAFIL | PMS-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | PMS | 11.9255 | 11.9255 | YES | NO | NO |
| 02409410 | TADALAFIL | PMS-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | PMS | 3.6471 | 3.6471 | YES | NO | NO |
| 02512297 | TADALAFIL | PRZ-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | PRZ | 12.3575 | 12.3575 | YES | NO | NO |
| 02512289 | TADALAFIL | PRZ-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | PRZ | 11.9250 | 11.9250 | YES | NO | NO |
| 02512270 | TADALAFIL | PRZ-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | PRZ | 3.6471 | 3.6471 | YES | NO | NO |
| 02512262 | TADALAFIL | PRZ-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | PRZ | 3.6470 | 3.6470 | YES | NO | NO |
| 02452502 | TADALAFIL | Priva-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | NRA | 12.3575 | 12.3575 | YES | NO | NO |
| 02452480 | TADALAFIL | Priva-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | NRA | 3.6471 | 3.6471 | YES | NO | NO |
| 02452499 | TADALAFIL | Priva-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | NRA | 11.9250 | 11.9250 | YES | NO | NO |
| 02452073 | TADALAFIL | Ran-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | RAN | 3.6471 | 3.6471 | YES | NO | NO |
| 02452111 | TADALAFIL | Ran-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | RAN | 12.3569 | 12.3569 | YES | NO | NO |
| 02452081 | TADALAFIL | Ran-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | RAN | 3.6471 | 3.6471 | YES | NO | NO |
| 02452103 | TADALAFIL | Ran-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | RAN | 11.9255 | 11.9255 | YES | NO | NO |
| 02454742 | TADALAFIL | Riva-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | RIA | 12.3569 | 12.3569 | YES | NO | NO |
| 02454726 | TADALAFIL | Riva-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | RIA | 3.6471 | 3.6471 | YES | NO | NO |
| 02536684 | TADALAFIL | Tadalafil (Off-Formulary Interchangeable) 5mg Tab | SIV | 3.8616 | 3.8616 | YES | NO | NO |
| 02457032 | TADALAFIL | Tadalafil (Off-Formulary Interchangeable) 20mg Tab | SAI | 12.3569 | 12.3569 | YES | NO | NO |
| 02536676 | TADALAFIL | Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | SIV | 3.8616 | 3.8616 | YES | NO | NO |
| 02536706 | TADALAFIL | Tadalafil (Off-Formulary Interchangeable) 20mg Tab | SIV | 13.0838 | 13.0838 | YES | NO | NO |
| 02536692 | TADALAFIL | Tadalafil (Off-Formulary Interchangeable) 10mg Tab | SIV | 12.6270 | 12.6270 | YES | NO | NO |
| 02457024 | TADALAFIL | Tadalafil (Off-Formulary Interchangeable) 10mg Tab | SAI | 11.9250 | 11.9250 | YES | NO | NO |
| 02457016 | TADALAFIL | Tadalafil (Off-Formulary Interchangeable) 5mg Tab | SAI | 3.6471 | 3.6471 | YES | NO | NO |
| 02440172 | TADALAFIL | Teva-Tadalafil (Off-Formulary Interchangeable) 20mg Tab | TEV | 13.0838 | 13.0838 | YES | NO | NO |
| 02440156 | TADALAFIL | Teva-Tadalafil (Off-Formulary Interchangeable) 5mg Tab | TEV | 3.8616 | 3.8616 | YES | NO | NO |
| 02440164 | TADALAFIL | Teva-Tadalafil (Off-Formulary Interchangeable) 10mg Tab | TEV | 12.6270 | 12.6270 | YES | NO | NO |
| 02440148 | TADALAFIL | Teva-Tadalafil (Off-Formulary Interchangeable) 2.5mg Tab | TEV | 3.8616 | 3.8616 | YES | NO | NO |
| 00812404 | TAMOXIFEN CITRATE | Apo-Tamox 10mg Tab | APX | 0.1750 | 0.1750 | YES | NO | NO |
| 00812390 | TAMOXIFEN CITRATE | Apo-Tamox 20mg Tab | APX | 0.3500 | 0.3500 | YES | NO | NO |
| 02048477 | TAMOXIFEN CITRATE | Nolvadex (Not a Benefit) 10mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02048485 | TAMOXIFEN CITRATE | Nolvadex D 20mg Tab | AZC | 0.3910 | 0.3500 | YES | NO | NO |
| 01926632 | TAMOXIFEN CITRATE | Tamofen (Not a Benefit) 20mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 01926624 | TAMOXIFEN CITRATE | Tamofen (Not a Benefit) 10mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 00851965 | TAMOXIFEN CITRATE | Teva-Tamoxifen 10mg Tab | TEV | 0.1750 | 0.1750 | YES | NO | NO |
| 00851973 | TAMOXIFEN CITRATE | Teva-Tamoxifen 20mg Tab | TEV | 0.3500 | 0.3500 | YES | NO | NO |
| 02362406 | TAMSULOSIN HCL | Apo-Tamsulosin CR Tab 0.4mg | APX | 0.1500 | 0.1500 | YES | NO | YES |
| 02545179 | TAMSULOSIN HCL | Auro-Tamsulosin CR Tab 0.4mg | AUR | 0.1500 | 0.1500 | YES | NO | NO |
| 02270102 | TAMSULOSIN HCL | Flomax CR Tab 0.4mg | BOE | 0.6700 | 0.1500 | YES | NO | YES |
| 02340208 | TAMSULOSIN HCL | Sandoz Tamsulosin CR Tab 0.4mg | SDZ | 0.1500 | 0.1500 | YES | NO | YES |
| 02427117 | TAMSULOSIN HCL | Tamsulosin CR Tab 0.4mg | SAI | 0.1500 | 0.1500 | YES | NO | YES |
| 02429667 | TAMSULOSIN HCL | Tamsulosin CR Tab 0.4mg | SIV | 0.1500 | 0.1500 | YES | NO | YES |
| 02368242 | TAMSULOSIN HCL | Teva-Tamsulosin CR Tab 0.4mg | TEV | 0.1500 | 0.1500 | YES | NO | YES |
| 02238123 | TAMSULOSIN HCL | Flomax (Not a Benefit) 0.4mg ER Cap | BOE | N/A | N/A | YES | NO | YES |
| 02352419 | TAMSULOSIN HCL | Jamp Tamsulosin 0.4mg ER Cap | JPC | 0.4750 | 0.4750 | YES | NO | YES |
| 02319217 | TAMSULOSIN HCL | Sandoz Tamsulosin 0.4mg ER Cap | SDZ | 0.4750 | 0.4750 | YES | NO | YES |
| 02517868 | TAZAROTENE | Arazlo 0.045% w/w Lot | BHC | 1.4051 | 1.4051 | NO | YES | NO |
| 02407493 | TELMISARTAN | Ach-Telmisartan 80mg Tab | ACH | 0.2161 | 0.2161 | YES | NO | NO |
| 02407485 | TELMISARTAN | Ach-Telmisartan 40mg Tab | ACH | 0.2161 | 0.2161 | YES | NO | NO |
| 02420082 | TELMISARTAN | Apo-Telmisartan 40mg Tab | APX | 0.2161 | 0.2161 | YES | NO | NO |
| 02420090 | TELMISARTAN | Apo-Telmisartan 80mg Tab | APX | 0.2161 | 0.2161 | YES | NO | NO |
| 02453576 | TELMISARTAN | Auro-Telmisartan 80mg Tab | AUR | 0.2161 | 0.2161 | YES | NO | NO |
| 02453568 | TELMISARTAN | Auro-Telmisartan 40mg Tab | AUR | 0.2161 | 0.2161 | YES | NO | NO |
| 02393255 | TELMISARTAN | Co Telmisartan 80mg Tab | COB | 0.2161 | 0.2161 | YES | NO | NO |
| 02386763 | TELMISARTAN | Jamp Telmisartan 80mg Tab | JPC | 0.2161 | 0.2161 | YES | NO | NO |
| 02386755 | TELMISARTAN | Jamp Telmisartan 40mg Tab | JPC | 0.2161 | 0.2161 | YES | NO | NO |
| 02240769 | TELMISARTAN | Micardis 40mg Tab | BOE | 1.3897 | 0.2161 | YES | NO | NO |
| 02240770 | TELMISARTAN | Micardis 80mg Tab | BOE | 1.3897 | 0.2161 | YES | NO | NO |
| 02486377 | TELMISARTAN | Mint-Telmisartan 80mg Tab | MIN | 0.2161 | 0.2161 | YES | NO | NO |
| 02486369 | TELMISARTAN | Mint-Telmisartan 40mg Tab | MIN | 0.2161 | 0.2161 | YES | NO | NO |
| 02503794 | TELMISARTAN | NRA-Telmisartan 40mg Tab | NRA | 0.2161 | 0.2161 | YES | NO | NO |
| 02503808 | TELMISARTAN | NRA-Telmisartan 80mg Tab | NRA | 0.2161 | 0.2161 | YES | NO | NO |
| 02499630 | TELMISARTAN | PMS-Telmisartan 80mg Tab | PMS | 0.2161 | 0.2161 | YES | NO | NO |
| 02499622 | TELMISARTAN | PMS-Telmisartan 40mg Tab | PMS | 0.2161 | 0.2161 | YES | NO | NO |
| 02375958 | TELMISARTAN | Sandoz Telmisartan 40mg Tab | SDZ | 0.2161 | 0.2161 | YES | NO | NO |
| 02375966 | TELMISARTAN | Sandoz Telmisartan 80mg Tab | SDZ | 0.2161 | 0.2161 | YES | NO | NO |
| 02388944 | TELMISARTAN | Telmisartan 40mg Tab | SAI | 0.2161 | 0.2161 | YES | NO | NO |
| 02388952 | TELMISARTAN | Telmisartan 80mg Tab | SAI | 0.2161 | 0.2161 | YES | NO | NO |
| 02390345 | TELMISARTAN | Telmisartan 40mg Tab | SIV | 0.2161 | 0.2161 | YES | NO | NO |
| 02390353 | TELMISARTAN | Telmisartan 80mg Tab | SIV | 0.2161 | 0.2161 | YES | NO | NO |
| 02320185 | TELMISARTAN | Teva-Telmisartan 80mg Tab | TEV | 0.2161 | 0.2161 | YES | NO | NO |
| 02320177 | TELMISARTAN | Teva-Telmisartan 40mg Tab | TEV | 0.2161 | 0.2161 | YES | NO | NO |
| 02559889 | TELMISARTAN & AMLODIPINE BESYLATE | Riva-Telmisartan / Amlodipine 80mg & 10mg Tab | RIA | 0.3648 | 0.3648 | YES | NO | NO |
| 02559870 | TELMISARTAN & AMLODIPINE BESYLATE | Riva-Telmisartan / Amlodipine 80mg & 5mg Tab | RIA | 0.3648 | 0.3648 | YES | NO | NO |
| 02559854 | TELMISARTAN & AMLODIPINE BESYLATE | Riva-Telmisartan / Amlodipine 40mg & 5mg Tab | RIA | 0.6096 | 0.6096 | YES | NO | NO |
| 02559862 | TELMISARTAN & AMLODIPINE BESYLATE | Riva-Telmisartan / Amlodipine 40mg & 10mg Tab | RIA | 0.6096 | 0.6096 | YES | NO | NO |
| 02371022 | TELMISARTAN & AMLODIPINE BESYLATE | Twynsta 40mg & 5mg Tab | BOE | 0.8128 | 0.6096 | YES | NO | NO |
| 02371057 | TELMISARTAN & AMLODIPINE BESYLATE | Twynsta 80mg & 10mg Tab | BOE | 0.8128 | 0.3648 | YES | NO | NO |
| 02371030 | TELMISARTAN & AMLODIPINE BESYLATE | Twynsta 40mg & 10mg Tab | BOE | 0.8128 | 0.6096 | YES | NO | NO |
| 02371049 | TELMISARTAN & AMLODIPINE BESYLATE | Twynsta 80mg & 5mg Tab | BOE | 0.8128 | 0.3648 | YES | NO | NO |
| 02420023 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Apo-Telmisartan/HCTZ 80mg & 12.5mg Tab | APX | 0.2098 | 0.2098 | YES | NO | NO |
| 02420031 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Apo-Telmisartan/HCTZ 80mg & 25mg Tab | APX | 0.2098 | 0.2098 | YES | NO | NO |
| 02456389 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Auro-Telmisartan HCTZ 80mg & 12.5mg Tab | AUR | 0.2098 | 0.2098 | YES | NO | NO |
| 02456397 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Auro-Telmisartan HCTZ 80mg & 25mg Tab | AUR | 0.2098 | 0.2098 | YES | NO | NO |
| 02393271 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Co Telmisartan/HCT 80mg & 25mg Tab | COB | 0.2098 | 0.2098 | YES | NO | NO |
| 02393263 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Co Telmisartan/HCT 80mg & 12.5mg Tab | COB | 0.2098 | 0.2098 | YES | NO | NO |
| 02389940 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Jamp Telmisartan-HCT 80mg & 12.5mg Tab | JPC | 0.2098 | 0.2098 | YES | NO | NO |
| 02389959 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Jamp Telmisartan-HCT 80mg & 25mg Tab | JPC | 0.2098 | 0.2098 | YES | NO | NO |
| 02244344 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Micardis Plus 80mg & 12.5mg Tab | BOE | 1.3897 | 0.2098 | YES | NO | NO |
| 02318709 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Micardis Plus 80mg & 25mg Tab | BOE | 1.3897 | 0.2098 | YES | NO | NO |
| 02504138 | TELMISARTAN & HYDROCHLOROTHIAZIDE | NRA-Telmisartan HCTZ 80mg & 25mg Tab | NRA | 0.2098 | 0.2098 | YES | NO | NO |
| 02504146 | TELMISARTAN & HYDROCHLOROTHIAZIDE | NRA-Telmisartan HCTZ 80mg & 12.5mg Tab | NRA | 0.2098 | 0.2098 | YES | NO | NO |
| 02393565 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Sandoz Telmisartan HCT 80mg & 25mg Tab | SDZ | 0.2098 | 0.2098 | YES | NO | NO |
| 02393557 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Sandoz Telmisartan HCT 80mg & 12.5mg Tab | SDZ | 0.2098 | 0.2098 | YES | NO | NO |
| 02390310 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Telmisartan HCTZ 80mg & 25mg Tab | SIV | 0.2098 | 0.2098 | YES | NO | NO |
| 02390302 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Telmisartan HCTZ 80mg & 12.5mg Tab | SIV | 0.2098 | 0.2098 | YES | NO | NO |
| 02419114 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Telmisartan and Hydrochlorothiazide Tab 80mg & 12.5mg Tab | ACH | 0.2098 | 0.2098 | YES | NO | NO |
| 02419122 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Telmisartan and Hydrochlorothiazide Tab 80mg & 25mg Tab | ACH | 0.2098 | 0.2098 | YES | NO | NO |
| 02395363 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Telmisartan/HCTZ 80mg & 25mg Tab | SAI | 0.2098 | 0.2098 | YES | NO | NO |
| 02395355 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Telmisartan/HCTZ 80mg & 12.5mg Tab | SAI | 0.2098 | 0.2098 | YES | NO | NO |
| 02330288 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Teva-Telmisartan HCTZ 80mg & 12.5mg Tab | TEV | 0.2098 | 0.2098 | YES | NO | NO |
| 02379252 | TELMISARTAN & HYDROCHLOROTHIAZIDE | Teva-Telmisartan HCTZ 80mg & 25mg Tab | TEV | 0.2098 | 0.2098 | YES | NO | NO |
| 00604453 | TEMAZEPAM | Restoril 15mg Cap | AAP | 0.2461 | 0.2461 | NO | NO | NO |
| 00604461 | TEMAZEPAM | Restoril 30mg Cap | AAP | 0.2980 | 0.2980 | NO | NO | NO |
| 02516802 | TEMOZOLOMIDE | Jamp Temozolomide 20mg Cap | JPC | 7.8000 | 7.8000 | YES | NO | NO |
| 02516829 | TEMOZOLOMIDE | Jamp Temozolomide 140mg Cap | JPC | 54.6025 | 54.6025 | YES | NO | NO |
| 02516810 | TEMOZOLOMIDE | Jamp Temozolomide 100mg Cap | JPC | 39.0015 | 39.0015 | YES | NO | NO |
| 02516845 | TEMOZOLOMIDE | Jamp Temozolomide 250mg Cap | JPC | 97.5010 | 97.5010 | YES | NO | NO |
| 02516799 | TEMOZOLOMIDE | Jamp Temozolomide 5mg Cap | JPC | 1.9500 | 1.9500 | YES | NO | NO |
| 02443511 | TEMOZOLOMIDE | Taro-Temozolomide 100mg Cap | TAR | 39.0015 | 39.0015 | YES | NO | NO |
| 02443538 | TEMOZOLOMIDE | Taro-Temozolomide 140mg Cap | TAR | 54.6025 | 54.6025 | YES | NO | NO |
| 02443481 | TEMOZOLOMIDE | Taro-Temozolomide 20mg Cap | TAR | 7.8000 | 7.8000 | YES | NO | NO |
| 02443554 | TEMOZOLOMIDE | Taro-Temozolomide 250mg Cap | TAR | 97.5010 | 97.5010 | YES | NO | NO |
| 02443473 | TEMOZOLOMIDE | Taro-Temozolomide 5mg Cap | TAR | 1.9500 | 1.9500 | YES | NO | NO |
| 02241093 | TEMOZOLOMIDE | Temodal 5mg Cap | MEK | 8.0340 | 1.9500 | YES | NO | NO |
