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DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOHLTC PaysInter- change- ableLimited UseThera- peutic Notes
02416255ABACAVIR & LAMIVUDINE & ZIDOVUDINEApo-Abacavir-Lamivudine-Zidovudine 300mg & 150mg & 300mg TabAPX13.642513.6425YESNOYES
02396769ABACAVIR SULFATEApo-Abacavir 300mg TabAPX3.48283.4828YESNOYES
02399539ABACAVIR SULFATE & LAMIVUDINEApo-Abacavir-Lamivudine 600mg & 300mg TabAPX5.98755.9875YESNOYES
02147629ACEBUTOLOL HCLApo-Acebutolol 400mg TabAPX0.24660.2466YESNONO
02147610ACEBUTOLOL HCLApo-Acebutolol 200mg TabAPX0.11770.1177YESNONO
02147602ACEBUTOLOL HCLApo-Acebutolol 100mg TabAPX0.07870.0787YESNONO
02229977ACETAMINOPHENApo-Acetaminophen Caplets 500mgAPX0.02850.0285YESNONO
02229873ACETAMINOPHENApo-Acetaminophen Caplets 325mgAPX0.02450.0245YESNONO
00544981ACETAMINOPHENApo-Acetaminophen Tab 325mgAPX0.02450.0245YESNONO
00545007ACETAMINOPHENApo-Acetaminophen Tab 500mgAPX0.02850.0285YESNONO
02207648ACYCLOVIRApo-Acyclovir 400mg TabAPX1.27001.2700YESNONO
02207621ACYCLOVIRApo-Acyclovir 200mg TabAPX0.63970.6397YESNONO
02207656ACYCLOVIRApo-Acyclovir 800mg TabAPX1.26731.2673YESNONO
02477130ACYCLOVIRApo-Acyclovir Ointment (Off-Formulary Interchangeable) 5% Top OintAPX12.3114N/AYESNONO
02420333ADEFOVIR DIPIVOXILApo-Adefovir (Off-Formulary Interchangeable) 10mg TabAPX20.4400N/AYESNONO
02248728ALENDRONATEApo-Alendronate 10mg TabAPX0.49870.4987YESNONO
02248727ALENDRONATEApo-Alendronate (Off-Formulary Interchangeable) 5mg TabAPX1.0370N/AYESNONO
02248730ALENDRONATEApo-Alendronate 70mg TabAPX2.10142.1014YESNONO
02454475ALENDRONATE & CHOLECALCIFEROLApo-Alendronate/Vitamin D3 70mg & 140mcg TabAPX1.21741.2174YESNONO
02454467ALENDRONATE & CHOLECALCIFEROLApo-Alendronate/Vitamin D3 70mg & 70mcg TabAPX2.43482.4348YESNOYES
02315866ALFUZOSIN HYDROCHLORIDEApo-Alfuzosin 10mg Prolong-Rel TabAPX0.26010.2601YESYESNO
02402777ALLOPURINOLApo-Allopurinol (Not a Benefit) 200mg TabAPXN/AN/AYESNOYES
02402769ALLOPURINOLApo-Allopurinol (Not a Benefit) 100mg TabAPXN/AN/AYESNOYES
02402785ALLOPURINOLApo-Allopurinol (Not a Benefit) 300mg TabAPXN/AN/AYESNOYES
02405792ALMOTRIPTANApo-Almotriptan (Off-Formulary Interchangeable) 6.25mg TabAPX9.78339.7833YESNONO
02405806ALMOTRIPTANApo-Almotriptan (Off-Formulary Interchangeable) 12.5mg TabAPX9.78339.7833YESNONO
00865400ALPRAZOLAMApo-Alpraz 0.5mg TabAPX0.07570.0757YESNONO
00865397ALPRAZOLAMApo-Alpraz 0.25mg TabAPX0.06330.0633YESNONO
02243611ALPRAZOLAMApo-Alpraz (Off-Formulary Interchangeable) 1mg TabAPX0.3099N/AYESNONO
02243612ALPRAZOLAMApo-Alpraz TS (Off-Formulary Interchangeable) 2mg TabAPX0.5508N/AYESNONO
02475383AMBRISENTANApo-Ambrisentan (Off-Formulary Interchangeable) 10mg TabAPX106.3288106.3288YESNONO
02475375AMBRISENTANApo-Ambrisentan (Off-Formulary Interchangeable) 5mg TabAPX106.3288106.3288YESNONO
00784400AMILORIDE HCL & HYDROCHLOROTHIAZIDEApo-Amilzide 5mg & 50mg TabAPX0.08380.0838YESNONO
