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DIN/ PIN/ NPN	Generic Name	Brand Name, Strength & Dosage Form	MFR	Drug Benefit Price or Unit Price	Amount MOH Pays	Interchangeable	Limited Use	Therapeutic Notes
00335061	AMITRIPTYLINE	Elavil 25mg Tab	AAP	0.1211	0.0580	YES	NO	NO
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
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
02457687	AMITRIPTYLINE	Jamp-Amitriptyline 50mg Tab	JPC	0.1078	0.1078	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
02429888	AMITRIPTYLINE	Mar-Amitriptyline 25mg Tab	MAR	0.0580	0.0580	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
00654507	AMITRIPTYLINE	PMS-Amitriptyline 50mg Tab	PMS	0.1078	0.1078	YES	NO	NO
02439662	BUPROPION HCL	Act Bupropion XL 300mg ER Tab	ACV	0.5853	0.5853	YES	YES	NO
02439654	BUPROPION HCL	Act Bupropion XL 150mg ER Tab	ACV	0.2926	0.2926	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	0.6335	0.2926	YES	YES	NO
02275104	BUPROPION HCL	Wellbutrin XL 300mg ER Tab	VAL	1.2674	0.5853	YES	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
02237825	BUPROPION HCL	Wellbutrin SR (Not a Benefit) 150mg Tab	VAL	N/A	N/A	YES	NO	NO
02237824	BUPROPION HCL	Wellbutrin SR (Not a Benefit) 100mg Tab	BIO	N/A	N/A	YES	NO	NO
02355256	CITALOPRAM HYDROBROMIDE	Accel Citalopram Tablets 20mg Tab	ACC	0.1332	0.1332	YES	NO	NO
02355264	CITALOPRAM HYDROBROMIDE	Accel Citalopram Tablets 40mg 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
02459914	CITALOPRAM HYDROBROMIDE	CCP-Citalopram 20mg Tab	CCP	0.1332	0.1332	YES	NO	NO
02459922	CITALOPRAM HYDROBROMIDE	CCP-Citalopram 40mg Tab	CCP	0.1332	0.1332	YES	NO	NO
02239606	CITALOPRAM HYDROBROMIDE	Celexa (Off-Formulary Interchangeable) 10mg Tab	VLH	N/A	N/A	YES	NO	NO
02239607	CITALOPRAM HYDROBROMIDE	Celexa 20mg Tab	VLH	1.8776	0.1332	YES	NO	NO
02239608	CITALOPRAM HYDROBROMIDE	Celexa 40mg Tab	VLH	1.8776	0.1332	YES	NO	NO
02430541	CITALOPRAM HYDROBROMIDE	Citalopram 20mg Tab	JPC	0.1332	0.1332	YES	NO	NO
02430517	CITALOPRAM HYDROBROMIDE	Citalopram (Off-Formulary Interchangeable) 10mg Tab	JPC	0.4464	N/A	YES	NO	NO
02353660	CITALOPRAM HYDROBROMIDE	Citalopram 20mg Tab	SAI	0.1332	0.1332	YES	NO	NO
02445719	CITALOPRAM HYDROBROMIDE	Citalopram (Off-Formulary Interchangeable) 10mg Tab	SAI	0.4464	N/A	YES	NO	NO
02387964	CITALOPRAM HYDROBROMIDE	Citalopram 40mg Tab	SIV	0.1332	0.1332	YES	NO	NO
02353679	CITALOPRAM HYDROBROMIDE	Citalopram 40mg Tab	SAI	0.1332	0.1332	YES	NO	NO
02387948	CITALOPRAM HYDROBROMIDE	Citalopram (Off-Formulary Interchangeable) 10mg Tab	SIV	0.4464	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
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
02467836	CITALOPRAM HYDROBROMIDE	M-Citalopram 20mg Tab	MAT	0.1332	0.1332	YES	NO	NO
02467844	CITALOPRAM HYDROBROMIDE	M-Citalopram 40mg Tab	MAT	0.1332	0.1332	YES	NO	NO
02371901	CITALOPRAM HYDROBROMIDE	Mar-Citalopram 40mg 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
02371898	CITALOPRAM HYDROBROMIDE	Mar-Citalopram 20mg Tab	MAR	0.1332	0.1332	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
02443899	CITALOPRAM HYDROBROMIDE	Natco-Citalopram 40mg 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
02443880	CITALOPRAM HYDROBROMIDE	Natco-Citalopram 20mg Tab	NAT	0.1332	0.1332	YES	NO	NO