| 02241094 | TEMOZOLOMIDE | Temodal 20mg Cap | MEK | 32.1360 | 7.8000 | YES | NO | NO |
| 02241095 | TEMOZOLOMIDE | Temodal 100mg Cap | MEK | 160.6862 | 39.0015 | YES | NO | NO |
| 02312794 | TEMOZOLOMIDE | Temodal 140mg Cap | MEK | 224.9623 | 54.6025 | YES | NO | NO |
| 02241096 | TEMOZOLOMIDE | Temodal 250mg Cap | MEK | 401.7041 | 97.5010 | YES | NO | NO |
| 02441160 | TEMOZOLOMIDE | Teva-Temozolomide 5mg Cap | TEV | 1.9500 | 1.9500 | YES | NO | NO |
| 02395274 | TEMOZOLOMIDE | Teva-Temozolomide 20mg Cap | TEV | 7.8000 | 7.8000 | YES | NO | NO |
| 02395312 | TEMOZOLOMIDE | Teva-Temozolomide 250mg Cap | TEV | 97.5010 | 97.5010 | YES | NO | NO |
| 02395290 | TEMOZOLOMIDE | Teva-Temozolomide 140mg Cap | TEV | 54.6025 | 54.6025 | YES | NO | NO |
| 02395282 | TEMOZOLOMIDE | Teva-Temozolomide 100mg Cap | TEV | 39.0015 | 39.0015 | YES | NO | NO |
| 02451980 | TENOFOVIR DISOPROXIL | Apo-Tenofovir 300mg Tab | APX | 4.8884 | 4.8884 | YES | YES | NO |
| 02460173 | TENOFOVIR DISOPROXIL | Auro-Tenofovir 300mg Tab | AUR | 4.8884 | 4.8884 | YES | YES | NO |
| 02479087 | TENOFOVIR DISOPROXIL | Jamp-Tenofovir 300mg Tab | JPC | 4.8884 | 4.8884 | YES | YES | NO |
| 02512939 | TENOFOVIR DISOPROXIL | Mint-Tenofovir 300mg Tab | MIN | 4.8884 | 4.8884 | YES | YES | NO |
| 02452634 | TENOFOVIR DISOPROXIL | Mylan-Tenofovir Disoproxil 300mg Tab | MYL | 4.8884 | 4.8884 | YES | YES | NO |
| 02472511 | TENOFOVIR DISOPROXIL | Nat-Tenofovir 300mg Tab | NAT | 4.8884 | 4.8884 | YES | YES | NO |
| 02453940 | TENOFOVIR DISOPROXIL | PMS-Tenofovir 300mg Tab | PMS | 4.8884 | 4.8884 | YES | YES | NO |
| 02512327 | TENOFOVIR DISOPROXIL | Tenofovir 300mg Tab | SAI | 4.8884 | 4.8884 | YES | YES | NO |
| 02523922 | TENOFOVIR DISOPROXIL | Tenofovir 300mg Tab | SIV | 4.8884 | 4.8884 | YES | YES | NO |
| 02403889 | TENOFOVIR DISOPROXIL | Teva-Tenofovir 300mg Tab | TEV | 4.8884 | 4.8884 | YES | YES | NO |
| 02247128 | TENOFOVIR DISOPROXIL | Viread 300mg Tab | GIL | 19.5537 | 4.8884 | YES | YES | NO |
| 02234505 | TERAZOSIN HCL | Apo-Terazosin 10mg Tab | APX | 0.9950 | 0.9950 | YES | NO | NO |
| 02234503 | TERAZOSIN HCL | Apo-Terazosin 2mg Tab | APX | 0.5005 | 0.5005 | YES | NO | NO |
| 02234502 | TERAZOSIN HCL | Apo-Terazosin 1mg Tab | APX | 0.3938 | 0.3938 | YES | NO | NO |
| 02234504 | TERAZOSIN HCL | Apo-Terazosin 5mg Tab | APX | 0.6797 | 0.6797 | YES | NO | NO |
| 00818666 | TERAZOSIN HCL | Hytrin (Not a Benefit) 5mg Tab | ABB | N/A | N/A | YES | NO | NO |
| 00818658 | TERAZOSIN HCL | Hytrin (Not a Benefit) 1mg Tab | ABB | N/A | N/A | YES | NO | NO |
| 00818674 | TERAZOSIN HCL | Hytrin (Not a Benefit) 10mg Tab | ABB | N/A | N/A | YES | NO | NO |
| 00818682 | TERAZOSIN HCL | Hytrin (Not a Benefit) 2mg Tab | ABB | N/A | N/A | YES | NO | NO |
| 02243519 | TERAZOSIN HCL | PMS-Terazosin 2mg Tab | PMS | 0.5005 | 0.5005 | YES | NO | NO |
| 02243521 | TERAZOSIN HCL | PMS-Terazosin 10mg Tab | PMS | 0.9950 | 0.9950 | YES | NO | NO |
| 02243520 | TERAZOSIN HCL | PMS-Terazosin 5mg Tab | PMS | 0.6797 | 0.6797 | YES | NO | NO |
| 02243518 | TERAZOSIN HCL | PMS-Terazosin 1mg Tab | PMS | 0.3938 | 0.3938 | YES | NO | NO |
| 02031094 | TERBINAFINE HCL | Lamisil 1% Cr | NOV | 0.6596 | 0.6596 | NO | NO | YES |
| 02239893 | TERBINAFINE HCL | Apo-Terbinafine 250mg Tab | APX | 0.7714 | 0.7714 | YES | NO | NO |
| 02320134 | TERBINAFINE HCL | Auro-Terbinafine 250mg Tab | AUR | 0.7714 | 0.7714 | YES | NO | NO |
| 02254727 | TERBINAFINE HCL | Co Terbinafine 250mg Tab | COB | 0.7714 | 0.7714 | YES | NO | NO |
| 02031116 | TERBINAFINE HCL | Lamisil (Not a Benefit) 250mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02294273 | TERBINAFINE HCL | PMS-Terbinafine 250mg Tab | PMS | 0.7714 | 0.7714 | YES | NO | NO |
| 02353121 | TERBINAFINE HCL | Terbinafine 250mg Tab | SAI | 0.7714 | 0.7714 | YES | NO | NO |
| 02385279 | TERBINAFINE HCL | Terbinafine 250mg Tab | SIV | 0.7714 | 0.7714 | YES | NO | NO |
| 02240346 | TERBINAFINE HCL | Teva-Terbinafine 250mg Tab | TEV | 0.7714 | 0.7714 | YES | NO | NO |
| 00786616 | TERBUTALINE SULFATE | Bricanyl Turbuhaler 0.5mg/Dose Inh-100 Dose Pk | AZC | 8.4900 | 8.4900 | NO | NO | NO |
| 09858138 | TERBUTALINE SULFATE | Bricanyl Turbuhaler 0.5mg/Dose Inh-120 Dose Pk | AZC | 11.3160 | 11.3160 | NO | NO | NO |
| 02247651 | TERCONAZOLE | Taro-Terconazole 0.4% Vag Cr | TAR | 0.6354 | 0.6354 | YES | NO | YES |
| 00894729 | TERCONAZOLE | Terazol 7 (Not a Benefit) 0.4% Vag Cr | JAN | N/A | N/A | YES | NO | YES |
| 02502933 | TERIFLUNOMIDE | Ach-Teriflunomide 14mg Tab | ACH | 14.9300 | 14.9300 | YES | YES | NO |
| 02500639 | TERIFLUNOMIDE | Apo-Teriflunomide 14mg Tab | APX | 14.9300 | 14.9300 | YES | YES | NO |
| 02416328 | TERIFLUNOMIDE | Aubagio (Not a Benefit) 14mg Tab | SAG | N/A | N/A | YES | NO | NO |
| 02504170 | TERIFLUNOMIDE | Jamp Teriflunomide 14mg Tab | JPC | 14.9300 | 14.9300 | YES | YES | NO |
| 02523833 | TERIFLUNOMIDE | M-Teriflunomide 14mg Tab | MAT | 14.9300 | 14.9300 | YES | YES | NO |
| 02500469 | TERIFLUNOMIDE | Mar-Teriflunomide 14mg Tab | MAR | 14.9300 | 14.9300 | YES | YES | NO |
| 02500310 | TERIFLUNOMIDE | Nat-Teriflunomide 14mg Tab | NAT | 14.9300 | 14.9300 | YES | YES | NO |
| 02500434 | TERIFLUNOMIDE | PMS-Teriflunomide 14mg Tab | PMS | 14.9300 | 14.9300 | YES | YES | NO |
| 02505843 | TERIFLUNOMIDE | Sandoz Teriflunomide 14mg Tab | SDZ | 14.9300 | 14.9300 | YES | YES | NO |
| 02501090 | TERIFLUNOMIDE | Teva-Teriflunomide 14mg Tab | TEV | 14.9300 | 14.9300 | YES | YES | NO |
| 02498804 | TERIPARATIDE | Apo-Teriparatide Injection 250mcg/mL Inj Sol-2.4mL Pref Pen | APX | 535.4700 | 535.4700 | YES | YES | NO |
| 09857535 | TERIPARATIDE | Forteo 250mcg/mL Inj Sol-2.4mL Pref Pen | LIL | 1238.8400 | 535.4700 | YES | YES | NO |
| 02486423 | TERIPARATIDE | Teva-Teriparatide Injection 250mcg/mL Inj Sol-2.4mL Pref Pen | TEV | 535.4700 | 535.4700 | YES | YES | NO |
| 02495589 | TERIPARATIDE | Osnuvo 250mcg/mL Inj Sol-3mL Cart Pk | AVP | 565.2600 | 565.2600 | NO | YES | NO |
| 02245345 | TESTOSTERONE | Androgel 1% 2.5g Foil Packet | SPH | 2.4965 | 1.6726 | YES | YES | NO |
| 02463792 | TESTOSTERONE | Taro-Testosterone Gel 1% 2.5g Foil Packet | TAR | 1.6726 | 1.6726 | YES | YES | NO |
| 02245346 | TESTOSTERONE | Androgel 1% 5.0g Foil Packet | SPH | 4.4145 | 2.9575 | YES | YES | NO |
| 02463806 | TESTOSTERONE | Taro-Testosterone Gel 1% 5.0g Foil Packet | TAR | 2.9575 | 2.9575 | YES | YES | NO |
| 02280248 | TESTOSTERONE | Testim 1% Top Gel-5g Pk | PPI | 4.3180 | 4.3180 | NO | YES | NO |
| 00030783 | TESTOSTERONE CYPIONATE | Depo-Testosterone 100mg/mL Oily Inj Sol-10mL Pk | PFI | 48.1300 | 34.8780 | YES | YES | NO |
| 02496003 | TESTOSTERONE CYPIONATE | Taro-Testosterone Cypionate Injection 100mg/mL Oily Inj Sol-10mL Pk | TAR | 34.8780 | 34.8780 | YES | YES | NO |
| 00029246 | TESTOSTERONE ENANTHATE | Delatestryl (Not a Benefit) 1000mg/5mL Oily Inj Sol-5mL Pk | VAL | N/A | N/A | YES | NO | NO |
| 02536315 | TESTOSTERONE ENANTHATE | Testosterone Enanthate Injection, USP 1000mg/5mL Oily Inj Sol-5mL Pk | HIK | 35.5943 | 35.5943 | YES | YES | NO |
| 00782327 | TESTOSTERONE UNDECANOATE | Andriol (Not a Benefit) 40mg Cap | ORG | N/A | N/A | YES | NO | NO |
| 02322498 | TESTOSTERONE UNDECANOATE | PMS-Testosterone 40mg Cap | PMS | 0.4700 | 0.4700 | YES | YES | NO |
| 02421186 | TESTOSTERONE UNDECANOATE | Taro-Testosterone 40mg Cap | TAR | 0.4700 | 0.4700 | YES | YES | NO |
| 02407590 | TETRABENAZINE | Apo-Tetrabenazine (Off-Formulary Interchangeable) 25mg Tab | APX | 4.8551 | 4.8551 | YES | NO | NO |
| 02199270 | TETRABENAZINE | Nitoman (Off-Formulary Interchangeable) 25mg Tab | VAL | N/A | N/A | YES | NO | NO |
| 02402424 | TETRABENAZINE | PMS-Tetrabenazine (Off-Formulary Interchangeable) 25mg Tab | PMS | 4.8551 | 4.8551 | YES | NO | NO |
| 02410338 | TETRABENAZINE | Tetrabenazine Tablets (Off-Formulary Interchangeable) 25mg Tab | STE | 4.8551 | 4.8551 | YES | NO | NO |
| 00580929 | TETRACYCLINE | Tetracycline 250mg Cap | AAP | 0.0670 | 0.0670 | YES | NO | YES |
| 00024422 | TETRACYCLINE | Tetracyn (Not a Benefit) 250mg Cap | PFI | N/A | N/A | YES | NO | YES |
| 02360101 | THEOPHYLLINE ANHYDROUS | Theo ER 400mg SR Tab | AAP | 0.3735 | 0.3734 | YES | NO | NO |
| 02360128 | THEOPHYLLINE ANHYDROUS | Theo ER 600mg SR Tab | AAP | 0.4524 | 0.4524 | YES | NO | NO |
| 02014165 | THEOPHYLLINE ANHYDROUS | Uniphyl (Not a Benefit) 400mg SR Tab | ELV | N/A | N/A | YES | NO | NO |
| 02014181 | THEOPHYLLINE ANHYDROUS | Uniphyl (Not a Benefit) 600mg SR Tab | ELV | N/A | N/A | YES | NO | NO |
| 00610267 | THIAMINE HCL | Vitamin B1 (Not a Benefit) 50mg Tab | LEA | N/A | N/A | YES | NO | NO |
| 00268631 | THIAMINE HCL | Vitamin B1-ICN (Not a Benefit) 50mg Tab | VAL | N/A | N/A | YES | NO | NO |
| 00282081 | THIOGUANINE | Lanvis 40mg Tab | ASN | 6.4201 | 6.4201 | NO | NO | NO |
| 02246016 | THYROTROPIN ALFA | Thyrogen 0.9mg/mL Inj Pd-2x1.1mg Vial Pk | GZM | 1887.4200 | 1887.4200 | NO | NO | NO |
| 02221950 | TIAPROFENIC ACID | Surgam (Not a Benefit) 300mg Tab | SAV | N/A | N/A | YES | NO | YES |
| 01989782 | TIAPROFENIC ACID | Surgam (Not a Benefit) 200mg Tab | HRU | N/A | N/A | YES | NO | YES |
| 02179679 | TIAPROFENIC ACID | Teva-Tiaprofenic 200mg Tab | TEV | 0.5728 | 0.5728 | YES | NO | YES |
| 02179687 | TIAPROFENIC ACID | Teva-Tiaprofenic 300mg Tab | TEV | 0.8070 | 0.8070 | YES | NO | YES |
| 02482622 | TICAGRELOR | Apo-Ticagrelor (Off-Formulary Interchangeable) 60mg Tab | APX | 1.2844 | N/A | YES | NO | NO |
| 02482630 | TICAGRELOR | Apo-Ticagrelor 90mg Tab | APX | 0.3960 | 0.3960 | YES | YES | NO |
| 02455005 | TICAGRELOR | Brilinta (Off-Formulary Interchangeable) 60mg Tab | AZC | N/A | N/A | YES | NO | NO |
| 02368544 | TICAGRELOR | Brilinta 90mg Tab | AZC | 1.7849 | 0.3960 | YES | YES | NO |
| 02531798 | TICAGRELOR | Jamp Ticagrelor (Off-Formulary Interchangeable) 60mg Tab | JPC | 1.2844 | N/A | YES | NO | NO |
| 02531801 | TICAGRELOR | Jamp Ticagrelor 90mg Tab | JPC | 0.3960 | 0.3960 | YES | YES | NO |
| 02529750 | TICAGRELOR | M-Ticagrelor (Off-Formulary Interchangeable) 60mg Tab | MAT | 1.2844 | N/A | YES | NO | NO |
| 02529769 | TICAGRELOR | M-Ticagrelor 90mg Tab | MAT | 0.3960 | 0.3960 | YES | YES | NO |
| 02492571 | TICAGRELOR | Taro-Ticagrelor (Off-Formulary Interchangeable) 60mg Tab | TAR | 1.2844 | N/A | YES | NO | NO |
| 02492598 | TICAGRELOR | Taro-Ticagrelor 90mg Tab | TAR | 0.3960 | 0.3960 | YES | YES | NO |
| 02162776 | TICLOPIDINE HCL | Ticlid (Not a Benefit) 250mg Tab | HLR | N/A | N/A | YES | NO | NO |
| 02237701 | TICLOPIDINE HCL | Ticlopidine 250mg Tab | AAP | 1.0679 | 1.0679 | YES | YES | NO |
| 02285401 | TIGECYCLINE | Tygacil 50mg/Vial Pd for Inj-5mLVial Pk (Preservative-Free) | PFI | 83.4740 | 83.4740 | NO | NO | NO |
| 02516098 | TILDRAKIZUMAB | Ilumya 100mg/mL Inj Sol-1mL Pref Syr (Preservative-Free) | SPC | 4935.0000 | 4935.0000 | NO | YES | NO |
| 02242275 | TIMOLOL MALEATE | Timolol Maleate-EX 0.25% Oph Gellan Sol | ALC | 2.9540 | 2.9540 | YES | NO | YES |
| 02242276 | TIMOLOL MALEATE | Timolol Maleate-EX 0.5% Oph Gellan Sol | ALC | 3.5320 | 3.5320 | YES | NO | YES |
| 02171899 | TIMOLOL MALEATE | Timoptic-XE 0.5% Oph Gellan Sol | ELV | 9.1190 | 3.5320 | YES | NO | YES |
| 02171880 | TIMOLOL MALEATE | Timoptic-XE (Not a Benefit) 0.25% Oph Gellan Sol | PFP | N/A | N/A | YES | NO | YES |
| 00755834 | TIMOLOL MALEATE | Apo-Timop 0.5% Oph Sol | APX | 1.2145 | 1.2145 | YES | NO | YES |
| 02447800 | TIMOLOL MALEATE | Jamp-Timolol 0.5% Oph Sol | JPC | 1.2145 | 1.2145 | YES | NO | YES |
| 02166720 | TIMOLOL MALEATE | Sandoz Timolol 0.5% Oph Sol | SDZ | 1.2145 | 1.2145 | YES | NO | YES |
| 02166712 | TIMOLOL MALEATE | Sandoz Timolol 0.25% Oph Sol | SDZ | 2.3503 | 2.3503 | YES | NO | YES |
| 00451207 | TIMOLOL MALEATE | Timoptic 0.5% Oph Sol | ELV | 7.1408 | 1.2145 | YES | NO | YES |
| 00451193 | TIMOLOL MALEATE | Timoptic (Not a Benefit) 0.25% Oph Sol | MFC | N/A | N/A | YES | NO | YES |
| 00353922 | TIMOLOL MALEATE | Blocadren (Not a Benefit) 10mg Tab | FRS | N/A | N/A | YES | NO | NO |
| 00353914 | TIMOLOL MALEATE | Blocadren (Not a Benefit) 5mg Tab | FRS | N/A | N/A | YES | NO | NO |
| 00495611 | TIMOLOL MALEATE | Blocadren (Not a Benefit) 20mg Tab | FRS | N/A | N/A | YES | NO | NO |
| 00755869 | TIMOLOL MALEATE | Timolol 20mg Tab | AAP | 0.6304 | 0.6304 | YES | NO | NO |
| 00755850 | TIMOLOL MALEATE | Timolol 10mg Tab | AAP | 0.3239 | 0.3239 | YES | NO | NO |
| 00755842 | TIMOLOL MALEATE | Timolol 5mg Tab | AAP | 0.2077 | 0.2077 | YES | NO | NO |
| 02415305 | TIMOLOL MALEATE & TRAVOPROST | Apo-Travoprost-Timop 0.5% & 0.004% Oph Sol | APX | 8.8425 | 8.8425 | YES | YES | NO |
| 02278251 | TIMOLOL MALEATE & TRAVOPROST | DuoTrav (Not a Benefit) 0.5% & 0.004% Oph Sol | ALC | N/A | N/A | YES | NO | NO |