02246194AMIODARONE HCLApo-Amiodarone 200mg TabAPX0.37060.3706YESNOYES
02273381AMLODIPINEApo-Amlodipine 10mg TabAPX0.19930.1993YESNONO
02273373AMLODIPINEApo-Amlodipine 5mg TabAPX0.13430.1343YESNONO
02411342AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 10mg & 80mg TabAPX0.80000.8000YESNOYES
02411326AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 10mg & 20mg TabAPX0.76360.7636YESNOYES
02411318AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 10mg & 10mg TabAPX0.61250.6125YESNOYES
02411296AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 5mg & 80mg TabAPX0.72320.7232YESNOYES
02411288AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 5mg & 40mg TabAPX0.72320.7232YESNOYES
02411261AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 5mg & 20mg TabAPX0.68420.6842YESNOYES
02411253AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 5mg & 10mg TabAPX0.58020.5802YESNOYES
02411334AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMApo-Amlodipine-Atorvastatin 10mg & 40mg TabAPX0.80000.8000YESNOYES
00628115AMOXICILLINApo-Amoxi 250mg CapAPX0.06720.0672YESNOYES
00628123AMOXICILLINApo-Amoxi 500mg CapAPX0.13080.1308YESNOYES
00628131AMOXICILLINApo-Amoxi 25mg/mL O/LAPX0.03530.0353YESNOYES
00628158AMOXICILLINApo-Amoxi 50mg/mL O/LAPX0.05400.0540YESNOYES
02243986AMOXICILLIN & CLAVULANIC ACIDApo-Amoxi Clav 25mg & 6.25mg/mL O/LAPX0.05170.0517YESNOYES
02243987AMOXICILLIN & CLAVULANIC ACIDApo-Amoxi Clav 50mg & 12.5mg/mL O/LAPX0.18300.1830YESNOYES
02288559AMOXICILLIN & CLAVULANIC ACIDApo-Amoxi Clav (Not a Benefit) 400mg & 57mg/5mL SuspAPXN/AN/AYESNOYES
02245623AMOXICILLIN & CLAVULANIC ACIDApo-Amoxi Clav 875mg & 125mg TabAPX0.55510.5551YESNOYES
02243351AMOXICILLIN & CLAVULANIC ACIDApo-Amoxi Clav 500mg & 125mg TabAPX0.75550.7555YESNOYES
02243350AMOXICILLIN & CLAVULANIC ACIDApo-Amoxi Clav 250mg & 125mg TabAPX0.93750.9375YESNOYES
02374420ANASTROZOLEApo-Anastrozole 1mg TabAPX0.95220.9522YESYESNO
02471086ARIPIPRAZOLEApo-Aripiprazole 2mg TabAPX0.80920.8092YESNOYES
02471124ARIPIPRAZOLEApo-Aripiprazole 20mg TabAPX1.00171.0017YESNOYES
02471116ARIPIPRAZOLEApo-Aripiprazole 15mg TabAPX1.26921.2692YESNOYES
02471108ARIPIPRAZOLEApo-Aripiprazole 10mg TabAPX1.07541.0754YESNOYES
02471094ARIPIPRAZOLEApo-Aripiprazole 5mg TabAPX0.90460.9046YESNOYES
02471132ARIPIPRAZOLEApo-Aripiprazole 30mg TabAPX1.00171.0017YESNOYES
00466611ASCORBIC ACIDApo-C (Not a Benefit) 500mg TabAPXN/AN/AYESNONO
00773689ATENOLOLApo-Atenol 50mg TabAPX0.11070.1107YESNONO
00773697ATENOLOLApo-Atenol 100mg TabAPX0.18210.1821YESNONO
02248763ATENOLOL & CHLORTHALIDONEApo-Atenidone 50 & 25mg TabAPX0.31950.3195YESNONO
02248764ATENOLOL & CHLORTHALIDONEApo-Atenidone 100 & 25mg TabAPX0.52360.5236YESNONO
02318032ATOMOXETINE HCLApo-Atomoxetine 18mg CapAPX0.57480.5748YESNONO
02318024ATOMOXETINE HCLApo-Atomoxetine 10mg CapAPX0.51060.5106YESNONO
02318040ATOMOXETINE HCLApo-Atomoxetine 25mg CapAPX0.64200.6420YESNONO