02248010	CITALOPRAM HYDROBROMIDE	PMS-Citalopram 20mg Tab	PMS	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
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
02248170	CITALOPRAM HYDROBROMIDE	Sandoz Citalopram 20mg Tab	SDZ	0.1332	0.1332	YES	NO	NO
02248171	CITALOPRAM HYDROBROMIDE	Sandoz Citalopram 40mg Tab	SDZ	0.1332	0.1332	YES	NO	NO
02355280	CITALOPRAM HYDROBROMIDE	Septa-Citalopram 40mg Tab	SET	0.1332	0.1332	YES	NO	NO
02355272	CITALOPRAM HYDROBROMIDE	Septa-Citalopram 20mg 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
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
02497506	CLOMIPRAMINE HCL	Taro-Clomipramine Cap 25mg	TAR	0.3417	0.3417	YES	NO	NO
02497514	CLOMIPRAMINE HCL	Taro-Clomipramine Cap 50mg	TAR	0.6291	0.6291	YES	NO	NO
00330566	CLOMIPRAMINE HCL	Anafranil 10mg Tab	APX	0.2949	0.2949	NO	NO	NO
02216272	DESIPRAMINE	Desipramine 75mg Tab	AAP	1.0408	1.0408	YES	NO	NO
02216264	DESIPRAMINE	Desipramine 50mg Tab	AAP	0.7827	0.7827	YES	NO	NO
02216256	DESIPRAMINE	Desipramine 25mg Tab	AAP	0.4441	0.4441	YES	NO	NO
02099144	DESIPRAMINE	Norpramin (Not a Benefit) 75mg Tab	HMR	N/A	N/A	YES	NO	NO
02099136	DESIPRAMINE	Norpramin (Not a Benefit) 50mg Tab	SAV	N/A	N/A	YES	NO	NO
02099128	DESIPRAMINE	Norpramin (Not a Benefit) 25mg Tab	SAV	N/A	N/A	YES	NO	NO
00010448	DESIPRAMINE	Pertofrane (Not a Benefit) 25mg Tab	GEI	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
02554976	DESVENLAFAXINE	Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab	SIV	2.3409	N/A	YES	NO	NO
02467127	DESVENLAFAXINE	Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab	APX	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
02535114	DESVENLAFAXINE	Desvenlafaxine (Off-Formulary Interchangeable) 100mg 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
02495139	DESVENLAFAXINE	Jamp Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab	JPC	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
02321106	DESVENLAFAXINE	Pristiq (Off-Formulary Interchangeable) 100mg ER Tab	PFI	N/A	N/A	YES	NO	NO
02321092	DESVENLAFAXINE	Pristiq (Off-Formulary Interchangeable) 50mg ER Tab	PFI	N/A	N/A	YES	NO	NO
02538423	DESVENLAFAXINE	Sandoz Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER Tab	SDZ	2.3409	N/A	YES	NO	NO
02538415	DESVENLAFAXINE	Sandoz Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER Tab	SDZ	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
02532158	DESVENLAFAXINE	Taro-Desvenlafaxine (Off-Formulary Interchangeable) 50mg 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
02049996	DOXEPIN HCL	Apo-Doxepin 10mg Cap	APX	0.2038	0.2038	YES	NO	NO
02050005	DOXEPIN HCL	Apo-Doxepin 25mg Cap	APX	0.2500	0.2500	YES	NO	NO
02050013	DOXEPIN HCL	Apo-Doxepin 50mg Cap	APX	0.4637	0.4637	YES	NO	NO
02050021	DOXEPIN HCL	Apo-Doxepin (Off-Formulary Interchangeable) 75mg Cap	APX	1.1363	N/A	YES	NO	NO
02050048	DOXEPIN HCL	Apo-Doxepin (Off-Formulary Interchangeable) 100mg Cap	APX	1.4944	N/A	YES	NO	NO
02559285	DOXEPIN HCL	Jamp Doxepin (Off-Formulary Interchangeable) 75mg Cap	JPC	1.1363	N/A	YES	NO	NO
02559293	DOXEPIN HCL	Jamp Doxepin (Off-Formulary Interchangeable) 100mg Cap	JPC	1.4944	N/A	YES	NO	NO
02559129	DOXEPIN HCL	Mar-Doxepin (Off-Formulary Interchangeable) 100mg Cap	MAR	1.4944	N/A	YES	NO	NO