| 09857644 | TIMOLOL MALEATE & TRAVOPROST | Apo-Travoprost-Timop PQ 0.5% & 0.004% Oph Sol-5mL Pk | APX | 44.2125 | 44.2125 | YES | YES | YES |
| 09857513 | TIMOLOL MALEATE & TRAVOPROST | DuoTrav PQ 0.5% & 0.004% Oph Sol-5mL Pk | NOV | 56.7000 | 44.2125 | YES | YES | YES |
| 02231478 | TINZAPARIN SODIUM | Innohep 10000IU/0.5mL Inj Pref Syr | LEO | 29.7939 | 29.7939 | NO | YES | NO |
| 02358174 | TINZAPARIN SODIUM | Innohep 14000IU/0.7mL Inj Pref Syr | LEO | 41.7497 | 41.7497 | NO | YES | NO |
| 02358158 | TINZAPARIN SODIUM | Innohep 3500IU/0.35mL Inj Pref Syr | LEO | 10.2157 | 10.2157 | NO | YES | NO |
| 02429489 | TINZAPARIN SODIUM | Innohep 16000IU/0.8mL Inj Pref Syr | LEO | 47.7158 | 47.7158 | NO | YES | NO |
| 02429470 | TINZAPARIN SODIUM | Innohep 12000IU/0.6mL Inj Pref Syr | LEO | 35.7866 | 35.7866 | NO | YES | NO |
| 02429462 | TINZAPARIN SODIUM | Innohep 8000IU/0.4mL Inj Pref Syr | LEO | 22.7208 | 22.7208 | NO | YES | NO |
| 09857367 | TINZAPARIN SODIUM | Innohep 2500IU/0.25mL Inj Pref Syr | LEO | 7.3042 | 7.3042 | NO | YES | NO |
| 02358166 | TINZAPARIN SODIUM | Innohep 4500IU/0.45mL Inj Pref Syr | LEO | 13.1374 | 13.1374 | NO | YES | NO |
| 02358182 | TINZAPARIN SODIUM | Innohep 18000IU/0.9mL Inj Pref Syr | LEO | 53.6727 | 53.6727 | NO | YES | NO |
| 02167840 | TINZAPARIN SODIUM | Innohep 10000IU/mL Inj-2mL Pk | LEO | 55.1469 | 55.1469 | NO | YES | NO |
| 02229515 | TINZAPARIN SODIUM | Innohep 20000IU/mL Inj-2mL Pk | LEO | 117.6245 | 117.6245 | NO | YES | NO |
| 02550865 | TIOTROPIUM BROMIDE MONOHYDRATE | Apo-Tiotropium 18mcg Inh Cap | APX | 0.9143 | 0.9143 | YES | NO | NO |
| 02537850 | TIOTROPIUM BROMIDE MONOHYDRATE | Lupin-Tiotropium 18mcg Inh Cap | LUP | 0.9143 | 0.9143 | YES | NO | YES |
| 02246793 | TIOTROPIUM BROMIDE MONOHYDRATE | Spiriva 18mcg Inh Cap | BOE | 0.9143 | 0.9143 | YES | NO | YES |
| 02435381 | TIOTROPIUM BROMIDE MONOHYDRATE | Spiriva Respimat 2.5mcg/Actuation Inh Sol-60 Actuation Pk | BOE | 54.8580 | 54.8580 | NO | NO | YES |
| 02441888 | TIOTROPIUM BROMIDE MONOHYDRATE & OLODATEROL HYDROCHLORIDE | Inspiolto Respimat 2.5mcg & 2.5mcg/Actuation Inh Sol-60 Actuation Pk | BOE | 64.3740 | 64.3740 | NO | YES | YES |
| 02259893 | TIZANIDINE HCL | Apo-Tizanidine (Off-Formulary Interchangeable) 4mg Tab | APX | 0.8758 | 0.8758 | YES | NO | YES |
| 02536765 | TIZANIDINE HCL | Mint-Tizanidine (Off-Formulary Interchangeable) 4mg Tab | MIN | 0.8758 | 0.8758 | YES | NO | YES |
| 02239170 | TIZANIDINE HCL | Zanaflex (Off-Formulary Interchangeable) 4mg Tab | ELA | N/A | N/A | YES | NO | YES |
| 02365154 | TOBRAMYCIN | TOBI Podhaler 28mg Inh Pd-Cap | BGP | 14.6911 | 14.6911 | NO | YES | NO |
| 02239630 | TOBRAMYCIN | TOBI 300mg/5mL Inh Sol-5mL Pk | BGP | 63.1930 | 41.0985 | YES | NO | YES |
| 02389622 | TOBRAMYCIN | Teva-Tobramycin 300mg/5mL Inh Sol-5mL Pk | TEV | 41.0985 | 41.0985 | YES | NO | YES |
| 00614254 | TOBRAMYCIN | Tobrex 0.3% Oph Oint | NOV | 2.7514 | 2.7514 | NO | NO | NO |
| 02241755 | TOBRAMYCIN | Sandoz Tobramycin 0.3% Oph Sol | SDZ | 1.3620 | 1.3620 | YES | NO | NO |
| 00513962 | TOBRAMYCIN | Tobrex 0.3% Oph Sol | NOV | 1.9400 | 1.3620 | YES | NO | NO |
| 00778915 | TOBRAMYCIN & DEXAMETHASONE | TobraDex 0.3% & 0.1% Oph Oint | NOV | 3.3171 | 3.3171 | NO | NO | NO |
| 00778907 | TOBRAMYCIN & DEXAMETHASONE | TobraDex 0.3% & 0.1% Oph Susp | NOV | 2.2500 | 2.2500 | NO | NO | NO |
| 00325449 | TOBRAMYCIN SULFATE | Nebcin (Not a Benefit) 80mg/2mL Inj Sol-2mL Pk | LIL | N/A | N/A | YES | NO | YES |
| 02241210 | TOBRAMYCIN SULFATE | Tobramycin 80mg/2mL Inj Sol-2mL Pk | SDZ | 3.1500 | 3.1500 | YES | NO | YES |
| 02533103 | TOBRAMYCIN SULFATE | Tobramycin Injection USP 80mg/2mL Inj Sol-2mL Pk | JPC | 3.1500 | 3.1500 | YES | NO | YES |
| 02502372 | TOBRAMYCIN SULFATE | Tobramycin Injection USP 80mg/2mL Inj Sol-2mL Pk | STE | 3.1500 | 3.1500 | YES | NO | YES |
| 02552469 | TOCILIZUMAB | Tyenne 200mg/10mL Inj Sol-10mL Vial Pk | FKC | 311.9025 | 311.9025 | NO | YES | NO |
| 02562030 | TOCILIZUMAB | Avtozma 200mg/10mL Inj Sol-10mL Vial Pk (Preservative-Free) | CEI | 311.9025 | 311.9025 | NO | YES | NO |
| 02552477 | TOCILIZUMAB | Tyenne 400mg/20mL Inj Sol-20mL Vial Pk | FKC | 623.8050 | 623.8050 | NO | YES | NO |
| 02562049 | TOCILIZUMAB | Avtozma 400mg/20mL Inj Sol-20mL Vial Pk (Preservative-Free) | CEI | 623.8050 | 623.8050 | NO | YES | NO |
| 02552450 | TOCILIZUMAB | Tyenne 80mg/4mL Inj Sol-4mL Vial Pk | FKC | 124.7610 | 124.7610 | NO | YES | NO |
| 02562022 | TOCILIZUMAB | Avtozma 80mg/4mL Inj Sol-4mL Vial Pk (Preservative-Free) | CEI | 124.7610 | 124.7610 | NO | YES | NO |
| 02552485 | TOCILIZUMAB | Tyenne 162mg/0.9mL Inj Sol-Pref Autoinj | FKC | 242.2875 | 242.2875 | NO | YES | NO |
| 02562065 | TOCILIZUMAB | Avtozma 162mg/0.9mL Inj Sol-Pref Autoinj (Preservative-Free) | CEI | 242.2875 | 242.2875 | NO | YES | NO |
| 02552493 | TOCILIZUMAB | Tyenne 162mg/0.9mL Inj Sol-Pref Syr | FKC | 244.9525 | 244.9525 | NO | YES | NO |
| 02562057 | TOCILIZUMAB | Avtozma 162mg/0.9mL Inj Sol-Pref Syr (Preservative-Free) | CEI | 244.9525 | 244.9525 | NO | YES | NO |
| 02530015 | TOFACITINIB | Auro-Tofacitinib 10mg Tab | AUR | 10.5859 | 10.5859 | YES | YES | NO |
| 02530007 | TOFACITINIB | Auro-Tofacitinib 5mg Tab | AUR | 5.9897 | 5.9897 | YES | YES | NO |
| 02522896 | TOFACITINIB | Jamp Tofacitinib 5mg Tab | JPC | 5.9897 | 5.9897 | YES | YES | NO |
| 02522799 | TOFACITINIB | PMS-Tofacitinib 5mg Tab | PMS | 5.9897 | 5.9897 | YES | YES | NO |
| 02551691 | TOFACITINIB | Sandoz Tofacitinib 5mg Tab | SDZ | 5.9897 | 5.9897 | YES | YES | NO |
| 02551705 | TOFACITINIB | Sandoz Tofacitinib 10mg Tab | SDZ | 10.5859 | 10.5859 | YES | YES | NO |
| 02511312 | TOFACITINIB | Taro-Tofacitinib 10mg Tab | TAR | 10.5859 | 10.5859 | YES | YES | NO |
| 02511304 | TOFACITINIB | Taro-Tofacitinib 5mg Tab | TAR | 5.9897 | 5.9897 | YES | YES | NO |
| 02480786 | TOFACITINIB | Xeljanz 10mg Tab | PFI | 43.7833 | 10.5859 | YES | YES | NO |
| 02423898 | TOFACITINIB | Xeljanz 5mg Tab | PFI | 24.7733 | 5.9897 | YES | YES | NO |
| 02553988 | TOFACITINIB CITRATE | Taro-Tofacitinib XR 11mg ER Tab | TAR | 27.2507 | 27.2507 | YES | YES | NO |
| 02470608 | TOFACITINIB CITRATE | Xeljanz XR 11mg ER Tab | PFI | 49.5467 | 27.2507 | YES | YES | NO |
| 02244612 | TOLTERODINE L-TARTRATE | Detrol LA 2mg SR Cap | UJC | 2.3187 | 0.9822 | YES | YES | NO |
| 02244613 | TOLTERODINE L-TARTRATE | Detrol LA 4mg SR Cap | UJC | 2.3187 | 0.9822 | YES | YES | NO |
| 02413159 | TOLTERODINE L-TARTRATE | Sandoz Tolterodine LA 4mg SR Cap | SDZ | 0.9822 | 0.9822 | YES | YES | NO |
| 02413140 | TOLTERODINE L-TARTRATE | Sandoz Tolterodine LA 2mg SR Cap | SDZ | 0.9822 | 0.9822 | YES | YES | NO |
| 02412195 | TOLTERODINE L-TARTRATE | Teva-Tolterodine LA 2mg SR Cap | TEV | 0.9822 | 0.9822 | YES | YES | NO |
| 02412209 | TOLTERODINE L-TARTRATE | Teva-Tolterodine LA 4mg SR Cap | TEV | 0.9822 | 0.9822 | YES | YES | NO |
| 02239064 | TOLTERODINE L-TARTRATE | Detrol 1mg Tab | UJC | 1.1592 | 0.4910 | YES | YES | NO |
| 02239065 | TOLTERODINE L-TARTRATE | Detrol 2mg Tab | UJC | 1.1592 | 0.4910 | YES | YES | NO |
| 02496844 | TOLTERODINE L-TARTRATE | Jamp Tolterodine 2mg Tab | JPC | 0.4910 | 0.4910 | YES | YES | NO |
| 02496836 | TOLTERODINE L-TARTRATE | Jamp Tolterodine 1mg Tab | JPC | 0.4910 | 0.4910 | YES | YES | NO |
| 02423308 | TOLTERODINE L-TARTRATE | Mint-Tolterodine 1mg Tab | MIN | 0.4910 | 0.4910 | YES | YES | NO |
| 02423316 | TOLTERODINE L-TARTRATE | Mint-Tolterodine 2mg Tab | MIN | 0.4910 | 0.4910 | YES | YES | NO |
| 02437503 | TOLVAPTAN | Jinarc (Off-Formulary Interchangeable) 45mg & 15mg 14-Tabs Pk | OTS | N/A | N/A | YES | NO | NO |
| 02437538 | TOLVAPTAN | Jinarc (Off-Formulary Interchangeable) 90mg & 30mg 14-Tabs Pk | OTS | N/A | N/A | YES | NO | NO |
| 02491583 | TOLVAPTAN | Jinarc (Off-Formulary Interchangeable) 30mg & 15mg 14-Tabs Pk | OTS | N/A | N/A | YES | NO | NO |
| 02437511 | TOLVAPTAN | Jinarc (Off-Formulary Interchangeable) 60mg & 30mg 14-Tabs Pk | OTS | N/A | N/A | YES | NO | NO |
| 02491575 | TOLVAPTAN | Jinarc (Off-Formulary Interchangeable) 15mg & 15mg 14-Tabs Pk | OTS | N/A | N/A | YES | NO | NO |
| 02557215 | TOLVAPTAN | Lupin-Tolvaptan (Off-Formulary Interchangeable) 90mg & 30mg 14-Tabs Pk | LUP | 864.0000 | N/A | YES | NO | NO |
| 02557207 | TOLVAPTAN | Lupin-Tolvaptan (Off-Formulary Interchangeable) 60mg & 30mg 14-Tabs Pk | LUP | 864.0000 | N/A | YES | NO | NO |
| 02557185 | TOLVAPTAN | Lupin-Tolvaptan (Off-Formulary Interchangeable) 30mg & 15mg 14-Tabs Pk | LUP | 863.8125 | N/A | YES | NO | NO |
| 02557177 | TOLVAPTAN | Lupin-Tolvaptan (Off-Formulary Interchangeable) 15mg & 15mg 14-Tabs Pk | LUP | 863.8125 | N/A | YES | NO | NO |
| 02557193 | TOLVAPTAN | Lupin-Tolvaptan (Off-Formulary Interchangeable) 45mg & 15mg 14-Tabs Pk | LUP | 863.8125 | N/A | YES | NO | NO |
| 02239908 | TOPIRAMATE | Topamax Sprinkle 25mg Sprinkle Cap | JNO | 2.3100 | 2.3100 | NO | YES | NO |
| 02239907 | TOPIRAMATE | Topamax Sprinkle 15mg Sprinkle Cap | JNO | 2.2095 | 2.2095 | NO | YES | NO |
| 02475944 | TOPIRAMATE | AG-Topiramate 100mg Tab | ANG | 0.4583 | 0.4583 | YES | NO | NO |
| 02475936 | TOPIRAMATE | AG-Topiramate 25mg Tab | ANG | 0.2433 | 0.2433 | YES | NO | NO |
| 02395738 | TOPIRAMATE | Ach-Topiramate 25mg Tab | ACH | 0.2433 | 0.2433 | YES | NO | NO |
| 02395746 | TOPIRAMATE | Ach-Topiramate 100mg Tab | ACH | 0.4583 | 0.4583 | YES | NO | NO |
| 02395754 | TOPIRAMATE | Ach-Topiramate 200mg Tab | ACH | 0.6748 | 0.6748 | YES | NO | NO |
| 02279630 | TOPIRAMATE | Apo-Topiramate 100mg Tab | APX | 0.4583 | 0.4583 | YES | NO | NO |
| 02279614 | TOPIRAMATE | Apo-Topiramate 25mg Tab | APX | 0.2433 | 0.2433 | YES | NO | NO |
| 02279649 | TOPIRAMATE | Apo-Topiramate 200mg Tab | APX | 0.6748 | 0.6748 | YES | NO | NO |
| 02345838 | TOPIRAMATE | Auro-Topiramate 100mg Tab | AUR | 0.4583 | 0.4583 | YES | NO | NO |
| 02345803 | TOPIRAMATE | Auro-Topiramate 25mg Tab | AUR | 0.2433 | 0.2433 | YES | NO | NO |
| 02345846 | TOPIRAMATE | Auro-Topiramate 200mg Tab | AUR | 0.6748 | 0.6748 | YES | NO | NO |
| 02345277 | TOPIRAMATE | Jamp Topiramate Tablets 200mg Tab | JPC | 0.6748 | 0.6748 | YES | NO | NO |
| 02345269 | TOPIRAMATE | Jamp Topiramate Tablets 100mg Tab | JPC | 0.4583 | 0.4583 | YES | NO | NO |
| 02345250 | TOPIRAMATE | Jamp Topiramate Tablets 25mg Tab | JPC | 0.2433 | 0.2433 | YES | NO | NO |
| 02435624 | TOPIRAMATE | Jamp-Topiramate 200mg Tab | JPC | 0.6748 | 0.6748 | YES | NO | NO |
| 02435608 | TOPIRAMATE | Jamp-Topiramate 25mg Tab | JPC | 0.2433 | 0.2433 | YES | NO | NO |
| 02435616 | TOPIRAMATE | Jamp-Topiramate 100mg Tab | JPC | 0.4583 | 0.4583 | YES | NO | NO |
| 02544377 | TOPIRAMATE | Jamp-Topiramate Tablets (Off-Formulary Interchangeable) 50mg Tab | JPC | 1.2434 | N/A | YES | NO | NO |
| 02432110 | TOPIRAMATE | Mar-Topiramate 200mg Tab | MAR | 0.6748 | 0.6748 | YES | NO | NO |
| 02432102 | TOPIRAMATE | Mar-Topiramate 100mg Tab | MAR | 0.4583 | 0.4583 | YES | NO | NO |
| 02432099 | TOPIRAMATE | Mar-Topiramate 25mg Tab | MAR | 0.2433 | 0.2433 | YES | NO | NO |
| 02315653 | TOPIRAMATE | Mint-Topiramate 100mg Tab | MIN | 0.4583 | 0.4583 | YES | NO | NO |
| 02315645 | TOPIRAMATE | Mint-Topiramate 25mg Tab | MIN | 0.2433 | 0.2433 | YES | NO | NO |
| 02315661 | TOPIRAMATE | Mint-Topiramate 200mg Tab | MIN | 0.6748 | 0.6748 | YES | NO | NO |
| 02263351 | TOPIRAMATE | Mylan-Topiramate 25mg Tab | MYL | 0.2433 | 0.2433 | YES | NO | NO |
| 02263378 | TOPIRAMATE | Mylan-Topiramate 100mg Tab | MYL | 0.4583 | 0.4583 | YES | NO | NO |
| 02263386 | TOPIRAMATE | Mylan-Topiramate 200mg Tab | MYL | 0.6748 | 0.6748 | YES | NO | NO |
| 02538474 | TOPIRAMATE | NRA-Topiramate 200mg Tab | NRA | 0.6748 | 0.6748 | YES | NO | NO |
| 02538466 | TOPIRAMATE | NRA-Topiramate 25mg Tab | NRA | 0.2433 | 0.2433 | YES | NO | NO |
| 02538458 | TOPIRAMATE | NRA-Topiramate 100mg Tab | NRA | 0.4583 | 0.4583 | YES | NO | NO |
| 02263017 | TOPIRAMATE | PMS-Topiramate 200mg Tab | PMS | 0.6748 | 0.6748 | YES | NO | NO |
| 02312085 | TOPIRAMATE | PMS-Topiramate (Off-Formulary Interchangeable) 50mg Tab | PMS | 1.2434 | N/A | YES | NO | NO |
| 02262991 | TOPIRAMATE | PMS-Topiramate 25mg Tab | PMS | 0.2433 | 0.2433 | YES | NO | NO |
| 02263009 | TOPIRAMATE | PMS-Topiramate 100mg Tab | PMS | 0.4583 | 0.4583 | YES | NO | NO |
| 02396092 | TOPIRAMATE | Ran-Topiramate 200mg Tab | RAN | 0.6748 | 0.6748 | YES | NO | NO |
| 02396084 | TOPIRAMATE | Ran-Topiramate 100mg Tab | RAN | 0.4583 | 0.4583 | YES | NO | NO |
| 02431823 | TOPIRAMATE | Sandoz Topiramate Tablets 200mg Tab | SDZ | 0.6748 | 0.6748 | YES | NO | NO |
| 02431815 | TOPIRAMATE | Sandoz Topiramate Tablets 100mg Tab | SDZ | 0.4583 | 0.4583 | YES | NO | NO |
| 02431807 | TOPIRAMATE | Sandoz Topiramate Tablets 25mg Tab | SDZ | 0.2433 | 0.2433 | YES | NO | NO |
| 02248862 | TOPIRAMATE | Teva-Topiramate 200mg Tab | TEV | 0.6748 | 0.6748 | YES | NO | NO |