02318059ATOMOXETINE HCLApo-Atomoxetine 40mg CapAPX0.73690.7369YESNONO
02318067ATOMOXETINE HCLApo-Atomoxetine 60mg CapAPX0.80920.8092YESNONO
02318075ATOMOXETINE HCLApo-Atomoxetine (Off-Formulary Interchangeable) 80mg CapAPX3.9961N/AYESNONO
02318083ATOMOXETINE HCLApo-Atomoxetine (Off-Formulary Interchangeable) 100mg CapAPX4.3521N/AYESNONO
02295318ATORVASTATIN CALCIUMApo-Atorvastatin 80mg TabAPX0.23420.2342YESNONO
02295296ATORVASTATIN CALCIUMApo-Atorvastatin 40mg TabAPX0.23420.2342YESNONO
02295288ATORVASTATIN CALCIUMApo-Atorvastatin 20mg TabAPX0.21790.2179YESNONO
02295261ATORVASTATIN CALCIUMApo-Atorvastatin 10mg TabAPX0.17430.1743YESNONO
02242907AZATHIOPRINEApo-Azathioprine 50mg TabAPX0.24050.2405YESNOYES
02247423AZITHROMYCINApo-Azithromycin 250mg TabAPX0.94100.9410YESNOYES
02415542AZITHROMYCINApo-Azithromycin Z 250mg TabAPX0.94100.9410YESNOYES
02139332BACLOFENApo-Baclofen 10mg TabAPX0.15950.1595YESNOYES
02139391BACLOFENApo-Baclofen 20mg TabAPX0.31040.3104YESNOYES
02296063BICALUTAMIDEApo-Bicalutamide 50mg TabAPX1.26901.2690YESNONO
00545023BISACODYLApo-Bisacodyl 5mg Ent TabAPX0.04500.0450YESNONO
02256134BISOPROLOL FUMARATEApo-Bisoprolol 5mg TabAPX0.07150.0715YESNONO
02256177BISOPROLOL FUMARATEApo-Bisoprolol 10mg TabAPX0.10440.1044YESNONO
02399202BOSENTAN MONOHYDRATEApo-Bosentan (Off-Formulary Interchangeable) 62.5mg TabAPX32.089332.0893YESNONO
02399210BOSENTAN MONOHYDRATEApo-Bosentan (Off-Formulary Interchangeable) 125mg TabAPX32.089332.0893YESNONO
02260077BRIMONIDINEApo-Brimonidine 0.2% Oph SolAPX1.15501.1550YESYESNO
02177153BROMAZEPAMApo-Bromazepam 1.5mg TabAPX0.10280.1028YESNONO
02177161BROMAZEPAMApo-Bromazepam 3mg TabAPX0.07760.0375YESNONO
02177188BROMAZEPAMApo-Bromazepam 6mg TabAPX0.11340.0548YESNONO
02211076BUSPIRONE HYDROCHLORIDEApo-Buspirone (Off-Formulary Interchangeable) 10mg TabAPX0.65210.6521YESNOYES
02455897CABERGOLINEApo-Cabergoline (Off-Formulary Interchangeable) 0.5mg TabAPX14.934514.9345YESNONO
02365340CANDESARTAN CILEXETILApo-Candesartan 4mg TabAPX0.17000.1700YESNONO
02399105CANDESARTAN CILEXETILApo-Candesartan 32mg TabAPX0.22810.2281YESNONO
02365367CANDESARTAN CILEXETILApo-Candesartan 16mg TabAPX0.22810.2281YESNONO
02365359CANDESARTAN CILEXETILApo-Candesartan 8mg TabAPX0.22810.2281YESNONO
02395134CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDEApo-Candesartan/HCTZ 32mg & 25mg TabAPX0.30080.3008YESNONO
02395126CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDEApo-Candesartan/HCTZ 32mg & 12.5mg TabAPX0.21560.2156YESNONO
02367866CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDEApo-Candesartan/HCTZ 16mg & 12.5mg TabAPX0.21560.2156YESNONO
00893617CAPTOPRILApo-Capto 50mg TabAPX0.55900.5590YESNONO
00893625CAPTOPRILApo-Capto 100mg TabAPX1.03951.0395YESNONO
00893609CAPTOPRILApo-Capto 25mg TabAPX0.30000.3000YESNONO
00893595CAPTOPRILApo-Capto 12.5mg TabAPX0.21200.2120YESNONO
02247935CARVEDILOLApo-Carvedilol 12.5mg TabAPX0.24310.2431YESYESNO