02559102	DOXEPIN HCL	Mar-Doxepin 50mg Cap	MAR	0.4637	0.4637	YES	NO	NO
02559099	DOXEPIN HCL	Mar-Doxepin 25mg Cap	MAR	0.2500	0.2500	YES	NO	NO
02559080	DOXEPIN HCL	Mar-Doxepin 10mg Cap	MAR	0.2038	0.2038	YES	NO	NO
02559110	DOXEPIN HCL	Mar-Doxepin (Off-Formulary Interchangeable) 75mg Cap	MAR	1.1363	N/A	YES	NO	NO
00326925	DOXEPIN HCL	Sinequan (Off-Formulary Interchangeable) 100mg Cap	AAP	N/A	N/A	YES	NO	NO
00024325	DOXEPIN HCL	Sinequan 10mg Cap	AAP	0.4075	0.2038	YES	NO	NO
00024333	DOXEPIN HCL	Sinequan 25mg Cap	AAP	0.5000	0.2500	YES	NO	NO
00024341	DOXEPIN HCL	Sinequan 50mg Cap	AAP	0.9274	0.4637	YES	NO	NO
00400750	DOXEPIN HCL	Sinequan (Off-Formulary Interchangeable) 75mg Cap	AAP	N/A	N/A	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
02522888	DULOXETINE	Accel-Duloxetine 60mg DR Cap	ACC	0.7327	0.7327	YES	NO	NO
02522861	DULOXETINE	Accel-Duloxetine 30mg DR Cap	ACC	0.3611	0.3611	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
02453630	DULOXETINE	Duloxetine 30mg DR Cap	SIV	0.4814	0.3611	YES	NO	NO
02453649	DULOXETINE	Duloxetine 60mg DR Cap	SIV	0.9769	0.7327	YES	NO	NO
02490897	DULOXETINE	Duloxetine 60mg DR Cap	SAI	0.9769	0.7327	YES	NO	NO
02490889	DULOXETINE	Duloxetine 30mg DR Cap	SAI	0.4814	0.3611	YES	NO	NO
02437082	DULOXETINE	Duloxetine DR 30mg DR Cap	TEV	0.4814	0.3611	YES	NO	NO
02437090	DULOXETINE	Duloxetine DR 60mg DR Cap	TEV	0.9769	0.7327	YES	NO	NO
02512505	DULOXETINE	Jamp Duloxetine Capsules 30mg DR Cap	JPC	0.4814	0.3611	YES	NO	NO
02512513	DULOXETINE	Jamp Duloxetine Capsules 60mg DR Cap	JPC	0.9769	0.7327	YES	NO	NO
02451921	DULOXETINE	Jamp-Duloxetine 60mg DR Cap	JPC	0.9769	0.7327	YES	NO	NO
02451913	DULOXETINE	Jamp-Duloxetine 30mg DR Cap	JPC	0.4814	0.3611	YES	NO	NO
02473208	DULOXETINE	M-Duloxetine 30mg DR Cap	MAT	0.4814	0.3611	YES	NO	NO
02473216	DULOXETINE	M-Duloxetine 60mg DR Cap	MAT	0.9769	0.7327	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
02429454	DULOXETINE	PMS-Duloxetine 60mg DR Cap	PMS	0.9769	0.7327	YES	NO	NO
02429446	DULOXETINE	PMS-Duloxetine 30mg DR Cap	PMS	0.4814	0.3611	YES	NO	NO
02438267	DULOXETINE	Ran-Duloxetine 60mg DR Cap	RAN	0.9769	0.7327	YES	NO	NO
02438259	DULOXETINE	Ran-Duloxetine 30mg DR Cap	RAN	0.4814	0.3611	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
02456753	DULOXETINE	Teva-Duloxetine 30mg DR Cap	TEV	0.4814	0.3611	YES	NO	NO
02456761	DULOXETINE	Teva-Duloxetine 60mg DR Cap	TEV	0.9769	0.7327	YES	NO	NO
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
02295016	ESCITALOPRAM	Apo-Escitalopram 10mg Tab	APX	0.3109	0.3109	YES	NO	NO
02295024	ESCITALOPRAM	Apo-Escitalopram 20mg Tab	APX	0.3310	0.3310	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	2.5438	0.3310	YES	NO	NO
02263238	ESCITALOPRAM	Cipralex 10mg Tab	VLH	2.3825	0.3109	YES	NO	NO
02430118	ESCITALOPRAM	Escitalopram 10mg Tab	SAI	0.3109	0.3109	YES	NO	NO
02429047	ESCITALOPRAM	Escitalopram 20mg Tab	SIV	0.3310	0.3310	YES	NO	NO
02430126	ESCITALOPRAM	Escitalopram 20mg Tab	SAI	0.3310	0.3310	YES	NO	NO
02429039	ESCITALOPRAM	Escitalopram 10mg Tab	SIV	0.3109	0.3109	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
02429799	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
02471426	ESCITALOPRAM	M-Escitalopram 20mg Tab	MAT	0.3310	0.3310	YES	NO	NO
02471418	ESCITALOPRAM	M-Escitalopram 10mg Tab	MAT	0.3109	0.3109	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