| 02248861 | TOPIRAMATE | Teva-Topiramate 100mg Tab | TEV | 0.4583 | 0.4583 | YES | NO | NO |
| 02248860 | TOPIRAMATE | Teva-Topiramate 25mg Tab | TEV | 0.2433 | 0.2433 | YES | NO | NO |
| 02231385 | TOPIRAMATE | Topamax (Off-Formulary Interchangeable) 50mg Tab | JNO | N/A | N/A | YES | NO | NO |
| 02230893 | TOPIRAMATE | Topamax 25mg Tab | JNO | 2.3213 | 0.2433 | YES | NO | NO |
| 02230896 | TOPIRAMATE | Topamax 200mg Tab | JNO | 6.4275 | 0.6748 | YES | NO | NO |
| 02230894 | TOPIRAMATE | Topamax 100mg Tab | JNO | 4.3530 | 0.4583 | YES | NO | NO |
| 02356856 | TOPIRAMATE | Topiramate 25mg Tab | SAI | 0.2433 | 0.2433 | YES | NO | NO |
| 02389460 | TOPIRAMATE | Topiramate 25mg Tab | SIV | 0.2433 | 0.2433 | YES | NO | NO |
| 02356864 | TOPIRAMATE | Topiramate 100mg Tab | SAI | 0.4583 | 0.4583 | YES | NO | NO |
| 02389487 | TOPIRAMATE | Topiramate 100mg Tab | SIV | 0.4583 | 0.4583 | YES | NO | NO |
| 02356872 | TOPIRAMATE | Topiramate 200mg Tab | SAI | 0.6748 | 0.6748 | YES | NO | NO |
| 02450445 | TRAMADOL HCL | Taro-Tramadol ER (Off-Formulary Interchangeable) 300mg ER Tab | TAR | 1.2854 | N/A | YES | NO | YES |
| 02450437 | TRAMADOL HCL | Taro-Tramadol ER (Off-Formulary Interchangeable) 200mg ER Tab | TAR | 0.9244 | N/A | YES | NO | YES |
| 02450429 | TRAMADOL HCL | Taro-Tramadol ER (Off-Formulary Interchangeable) 100mg ER Tab | TAR | 0.7853 | N/A | YES | NO | YES |
| 02296381 | TRAMADOL HCL | Tridural (Off-Formulary Interchangeable) 100mg ER Tab | PAL | N/A | N/A | YES | NO | YES |
| 02296411 | TRAMADOL HCL | Tridural (Off-Formulary Interchangeable) 300mg ER Tab | PAL | N/A | N/A | YES | NO | YES |
| 02296403 | TRAMADOL HCL | Tridural (Off-Formulary Interchangeable) 200mg ER Tab | PAL | N/A | N/A | YES | NO | YES |
| 02426153 | TRAMADOL HCL | Apo-Tramadol (Off-Formulary Interchangeable) 50mg Tab | APX | 0.6386 | N/A | YES | NO | YES |
| 02479672 | TRAMADOL HCL | Auro-Tramadol (Off-Formulary Interchangeable) 50mg Tab | AUR | 0.6386 | N/A | YES | NO | YES |
| 02507005 | TRAMADOL HCL | Jamp Tramadol (Off-Formulary Interchangeable) 50mg Tab | JPC | 0.6386 | N/A | YES | NO | YES |
| 02518759 | TRAMADOL HCL | Jamp Tramadol HCl (Off-Formulary Interchangeable) 50mg Tab | JPC | 0.6386 | N/A | YES | NO | YES |
| 02480859 | TRAMADOL HCL | Mar-Tramadol (Off-Formulary Interchangeable) 50mg Tab | MAR | 0.6386 | N/A | YES | NO | YES |
| 02493764 | TRAMADOL HCL | Sandoz Tramadol (Off-Formulary Interchangeable) 50mg Tab | SDZ | 0.6386 | N/A | YES | NO | YES |
| 02349469 | TRAMADOL HCL | Ultram (Off-Formulary Interchangeable) 50mg Tab | JAN | N/A | N/A | YES | NO | YES |
| 02336790 | TRAMADOL HCL & ACETAMINOPHEN | Apo-Tramadol/Acet (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | APX | 0.6264 | N/A | YES | NO | YES |
| 02439050 | TRAMADOL HCL & ACETAMINOPHEN | Auro-Tramadol/Acetaminophen (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | AUR | 0.6264 | N/A | YES | NO | YES |
| 02383209 | TRAMADOL HCL & ACETAMINOPHEN | Co Tramadol/Acet (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | COB | 0.6264 | N/A | YES | NO | YES |
| 02388308 | TRAMADOL HCL & ACETAMINOPHEN | Jamp-Acet-Tramadol (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | JPC | 0.6264 | N/A | YES | NO | YES |
| 02388324 | TRAMADOL HCL & ACETAMINOPHEN | Mar-Tramadol/Acet (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | MAR | 0.6264 | N/A | YES | NO | YES |
| 02389800 | TRAMADOL HCL & ACETAMINOPHEN | Mint-Tramadol/Acet (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | MIN | 0.6264 | N/A | YES | NO | YES |
| 02469650 | TRAMADOL HCL & ACETAMINOPHEN | NRA-Tramadol/ACET (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | NRA | 0.6264 | N/A | YES | NO | YES |
| 02401657 | TRAMADOL HCL & ACETAMINOPHEN | PMS-Tramadol-Acet (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | PMS | 0.6264 | N/A | YES | NO | YES |
| 02388197 | TRAMADOL HCL & ACETAMINOPHEN | Taro-Tramadol/Acet (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | SPC | 0.6264 | N/A | YES | NO | YES |
| 02347180 | TRAMADOL HCL & ACETAMINOPHEN | Teva-Tramadol/Acetaminophen (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | TEV | 0.6264 | N/A | YES | NO | YES |
| 02264846 | TRAMADOL HCL & ACETAMINOPHEN | Tramacet (Off-Formulary Interchangeable) 37.5mg & 325mg Tab | JAN | N/A | N/A | YES | NO | YES |
| 02471868 | TRANDOLAPRIL | Auro-Trandolapril (Off-Formulary Interchangeable) 0.5mg Cap | AUR | 0.2372 | N/A | YES | NO | NO |
| 02471876 | TRANDOLAPRIL | Auro-Trandolapril 1mg Cap | AUR | 0.1762 | 0.1762 | YES | NO | NO |
| 02471884 | TRANDOLAPRIL | Auro-Trandolapril 2mg Cap | AUR | 0.2025 | 0.2025 | YES | NO | NO |
| 02471892 | TRANDOLAPRIL | Auro-Trandolapril 4mg Cap | AUR | 0.2498 | 0.2498 | YES | NO | NO |
| 02239267 | TRANDOLAPRIL | Mavik 4mg Cap | BGP | 1.0594 | 0.2498 | YES | NO | NO |
| 02231459 | TRANDOLAPRIL | Mavik 1mg Cap | BGP | 0.7471 | 0.1762 | YES | NO | NO |
| 02231457 | TRANDOLAPRIL | Mavik (Off-Formulary Interchangeable) 0.5mg Cap | BGP | N/A | N/A | YES | NO | NO |
| 02231460 | TRANDOLAPRIL | Mavik 2mg Cap | BGP | 0.8586 | 0.2025 | YES | NO | NO |
| 02357771 | TRANDOLAPRIL | PMS-Trandolapril 2mg Cap | PMS | 0.2025 | 0.2025 | YES | NO | NO |
| 02357763 | TRANDOLAPRIL | PMS-Trandolapril 1mg Cap | PMS | 0.1762 | 0.1762 | YES | NO | NO |
| 02357755 | TRANDOLAPRIL | PMS-Trandolapril (Off-Formulary Interchangeable) 0.5mg Cap | PMS | 0.2372 | N/A | YES | NO | NO |
| 02357798 | TRANDOLAPRIL | PMS-Trandolapril 4mg Cap | PMS | 0.2498 | 0.2498 | YES | NO | NO |
| 02325756 | TRANDOLAPRIL | Sandoz Trandolapril 2mg Cap | SDZ | 0.2025 | 0.2025 | YES | NO | NO |
| 02325748 | TRANDOLAPRIL | Sandoz Trandolapril 1mg Cap | SDZ | 0.1762 | 0.1762 | YES | NO | NO |
| 02325764 | TRANDOLAPRIL | Sandoz Trandolapril 4mg Cap | SDZ | 0.2498 | 0.2498 | YES | NO | NO |
| 02325721 | TRANDOLAPRIL | Sandoz Trandolapril (Off-Formulary Interchangeable) 0.5mg Cap | SDZ | 0.2372 | N/A | YES | NO | NO |
| 02415437 | TRANDOLAPRIL | Teva-Trandolapril 1mg Cap | TEV | 0.1762 | 0.1762 | YES | NO | NO |
| 02415429 | TRANDOLAPRIL | Teva-Trandolapril (Off-Formulary Interchangeable) 0.5mg Cap | TEV | 0.2372 | N/A | YES | NO | NO |
| 02415453 | TRANDOLAPRIL | Teva-Trandolapril 4mg Cap | TEV | 0.2498 | 0.2498 | YES | NO | NO |
| 02415445 | TRANDOLAPRIL | Teva-Trandolapril 2mg Cap | TEV | 0.2025 | 0.2025 | YES | NO | NO |
| 02525070 | TRANDOLAPRIL | Trandolapril 4mg Cap | SAI | 0.2498 | 0.2498 | YES | NO | NO |
| 02526573 | TRANDOLAPRIL | Trandolapril 2mg Cap | SIV | 0.2025 | 0.2025 | YES | NO | NO |
| 02525054 | TRANDOLAPRIL | Trandolapril 2mg Cap | SAI | 0.2025 | 0.2025 | YES | NO | NO |
| 02526565 | TRANDOLAPRIL | Trandolapril 1mg Cap | SIV | 0.1762 | 0.1762 | YES | NO | NO |
| 02525046 | TRANDOLAPRIL | Trandolapril 1mg Cap | SAI | 0.1762 | 0.1762 | YES | NO | NO |
| 02526581 | TRANDOLAPRIL | Trandolapril 4mg Cap | SIV | 0.2498 | 0.2498 | YES | NO | NO |
| 02064405 | TRANEXAMIC ACID | Cyklokapron (Off-Formulary Interchangeable) 500mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02409097 | TRANEXAMIC ACID | Gd-Tranexamic Acid (Off-Formulary Interchangeable) 500mg Tab | GEM | 0.8071 | 0.8071 | YES | NO | NO |
| 02496232 | TRANEXAMIC ACID | Mar-Tranexamic Acid (Off-Formulary Interchangeable) 500mg Tab | MAR | 0.8071 | 0.8071 | YES | NO | NO |
| 02519194 | TRANEXAMIC ACID | Tranexamic Acid (Off-Formulary Interchangeable) 500mg Tab | JPC | 0.8071 | 0.8071 | YES | NO | NO |
| 02401231 | TRANEXAMIC ACID | Tranexamic Acid Tablets (Off-Formulary Interchangeable) 500mg Tab | STE | 0.8071 | 0.8071 | YES | NO | NO |
| 01919598 | TRANYLCYPROMINE SULFATE | Parnate 10mg Tab | GSK | 0.5374 | 0.5374 | NO | NO | YES |
| 02457997 | TRAVOPROST | IZBA 0.003% Oph Sol (with Preservative) | NOV | 3.9400 | 3.9400 | NO | YES | NO |
| 02548089 | TRAVOPROST | Jamp Travoprost Z 0.004% Oph Sol-5mL Pk | JPC | 28.7600 | 28.7600 | YES | YES | NO |
| 02413167 | TRAVOPROST | Sandoz Travoprost 0.004% Oph Sol-5mL Pk | SDZ | 28.7600 | 28.7600 | YES | YES | NO |
| 09857332 | TRAVOPROST | Travatan Z 0.004% Oph Sol-5mL Pk | NOV | 58.9600 | 28.7600 | YES | YES | NO |
| 02147637 | TRAZODONE HYDROCHLORIDE | Apo-Trazodone 50mg Tab | APX | 0.0554 | 0.0554 | YES | NO | NO |
| 02147645 | TRAZODONE HYDROCHLORIDE | Apo-Trazodone 100mg Tab | APX | 0.0989 | 0.0989 | YES | NO | NO |
| 02147653 | TRAZODONE HYDROCHLORIDE | Apo-Trazodone D 150mg Tab | APX | 0.1453 | 0.1453 | YES | NO | NO |
| 00579378 | TRAZODONE HYDROCHLORIDE | Desyrel (Not a Benefit) 100mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00579351 | TRAZODONE HYDROCHLORIDE | Desyrel (Not a Benefit) 50mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 00702277 | TRAZODONE HYDROCHLORIDE | Desyrel Dividose (Not a Benefit) 150mg Tab | BQU | N/A | N/A | YES | NO | NO |
| 02442809 | TRAZODONE HYDROCHLORIDE | Jamp Trazodone 50mg Tab | JPC | 0.0554 | 0.0554 | YES | NO | NO |
| 02442817 | TRAZODONE HYDROCHLORIDE | Jamp Trazodone 100mg Tab | JPC | 0.0989 | 0.0989 | YES | NO | NO |
| 02442825 | TRAZODONE HYDROCHLORIDE | Jamp Trazodone 150mg Tab | JPC | 0.1453 | 0.1453 | YES | NO | NO |
| 01937227 | TRAZODONE HYDROCHLORIDE | PMS-Trazodone 50mg Tab | PMS | 0.0554 | 0.0554 | YES | NO | NO |
| 01937235 | TRAZODONE HYDROCHLORIDE | PMS-Trazodone 100mg Tab | PMS | 0.0989 | 0.0989 | YES | NO | NO |
| 02144298 | TRAZODONE HYDROCHLORIDE | Teva-Trazodone 150mg Tab | TEV | 0.1453 | 0.1453 | YES | NO | NO |
| 02144271 | TRAZODONE HYDROCHLORIDE | Teva-Trazodone 100mg Tab | TEV | 0.0989 | 0.0989 | YES | NO | NO |
| 02144263 | TRAZODONE HYDROCHLORIDE | Teva-Trazodone 50mg Tab | TEV | 0.0554 | 0.0554 | YES | NO | NO |
| 02348772 | TRAZODONE HYDROCHLORIDE | Trazodone 50mg Tab | SAI | 0.0554 | 0.0554 | YES | NO | NO |
| 02348780 | TRAZODONE HYDROCHLORIDE | Trazodone 100mg Tab | SAI | 0.0989 | 0.0989 | YES | NO | NO |
| 02348799 | TRAZODONE HYDROCHLORIDE | Trazodone 150mg Tab | SAI | 0.1453 | 0.1453 | YES | NO | NO |
| 02520036 | TRETINOIN | Jamp Tretinoin (Off-Formulary Interchangeable) 10mg Cap | JPC | 13.9284 | 13.9284 | YES | NO | NO |
| 02145839 | TRETINOIN | Vesanoid (Off-Formulary Interchangeable) 10mg Cap | HLR | N/A | N/A | YES | NO | NO |
| 00657204 | TRETINOIN | Stieva-A 0.01% Cr | STI | 0.3212 | 0.3212 | NO | YES | NO |
| 00578576 | TRETINOIN | Stieva-A 0.025% Cr | STI | 0.3212 | 0.3212 | NO | YES | NO |
| 00518182 | TRETINOIN | Stieva-A 0.05% Cr | STI | 0.2144 | 0.2144 | YES | YES | NO |
| 01926519 | TRETINOIN | Vitamin A Acid (Not a Benefit) 0.05% Cr | SAV | N/A | N/A | YES | NO | NO |
| 01926462 | TRETINOIN | Vitamin A Acid 0.01% Gel | VAL | 0.4266 | 0.4266 | NO | YES | NO |
| 01926489 | TRETINOIN | Vitamin A Acid 0.05% Gel | VAL | 0.4266 | 0.4266 | NO | YES | NO |
| 02194058 | TRIAMCINOLONE ACETONIDE | Aristocort R (Not a Benefit) 0.1% Cr | VAL | N/A | N/A | YES | NO | NO |
| 00029114 | TRIAMCINOLONE ACETONIDE | Kenalog (Not a Benefit) 0.1% Cr | WSQ | N/A | N/A | YES | NO | NO |
| 00716960 | TRIAMCINOLONE ACETONIDE | Triaderm 0.1% Cr | TAR | 0.0533 | 0.0533 | YES | NO | NO |
| 00990876 | TRIAMCINOLONE ACETONIDE | Kenalog-40 40mg/mL Inj Susp-1mL Pk | BQU | 8.9610 | 8.9610 | NO | NO | NO |
| 01999761 | TRIAMCINOLONE ACETONIDE | Kenalog-10 50mg/5mL Inj Susp-5mL Pk | BQU | 19.4500 | 19.4500 | NO | NO | NO |
| 01999869 | TRIAMCINOLONE ACETONIDE | Kenalog-40 200mg/5mL Inj Susp-5mL Pk | BQU | 31.6500 | 31.6500 | NO | NO | NO |
| 02437635 | TRIAMCINOLONE ACETONIDE | Apo-Triamcinolone AQ (Off-Formulary Interchangeable) 55mcg/Metered Dose Nas Sp-120 Dose Pk (with Preservative) | APX | 18.0000 | 18.0000 | YES | NO | YES |
| 02213834 | TRIAMCINOLONE ACETONIDE | Nasacort AQ (Off-Formulary Interchangeable) 55mcg/Metered Dose Nas Sp-120 Dose Pk (with Preservative) | SCO | N/A | N/A | YES | NO | YES |
| 02194031 | TRIAMCINOLONE ACETONIDE | Aristocort R 0.1% Oint | VAE | 0.1821 | 0.1821 | YES | NO | NO |
| 01999796 | TRIAMCINOLONE ACETONIDE | Kenalog (Not a Benefit) 0.1% Oint | WSQ | N/A | N/A | YES | NO | NO |
| 01999788 | TRIAMCINOLONE ACETONIDE 0.1% IN ORABASE | Kenalog-Orabase (Not a Benefit) Oral Top Oint | BQU | N/A | N/A | YES | NO | NO |
| 01964054 | TRIAMCINOLONE ACETONIDE 0.1% IN ORABASE | Oracort Oral Top Oint | TAR | 1.5607 | 1.5607 | YES | NO | NO |
| 02470632 | TRIAMCINOLONE HEXACETONIDE | Trispan 20mg/mL 1mL-Amp Pk | MDX | 18.0000 | 18.0000 | NO | YES | NO |
| 00443158 | TRIAZOLAM | Halcion (Not a Benefit) 0.25mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 00512559 | TRIAZOLAM | Halcion (Not a Benefit) 0.125mg Tab | UPJ | N/A | N/A | YES | NO | NO |
| 00808571 | TRIAZOLAM | Triazolam 0.25mg Tab | AAP | 0.2551 | 0.2551 | YES | NO | NO |
| 00808563 | TRIAZOLAM | Triazolam 0.125mg Tab | AAP | 0.1496 | 0.1496 | YES | NO | NO |
| 01918206 | TRIFLUOPERAZINE | Stelazine (Not a Benefit) 1mg Tab | SMJ | N/A | N/A | YES | NO | NO |