02247934CARVEDILOLApo-Carvedilol 6.25mg TabAPX0.24310.2431YESYESNO
02247936CARVEDILOLApo-Carvedilol 25mg TabAPX0.24310.2431YESYESNO
02247933CARVEDILOLApo-Carvedilol 3.125mg TabAPX0.24310.2431YESYESNO
02240774CEFADROXILApo-Cefadroxil 500mg CapAPX0.84210.8421YESNONO
02467518CEFEPIMEApo-Cefepime (Off-Formulary Interchangeable) 2g Inj Pd-Vial PkAPX30.2000N/AYESNONO
02467496CEFEPIMEApo-Cefepime (Off-Formulary Interchangeable) 1g Inj Pd-Vial PkAPX15.1003N/AYESNONO
02319039CEFEPIMECefepime for Injection (Off-Formulary Interchangeable) 2g Inj Pd-Vial PkAPX30.1963N/AYESNONO
02319020CEFEPIMECefepime for Injection (Off-Formulary Interchangeable) 1g Inj Pd-Vial PkAPX12.9360N/AYESNONO
02293005CEFPROZILApo-Cefprozil 500mg TabAPX0.84940.8494YESNONO
02292998CEFPROZILApo-Cefprozil 250mg TabAPX0.43320.4332YESNONO
02292904CEFTRIAXONE DISODIUMCeftriaxone for Injection USP (Off-Formulary Interchangeable) 10g/Vial Inj Pd-1 Vial PkAPX214.2000214.2000YESNONO
02244394CEFUROXIME AXETILApo-Cefuroxime 500mg TabAPX1.43371.4337YESNONO
02244393CEFUROXIME AXETILApo-Cefuroxime 250mg TabAPX0.72370.7237YESNONO
02418940CELECOXIBApo-Celecoxib 200mg CapAPX0.25580.2558YESYESYES
02418932CELECOXIBApo-Celecoxib 100mg CapAPX0.12790.1279YESYESYES
00768723CEPHALEXIN MONOHYDRATEApo-Cephalex 250mg TabAPX0.08660.0866YESNONO
00768715CEPHALEXIN MONOHYDRATEApo-Cephalex 500mg TabAPX0.17310.1731YESNONO
02453363CETIRIZINE HYDROCHLORIDEApo-Cetirizine (Off-Formulary Interchangeable) 20mg TabAPX0.7535N/AYESNONO
02231603CETIRIZINE HYDROCHLORIDEApo-Cetirizine (Off-Formulary Interchangeable) 10mg TabAPX0.4083N/AYESNONO
02298953CICLOPIROXApo-Ciclopirox (Off-Formulary Interchangeable) 8% W/W Top SolAPX7.7433N/AYESNOYES
02291134CILAZAPRILApo-Cilazapril 1mg TabAPX0.31150.3115YESNONO
02291150CILAZAPRILApo-Cilazapril 5mg TabAPX0.49890.4989YESNONO
02291142CILAZAPRILApo-Cilazapril 2.5mg TabAPX0.42950.4295YESNONO
02284987CILAZAPRIL & HYDROCHLOROTHIAZIDEApo-Cilazapril/HCTZ 5mg/12.5mg TabAPX0.41700.4170YESNONO
00749494CIMETIDINEApo-Cimetidine 800mg TabAPX0.25300.2530YESNOYES
00600059CIMETIDINEApo-Cimetidine 400mg TabAPX0.29300.2930YESNOYES
00487872CIMETIDINEApo-Cimetidine 300mg TabAPX0.34230.3423YESNOYES
00600067CIMETIDINEApo-Cimetidine 600mg TabAPX0.34050.3405YESNOYES
00584215CIMETIDINEApo-Cimetidine 200mg TabAPX0.32840.3284YESNOYES
02452715CINACALCETApo-Cinacalcet (Off-Formulary Interchangeable) 90mg TabAPX27.051727.0517YESNONO
02452693CINACALCETApo-Cinacalcet (Off-Formulary Interchangeable) 30mg TabAPX10.194710.1947YESNONO
02452707CINACALCETApo-Cinacalcet (Off-Formulary Interchangeable) 60mg TabAPX18.590018.5900YESNONO
02263130CIPROFLOXACINApo-Ciproflox (Off-Formulary Interchangeable) 0.3% Oph Sol-5mL PkAPX1.7600N/AYESNOYES
02229523CIPROFLOXACINApo-Ciproflox 750mg TabAPX0.92010.9201YESNOYES
02229522CIPROFLOXACINApo-Ciproflox 500mg TabAPX0.50250.5025YESNOYES
02229521CIPROFLOXACINApo-Ciproflox 250mg TabAPX0.44540.4454YESNOYES