02407418	ESCITALOPRAM	Mint-Escitalopram 10mg Tab	MIN	0.3109	0.3109	YES	NO	NO
02407434	ESCITALOPRAM	Mint-Escitalopram 20mg Tab	MIN	0.3310	0.3310	YES	NO	NO
02309467	ESCITALOPRAM	Mylan-Escitalopram 10mg Tab	MYL	0.3109	0.3109	YES	NO	NO
02309475	ESCITALOPRAM	Mylan-Escitalopram 20mg Tab	MYL	0.3310	0.3310	YES	NO	NO
02476851	ESCITALOPRAM	NRA-Escitalopram 10mg Tab	NRA	0.3109	0.3109	YES	NO	NO
02476878	ESCITALOPRAM	NRA-Escitalopram 20mg Tab	NRA	0.3310	0.3310	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
02469243	ESCITALOPRAM	PMS-Escitalopram 10mg Tab	PMS	0.3109	0.3109	YES	NO	NO
02469251	ESCITALOPRAM	PMS-Escitalopram 20mg Tab	PMS	0.3310	0.3310	YES	NO	NO
02385481	ESCITALOPRAM	Ran-Escitalopram 10mg Tab	RAN	0.3109	0.3109	YES	NO	NO
02385503	ESCITALOPRAM	Ran-Escitalopram 20mg Tab	RAN	0.3310	0.3310	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
02485052	FLUOXETINE HCL	AG-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	ANG	1.1773	N/A	YES	NO	YES
02485060	FLUOXETINE HCL	AG-Fluoxetine 20mg Cap	ANG	0.3311	0.3311	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
02216353	FLUOXETINE HCL	Apo-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	APX	1.1773	N/A	YES	NO	YES
02216361	FLUOXETINE HCL	Apo-Fluoxetine 20mg Cap	APX	0.3311	0.3311	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
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
02286068	FLUOXETINE HCL	Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	SAI	1.1773	N/A	YES	NO	YES
02386402	FLUOXETINE HCL	Jamp-Fluoxetine 20mg Cap	JPC	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
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
02392909	FLUOXETINE HCL	Mar-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	MAR	1.1773	N/A	YES	NO	YES
02392917	FLUOXETINE HCL	Mar-Fluoxetine 20mg Cap	MAR	0.3311	0.3311	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
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
02177579	FLUOXETINE HCL	PMS-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	PMS	1.1773	N/A	YES	NO	YES
02177587	FLUOXETINE HCL	PMS-Fluoxetine 20mg Cap	PMS	0.3311	0.3311	YES	NO	YES
02018985	FLUOXETINE HCL	Prozac (Off-Formulary Interchangeable) 10mg Cap	LIL	N/A	N/A	YES	NO	YES
00636622	FLUOXETINE HCL	Prozac 20mg Cap	LIL	2.4865	0.3311	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
02216582	FLUOXETINE HCL	Teva-Fluoxetine (Off-Formulary Interchangeable) 10mg Cap	TEV	1.1773	N/A	YES	NO	YES
02216590	FLUOXETINE HCL	Teva-Fluoxetine 20mg Cap	TEV	0.3311	0.3311	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
02231329	FLUVOXAMINE MALEATE	Apo-Fluvoxamine 50mg Tab	APX	0.5410	0.5410	YES	NO	YES
02231330	FLUVOXAMINE MALEATE	Apo-Fluvoxamine 100mg Tab	APX	0.9728	0.9728	YES	NO	YES
01919369	FLUVOXAMINE MALEATE	Luvox 100mg Tab	BGP	2.0659	0.9728	YES	NO	YES
01919342	FLUVOXAMINE MALEATE	Luvox 50mg Tab	BGP	1.1489	0.5410	YES	NO	YES
02255537	FLUVOXAMINE MALEATE	Teva-Fluvoxamine 100mg Tab	TEV	0.9728	0.9728	YES	NO	YES
02255529	FLUVOXAMINE MALEATE	Teva-Fluvoxamine 50mg Tab	TEV	0.5410	0.5410	YES	NO	YES
00312797	IMIPRAMINE	Apo-Imipramine Tablets 25mg Tab	APX	0.2316	0.2316	YES	NO	NO
00326852	IMIPRAMINE	Apo-Imipramine Tablets 50mg Tab	APX	0.4519	0.4519	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