| 01918222 | TRIFLUOPERAZINE | Stelazine (Not a Benefit) 5mg Tab | SMJ | N/A | N/A | YES | NO | NO |
| 01918214 | TRIFLUOPERAZINE | Stelazine (Not a Benefit) 2mg Tab | SMJ | N/A | N/A | YES | NO | NO |
| 01918230 | TRIFLUOPERAZINE | Stelazine (Not a Benefit) 10mg Tab | SMJ | N/A | N/A | YES | NO | NO |
| 00345539 | TRIFLUOPERAZINE | Trifluoperazine 1mg Tab | AAP | 0.1340 | 0.1340 | YES | NO | NO |
| 00326836 | TRIFLUOPERAZINE | Trifluoperazine 10mg Tab | AAP | 0.2846 | 0.2846 | YES | NO | NO |
| 00312746 | TRIFLUOPERAZINE | Trifluoperazine 5mg Tab | AAP | 0.2375 | 0.2375 | YES | NO | NO |
| 00312754 | TRIFLUOPERAZINE | Trifluoperazine 2mg Tab | AAP | 0.1793 | 0.1793 | YES | NO | NO |
| 00015040 | TRIHEXYPHENIDYL HCL | Artane (Not a Benefit) 2mg Tab | LED | N/A | N/A | YES | NO | NO |
| 00015059 | TRIHEXYPHENIDYL HCL | Artane (Not a Benefit) 5mg Tab | LED | N/A | N/A | YES | NO | NO |
| 00545058 | TRIHEXYPHENIDYL HCL | Trihexyphenidyl 2mg Tab | AAP | 0.0376 | 0.0376 | YES | NO | NO |
| 00545074 | TRIHEXYPHENIDYL HCL | Trihexyphenidyl 5mg Tab | AAP | 0.0681 | 0.0681 | YES | NO | NO |
| 02245663 | TRIMEBUTINE MALEATE | Apo-Trimebutine (Off-Formulary Interchangeable) 100mg Tab | APX | 0.3265 | 0.3265 | YES | NO | NO |
| 02245664 | TRIMEBUTINE MALEATE | Apo-Trimebutine (Off-Formulary Interchangeable) 200mg Tab | APX | 0.7677 | 0.7677 | YES | NO | NO |
| 02538202 | TRIMEBUTINE MALEATE | Mint-Trimebutine (Off-Formulary Interchangeable) 100mg Tab | MIN | 0.3265 | 0.3265 | YES | NO | NO |
| 02538210 | TRIMEBUTINE MALEATE | Mint-Trimebutine (Off-Formulary Interchangeable) 200mg Tab | MIN | 0.7677 | 0.7677 | YES | NO | NO |
| 00587869 | TRIMEBUTINE MALEATE | Modulon (Off-Formulary Interchangeable) 100mg Tab | BFI | N/A | N/A | YES | NO | NO |
| 00803499 | TRIMEBUTINE MALEATE | Modulon (Off-Formulary Interchangeable) 200mg Tab | BFI | N/A | N/A | YES | NO | NO |
| 00675229 | TRIMETHOPRIM | Proloprim (Not a Benefit) 100mg Tab | BWE | N/A | N/A | YES | NO | NO |
| 00677590 | TRIMETHOPRIM | Proloprim (Not a Benefit) 200mg Tab | BWE | N/A | N/A | YES | NO | NO |
| 02243117 | TRIMETHOPRIM | Trimethoprim 200mg Tab | AAP | 0.5378 | 0.5378 | YES | NO | NO |
| 02243116 | TRIMETHOPRIM | Trimethoprim 100mg Tab | AAP | 0.2617 | 0.2617 | YES | NO | NO |
| 01926349 | TRIMIPRAMINE | Surmontil (Not a Benefit) 75mg Cap | RPP | N/A | N/A | YES | NO | NO |
| 02070987 | TRIMIPRAMINE | Trimipramine 75mg Cap | AAP | 0.7800 | 0.7800 | YES | NO | NO |
| 01926284 | TRIMIPRAMINE | Surmontil (Not a Benefit) 100mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 01926322 | TRIMIPRAMINE | Surmontil (Not a Benefit) 25mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 01926330 | TRIMIPRAMINE | Surmontil (Not a Benefit) 50mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 01926357 | TRIMIPRAMINE | Surmontil (Not a Benefit) 12.5mg Tab | RPP | N/A | N/A | YES | NO | NO |
| 00740799 | TRIMIPRAMINE | Trimipramine 12.5mg Tab | AAP | 0.2156 | 0.2156 | YES | NO | NO |
| 00740829 | TRIMIPRAMINE | Trimipramine 100mg Tab | AAP | 0.9889 | 0.9889 | YES | NO | NO |
| 00740810 | TRIMIPRAMINE | Trimipramine 50mg Tab | AAP | 0.5795 | 0.5795 | YES | NO | NO |
| 00740802 | TRIMIPRAMINE | Trimipramine 25mg Tab | AAP | 0.2960 | 0.2960 | YES | NO | NO |
| 09857199 | TRIPTORELIN PAMOATE | Trelstar (1 Month) 3.75mg/Vial Inj Pd with Sterile Water-Vial Pk | KNT | 346.3100 | 346.3100 | NO | NO | NO |
| 09857200 | TRIPTORELIN PAMOATE | Trelstar LA (3 Month) 11.25mg/Vial Inj Pd with Sterile Water-Vial Pk | KNT | 1038.9700 | 1038.9700 | NO | NO | NO |
| 02240000 | TRIPTORELIN PAMOATE | Trelstar (1 Month) 3.75mg/Vial Inj Pd-Vial Pk | KNT | 346.3100 | 346.3100 | NO | NO | NO |
| 02243856 | TRIPTORELIN PAMOATE | Trelstar LA (3 Month) 11.25mg/Vial Inj Pd-Vial Pk | KNT | 1038.9700 | 1038.9700 | NO | NO | NO |
| 02412322 | TRIPTORELIN PAMOATE | Trelstar 22.5mg/Vial SR Inj Pd with Sterile Water-Vial Pk | KNT | 1659.9000 | 1659.9000 | NO | NO | NO |
| 02506661 | TROSPIUM CHLORIDE | Jamp Trospium 20mg Tab | JPC | 0.4072 | 0.4072 | YES | YES | NO |
| 02488353 | TROSPIUM CHLORIDE | Mar-Trospium 20mg Tab | MAR | 0.4072 | 0.4072 | YES | YES | NO |
| 02275066 | TROSPIUM CHLORIDE | Trosec (Not a Benefit) 20mg Tab | SUO | N/A | N/A | YES | NO | NO |
| 02248540 | TRYPTOPHAN | Apo-Tryptophan (Off-Formulary Interchangeable) 500mg Cap | APX | 0.4987 | N/A | YES | NO | NO |
| 02240334 | TRYPTOPHAN | Ratio-Tryptophan (Off-Formulary Interchangeable) 500mg Cap | RPH | 0.4987 | N/A | YES | NO | NO |
| 00718149 | TRYPTOPHAN | Tryptan (Off-Formulary Interchangeable) 500mg Cap | VAL | N/A | N/A | YES | NO | NO |
| 02248538 | TRYPTOPHAN | Apo-Tryptophan (Off-Formulary Interchangeable) 500mg Tab | APX | 0.4987 | N/A | YES | NO | NO |
| 02458721 | TRYPTOPHAN | Apo-Tryptophan (Off-Formulary Interchangeable) 750mg Tab | APX | 1.2444 | N/A | YES | NO | NO |
| 02248539 | TRYPTOPHAN | Apo-Tryptophan (Off-Formulary Interchangeable) 1g Tab | APX | 0.8978 | N/A | YES | NO | NO |
| 02237250 | TRYPTOPHAN | Ratio-Tryptophan (Off-Formulary Interchangeable) 1g Tab | RPH | 0.8978 | N/A | YES | NO | NO |
| 02240333 | TRYPTOPHAN | Ratio-Tryptophan (Off-Formulary Interchangeable) 500mg Tab | RPH | 0.4987 | N/A | YES | NO | NO |
| 02239327 | TRYPTOPHAN | Tryptan (Off-Formulary Interchangeable) 750mg Tab | VAL | N/A | N/A | YES | NO | NO |
| 00654531 | TRYPTOPHAN | Tryptan (Off-Formulary Interchangeable) 1g Tab | VAL | N/A | N/A | YES | NO | NO |
| 02029456 | TRYPTOPHAN | Tryptan (Off-Formulary Interchangeable) 500mg Tab | VAL | N/A | N/A | YES | NO | NO |
| 02423596 | UMECLIDINIUM | Incruse Ellipta 62.5mcg Blister Pd Inh-30 Dose Pk | GSK | 50.0000 | 50.0000 | NO | NO | NO |
| 02418401 | UMECLIDINIUM & VILANTEROL | Anoro Ellipta 62.5mcg & 25mcg Blister Pd Inh-30 Dose Pk | GSK | 88.5100 | 88.5100 | NO | YES | NO |
| 02539721 | UPADACITINIB | Rinvoq 45mg ER Tab | ABV | 101.8100 | 101.8100 | NO | YES | NO |
| 02520893 | UPADACITINIB | Rinvoq 30mg ER Tab | ABV | 76.9600 | 76.9600 | NO | YES | NO |
| 02495155 | UPADACITINIB | Rinvoq 15mg ER Tab | ABV | 51.6810 | 51.6810 | NO | YES | NO |
| 02505371 | URSODIOL | AG-Ursodiol 500mg Tab | ANG | 0.7242 | 0.7242 | YES | YES | NO |
| 02505363 | URSODIOL | AG-Ursodiol 250mg Tab | ANG | 0.3818 | 0.3818 | YES | YES | NO |
| 02426919 | URSODIOL | GLN-Ursodiol 500mg Tab | GLP | 0.7242 | 0.7242 | YES | YES | NO |
| 02426900 | URSODIOL | GLN-Ursodiol 250mg Tab | GLP | 0.3818 | 0.3818 | YES | YES | NO |
| 02472406 | URSODIOL | Jamp-Ursodiol 500mg Tab | JPC | 0.7242 | 0.7242 | YES | YES | NO |
| 02472392 | URSODIOL | Jamp-Ursodiol 250mg Tab | JPC | 0.3818 | 0.3818 | YES | YES | NO |
| 02544024 | URSODIOL | NRA-Ursodiol 500mg Tab | NRA | 0.7242 | 0.7242 | YES | YES | NO |
| 02544032 | URSODIOL | NRA-Ursodiol 250mg Tab | NRA | 0.3818 | 0.3818 | YES | YES | NO |
| 02273500 | URSODIOL | PMS-Ursodiol C 500mg Tab | PMS | 0.7242 | 0.7242 | YES | YES | NO |
| 02273497 | URSODIOL | PMS-Ursodiol C 250mg Tab | PMS | 0.3818 | 0.3818 | YES | YES | NO |
| 02238984 | URSODIOL | Urso (Not a Benefit) 250mg Tab | BFI | N/A | N/A | YES | NO | NO |
| 02245894 | URSODIOL | Urso DS 500mg Tab | BFI | 3.1751 | 0.7242 | YES | YES | NO |
| 02515520 | URSODIOL | Ursodiol C 250mg Tab | SAI | 0.3818 | 0.3818 | YES | YES | NO |
| 02515539 | URSODIOL | Ursodiol C 500mg Tab | SAI | 0.7242 | 0.7242 | YES | YES | NO |
| 02553317 | USTEKINUMAB | Wezlana 45mg/0.5mL Inj Sol-0.5mL Pref Autoinj (Preservative-Free) | AMG | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02543036 | USTEKINUMAB | Jamteki 45mg/0.5mL Inj Sol-0.5mL Pref Syr Pk | JPC | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02544180 | USTEKINUMAB | Wezlana 45mg/0.5mL Inj Sol-0.5mL Pref Syr Pk | AMG | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02550245 | USTEKINUMAB | Steqeyma 45mg/0.5mL Inj Sol-0.5mL Pref Syr Pk (Preservative-Free) | CEH | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02554283 | USTEKINUMAB | Otulfi 45mg/0.5mL Inj Sol-0.5mL Pref Syr Pk (Preservative-Free) | FKC | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02544202 | USTEKINUMAB | Wezlana 45mg/0.5mL Inj Sol-0.5mL Vial Pk | AMG | 2755.8840 | 2755.8840 | NO | YES | NO |
| 09858364 | USTEKINUMAB | Jamteki 45mg/0.5mL Inj Sol-0.5mL Vial Pk (Preservative-Free) | JPC | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02558270 | USTEKINUMAB | Steqeyma 45mg/0.5mL Inj Sol-0.5mL Vial Pk (Preservative-Free) | CEH | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02550253 | USTEKINUMAB | Steqeyma 90mg/1.0mL Inj Sol-1.0mL Pref Syr Pk (Preservative-Free) | CEH | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02554291 | USTEKINUMAB | Otulfi 90mg/mL Inj Sol-1.0mL Pref Syr Pk (Preservative-Free) | FKC | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02553309 | USTEKINUMAB | Wezlana 90mg/mL Inj Sol-1mL Pref Autoinj (Preservative-Free) | AMG | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02543044 | USTEKINUMAB | Jamteki 90mg/mL Inj Sol-1mL Pref Syr Pk | JPC | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02544199 | USTEKINUMAB | Wezlana 90mg/mL Inj Sol-1mL Pref Syr Pk | AMG | 2755.8840 | 2755.8840 | NO | YES | NO |
| 02544210 | USTEKINUMAB | Wezlana I.V. 130mg/26mL Inj Sol-26mL Vial Pk | AMG | 1248.0000 | 1248.0000 | NO | YES | NO |
| 02553120 | USTEKINUMAB | Jamteki I.V. 5mg/mL Inj Sol-26mL Vial Pk (Preservative-Free) | JPC | 1248.0000 | 1248.0000 | NO | YES | NO |
| 02550261 | USTEKINUMAB | Steqeyma I.V. 5mg/mL Inj Sol-26mL Vial Pk (Preservative-Free) | CEH | 1248.0000 | 1248.0000 | NO | YES | NO |
| 02320673 | USTEKINUMAB | Stelara 45mg/0.5mL Inj Sol-Pref Syr Pk | JAN | 4593.1400 | 4593.1400 | NO | YES | NO |
| 02320681 | USTEKINUMAB | Stelara 90mg/mL Inj Sol-Pref Syr Pk | JAN | 4593.1400 | 4593.1400 | NO | YES | NO |
| 02554305 | USTEKINUMAB | Otulfi 5mg/mL Inj Sol-Vial Pk (Preservative-Free) | FKC | 1248.0000 | 1248.0000 | NO | YES | NO |
| 02354705 | VALACYCLOVIR | Apo-Valacyclovir (Off-Formulary Interchangeable) 1000mg Tab | APX | 5.8537 | N/A | YES | NO | NO |
| 02295822 | VALACYCLOVIR | Apo-Valacyclovir 500mg Tab | APX | 0.6198 | 0.6198 | YES | NO | NO |
| 02405059 | VALACYCLOVIR | Auro-Valacyclovir (Off-Formulary Interchangeable) 1000mg Tab | AUR | 5.8537 | N/A | YES | NO | NO |
| 02405040 | VALACYCLOVIR | Auro-Valacyclovir 500mg Tab | AUR | 0.6198 | 0.6198 | YES | NO | NO |
| 02331748 | VALACYCLOVIR | Co Valacyclovir 500mg Tab | COB | 0.6198 | 0.6198 | YES | NO | NO |
| 02440598 | VALACYCLOVIR | Jamp Valacyclovir 500mg Tab | JPC | 0.6198 | 0.6198 | YES | NO | NO |
| 02441454 | VALACYCLOVIR | Jamp-Valacyclovir 500mg Tab | JPC | 0.6198 | 0.6198 | YES | NO | NO |
| 02351579 | VALACYCLOVIR | Mylan-Valacyclovir 500mg Tab | MYL | 0.6198 | 0.6198 | YES | NO | NO |
| 02351560 | VALACYCLOVIR | Mylan-Valacyclovir (Off-Formulary Interchangeable) 1000mg Tab | MYL | 5.8537 | N/A | YES | NO | NO |
| 02298457 | VALACYCLOVIR | PMS-Valacyclovir 500mg Tab | PMS | 0.6198 | 0.6198 | YES | NO | NO |
| 02381230 | VALACYCLOVIR | PMS-Valacyclovir (Off-Formulary Interchangeable) 1000mg Tab | PMS | 5.8537 | N/A | YES | NO | NO |
| 02316447 | VALACYCLOVIR | Riva-Valacyclovir 500mg Tab | RIA | 0.6198 | 0.6198 | YES | NO | NO |
| 02347091 | VALACYCLOVIR | Sandoz Valacyclovir 500mg Tab | SDZ | 0.6198 | 0.6198 | YES | NO | NO |
| 02357534 | VALACYCLOVIR | Teva-Valacyclovir 500mg Tab | TEV | 0.6198 | 0.6198 | YES | NO | NO |
| 02442000 | VALACYCLOVIR | Valacyclovir 500mg Tab | SIV | 0.6198 | 0.6198 | YES | NO | NO |
| 02519585 | VALACYCLOVIR | Valacyclovir (Off-Formulary Interchangeable) 1000mg Tab | SAI | 5.8537 | N/A | YES | NO | NO |
| 02454645 | VALACYCLOVIR | Valacyclovir 500mg Tab | SAI | 0.6198 | 0.6198 | YES | NO | NO |
| 02246559 | VALACYCLOVIR | Valtrex (Off-Formulary Interchangeable) 1000mg Tab | GSK | N/A | N/A | YES | NO | NO |
| 02219492 | VALACYCLOVIR | Valtrex 500mg Tab | GSK | 4.5647 | 0.6198 | YES | NO | NO |
| 02535483 | VALGANCICLOVIR | Auro-Valganciclovir 50mg/mL Pd for Oral Sol-100mL Pk | AUR | 150.9900 | 150.9900 | YES | YES | NO |
| 02306085 | VALGANCICLOVIR | Valcyte 50mg/mL Pd for Oral Sol-100mL Pk | CHE | 315.5347 | 150.9900 | YES | YES | NO |
| 02435179 | VALGANCICLOVIR | Auro-Valganciclovir 450mg Tab | AUR | 5.8553 | 5.8553 | YES | YES | NO |
| 02495457 | VALGANCICLOVIR | Mint-Valganciclovir 450mg Tab | MIN | 5.8553 | 5.8553 | YES | YES | NO |
| 02413825 | VALGANCICLOVIR | Teva-Valganciclovir 450mg Tab | TEV | 5.8553 | 5.8553 | YES | YES | NO |
| 02245777 | VALGANCICLOVIR | Valcyte 450mg Tab | CHE | 28.4003 | 5.8553 | YES | YES | NO |
| 02238370 | VALPROATE SODIUM | Apo-Valproic 50mg/mL O/L | APX | 0.0605 | 0.0398 | YES | NO | NO |
| 00443832 | VALPROATE SODIUM | Depakene 50mg/mL O/L | BGP | 0.1473 | 0.0398 | YES | NO | NO |
| 02532441 | VALPROATE SODIUM | Jamp Valproic Acid Oral Solution 50mg/mL O/L | JPC | 0.0398 | 0.0398 | YES | NO | NO |