02246057CITALOPRAM HYDROBROMIDEApo-Citalopram 40mg TabAPX0.13320.1332YESNONO
02246056CITALOPRAM HYDROBROMIDEApo-Citalopram 20mg TabAPX0.13320.1332YESNONO
02413345CLARITHROMYCINApo-Clarithromycin XL 500mg ER TabAPX1.25721.2572YESNOYES
02274752CLARITHROMYCINApo-Clarithromycin (Off-Formulary Interchangeable) 500mg TabAPX2.2009N/AYESNOYES
02274744CLARITHROMYCINApo-Clarithromycin 250mg TabAPX0.41220.4122YESNOYES
02245233CLINDAMYCIN HCLApo-Clindamycin 300mg CapAPX0.44340.4434YESNONO
02245232CLINDAMYCIN HCLApo-Clindamycin 150mg CapAPX0.22170.2217YESNONO
02244638CLOBAZAMApo-Clobazam 10mg TabAPX0.21970.1098YESYESNO
02475162CLOBETASOL PROPIONATEApo-Clobetasol Spray (Off-Formulary Interchangeable) 0.05% w/w Top Sol Sp-59mL PkAPX113.6300N/AYESNOYES
02177889CLONAZEPAMApo-Clonazepam 0.5mg TabAPX0.04180.0418YESNONO
02177897CLONAZEPAMApo-Clonazepam 2mg TabAPX0.07210.0721YESNONO
02398591CLOPIDOGREL BISULFATEApo-Clopidogrel (Off-Formulary Interchangeable) 300mg TabAPX9.5447N/AYESNONO
02252767CLOPIDOGREL BISULFATEApo-Clopidogrel 75mg TabAPX0.26310.2631YESNONO
02177145CYCLOBENZAPRINE HCLApo-Cyclobenzaprine (Not a Benefit) 10mg TabAPXN/AN/AYESNOYES
02244324CYCLOSPORINEApo-Cyclosporine Oral Solution 100mg/mL O/LAPX3.77073.7707YESYESNO
02468913DABIGATRAN ETEXILATEApo-Dabigatran 150mg CapAPX1.25401.2540YESYESNO
02468905DABIGATRAN ETEXILATEApo-Dabigatran 110mg CapAPX1.25401.2540YESYESNO
02485281DEFERASIROXApo-Deferasirox (Type J) (Off-Formulary Interchangeable) 360mg TabAPX37.037137.0371YESNONO
02485273DEFERASIROXApo-Deferasirox (Type J) (Off-Formulary Interchangeable) 180mg TabAPX18.517318.5173YESNONO
02485265DEFERASIROXApo-Deferasirox (Type J) (Off-Formulary Interchangeable) 90mg TabAPX9.25829.2582YESNONO
02461560DEFERASIROXApo-Deferasirox (Off-Formulary Interchangeable) 500mg Tab for SuspAPX36.890936.8909YESNONO
02461544DEFERASIROXApo-Deferasirox (Off-Formulary Interchangeable) 125mg Tab for SuspAPX9.22289.2228YESNONO
02461552DEFERASIROXApo-Deferasirox (Off-Formulary Interchangeable) 250mg Tab for SuspAPX18.445318.4453YESNONO
02410249DESOGESTREL & ETHINYL ESTRADIOLMirvala 21 0.15mg & 0.03mg Tab-21 PkAPX7.77007.7700YESNONO
02410257DESOGESTREL & ETHINYL ESTRADIOLMirvala 28 0.15mg & 0.03mg Tab-28 PkAPX7.77007.7700YESNONO
02466988DESVENLAFAXINEApo-Desvenlafaxine (Off-Formulary Interchangeable) 50mg ER TabAPX2.3409N/AYESNONO
02466996DESVENLAFAXINEApo-Desvenlafaxine (Off-Formulary Interchangeable) 100mg ER TabAPX2.3409N/AYESNONO
02261081DEXAMETHASONEApo-Dexamethasone 0.5mg TabAPX0.15640.1564YESNONO
02250055DEXAMETHASONEApo-Dexamethasone 4mg TabAPX0.30460.3046YESNONO
00362158DIAZEPAMApo-Diazepam 5mg TabAPX0.06500.0650YESNONO
00405337DIAZEPAMApo-Diazepam 10mg TabAPX0.08670.0867YESNONO
00405329DIAZEPAMApo-Diazepam 2mg TabAPX0.05320.0532YESNONO
02243433DICLOFENAC POTASSIUMApo-Diclo Rapide (Off-Formulary Interchangeable) 50mg TabAPX0.3937N/AYESNOYES
00839183DICLOFENAC SODIUMApo-Diclo 50mg Ent TabAPX0.20640.2064YESNOYES