02299801	MIRTAZAPINE	Auro-Mirtazapine OD 15mg Orally Disintegrating Tab	AUR	0.4046	0.4046	YES	NO	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
02248542	MIRTAZAPINE	Remeron RD 15mg Orally Disintegrating Tab	OCI	0.5529	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
02286629	MIRTAZAPINE	Apo-Mirtazapine 30mg Tab	APX	0.3100	0.3100	YES	NO	NO
02411717	MIRTAZAPINE	Auro-Mirtazapine (Off-Formulary Interchangeable) 45mg Tab	AUR	1.1250	N/A	YES	NO	NO
02411709	MIRTAZAPINE	Auro-Mirtazapine 30mg Tab	AUR	0.3100	0.3100	YES	NO	NO
02411695	MIRTAZAPINE	Auro-Mirtazapine (Off-Formulary Interchangeable) 15mg Tab	AUR	0.3750	N/A	YES	NO	NO
02496674	MIRTAZAPINE	Mirtazapine 30mg Tab	SIV	0.3100	0.3100	YES	NO	NO
02496682	MIRTAZAPINE	Mirtazapine (Off-Formulary Interchangeable) 45mg Tab	SIV	1.1250	N/A	YES	NO	NO
02496666	MIRTAZAPINE	Mirtazapine (Off-Formulary Interchangeable) 15mg Tab	SIV	0.3750	N/A	YES	NO	NO
02370689	MIRTAZAPINE	Mirtazapine 30mg Tab	SAI	0.3100	0.3100	YES	NO	NO
02532689	MIRTAZAPINE	Mirtazapine (Off-Formulary Interchangeable) 15mg Tab	SAI	0.3750	N/A	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
02259354	MIRTAZAPINE	Teva-Mirtazapine 30mg Tab	TEV	0.3100	0.3100	YES	NO	NO
02541572	MIRTAZAPINE	Teva-Mirtazapine (Off-Formulary Interchangeable) 15mg Tab	TEV	0.3750	N/A	YES	NO	NO
02541580	MIRTAZAPINE	Teva-Mirtazapine (Off-Formulary Interchangeable) 45mg Tab	TEV	1.1250	N/A	YES	NO	NO
02166747	MOCLOBEMIDE	Manerix 300mg Tab	MAB	1.7921	1.0399	YES	NO	NO
00899348	MOCLOBEMIDE	Manerix (Not a Benefit) 100mg Tab	HLR	N/A	N/A	YES	NO	NO
00899356	MOCLOBEMIDE	Manerix 150mg Tab	MAB	0.9126	0.5295	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
00015237	NORTRIPTYLINE	Aventyl 25mg Cap	AAP	0.6054	0.6054	NO	NO	NO
00015229	NORTRIPTYLINE	Aventyl 10mg Cap	AAP	0.2995	0.2995	NO	NO	NO
02475537	PAROXETINE HCL	AG-Paroxetine (Off-Formulary Interchangeable) 10mg Tab	ANG	1.0430	N/A	YES	NO	NO
02475545	PAROXETINE HCL	AG-Paroxetine 20mg Tab	ANG	0.3250	0.3250	YES	NO	NO
02475553	PAROXETINE HCL	AG-Paroxetine 30mg Tab	ANG	0.3453	0.3453	YES	NO	NO
02240907	PAROXETINE HCL	Apo-Paroxetine (Off-Formulary Interchangeable) 10mg Tab	APX	1.0430	N/A	YES	NO	NO
02240908	PAROXETINE HCL	Apo-Paroxetine 20mg Tab	APX	0.3250	0.3250	YES	NO	NO
02240909	PAROXETINE HCL	Apo-Paroxetine 30mg Tab	APX	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
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
02262746	PAROXETINE HCL	Co Paroxetine (Off-Formulary Interchangeable) 10mg Tab	COB	1.0430	N/A	YES	NO	NO
02262754	PAROXETINE HCL	Co Paroxetine 20mg Tab	COB	0.3250	0.3250	YES	NO	NO
02507781	PAROXETINE HCL	Jamp Paroxetine Tablets 20mg Tab	JPC	0.3250	0.3250	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
02368870	PAROXETINE HCL	Jamp-Paroxetine 20mg Tab	JPC	0.3250	0.3250	YES	NO	NO
02368889	PAROXETINE HCL	Jamp-Paroxetine 30mg Tab	JPC	0.3453	0.3453	YES	NO	NO
02368862	PAROXETINE HCL	Jamp-Paroxetine (Off-Formulary Interchangeable) 10mg Tab	JPC	1.0430	N/A	YES	NO	NO
02467429	PAROXETINE HCL	M-Paroxetine 30mg Tab	MAT	0.3453	0.3453	YES	NO	NO
02467410	PAROXETINE HCL	M-Paroxetine 20mg Tab	MAT	0.3250	0.3250	YES	NO	NO
02467402	PAROXETINE HCL	M-Paroxetine (Off-Formulary Interchangeable) 10mg Tab	MAT	1.0430	N/A	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