| 02549190 | VALPROATE SODIUM | Odan-Valproic Acid 50mg/mL O/L | ODN | 0.0398 | 0.0398 | YES | NO | NO |
| 02236807 | VALPROATE SODIUM | PMS-Valproic Acid 50mg/mL O/L | PMS | 0.0398 | 0.0398 | YES | NO | NO |
| 02238048 | VALPROIC ACID | Apo-Valproic 250mg Cap | APX | 0.2905 | 0.2905 | YES | NO | NO |
| 00443840 | VALPROIC ACID | Depakene (Not a Benefit) 250mg Cap | ABB | N/A | N/A | YES | NO | NO |
| 02230768 | VALPROIC ACID | PMS-Valproic Acid 250mg Cap | PMS | 0.2905 | 0.2905 | YES | NO | NO |
| 00507989 | VALPROIC ACID | Depakene (Not a Benefit) 500mg Ent Cap | ABB | N/A | N/A | YES | NO | NO |
| 02229628 | VALPROIC ACID | PMS-Valproic Acid 500mg Ent Cap | PMS | 0.8102 | 0.8102 | YES | NO | NO |
| 02371510 | VALSARTAN | Apo-Valsartan (Off-Formulary Interchangeable) 40mg Tab | APX | 0.5823 | N/A | YES | NO | NO |
| 02371529 | VALSARTAN | Apo-Valsartan 80mg Tab | APX | 0.2159 | 0.2159 | YES | NO | NO |
| 02371537 | VALSARTAN | Apo-Valsartan 160mg Tab | APX | 0.2159 | 0.2159 | YES | NO | NO |
| 02371545 | VALSARTAN | Apo-Valsartan 320mg Tab | APX | 0.2098 | 0.2098 | YES | NO | NO |
| 02414236 | VALSARTAN | Auro-Valsartan 160mg Tab | AUR | 0.2159 | 0.2159 | YES | NO | NO |
| 02414244 | VALSARTAN | Auro-Valsartan 320mg Tab | AUR | 0.2098 | 0.2098 | YES | NO | NO |
| 02414228 | VALSARTAN | Auro-Valsartan 80mg Tab | AUR | 0.2159 | 0.2159 | YES | NO | NO |
| 02414201 | VALSARTAN | Auro-Valsartan (Off-Formulary Interchangeable) 40mg Tab | AUR | 0.5823 | N/A | YES | NO | NO |
| 02337495 | VALSARTAN | Co Valsartan 80mg Tab | COB | 0.2159 | 0.2159 | YES | NO | NO |
| 02337509 | VALSARTAN | Co Valsartan 160mg Tab | COB | 0.2159 | 0.2159 | YES | NO | NO |
| 02337517 | VALSARTAN | Co Valsartan 320mg Tab | COB | 0.2098 | 0.2098 | YES | NO | NO |
| 02337487 | VALSARTAN | Co Valsartan (Off-Formulary Interchangeable) 40mg Tab | COB | 0.5823 | N/A | YES | NO | NO |
| 02270528 | VALSARTAN | Diovan (Off-Formulary Interchangeable) 40mg Tab | NOV | N/A | N/A | YES | NO | NO |
| 02244782 | VALSARTAN | Diovan 160mg Tab | NOV | 1.5225 | 0.2159 | YES | NO | NO |
| 02289504 | VALSARTAN | Diovan 320mg Tab | NOV | 1.4828 | 0.2098 | YES | NO | NO |
| 02244781 | VALSARTAN | Diovan 80mg Tab | NOV | 1.5275 | 0.2159 | YES | NO | NO |
| 02524546 | VALSARTAN | M-Valsartan 160mg Tab | MAT | 0.2159 | 0.2159 | YES | NO | NO |
| 02524511 | VALSARTAN | M-Valsartan (Off-Formulary Interchangeable) 40mg Tab | MAT | 0.5823 | N/A | YES | NO | NO |
| 02524538 | VALSARTAN | M-Valsartan 80mg Tab | MAT | 0.2159 | 0.2159 | YES | NO | NO |
| 02356759 | VALSARTAN | Sandoz Valsartan 80mg Tab | SDZ | 0.2159 | 0.2159 | YES | NO | NO |
| 02356775 | VALSARTAN | Sandoz Valsartan 320mg Tab | SDZ | 0.2098 | 0.2098 | YES | NO | NO |
| 02356740 | VALSARTAN | Sandoz Valsartan (Off-Formulary Interchangeable) 40mg Tab | SDZ | 0.5823 | N/A | YES | NO | NO |
| 02356767 | VALSARTAN | Sandoz Valsartan 160mg Tab | SDZ | 0.2159 | 0.2159 | YES | NO | NO |
| 02363119 | VALSARTAN | Taro-Valsartan 160mg Tab | SPC | 0.2159 | 0.2159 | YES | NO | NO |
| 02363100 | VALSARTAN | Taro-Valsartan 80mg Tab | SPC | 0.2159 | 0.2159 | YES | NO | NO |
| 02363062 | VALSARTAN | Taro-Valsartan (Off-Formulary Interchangeable) 40mg Tab | SPC | 0.5823 | N/A | YES | NO | NO |
| 02356643 | VALSARTAN | Teva-Valsartan (Off-Formulary Interchangeable) 40mg Tab | TEV | 0.5823 | N/A | YES | NO | NO |
| 02356651 | VALSARTAN | Teva-Valsartan 80mg Tab | TEV | 0.2159 | 0.2159 | YES | NO | NO |
| 02356686 | VALSARTAN | Teva-Valsartan 320mg Tab | TEV | 0.2098 | 0.2098 | YES | NO | NO |
| 02356678 | VALSARTAN | Teva-Valsartan 160mg Tab | TEV | 0.2159 | 0.2159 | YES | NO | NO |
| 02366940 | VALSARTAN | Valsartan (Off-Formulary Interchangeable) 40mg Tab | SAI | 0.5823 | N/A | YES | NO | NO |
| 02384531 | VALSARTAN | Valsartan 80mg Tab | SIV | 0.2159 | 0.2159 | YES | NO | NO |
| 02384523 | VALSARTAN | Valsartan (Off-Formulary Interchangeable) 40mg Tab | SIV | 0.5823 | N/A | YES | NO | NO |
| 02366959 | VALSARTAN | Valsartan 80mg Tab | SAI | 0.2159 | 0.2159 | YES | NO | NO |
| 02366975 | VALSARTAN | Valsartan 320mg Tab | SAI | 0.2098 | 0.2098 | YES | NO | NO |
| 02384558 | VALSARTAN | Valsartan 160mg Tab | SIV | 0.2159 | 0.2159 | YES | NO | NO |
| 02366967 | VALSARTAN | Valsartan 160mg Tab | SAI | 0.2159 | 0.2159 | YES | NO | NO |
| 02384566 | VALSARTAN | Valsartan 320mg Tab | SIV | 0.2098 | 0.2098 | YES | NO | NO |
| 02382555 | VALSARTAN & HYDROCHLOROTHIAZIDE | Apo-Valsartan/HCTZ 160mg & 12.5mg Tab | APX | 0.2240 | 0.2240 | YES | NO | NO |
| 02382598 | VALSARTAN & HYDROCHLOROTHIAZIDE | Apo-Valsartan/HCTZ 320mg & 25mg Tab | APX | 0.2231 | 0.2231 | YES | NO | NO |
| 02382571 | VALSARTAN & HYDROCHLOROTHIAZIDE | Apo-Valsartan/HCTZ 320mg & 12.5mg Tab | APX | 0.2235 | 0.2235 | YES | NO | NO |
| 02382547 | VALSARTAN & HYDROCHLOROTHIAZIDE | Apo-Valsartan/HCTZ 80mg & 12.5mg Tab | APX | 0.2213 | 0.2213 | YES | NO | NO |
| 02382563 | VALSARTAN & HYDROCHLOROTHIAZIDE | Apo-Valsartan/HCTZ 160mg & 25mg Tab | APX | 0.2238 | 0.2238 | YES | NO | NO |
| 02408120 | VALSARTAN & HYDROCHLOROTHIAZIDE | Auro-Valsartan HCT 160mg & 12.5mg Tab | AUR | 0.2240 | 0.2240 | YES | NO | NO |
| 02408112 | VALSARTAN & HYDROCHLOROTHIAZIDE | Auro-Valsartan HCT 80mg & 12.5mg Tab | AUR | 0.2213 | 0.2213 | YES | NO | NO |
| 02408139 | VALSARTAN & HYDROCHLOROTHIAZIDE | Auro-Valsartan HCT 160mg & 25mg Tab | AUR | 0.2238 | 0.2238 | YES | NO | NO |
| 02408155 | VALSARTAN & HYDROCHLOROTHIAZIDE | Auro-Valsartan HCT 320mg & 25mg Tab | AUR | 0.2231 | 0.2231 | YES | NO | NO |
| 02408147 | VALSARTAN & HYDROCHLOROTHIAZIDE | Auro-Valsartan HCT 320mg & 12.5mg Tab | AUR | 0.2235 | 0.2235 | YES | NO | NO |
| 02241900 | VALSARTAN & HYDROCHLOROTHIAZIDE | Diovan-HCT 80mg & 12.5mg Tab | NOV | 1.5139 | 0.2213 | YES | NO | NO |
| 02308916 | VALSARTAN & HYDROCHLOROTHIAZIDE | Diovan-HCT 320mg & 25mg Tab | NOV | 1.5250 | 0.2231 | YES | NO | NO |
| 02308908 | VALSARTAN & HYDROCHLOROTHIAZIDE | Diovan-HCT 320mg & 12.5mg Tab | NOV | 1.5275 | 0.2235 | YES | NO | NO |
| 02241901 | VALSARTAN & HYDROCHLOROTHIAZIDE | Diovan-HCT 160mg & 12.5mg Tab | NOV | 1.5310 | 0.2240 | YES | NO | NO |
| 02246955 | VALSARTAN & HYDROCHLOROTHIAZIDE | Diovan-HCT 160mg & 25mg Tab | NOV | 1.5310 | 0.2238 | YES | NO | NO |
| 02356708 | VALSARTAN & HYDROCHLOROTHIAZIDE | Sandoz Valsartan HCT 160mg & 12.5mg Tab | SDZ | 0.2240 | 0.2240 | YES | NO | NO |
| 02356716 | VALSARTAN & HYDROCHLOROTHIAZIDE | Sandoz Valsartan HCT 160mg & 25mg Tab | SDZ | 0.2238 | 0.2238 | YES | NO | NO |
| 02356724 | VALSARTAN & HYDROCHLOROTHIAZIDE | Sandoz Valsartan HCT 320mg & 12.5mg Tab | SDZ | 0.2235 | 0.2235 | YES | NO | NO |
| 02356732 | VALSARTAN & HYDROCHLOROTHIAZIDE | Sandoz Valsartan HCT 320mg & 25mg Tab | SDZ | 0.2231 | 0.2231 | YES | NO | NO |
| 02356694 | VALSARTAN & HYDROCHLOROTHIAZIDE | Sandoz Valsartan HCT 80mg & 12.5mg Tab | SDZ | 0.2213 | 0.2213 | YES | NO | NO |
| 02357003 | VALSARTAN & HYDROCHLOROTHIAZIDE | Teva-Valsartan/HCTZ 160mg & 12.5mg Tab | TEV | 0.2240 | 0.2240 | YES | NO | NO |
| 02356996 | VALSARTAN & HYDROCHLOROTHIAZIDE | Teva-Valsartan/HCTZ 80mg & 12.5mg Tab | TEV | 0.2213 | 0.2213 | YES | NO | NO |
| 02357046 | VALSARTAN & HYDROCHLOROTHIAZIDE | Teva-Valsartan/HCTZ 320mg & 25mg Tab | TEV | 0.2231 | 0.2231 | YES | NO | NO |
| 02357038 | VALSARTAN & HYDROCHLOROTHIAZIDE | Teva-Valsartan/HCTZ 320mg & 12.5mg Tab | TEV | 0.2235 | 0.2235 | YES | NO | NO |
| 02357011 | VALSARTAN & HYDROCHLOROTHIAZIDE | Teva-Valsartan/HCTZ 160mg & 25mg Tab | TEV | 0.2238 | 0.2238 | YES | NO | NO |
| 02367033 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 320mg & 12.5mg Tab | SAI | 0.2235 | 0.2235 | YES | NO | NO |
| 02384736 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 80mg & 12.5mg Tab | SIV | 0.2213 | 0.2213 | YES | NO | NO |
| 02367009 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 80mg & 12.5mg Tab | SAI | 0.2213 | 0.2213 | YES | NO | NO |
| 02367041 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 320mg & 25mg Tab | SAI | 0.2231 | 0.2231 | YES | NO | NO |
| 02367017 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 160mg & 12.5mg Tab | SAI | 0.2240 | 0.2240 | YES | NO | NO |
| 02367025 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 160mg & 25mg Tab | SAI | 0.2238 | 0.2238 | YES | NO | NO |
| 02384760 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 320mg & 12.5mg Tab | SIV | 0.2235 | 0.2235 | YES | NO | NO |
| 02384744 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 160mg & 12.5mg Tab | SIV | 0.2240 | 0.2240 | YES | NO | NO |
| 02384752 | VALSARTAN & HYDROCHLOROTHIAZIDE | Valsartan HCT 160mg & 25mg Tab | SIV | 0.2238 | 0.2238 | YES | NO | NO |
| 09858007 | VALVED HOLDING CHAMBER | A2A Spacer with Medium Mask | CCI | N/A | 12.0000 | NO | NO | NO |
| 09858006 | VALVED HOLDING CHAMBER | A2A Spacer with Small Mask | CCI | N/A | 12.0000 | NO | NO | NO |
| 09858018 | VALVED HOLDING CHAMBER | AeroChamber Plus FlowVu Adult Large Mask | TMI | N/A | 42.8500 | NO | NO | NO |
| 09858016 | VALVED HOLDING CHAMBER | AeroChamber Plus FlowVu Adult Mouthpiece | TMI | N/A | 25.3200 | NO | NO | NO |
| 09858017 | VALVED HOLDING CHAMBER | AeroChamber Plus FlowVu Adult Sm. Mask | TMI | N/A | 42.8500 | NO | NO | NO |
| 09858013 | VALVED HOLDING CHAMBER | AeroChamber Plus FlowVu Child Med. Mask | TMI | N/A | 40.5000 | NO | NO | NO |
| 09858015 | VALVED HOLDING CHAMBER | AeroChamber Plus FlowVu Girls Mouthpiece | TMI | N/A | 25.3200 | NO | NO | NO |
| 09858012 | VALVED HOLDING CHAMBER | AeroChamber Plus FlowVu Infant Sm. Mask | TMI | N/A | 40.5000 | NO | NO | NO |
| 09858014 | VALVED HOLDING CHAMBER | AeroChamber Plus FlowVu Youth Mouthpiece | TMI | N/A | 25.3200 | NO | NO | NO |
| 09858008 | VALVED HOLDING CHAMBER | Optichamber Diamond Chamber | RRD | N/A | 16.3400 | NO | NO | NO |
| 09858011 | VALVED HOLDING CHAMBER | Optichamber Diamond Chamber + Large Mask | RRD | N/A | 30.7800 | NO | NO | NO |
| 09858009 | VALVED HOLDING CHAMBER | Optichamber Diamond Chamber + Small Mask | RRD | N/A | 27.9300 | NO | NO | NO |
| 09858010 | VALVED HOLDING CHAMBER | Optichamber Diamond Chamber+Medium Mask | RRD | N/A | 27.9300 | NO | NO | NO |
| 09858005 | VALVED HOLDING CHAMBER | A2A Aerosol to Airways Spacer Chamber | CCI | N/A | 9.0000 | NO | NO | NO |
| 02407744 | VANCOMYCIN HCL | Jamp-Vancomycin 125mg Cap | JPC | 5.1800 | 5.1800 | YES | YES | NO |
| 02407752 | VANCOMYCIN HCL | Jamp-Vancomycin (Off-Formulary Interchangeable) 250mg Cap | JPC | 10.3600 | 10.3600 | YES | NO | NO |
| 00788716 | VANCOMYCIN HCL | Vancocin (Off-Formulary Interchangeable) 250mg Cap | SLP | 10.3600 | 10.3600 | YES | NO | NO |
| 00800430 | VANCOMYCIN HCL | Vancocin 125mg Cap | SLP | 5.1800 | 5.1800 | YES | YES | NO |
| 02476088 | VARDENAFIL HCL | Jamp-Vardenafil ODT (Off-Formulary Interchangeable) 10mg Orally Disintergrating Tab | JPC | 5.8778 | N/A | YES | NO | NO |
| 02372436 | VARDENAFIL HCL | Staxyn (Off-Formulary Interchangeable) 10mg Orally Disintergrating Tab | BAH | N/A | N/A | YES | NO | NO |
| 02471663 | VARDENAFIL HCL | Apo-Vardenafil (Off-Formulary Interchangeable) 20mg Tab | APX | 11.6811 | N/A | YES | NO | NO |
| 02471655 | VARDENAFIL HCL | Apo-Vardenafil (Off-Formulary Interchangeable) 10mg Tab | APX | 10.3976 | N/A | YES | NO | NO |
| 02471647 | VARDENAFIL HCL | Apo-Vardenafil (Off-Formulary Interchangeable) 5mg Tab | APX | 9.3203 | N/A | YES | NO | NO |
| 02475677 | VARDENAFIL HCL | Jamp-Vardenafil IR (Off-Formulary Interchangeable) 5mg Tab | JPC | 9.3203 | N/A | YES | NO | NO |
| 02475693 | VARDENAFIL HCL | Jamp-Vardenafil IR (Off-Formulary Interchangeable) 20mg Tab | JPC | 11.6811 | N/A | YES | NO | NO |
| 02475685 | VARDENAFIL HCL | Jamp-Vardenafil IR (Off-Formulary Interchangeable) 10mg Tab | JPC | 10.4019 | N/A | YES | NO | NO |
| 02250489 | VARDENAFIL HCL | Levitra (Off-Formulary Interchangeable) 20mg Tab | BAY | N/A | N/A | YES | NO | NO |
| 02250462 | VARDENAFIL HCL | Levitra (Off-Formulary Interchangeable) 5mg Tab | BAY | N/A | N/A | YES | NO | NO |
| 02250470 | VARDENAFIL HCL | Levitra (Off-Formulary Interchangeable) 10mg Tab | BAY | N/A | N/A | YES | NO | NO |
| 02464209 | VARDENAFIL HCL | Mylan-Vardenafil (Off-Formulary Interchangeable) 5mg Tab | MYL | 9.3203 | N/A | YES | NO | NO |
| 02464233 | VARDENAFIL HCL | Mylan-Vardenafil (Off-Formulary Interchangeable) 20mg Tab | MYL | 11.6811 | N/A | YES | NO | NO |
| 02464225 | VARDENAFIL HCL | Mylan-Vardenafil (Off-Formulary Interchangeable) 10mg Tab | MYL | 10.3976 | N/A | YES | NO | NO |
| 02520400 | VARDENAFIL HCL | Vardenafil (Off-Formulary Interchangeable) 20mg Tab | SAI | 11.6811 | N/A | YES | NO | NO |
| 02520397 | VARDENAFIL HCL | Vardenafil (Off-Formulary Interchangeable) 10mg Tab | SAI | 10.3976 | N/A | YES | NO | NO |
| 02419882 | VARENICLINE TARTRATE | Apo-Varenicline 0.5mg Tab | APX | 0.4618 | 0.4618 | YES | YES | NO |