00839175DICLOFENAC SODIUMApo-Diclo 25mg Ent TabAPX0.07810.0781YESNOYES
02091194DICLOFENAC SODIUMApo-Diclo SR 100mg LA TabAPX0.40480.4048YESNOYES
02162814DICLOFENAC SODIUMApo-Diclo SR 75mg LA TabAPX0.24330.2433YESNOYES
02441020DICLOFENAC SODIUMApo-Diclofenac Ophthalmic 0.1% Oph SolAPX1.77101.7710YESNONO
02281228DIGOXINApo-Digoxin (Not a Benefit) 0.125mg TabAPXN/AN/AYESNOYES
02281201DIGOXINApo-Digoxin (Not a Benefit) 0.25mg TabAPXN/AN/AYESNOYES
02230997DILTIAZEM HCLApo-Diltiaz CD 120mg LA CapAPX0.36340.3634YESNONO
02230998DILTIAZEM HCLApo-Diltiaz CD 180mg LA CapAPX0.48240.4824YESNONO
02229526DILTIAZEM HCLApo-Diltiaz CD 300mg LA CapAPX0.79990.7999YESNONO
02230999DILTIAZEM HCLApo-Diltiaz CD 240mg LA CapAPX0.63990.6399YESNONO
00771376DILTIAZEM HCLApo-Diltiaz 30mg TabAPX0.18660.1866YESNONO
00771384DILTIAZEM HCLApo-Diltiaz 60mg TabAPX0.32730.3273YESNONO
00363766DIMENHYDRINATEApo-Dimenhydrinate (Not a Benefit) 50mg TabAPXN/AN/AYESNONO
00895644DIPYRIDAMOLEApo-Dipyridamole (Off-Formulary Interchangeable) 25mg TabAPX0.2633N/AYESNONO
00895652DIPYRIDAMOLEApo-Dipyridamole (Off-Formulary Interchangeable) 50mg TabAPX0.36850.3685YESNONO
00895660DIPYRIDAMOLEApo-Dipyridamole (Off-Formulary Interchangeable) 75mg TabAPX0.4963N/AYESNONO
02239700DIVALPROEX SODIUMApo-Divalproex 500mg Ent TabAPX0.26040.2604YESNONO
02239699DIVALPROEX SODIUMApo-Divalproex 250mg Ent TabAPX0.13010.1301YESNONO
02239698DIVALPROEX SODIUMApo-Divalproex 125mg Ent TabAPX0.07240.0724YESNONO
02103613DOMPERIDONE MALEATEApo-Domperidone 10mg TabAPX0.04280.0428YESNONO
02362279DONEPEZIL HCLApo-Donepezil 10mg TabAPX0.45860.4586YESYESNO
02362260DONEPEZIL HCLApo-Donepezil 5mg TabAPX0.45860.4586YESYESNO
02299615DORZOLAMIDE HCL & TIMOLOL MALEATEApo-Dorzo-Timop 2% & 0.5% Oph SolAPX4.26152.0951YESYESNO
02240590DOXAZOSIN MESYLATEApo-Doxazosin 4mg TabAPX0.53610.5361YESNONO
02240589DOXAZOSIN MESYLATEApo-Doxazosin 2mg TabAPX0.41230.4123YESNONO
02240588DOXAZOSIN MESYLATEApo-Doxazosin 1mg TabAPX0.34370.3437YESNONO
00874256DOXYCYCLINE HYCLATEApo-Doxy-Tabs 100mg TabAPX0.58600.5860YESNONO
02413248DOXYLAMINE SUCCINATE AND PYRIDOXINE HCLApo-Doxylamine/B6 10mg & 10mg SR TabAPX0.64020.6402YESNONO
02440423DULOXETINEApo-Duloxetine 30mg DR CapAPX0.48140.4814YESNONO
02440431DULOXETINEApo-Duloxetine 60mg DR CapAPX0.97690.9769YESNONO
02404206DUTASTERIDEApo-Dutasteride 0.5mg CapAPX0.30270.3027YESYESNO
02468247EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINEApo-Efavirenz-Emtricitabine-Tenofovir 600mg/300mg/200mg TabAPX11.330011.3300YESNOYES
02386062ELETRIPTANApo-Eletriptan (Off-Formulary Interchangeable) 40mg TabAPX10.0850N/AYESNONO
02386054ELETRIPTANApo-Eletriptan (Off-Formulary Interchangeable) 20mg TabAPX10.0850N/AYESNONO
02452006EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATEApo-Emtricitabine-Tenofovir 200mg & 300mg TabAPX7.30357.3035YESNOYES
02019906ENALAPRIL MALEATEApo-Enalapril 20mg TabAPX0.31950.3195YESNONO