02411954	PAROXETINE HCL	Mar-Paroxetine 20mg Tab	MAR	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
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
02479788	PAROXETINE HCL	NRA-Paroxetine 30mg Tab	NRA	0.3453	0.3453	YES	NO	NO
02479753	PAROXETINE HCL	NRA-Paroxetine (Off-Formulary Interchangeable) 10mg Tab	NRA	1.0430	N/A	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
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
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
02388243	PAROXETINE HCL	Paroxetine 30mg Tab	SIV	0.3453	0.3453	YES	NO	NO
02282844	PAROXETINE HCL	Paroxetine (Off-Formulary Interchangeable) 10mg Tab	SAI	1.0430	N/A	YES	NO	NO
02027887	PAROXETINE HCL	Paxil (Off-Formulary Interchangeable) 10mg Tab	SMJ	N/A	N/A	YES	NO	NO
01940481	PAROXETINE HCL	Paxil 20mg Tab	GSK	2.5496	0.3250	YES	NO	NO
01940473	PAROXETINE HCL	Paxil 30mg Tab	GSK	2.7080	0.3453	YES	NO	NO
02431793	PAROXETINE HCL	Sandoz Paroxetine Tablets 30mg Tab	SDZ	0.3453	0.3453	YES	NO	NO
02431777	PAROXETINE HCL	Sandoz Paroxetine Tablets (Off-Formulary Interchangeable) 10mg Tab	SDZ	1.0430	N/A	YES	NO	NO
02431785	PAROXETINE HCL	Sandoz Paroxetine Tablets 20mg Tab	SDZ	0.3250	0.3250	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
00476552	PHENELZINE SULFATE	Nardil 15mg Tab	SLP	0.4905	0.4905	NO	NO	YES
02489139	RASAGILINE MESYLATE	ASN-Rasagiline (Off-Formulary Interchangeable) 1mg Tab	ASL	6.1285	6.1285	YES	NO	NO
02489120	RASAGILINE MESYLATE	ASN-Rasagiline (Off-Formulary Interchangeable) 0.5mg Tab	ASL	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
02404699	RASAGILINE MESYLATE	Apo-Rasagiline (Off-Formulary Interchangeable) 1mg Tab	APX	6.1285	6.1285	YES	NO	NO
02284650	RASAGILINE MESYLATE	Azilect (Off-Formulary Interchangeable) 1mg Tab	TEI	9.9904	6.1285	YES	NO	NO
02284642	RASAGILINE MESYLATE	Azilect (Off-Formulary Interchangeable) 0.5mg Tab	TEI	9.9904	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
02477882	SERTRALINE HCL	AG-Sertraline 25mg Cap	ANG	0.1516	0.1516	YES	NO	YES
02477890	SERTRALINE HCL	AG-Sertraline 50mg Cap	ANG	0.3032	0.3032	YES	NO	YES
02477904	SERTRALINE HCL	AG-Sertraline 100mg Cap	ANG	0.3303	0.3303	YES	NO	YES
02238280	SERTRALINE HCL	Apo-Sertraline 25mg Cap	APX	0.1516	0.1516	YES	NO	YES
02238281	SERTRALINE HCL	Apo-Sertraline 50mg Cap	APX	0.3032	0.3032	YES	NO	YES
02238282	SERTRALINE HCL	Apo-Sertraline 100mg Cap	APX	0.3303	0.3303	YES	NO	YES
02390922	SERTRALINE HCL	Auro-Sertraline 100mg Cap	AUR	0.3303	0.3303	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
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
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
02357178	SERTRALINE HCL	Jamp-Sertraline 100mg Cap	JPC	0.3303	0.3303	YES	NO	YES
02530953	SERTRALINE HCL	M-Sertraline 100mg Cap	MAT	0.3303	0.3303	YES	NO	YES
02530937	SERTRALINE HCL	M-Sertraline 25mg Cap	MAT	0.1516	0.1516	YES	NO	YES
02530945	SERTRALINE HCL	M-Sertraline 50mg Cap	MAT	0.3032	0.3032	YES	NO	YES
02399431	SERTRALINE HCL	Mar-Sertraline 100mg Cap	MAR	0.3303	0.3303	YES	NO	YES
02399415	SERTRALINE HCL	Mar-Sertraline 25mg Cap	MAR	0.1516	0.1516	YES	NO	YES
02399423	SERTRALINE HCL	Mar-Sertraline 50mg Cap	MAR	0.3032	0.3032	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