| 02419890 | VARENICLINE TARTRATE | Apo-Varenicline 1.0mg Tab | APX | 0.4618 | 0.4618 | YES | YES | NO |
| 02291185 | VARENICLINE TARTRATE | Champix (Not a Benefit) 1.0mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02291177 | VARENICLINE TARTRATE | Champix (Not a Benefit) 0.5mg Tab | PFI | N/A | N/A | YES | NO | NO |
| 02546957 | VARENICLINE TARTRATE | Mint-Varenicline 1.0mg Tab | MIN | 0.4618 | 0.4618 | YES | YES | NO |
| 02546949 | VARENICLINE TARTRATE | Mint-Varenicline 0.5mg Tab | MIN | 0.4618 | 0.4618 | YES | YES | NO |
| 02542951 | VARENICLINE TARTRATE | NRA-Varenicline 0.5mg Tab | NRA | 0.4618 | 0.4618 | YES | YES | NO |
| 02542978 | VARENICLINE TARTRATE | NRA-Varenicline 1.0mg Tab | NRA | 0.4618 | 0.4618 | YES | YES | NO |
| 02426226 | VARENICLINE TARTRATE | Teva-Varenicline 0.5mg Tab | TEV | 0.4618 | 0.4618 | YES | YES | NO |
| 02426234 | VARENICLINE TARTRATE | Teva-Varenicline 1.0mg Tab | TEV | 0.4618 | 0.4618 | YES | YES | NO |
| 02435675 | VARENICLINE TARTRATE | Apo-Varenicline 0.5mg & 1.0mg Tab (Starter Pack-53 Tabs) | APX | 24.3853 | 24.3853 | YES | YES | NO |
| 09857519 | VARENICLINE TARTRATE | Champix (Not a Benefit) 0.5mg & 1.0mg Tab (Starter Pack-53 Tabs) | PFI | N/A | N/A | YES | NO | NO |
| 02546965 | VARENICLINE TARTRATE | Mint-Varenicline 0.5mg & 1.0mg Tab (Starter Pack-53 Tabs) | MIN | 24.3853 | 24.3853 | YES | YES | NO |
| 02542986 | VARENICLINE TARTRATE | NRA-Varenicline 0.5mg & 1.0mg Tab (Starter Pack-53 Tabs) | NRA | 24.3853 | 24.3853 | YES | YES | NO |
| 09857631 | VARENICLINE TARTRATE | Teva-Varenicline 0.5mg & 1.0mg Tab (Starter Pack-53 Tabs) | TEV | 24.3853 | 24.3853 | YES | YES | YES |
| 02304317 | VENLAFAXINE HCL | ACT Venlafaxine XR 37.5mg ER Cap | TEV | 0.0913 | 0.0913 | YES | NO | NO |
| 02304333 | VENLAFAXINE HCL | ACT Venlafaxine XR 150mg ER Cap | TEV | 0.1927 | 0.1927 | YES | NO | NO |
| 02304325 | VENLAFAXINE HCL | ACT Venlafaxine XR 75mg ER Cap | TEV | 0.1825 | 0.1825 | YES | NO | NO |
| 02331683 | VENLAFAXINE HCL | Apo-Venlafaxine XR 37.5mg ER Cap | APX | 0.0913 | 0.0913 | YES | NO | NO |
| 02331705 | VENLAFAXINE HCL | Apo-Venlafaxine XR 150mg ER Cap | APX | 0.1927 | 0.1927 | YES | NO | NO |
| 02331691 | VENLAFAXINE HCL | Apo-Venlafaxine XR 75mg ER Cap | APX | 0.1825 | 0.1825 | YES | NO | NO |
| 02452855 | VENLAFAXINE HCL | Auro-Venlafaxine XR 150mg ER Cap | AUR | 0.1927 | 0.1927 | YES | NO | NO |
| 02452839 | VENLAFAXINE HCL | Auro-Venlafaxine XR 37.5mg ER Cap | AUR | 0.0913 | 0.0913 | YES | NO | NO |
| 02452847 | VENLAFAXINE HCL | Auro-Venlafaxine XR 75mg ER Cap | AUR | 0.1825 | 0.1825 | YES | NO | NO |
| 02237279 | VENLAFAXINE HCL | Effexor XR 37.5mg ER Cap | UJC | 1.1374 | 0.0913 | YES | NO | NO |
| 02237280 | VENLAFAXINE HCL | Effexor XR 75mg ER Cap | UJC | 2.2741 | 0.1825 | YES | NO | NO |
| 02237282 | VENLAFAXINE HCL | Effexor XR 150mg ER Cap | UJC | 2.4018 | 0.1927 | YES | NO | NO |
| 02471280 | VENLAFAXINE HCL | M-Venlafaxine XR 37.5mg ER Cap | MAT | 0.0913 | 0.0913 | YES | NO | NO |
| 02471302 | VENLAFAXINE HCL | M-Venlafaxine XR 150mg ER Cap | MAT | 0.1927 | 0.1927 | YES | NO | NO |
| 02471299 | VENLAFAXINE HCL | M-Venlafaxine XR 75mg ER Cap | MAT | 0.1825 | 0.1825 | YES | NO | NO |
| 02522985 | VENLAFAXINE HCL | Mint-Venlafaxine XR 75mg ER Cap | MIN | 0.1825 | 0.1825 | YES | NO | NO |
| 02522977 | VENLAFAXINE HCL | Mint-Venlafaxine XR 37.5mg ER Cap | MIN | 0.0913 | 0.0913 | YES | NO | NO |
| 02522993 | VENLAFAXINE HCL | Mint-Venlafaxine XR 150mg ER Cap | MIN | 0.1927 | 0.1927 | YES | NO | NO |
| 02278553 | VENLAFAXINE HCL | PMS-Venlafaxine XR 75mg ER Cap | PMS | 0.1825 | 0.1825 | YES | NO | NO |
| 02278561 | VENLAFAXINE HCL | PMS-Venlafaxine XR 150mg ER Cap | PMS | 0.1927 | 0.1927 | YES | NO | NO |
| 02278545 | VENLAFAXINE HCL | PMS-Venlafaxine XR 37.5mg ER Cap | PMS | 0.0913 | 0.0913 | YES | NO | NO |
| 02521466 | VENLAFAXINE HCL | PMSC-Venlafaxine XR 37.5mg ER Cap | PMS | 0.0913 | 0.0913 | YES | NO | NO |
| 02521474 | VENLAFAXINE HCL | PMSC-Venlafaxine XR 150mg ER Cap | PMS | 0.1927 | 0.1927 | YES | NO | NO |
| 02521482 | VENLAFAXINE HCL | PMSC-Venlafaxine XR 75mg ER Cap | PMS | 0.1825 | 0.1825 | YES | NO | NO |
| 02310333 | VENLAFAXINE HCL | Sandoz Venlafaxine XR 150mg ER Cap | SDZ | 0.1927 | 0.1927 | YES | NO | NO |
| 02310325 | VENLAFAXINE HCL | Sandoz Venlafaxine XR 75mg ER Cap | SDZ | 0.1825 | 0.1825 | YES | NO | NO |
| 02310317 | VENLAFAXINE HCL | Sandoz Venlafaxine XR 37.5mg ER Cap | SDZ | 0.0913 | 0.0913 | YES | NO | NO |
| 02380080 | VENLAFAXINE HCL | Taro-Venlafaxine XR 75mg ER Cap | SPC | 0.1825 | 0.1825 | YES | NO | NO |
| 02380099 | VENLAFAXINE HCL | Taro-Venlafaxine XR 150mg ER Cap | SPC | 0.1927 | 0.1927 | YES | NO | NO |
| 02380072 | VENLAFAXINE HCL | Taro-Venlafaxine XR 37.5mg ER Cap | SPC | 0.0913 | 0.0913 | YES | NO | NO |
| 02275031 | VENLAFAXINE HCL | Teva-Venlafaxine XR 75mg ER Cap | TEV | 0.1825 | 0.1825 | YES | NO | NO |
| 02275058 | VENLAFAXINE HCL | Teva-Venlafaxine XR 150mg ER Cap | TEV | 0.1927 | 0.1927 | YES | NO | NO |
| 02275023 | VENLAFAXINE HCL | Teva-Venlafaxine XR 37.5mg ER Cap | TEV | 0.0913 | 0.0913 | YES | NO | NO |
| 02516535 | VENLAFAXINE HCL | Venlafaxine XR 37.5mg ER Cap | JPC | 0.0913 | 0.0913 | YES | NO | NO |
| 02489678 | VENLAFAXINE HCL | Venlafaxine XR 37.5mg ER Cap | RIA | 0.0913 | 0.0913 | YES | NO | NO |
| 02385929 | VENLAFAXINE HCL | Venlafaxine XR 37.5mg ER Cap | SIV | 0.0913 | 0.0913 | YES | NO | NO |
| 02354713 | VENLAFAXINE HCL | Venlafaxine XR 37.5mg ER Cap | SAI | 0.0913 | 0.0913 | YES | NO | NO |
| 02489694 | VENLAFAXINE HCL | Venlafaxine XR 150mg ER Cap | RIA | 0.1927 | 0.1927 | YES | NO | NO |
| 02385945 | VENLAFAXINE HCL | Venlafaxine XR 150mg ER Cap | SIV | 0.1927 | 0.1927 | YES | NO | NO |
| 02354748 | VENLAFAXINE HCL | Venlafaxine XR 150mg ER Cap | SAI | 0.1927 | 0.1927 | YES | NO | NO |
| 02516551 | VENLAFAXINE HCL | Venlafaxine XR 150mg ER Cap | JPC | 0.1927 | 0.1927 | YES | NO | NO |
| 02516543 | VENLAFAXINE HCL | Venlafaxine XR 75mg ER Cap | JPC | 0.1825 | 0.1825 | YES | NO | NO |
| 02489686 | VENLAFAXINE HCL | Venlafaxine XR 75mg ER Cap | RIA | 0.1825 | 0.1825 | YES | NO | NO |
| 02385937 | VENLAFAXINE HCL | Venlafaxine XR 75mg ER Cap | SIV | 0.1825 | 0.1825 | YES | NO | NO |
| 02354721 | VENLAFAXINE HCL | Venlafaxine XR 75mg ER Cap | SAI | 0.1825 | 0.1825 | YES | NO | NO |
| 02246893 | VERAPAMIL HCL | Apo-Verap SR (Off-Formulary Interchangeable) 120mg LA Tab | APX | 0.6900 | N/A | YES | NO | NO |
| 02246894 | VERAPAMIL HCL | Apo-Verap SR 180mg LA Tab | APX | 0.5204 | 0.5204 | YES | NO | NO |
| 00742554 | VERAPAMIL HCL | Isoptin SR 240mg LA Tab | BGP | 2.7323 | 1.7143 | YES | NO | NO |
| 01934317 | VERAPAMIL HCL | Isoptin SR 180mg LA Tab | BGP | 2.0488 | 0.5204 | YES | NO | NO |
| 01907123 | VERAPAMIL HCL | Isoptin SR (Off-Formulary Interchangeable) 120mg LA Tab | BGP | N/A | N/A | YES | NO | NO |
| 02210347 | VERAPAMIL HCL | Mylan-Verapamil SR (Off-Formulary Interchangeable) 120mg LA Tab | MYL | 0.6900 | N/A | YES | NO | NO |
| 02450488 | VERAPAMIL HCL | Mylan-Verapamil SR 180mg LA Tab | MYL | 0.5204 | 0.5204 | YES | NO | NO |
| 02450496 | VERAPAMIL HCL | Mylan-Verapamil SR 240mg LA Tab | MYL | 1.7143 | 1.7143 | YES | NO | NO |
| 00782491 | VERAPAMIL HCL | AA-Verap 120mg Tab | AAP | 0.4250 | 0.4250 | YES | NO | NO |
| 00782483 | VERAPAMIL HCL | AA-Verap 80mg Tab | AAP | 0.2735 | 0.2735 | YES | NO | NO |
| 00554324 | VERAPAMIL HCL | Isoptin (Not a Benefit) 120mg Tab | ABB | N/A | N/A | YES | NO | NO |
| 00554316 | VERAPAMIL HCL | Isoptin (Not a Benefit) 80mg Tab | ABB | N/A | N/A | YES | NO | NO |
| 02237921 | VERAPAMIL HCL | Mylan-Verapamil 80mg Tab | MYL | 0.2735 | 0.2735 | YES | NO | NO |
| 02237922 | VERAPAMIL HCL | Mylan-Verapamil 120mg Tab | MYL | 0.4250 | 0.4250 | YES | NO | NO |
| 02537044 | VERICIGUAT | Verquvo 2.5mg Tab | BAH | 4.8300 | 4.8300 | NO | YES | NO |
| 02537052 | VERICIGUAT | Verquvo 5mg Tab | BAH | 4.8300 | 4.8300 | NO | YES | NO |
| 02537060 | VERICIGUAT | Verquvo 10mg Tab | BAH | 4.8300 | 4.8300 | NO | YES | NO |
| 09858315 | VIGABATRIN | Vigabatrin for Oral Solution, USP 500mg (Temporary Benefit) 500mg/Sachet Pd for Oral Sol | DRR | 5.0000 | 5.0000 | NO | NO | NO |
| 02065819 | VIGABATRIN | Sabril 500mg Tab | OVA | 0.9566 | 0.9566 | NO | YES | NO |
| 09858318 | VIGABATRIN | Vigabatrin Tablets, USP (Temporary Benefit) 500mg Tab | DRR | 5.0000 | 5.0000 | NO | NO | NO |
| 02551829 | VILAZODONE HYDROCHLORIDE | Apo-Vilazodone (Off-Formulary Interchangeable) 20mg Tab | APX | 3.0482 | N/A | YES | NO | NO |
| 02551810 | VILAZODONE HYDROCHLORIDE | Apo-Vilazodone (Off-Formulary Interchangeable) 10mg Tab | APX | 3.0482 | N/A | YES | NO | NO |
| 02551837 | VILAZODONE HYDROCHLORIDE | Apo-Vilazodone (Off-Formulary Interchangeable) 40mg Tab | APX | 4.0577 | N/A | YES | NO | NO |
| 02443724 | VILAZODONE HYDROCHLORIDE | Viibryd (Off-Formulary Interchangeable) 10mg Tab | ABV | N/A | N/A | YES | NO | NO |
| 02443740 | VILAZODONE HYDROCHLORIDE | Viibryd (Off-Formulary Interchangeable) 40mg Tab | ABV | N/A | N/A | YES | NO | NO |
| 02443732 | VILAZODONE HYDROCHLORIDE | Viibryd (Off-Formulary Interchangeable) 20mg Tab | ABV | N/A | N/A | YES | NO | NO |
| 00611182 | VINCRISTINE SULFATE | Oncovin (Not a Benefit) 1mg/mL Inj Sol | LIL | N/A | N/A | YES | NO | NO |
| 02143305 | VINCRISTINE SULFATE | Vincristine Sulfate 1mg/mL Inj Sol | NOP | 30.6000 | 30.6000 | YES | NO | NO |
| 02525798 | VORICONAZOLE | Jamp Voriconazole 200mg Tab | JPC | 26.4807 | 26.4807 | YES | YES | NO |
| 02525771 | VORICONAZOLE | Jamp Voriconazole 50mg Tab | JPC | 6.7818 | 6.7818 | YES | YES | NO |
| 02399253 | VORICONAZOLE | Sandoz Voriconazole 200mg Tab | SDZ | 26.4807 | 26.4807 | YES | YES | NO |
| 02399245 | VORICONAZOLE | Sandoz Voriconazole 50mg Tab | SDZ | 6.7818 | 6.7818 | YES | YES | NO |
| 02256460 | VORICONAZOLE | Vfend 50mg Tab | PFI | 13.5635 | 6.7818 | YES | YES | NO |
| 02256479 | VORICONAZOLE | Vfend 200mg Tab | PFI | 54.2323 | 26.4807 | YES | YES | NO |
| 02552779 | VORTIOXETINE HYDROBROMIDE | Apo-Vortioxetine 20mg Tab | APX | 1.8028 | 1.8028 | YES | NO | NO |
| 02552744 | VORTIOXETINE HYDROBROMIDE | Apo-Vortioxetine 5mg Tab | APX | 1.5853 | 1.5853 | YES | NO | NO |
| 02552752 | VORTIOXETINE HYDROBROMIDE | Apo-Vortioxetine 10mg Tab | APX | 1.6606 | 1.6606 | YES | NO | NO |
| 02432927 | VORTIOXETINE HYDROBROMIDE | Trintellix 10mg Tab | VLH | 3.0192 | 1.6606 | YES | NO | NO |
| 02432919 | VORTIOXETINE HYDROBROMIDE | Trintellix 5mg Tab | VLH | 2.8824 | 1.5853 | YES | NO | NO |
| 02432943 | VORTIOXETINE HYDROBROMIDE | Trintellix 20mg Tab | VLH | 3.2779 | 1.8028 | YES | NO | NO |
| 02242927 | WARFARIN | Apo-Warfarin 4mg Tab | APX | 0.1043 | 0.1043 | YES | NO | YES |
| 02242925 | WARFARIN | Apo-Warfarin 2mg Tab | APX | 0.0841 | 0.0841 | YES | NO | YES |
| 02245618 | WARFARIN | Apo-Warfarin 3mg Tab | APX | 0.1043 | 0.1043 | YES | NO | YES |
| 02242924 | WARFARIN | Apo-Warfarin 1mg Tab | APX | 0.0796 | 0.0796 | YES | NO | YES |
| 02242928 | WARFARIN | Apo-Warfarin 5mg Tab | APX | 0.0675 | 0.0675 | YES | NO | YES |
| 02242926 | WARFARIN | Apo-Warfarin 2.5mg Tab | APX | 0.0674 | 0.0674 | YES | NO | YES |
| 02242929 | WARFARIN | Apo-Warfarin 10mg Tab | APX | 0.1211 | 0.1211 | YES | NO | YES |
| 01918338 | WARFARIN | Coumadin (Not a Benefit) 2mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 02007959 | WARFARIN | Coumadin (Not a Benefit) 4mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 02240205 | WARFARIN | Coumadin (Not a Benefit) 3mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 01918354 | WARFARIN | Coumadin (Not a Benefit) 5mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 01918311 | WARFARIN | Coumadin (Not a Benefit) 1mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 02240206 | WARFARIN | Coumadin (Not a Benefit) 6mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 01918346 | WARFARIN | Coumadin (Not a Benefit) 2.5mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 01918362 | WARFARIN | Coumadin (Not a Benefit) 10mg Tab | BQU | N/A | N/A | YES | NO | YES |
| 02242687 | WARFARIN | Taro-Warfarin 10mg Tab | TAR | 0.1211 | 0.1211 | YES | NO | YES |
| 02242686 | WARFARIN | Taro-Warfarin (Off-Formulary Interchangeable) 6mg Tab | TAR | 0.5160 | N/A | YES | NO | YES |
| 02242685 | WARFARIN | Taro-Warfarin 5mg Tab | TAR | 0.0675 | 0.0675 | YES | NO | YES |
| 02242684 | WARFARIN | Taro-Warfarin 4mg Tab | TAR | 0.1043 | 0.1043 | YES | NO | YES |
| 02242683 | WARFARIN | Taro-Warfarin 3mg Tab | TAR | 0.1043 | 0.1043 | YES | NO | YES |
| 02242682 | WARFARIN | Taro-Warfarin 2.5mg Tab | TAR | 0.0674 | 0.0674 | YES | NO | YES |
| 02242681 | WARFARIN | Taro-Warfarin 2mg Tab | TAR | 0.0841 | 0.0841 | YES | NO | YES |
| 02242680 | WARFARIN | Taro-Warfarin 1mg Tab | TAR | 0.0796 | 0.0796 | YES | NO | YES |