02019892ENALAPRIL MALEATEApo-Enalapril 10mg TabAPX0.26470.2647YESNONO
02019884ENALAPRIL MALEATEApo-Enalapril 5mg TabAPX0.22030.2203YESNONO
02020025ENALAPRIL MALEATEApo-Enalapril 2.5mg TabAPX0.18630.1863YESNONO
02321459ENTACAPONEApo-Entacapone 200mg TabAPX0.40100.4010YESYESNO
02396955ENTECAVIRApo-Entecavir 0.5mg TabAPX5.50005.5000YESYESNO
02461870ERLOTINIBApo-Erlotinib (Off-Formulary Interchangeable) 100mg TabAPX47.466747.4667YESNONO
02461889ERLOTINIBApo-Erlotinib (Off-Formulary Interchangeable) 150mg TabAPX71.200071.2000YESNONO
02461862ERLOTINIBApo-Erlotinib (Off-Formulary Interchangeable) 25mg TabAPX11.866711.8667YESNONO
00726672ERYTHROMYCIN BASEApo-Erythro E-C (Not a Benefit) 250mg Ent Pel CapAPXN/AN/AYESNOYES
02295024ESCITALOPRAMApo-Escitalopram 20mg TabAPX0.33100.3310YESNONO
02295016ESCITALOPRAMApo-Escitalopram 10mg TabAPX0.31090.3109YESNONO
02339102ESOMEPRAZOLEApo-Esomeprazole DR Tab (Off-Formulary Interchangeable) 40mgAPX1.8690N/AYESNONO
02339099ESOMEPRAZOLEApo-Esomeprazole (Off-Formulary Interchangeable) 20mg DR TabAPX1.8690N/AYESNONO
02387875ETHINYL ESTRADIOL & LEVONORGESTRELAlysena 21 20mcg & 100mcg Tab-21 PkAPX9.74009.7400YESNONO
02387085ETHINYL ESTRADIOL & LEVONORGESTRELOvima 21 0.03mg & 0.15mg Tab-21 PkAPX7.28007.2800YESNONO
02387883ETHINYL ESTRADIOL & LEVONORGESTRELAlysena 28 20mcg & 100mcg Tab-28 PkAPX9.74009.7400YESNONO
02387093ETHINYL ESTRADIOL & LEVONORGESTRELOvima 28 0.03mg & 0.15mg Tab-28 PkAPX7.28007.2800YESNONO
02232318ETODOLACApo-Etodolac (Off-Formulary Interchangeable) 300mg CapAPX0.7600N/AYESNOYES
02232317ETODOLACApo-Etodolac (Off-Formulary Interchangeable) 200mg CapAPX0.7600N/AYESNOYES
02419726EXEMESTANEApo-Exemestane 25mg TabAPX1.32631.3263YESYESNO
02427826EZETIMIBEApo-Ezetimibe 10mg TabAPX0.18110.1811YESYESNO
02292068FAMCICLOVIRApo-Famciclovir 500mg TabAPX1.34361.3436YESYESNO
02292025FAMCICLOVIRApo-Famciclovir (Off-Formulary Interchangeable) 125mg TabAPX2.02402.0240YESNONO
02292041FAMCICLOVIRApo-Famciclovir (Off-Formulary Interchangeable) 250mg TabAPX2.72002.7200YESNONO
01953834FAMOTIDINEApo-Famotidine 40mg TabAPX0.48340.4834YESNOYES
01953842FAMOTIDINEApo-Famotidine 20mg TabAPX0.26580.2658YESNOYES
02452367FELODIPINEApo-Felodipine 2.5mg ER TabAPX0.40500.4050YESNOYES
02452375FELODIPINEApo-Felodipine 5mg ER TabAPX0.35650.3565YESNOYES
02452383FELODIPINEApo-Felodipine 10mg ER TabAPX0.53500.5350YESNOYES
02239864FENOFIBRATEApo-Feno-Micro 200mg CapAPX0.27230.2723YESNONO
02243180FENOFIBRATEApo-Feno-Micro (Off-Formulary Interchangeable) 67mg CapAPX0.5479N/AYESNONO
02225980FENOFIBRATEApo-Fenofibrate 100mg CapAPX0.61050.6105YESNONO
02246860FENOFIBRATEApo-Feno-Super 160mg TabAPX0.31160.3116YESNONO
02246859FENOFIBRATEApo-Feno-Super (Off-Formulary Interchangeable) 100mg TabAPX0.7875N/AYESNONO
02314657FENTANYL TRANSDERMAL SYSTEMApo-Fentanyl Matrix (Off-Formulary Interchangeable) 75mcg/hr Trans PatchAPX9.6817N/AYESNOYES