02488434	SERTRALINE HCL	NRA-Sertraline 25mg Cap	NRA	0.1516	0.1516	YES	NO	YES
02488450	SERTRALINE HCL	NRA-Sertraline 100mg Cap	NRA	0.3303	0.3303	YES	NO	YES
02488442	SERTRALINE HCL	NRA-Sertraline 50mg Cap	NRA	0.3032	0.3032	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
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
02353547	SERTRALINE HCL	Sertraline 100mg Cap	SAI	0.3303	0.3303	YES	NO	YES
02386097	SERTRALINE HCL	Sertraline 100mg Cap	SIV	0.3303	0.3303	YES	NO	YES
02386089	SERTRALINE HCL	Sertraline 50mg Cap	SIV	0.3032	0.3032	YES	NO	YES
02386070	SERTRALINE HCL	Sertraline 25mg Cap	SIV	0.1516	0.1516	YES	NO	YES
02469642	SERTRALINE HCL	Sertraline 100mg Cap	JPC	0.3303	0.3303	YES	NO	YES
02469634	SERTRALINE HCL	Sertraline 50mg Cap	JPC	0.3032	0.3032	YES	NO	YES
02469626	SERTRALINE HCL	Sertraline 25mg Cap	JPC	0.1516	0.1516	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
02240481	SERTRALINE HCL	Teva-Sertraline 100mg Cap	TEV	0.3303	0.3303	YES	NO	YES
02132702	SERTRALINE HCL	Zoloft 25mg Cap	UJC	1.0460	0.1516	YES	NO	YES
01962817	SERTRALINE HCL	Zoloft 50mg Cap	UJC	2.0919	0.3032	YES	NO	YES
01962779	SERTRALINE HCL	Zoloft 100mg Cap	UJC	2.2791	0.3303	YES	NO	YES
01919598	TRANYLCYPROMINE SULFATE	Parnate 10mg Tab	GSK	0.5476	0.5476	NO	NO	YES
02147645	TRAZODONE HYDROCHLORIDE	Apo-Trazodone 100mg Tab	APX	0.0989	0.0989	YES	NO	NO
02147637	TRAZODONE HYDROCHLORIDE	Apo-Trazodone 50mg Tab	APX	0.0554	0.0554	YES	NO	NO
02147653	TRAZODONE HYDROCHLORIDE	Apo-Trazodone D 150mg Tab	APX	0.1453	0.1453	YES	NO	NO
00579351	TRAZODONE HYDROCHLORIDE	Desyrel (Not a Benefit) 50mg Tab	BQU	N/A	N/A	YES	NO	NO
00579378	TRAZODONE HYDROCHLORIDE	Desyrel (Not a Benefit) 100mg 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
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
02442809	TRAZODONE HYDROCHLORIDE	Jamp Trazodone 50mg Tab	JPC	0.0554	0.0554	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
01926349	TRIMIPRAMINE	Surmontil (Not a Benefit) 75mg Cap	RPP	N/A	N/A	YES	NO	NO
02070987	TRIMIPRAMINE	Trimipramine 75mg Cap	AAP	0.7972	0.7972	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
01926322	TRIMIPRAMINE	Surmontil (Not a Benefit) 25mg Tab	RPP	N/A	N/A	YES	NO	NO
01926284	TRIMIPRAMINE	Surmontil (Not a Benefit) 100mg Tab	RPP	N/A	N/A	YES	NO	NO
00740829	TRIMIPRAMINE	Trimipramine 100mg Tab	AAP	1.0107	1.0107	YES	NO	NO
00740810	TRIMIPRAMINE	Trimipramine 50mg Tab	AAP	0.5922	0.5922	YES	NO	NO
00740799	TRIMIPRAMINE	Trimipramine 12.5mg Tab	AAP	0.2203	0.2203	YES	NO	NO
00740802	TRIMIPRAMINE	Trimipramine 25mg Tab	AAP	0.3025	0.3025	YES	NO	NO
02304317	VENLAFAXINE HCL	ACT Venlafaxine XR 37.5mg ER Cap	TEV	0.0913	0.0913	YES	NO	NO
02304325	VENLAFAXINE HCL	ACT Venlafaxine XR 75mg ER Cap	TEV	0.1825	0.1825	YES	NO	NO
02304333	VENLAFAXINE HCL	ACT Venlafaxine XR 150mg ER Cap	TEV	0.1927	0.1927	YES	NO	NO
02331705	VENLAFAXINE HCL	Apo-Venlafaxine XR 150mg ER Cap	APX	0.1927	0.1927	YES	NO	NO
02331683	VENLAFAXINE HCL	Apo-Venlafaxine XR 37.5mg ER Cap	APX	0.0913	0.0913	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
02237280	VENLAFAXINE HCL	Effexor XR 75mg ER Cap	UJC	2.3242	0.1825	YES	NO	NO
02237279	VENLAFAXINE HCL	Effexor XR 37.5mg ER Cap	UJC	1.1625	0.0913	YES	NO	NO
02237282	VENLAFAXINE HCL	Effexor XR 150mg ER Cap	UJC	2.4546	0.1927	YES	NO	NO