| 02240863 | ZANAMIVIR | Relenza 5mg Pd Inh-5 Rotadisks Pk | GSK | 49.2300 | 49.2300 | NO | YES | NO |
| 01946323 | ZIDOVUDINE | Apo-Zidovudine (Off-Formulary Interchangeable) 100mg Cap | APX | 2.2366 | N/A | YES | NO | NO |
| 01902660 | ZIDOVUDINE | Retrovir (Off-Formulary Interchangeable) 100mg Cap | VIH | N/A | N/A | YES | NO | NO |
| 01945939 | ZINC SULFATE | Anusol Ointment 0.5% Oint | CDC | 0.2187 | 0.2187 | NO | NO | NO |
| 00621439 | ZINC SULFATE | Anuzinc 10mg Sup | SDZ | 0.3542 | 0.3542 | NO | NO | NO |
| 02449579 | ZIPRASIDONE HCL MONOHYDRATE | Auro-Ziprasidone 80mg Cap | AUR | 1.5786 | 1.5786 | YES | NO | NO |
| 02449560 | ZIPRASIDONE HCL MONOHYDRATE | Auro-Ziprasidone 60mg Cap | AUR | 1.5786 | 1.5786 | YES | NO | NO |
| 02449552 | ZIPRASIDONE HCL MONOHYDRATE | Auro-Ziprasidone 40mg Cap | AUR | 1.5786 | 1.5786 | YES | NO | NO |
| 02449544 | ZIPRASIDONE HCL MONOHYDRATE | Auro-Ziprasidone 20mg Cap | AUR | 1.3784 | 1.3784 | YES | NO | NO |
| 02298619 | ZIPRASIDONE HCL MONOHYDRATE | Zeldox 60mg Cap | UJC | 2.5105 | 1.5786 | YES | NO | NO |
| 02298597 | ZIPRASIDONE HCL MONOHYDRATE | Zeldox 20mg Cap | UJC | 2.1916 | 1.3784 | YES | NO | NO |
| 02298627 | ZIPRASIDONE HCL MONOHYDRATE | Zeldox 80mg Cap | UJC | 2.5105 | 1.5786 | YES | NO | NO |
| 02298600 | ZIPRASIDONE HCL MONOHYDRATE | Zeldox 40mg Cap | UJC | 2.5105 | 1.5786 | YES | NO | NO |
| 02269198 | ZOLEDRONIC ACID | Aclasta 5mg/100mL Inj Sol-100mL Pk (Preservative-Free) | SDZ | 882.0900 | 356.0100 | YES | YES | NO |
| 02415100 | ZOLEDRONIC ACID | Taro-Zoledronic Acid 5mg/100mL Inj Sol-100mL Pk (Preservative-Free) | TAR | 356.0100 | 356.0100 | YES | YES | NO |
| 02422433 | ZOLEDRONIC ACID | Zoledronic Acid Injection 5mg/100mL Inj Sol-100mL Pk (Preservative-Free) | DRR | 356.0100 | 356.0100 | YES | YES | NO |
| 02482525 | ZOLEDRONIC ACID | Jamp-Zoledronic Acid (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | JPC | 415.5600 | 415.5600 | YES | NO | NO |
| 02415186 | ZOLEDRONIC ACID | Taro-Zoledronic Acid Concentrate (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | TAR | 415.5600 | 415.5600 | YES | NO | NO |
| 02422425 | ZOLEDRONIC ACID | Zoledronic Acid for Inj. Concentrate (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | DRR | 415.5600 | 415.5600 | YES | NO | NO |
| 02413701 | ZOLEDRONIC ACID | Zoledronic Acid for Inj. Concentrate (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | OMG | 415.0000 | 415.0000 | YES | NO | NO |
| 02407639 | ZOLEDRONIC ACID | Zoledronic Acid for Injection (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | TEV | 415.5600 | 415.5600 | YES | NO | NO |
| 02472805 | ZOLEDRONIC ACID | Zoledronic Acid for Injection (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | MAR | 415.5600 | 415.5600 | YES | NO | NO |
| 02434458 | ZOLEDRONIC ACID | Zoledronic Acid for Injection (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | FKC | 415.5600 | 415.5600 | YES | NO | NO |
| 02444739 | ZOLEDRONIC ACID | Zoledronic Acid for Injection (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | MDI | 415.5600 | 415.5600 | YES | NO | NO |
| 02401606 | ZOLEDRONIC ACID | Zoledronic Acid-Z (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | SDZ | 415.5600 | 415.5600 | YES | NO | NO |
| 02248296 | ZOLEDRONIC ACID | Zometa Concentrate (Off-Formulary Interchangeable) 4mg/5mL Inj Sol-5mL Pk (Preservative-Free) | NOV | N/A | N/A | YES | NO | NO |
| 02381575 | ZOLMITRIPTAN | Apo-Zolmitriptan Rapid (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | APX | 6.8633 | 6.8633 | YES | NO | NO |
| 02428237 | ZOLMITRIPTAN | Jamp-Zolmitriptan ODT (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | JPC | 6.8633 | 6.8633 | YES | NO | NO |
| 02419513 | ZOLMITRIPTAN | Mint-Zolmitriptan ODT (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | MIN | 6.8625 | 6.8625 | YES | NO | NO |
| 02362996 | ZOLMITRIPTAN | Sandoz Zolmitriptan ODT (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | SDZ | 6.8625 | 6.8625 | YES | NO | NO |
| 02428474 | ZOLMITRIPTAN | Septa-Zolmitriptan-ODT (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | SET | 6.8633 | 6.8633 | YES | NO | NO |
| 02342545 | ZOLMITRIPTAN | Teva-Zolmitriptan OD (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | TEV | 6.8633 | 6.8633 | YES | NO | NO |
| 02442671 | ZOLMITRIPTAN | Zolmitriptan ODT (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | SAI | 6.8633 | 6.8633 | YES | NO | NO |
| 02243045 | ZOLMITRIPTAN | Zomig Rapimelt (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating Tab | AZC | 17.3848 | 6.8633 | YES | NO | NO |
| 02380951 | ZOLMITRIPTAN | Apo-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | APX | 6.8583 | 6.8583 | YES | NO | NO |
| 02481030 | ZOLMITRIPTAN | Auro-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | AUR | 6.8633 | 6.8633 | YES | NO | NO |
| 02458780 | ZOLMITRIPTAN | CCP-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | CCP | 6.8586 | 6.8586 | YES | NO | NO |
| 02477106 | ZOLMITRIPTAN | Jamp Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | JPC | 6.8583 | 6.8583 | YES | NO | NO |
| 02421623 | ZOLMITRIPTAN | Jamp-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | JPC | 6.8583 | 6.8583 | YES | NO | NO |
| 02399458 | ZOLMITRIPTAN | Mar-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | MAR | 6.8583 | 6.8583 | YES | NO | NO |
| 02419521 | ZOLMITRIPTAN | Mint-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | MIN | 6.8583 | 6.8583 | YES | NO | NO |
| 02489392 | ZOLMITRIPTAN | NRA-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | NRA | 6.8600 | 6.8600 | YES | NO | NO |
| 02421534 | ZOLMITRIPTAN | Nat-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | NAT | 6.8633 | 6.8633 | YES | NO | NO |
| 02362988 | ZOLMITRIPTAN | Sandoz Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | SDZ | 6.8586 | 6.8586 | YES | NO | NO |
| 02313960 | ZOLMITRIPTAN | Teva-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | TEV | 6.8583 | 6.8583 | YES | NO | NO |
| 02442655 | ZOLMITRIPTAN | Zolmitriptan (Off-Formulary Interchangeable) 2.5mg Tab | SAI | 6.8583 | 6.8583 | YES | NO | NO |
| 02238660 | ZOLMITRIPTAN | Zomig (Off-Formulary Interchangeable) 2.5mg Tab | AZC | 17.3848 | 6.8633 | YES | NO | NO |
| 02436159 | ZOLPIDEM TARTRATE | Apo-Zolpidem ODT (Off-Formulary Interchangeable) 5mg SL Tab | APX | 1.1825 | N/A | YES | NO | NO |
| 02434946 | ZOLPIDEM TARTRATE | Apo-Zolpidem ODT (Off-Formulary Interchangeable) 10mg SL Tab | APX | 1.1884 | N/A | YES | NO | NO |
| 02540592 | ZOLPIDEM TARTRATE | Jamp Zolpidem ODT (Off-Formulary Interchangeable) 5mg SL Tab | JPC | 1.1827 | N/A | YES | NO | NO |
| 02540606 | ZOLPIDEM TARTRATE | Jamp Zolpidem ODT (Off-Formulary Interchangeable) 10mg SL Tab | JPC | 1.1883 | N/A | YES | NO | NO |
| 02472848 | ZOLPIDEM TARTRATE | Mint-Zolpidem ODT (Off-Formulary Interchangeable) 10mg SL Tab | MIN | 1.1883 | N/A | YES | NO | NO |
| 02472821 | ZOLPIDEM TARTRATE | Mint-Zolpidem ODT (Off-Formulary Interchangeable) 5mg SL Tab | MIN | 1.1827 | N/A | YES | NO | NO |
| 02436175 | ZOLPIDEM TARTRATE | PMS-Zolpidem ODT (Off-Formulary Interchangeable) 5mg SL Tab | PMS | 1.1827 | N/A | YES | NO | NO |
| 02436183 | ZOLPIDEM TARTRATE | PMS-Zolpidem ODT (Off-Formulary Interchangeable) 10mg SL Tab | PMS | 1.1883 | N/A | YES | NO | NO |
| 02370433 | ZOLPIDEM TARTRATE | Sublinox (Off-Formulary Interchangeable) 10mg SL Tab | VAL | N/A | N/A | YES | NO | NO |
| 02391678 | ZOLPIDEM TARTRATE | Sublinox (Off-Formulary Interchangeable) 5mg SL Tab | VAL | N/A | N/A | YES | NO | NO |
| 02475847 | ZOPICLONE | AG-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | ANG | 0.4685 | 0.4685 | YES | NO | NO |
| 02475839 | ZOPICLONE | AG-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | ANG | 0.2231 | 0.2231 | YES | NO | NO |
| 02218313 | ZOPICLONE | Apo-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | APX | 0.4685 | 0.4685 | YES | NO | NO |
| 02245077 | ZOPICLONE | Apo-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | APX | 0.2231 | 0.2231 | YES | NO | NO |
| 02271931 | ZOPICLONE | Co Zopiclone (Off-Formulary Interchangeable) 5mg Tab | COB | 0.2231 | 0.2231 | YES | NO | NO |
| 02271958 | ZOPICLONE | Co Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | COB | 0.4685 | 0.4685 | YES | NO | NO |
| 02216167 | ZOPICLONE | Imovane (Off-Formulary Interchangeable) 5mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02125285 | ZOPICLONE | Imovane (Off-Formulary Interchangeable) 3.75mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 01926799 | ZOPICLONE | Imovane (Off-Formulary Interchangeable) 7.5mg Tab | SAV | N/A | N/A | YES | NO | NO |
| 02549271 | ZOPICLONE | Jamp Zopiclone (Off-Formulary Interchangeable) 3.75mg Tab | JPC | 0.2343 | N/A | YES | NO | NO |
| 02549301 | ZOPICLONE | Jamp Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | JPC | 0.4685 | 0.4685 | YES | NO | NO |
| 02549298 | ZOPICLONE | Jamp Zopiclone (Off-Formulary Interchangeable) 5mg Tab | JPC | 0.2231 | 0.2231 | YES | NO | NO |
| 02356805 | ZOPICLONE | Jamp-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | JPC | 0.4685 | 0.4685 | YES | NO | NO |
| 02406969 | ZOPICLONE | Jamp-Zopiclone Tablets (Off-Formulary Interchangeable) 5mg Tab | JPC | 0.2231 | 0.2231 | YES | NO | NO |
| 02406977 | ZOPICLONE | Jamp-Zopiclone Tablets (Off-Formulary Interchangeable) 7.5mg Tab | JPC | 0.4685 | 0.4685 | YES | NO | NO |
| 02467968 | ZOPICLONE | M-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | MAT | 0.4685 | 0.4685 | YES | NO | NO |
| 02467941 | ZOPICLONE | M-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | MAT | 0.2231 | 0.2231 | YES | NO | NO |
| 02386798 | ZOPICLONE | Mar-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | MAR | 0.4685 | 0.4685 | YES | NO | NO |
| 02386771 | ZOPICLONE | Mar-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | MAR | 0.2231 | 0.2231 | YES | NO | NO |
| 02391724 | ZOPICLONE | Mint-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | MIN | 0.4685 | 0.4685 | YES | NO | NO |
| 02391716 | ZOPICLONE | Mint-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | MIN | 0.2231 | 0.2231 | YES | NO | NO |
| 02477386 | ZOPICLONE | NRA-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | NRA | 0.4685 | 0.4685 | YES | NO | NO |
| 02477378 | ZOPICLONE | NRA-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | NRA | 0.2231 | 0.2231 | YES | NO | NO |
| 02240606 | ZOPICLONE | PMS-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | PMS | 0.4685 | 0.4685 | YES | NO | NO |
| 02458543 | ZOPICLONE | PMS-Zopiclone (Off-Formulary Interchangeable) 3.75mg Tab | PMS | 0.2343 | N/A | YES | NO | NO |
| 02243426 | ZOPICLONE | PMS-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | PMS | 0.2231 | 0.2231 | YES | NO | NO |
| 02267918 | ZOPICLONE | Ran-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | RAN | 0.2231 | 0.2231 | YES | NO | NO |
| 02267926 | ZOPICLONE | Ran-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | RAN | 0.4685 | 0.4685 | YES | NO | NO |
| 02242481 | ZOPICLONE | Ratio-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | RPH | 0.4685 | 0.4685 | YES | NO | NO |
| 02246534 | ZOPICLONE | Ratio-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | RPH | 0.2231 | 0.2231 | YES | NO | NO |
| 02278030 | ZOPICLONE | Riva-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | RIA | 0.2231 | 0.2231 | YES | NO | NO |
| 02278049 | ZOPICLONE | Riva-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | RIA | 0.4685 | 0.4685 | YES | NO | NO |
| 02257572 | ZOPICLONE | Sandoz Zopiclone (Off-Formulary Interchangeable) 5mg Tab | SDZ | 0.2231 | 0.2231 | YES | NO | NO |
| 02008203 | ZOPICLONE | Sandoz Zopiclone Tablet (Off-Formulary Interchangeable) 7.5mg Tab | SDZ | 0.4685 | 0.4685 | YES | NO | NO |
| 02386917 | ZOPICLONE | Septa-Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | SET | 0.4685 | 0.4685 | YES | NO | NO |
| 02386909 | ZOPICLONE | Septa-Zopiclone (Off-Formulary Interchangeable) 5mg Tab | SET | 0.2231 | 0.2231 | YES | NO | NO |
| 02282445 | ZOPICLONE | Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | SAI | 0.4685 | 0.4685 | YES | NO | NO |
| 02385821 | ZOPICLONE | Zopiclone (Off-Formulary Interchangeable) 5mg Tab | SIV | 0.2231 | 0.2231 | YES | NO | NO |
| 02344122 | ZOPICLONE | Zopiclone (Off-Formulary Interchangeable) 5mg Tab | SAI | 0.2231 | 0.2231 | YES | NO | NO |
| 02385848 | ZOPICLONE | Zopiclone (Off-Formulary Interchangeable) 7.5mg Tab | SIV | 0.4685 | 0.4685 | YES | NO | NO |
| 02230406 | ZUCLOPENTHIXOL DECANOATE | Clopixol Depot 200mg/mL Inj-1mL Pk | VLH | 21.3154 | 21.3154 | NO | NO | NO |
| 02230403 | ZUCLOPENTHIXOL DIHYDROCHLORIDE | Clopixol 25mg Tab | VLH | 1.3705 | 1.3705 | NO | NO | NO |
| 02230402 | ZUCLOPENTHIXOL DIHYDROCHLORIDE | Clopixol 10mg Tab | VLH | 0.5483 | 0.5483 | NO | NO | NO |