02471302	VENLAFAXINE HCL	M-Venlafaxine XR 150mg ER Cap	MAT	0.1927	0.1927	YES	NO	NO
02471280	VENLAFAXINE HCL	M-Venlafaxine XR 37.5mg ER Cap	MAT	0.0913	0.0913	YES	NO	NO
02471299	VENLAFAXINE HCL	M-Venlafaxine XR 75mg ER Cap	MAT	0.1825	0.1825	YES	NO	NO
02522993	VENLAFAXINE HCL	Mint-Venlafaxine XR 150mg ER Cap	MIN	0.1927	0.1927	YES	NO	NO
02522977	VENLAFAXINE HCL	Mint-Venlafaxine XR 37.5mg ER Cap	MIN	0.0913	0.0913	YES	NO	NO
02522985	VENLAFAXINE HCL	Mint-Venlafaxine XR 75mg ER Cap	MIN	0.1825	0.1825	YES	NO	NO
02278561	VENLAFAXINE HCL	PMS-Venlafaxine XR 150mg ER Cap	PMS	0.1927	0.1927	YES	NO	NO
02278553	VENLAFAXINE HCL	PMS-Venlafaxine XR 75mg ER Cap	PMS	0.1825	0.1825	YES	NO	NO
02278545	VENLAFAXINE HCL	PMS-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
02521466	VENLAFAXINE HCL	PMSC-Venlafaxine XR 37.5mg ER Cap	PMS	0.0913	0.0913	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
02380099	VENLAFAXINE HCL	Taro-Venlafaxine XR 150mg ER Cap	SPC	0.1927	0.1927	YES	NO	NO
02380080	VENLAFAXINE HCL	Taro-Venlafaxine XR 75mg ER Cap	SPC	0.1825	0.1825	YES	NO	NO
02380072	VENLAFAXINE HCL	Taro-Venlafaxine XR 37.5mg ER Cap	SPC	0.0913	0.0913	YES	NO	NO
02275023	VENLAFAXINE HCL	Teva-Venlafaxine XR 37.5mg ER Cap	TEV	0.0913	0.0913	YES	NO	NO
02275058	VENLAFAXINE HCL	Teva-Venlafaxine XR 150mg ER Cap	TEV	0.1927	0.1927	YES	NO	NO
02275031	VENLAFAXINE HCL	Teva-Venlafaxine XR 75mg ER Cap	TEV	0.1825	0.1825	YES	NO	NO
02489678	VENLAFAXINE HCL	Venlafaxine XR 37.5mg ER Cap	RIA	0.0913	0.0913	YES	NO	NO
02489686	VENLAFAXINE HCL	Venlafaxine XR 75mg ER Cap	RIA	0.1825	0.1825	YES	NO	NO
02385945	VENLAFAXINE HCL	Venlafaxine XR 150mg ER Cap	SIV	0.1927	0.1927	YES	NO	NO
02385937	VENLAFAXINE HCL	Venlafaxine XR 75mg ER Cap	SIV	0.1825	0.1825	YES	NO	NO
02385929	VENLAFAXINE HCL	Venlafaxine XR 37.5mg ER Cap	SIV	0.0913	0.0913	YES	NO	NO
02354748	VENLAFAXINE HCL	Venlafaxine XR 150mg ER Cap	SAI	0.1927	0.1927	YES	NO	NO
02489694	VENLAFAXINE HCL	Venlafaxine XR 150mg ER Cap	RIA	0.1927	0.1927	YES	NO	NO
02354713	VENLAFAXINE HCL	Venlafaxine XR 37.5mg ER Cap	SAI	0.0913	0.0913	YES	NO	NO
02354721	VENLAFAXINE HCL	Venlafaxine XR 75mg ER Cap	SAI	0.1825	0.1825	YES	NO	NO
02516543	VENLAFAXINE HCL	Venlafaxine XR 75mg ER Cap	JPC	0.1825	0.1825	YES	NO	NO
02516535	VENLAFAXINE HCL	Venlafaxine XR 37.5mg ER Cap	JPC	0.0913	0.0913	YES	NO	NO
02516551	VENLAFAXINE HCL	Venlafaxine XR 150mg ER Cap	JPC	0.1927	0.1927	YES	NO	NO
02551810	VILAZODONE HYDROCHLORIDE	Apo-Vilazodone (Off-Formulary Interchangeable) 10mg Tab	APX	3.0482	N/A	YES	NO	NO
02551829	VILAZODONE HYDROCHLORIDE	Apo-Vilazodone (Off-Formulary Interchangeable) 20mg 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
02443732	VILAZODONE HYDROCHLORIDE	Viibryd (Off-Formulary Interchangeable) 20mg Tab	ABV	N/A	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
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
02552779	VORTIOXETINE HYDROBROMIDE	Apo-Vortioxetine 20mg Tab	APX	1.8028	1.8028	YES	NO	NO
02432919	VORTIOXETINE HYDROBROMIDE	Trintellix 5mg Tab	VLH	2.8824	1.5853	YES	NO	NO
02432927	VORTIOXETINE HYDROBROMIDE	Trintellix 10mg Tab	VLH	3.0192	1.6606	YES	NO	NO
02432943	VORTIOXETINE HYDROBROMIDE	Trintellix 20mg Tab	VLH	3.2779	1.8028	YES	NO	NO

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