02314665FENTANYL TRANSDERMAL SYSTEMApo-Fentanyl Matrix (Off-Formulary Interchangeable) 100mcg/hr Trans PatchAPX12.0512N/AYESNOYES
02314649FENTANYL TRANSDERMAL SYSTEMApo-Fentanyl Matrix 50mcg/hr Trans PatchAPX6.88386.8838YESYESYES
02314630FENTANYL TRANSDERMAL SYSTEMApo-Fentanyl Matrix 25mcg/hr Trans PatchAPX3.65823.6582YESYESYES
02441489FILGRASTIMGrastofil 300mcg/0.5mL Pref Syr-0.5mL PkAPX144.3135144.3135NONONO
02454548FILGRASTIMGrastofil 480mcg/0.8mL Pref Syr-0.8mL PkAPX230.9017230.9017NONONO
02365383FINASTERIDEApo-Finasteride 5mg TabAPX0.41380.4138YESYESNO
02244842FLAVOXATE HCLApo-Flavoxate (Not a Benefit) 200mg TabAPXN/AN/AYESNONO
02275538FLECAINIDE ACETATEApo-Flecainide 50mg TabAPX0.27780.2778YESNONO
02275546FLECAINIDE ACETATEApo-Flecainide 100mg TabAPX0.55580.5558YESNONO
02241895FLUCONAZOLEApo-Fluconazole-150 150mg CapAPX3.94243.9424YESYESYES
02237370FLUCONAZOLEApo-Fluconazole 50mg TabAPX1.29041.2904YESNONO
02237371FLUCONAZOLEApo-Fluconazole 100mg TabAPX2.28912.2891YESNONO
02239288FLUNISOLIDEApo-Flunisolide 0.025% Nas Sp-25mL PkAPX18.810018.8100YESNOYES
02216353FLUOXETINE HCLApo-Fluoxetine (Off-Formulary Interchangeable) 10mg CapAPX1.1773N/AYESNOYES
02216361FLUOXETINE HCLApo-Fluoxetine 20mg CapAPX0.33110.3311YESNOYES
02231328FLUOXETINE HCLApo-Fluoxetine 20mg/5mL Oral SolAPX0.30840.3084YESNOYES
00405345FLUPHENAZINE HCLApo-Fluphenazine 1mg TabAPX0.17390.1739YESNONO
00410632FLUPHENAZINE HCLApo-Fluphenazine 2mg TabAPX0.22520.2252YESNONO
00405361FLUPHENAZINE HCLApo-Fluphenazine 5mg TabAPX0.17200.1720YESNONO
00521701FLURAZEPAMApo-Flurazepam 30mg CapAPX0.13640.1364YESNOYES
00521698FLURAZEPAMApo-Flurazepam 15mg CapAPX0.11660.1166YESNOYES
01912046FLURBIPROFENApo-Flurbiprofen 50mg TabAPX0.22210.2221YESNOYES
01912038FLURBIPROFENApo-Flurbiprofen 100mg TabAPX0.30390.3039YESNOYES
02238560FLUTAMIDEApo-Flutamide 250mg TabAPX1.82551.8255YESNONO
02294745FLUTICASONE PROPIONATEApo-Fluticasone (Off-Formulary Interchangeable) 50mcg/Actuation Nas Sp-120 Dose PkAPX21.9700N/AYESNOYES
02231330FLUVOXAMINE MALEATEApo-Fluvoxamine 100mg TabAPX0.37830.3783YESNOYES
02231329FLUVOXAMINE MALEATEApo-Fluvoxamine 50mg TabAPX0.21050.2105YESNOYES
02266016FOSINOPRIL SODIUMApo-Fosinopril 20mg TabAPX0.26190.2619YESNONO
02266008FOSINOPRIL SODIUMApo-Fosinopril 10mg TabAPX0.21780.2178YESNONO
02426471FROVATRIPTAN SUCCINATEApo-Frovatriptan (Off-Formulary Interchangeable) 2.5mg TabAPX12.5033N/AYESNONO
00362166FUROSEMIDEApo-Furosemide 40mg TabAPX0.03270.0327YESNONO
00396788FUROSEMIDEApo-Furosemide 20mg TabAPX0.02190.0219YESNONO
02244306GABAPENTINApo-Gabapentin 400mg CapAPX0.12060.1206YESNONO
02244305GABAPENTINApo-Gabapentin 300mg CapAPX0.10120.1012YESNONO
02244304GABAPENTINApo-Gabapentin 100mg CapAPX0.04160.0416YESNONO
02293358GABAPENTINApo-Gabapentin (Off-Formulary Interchangeable) 600mg TabAPX1.3045N/AYESNONO
02293366GABAPENTINApo-Gabapentin (Off-Formulary Interchangeable) 800mg TabAPX1.7393N/AYESNONO
02468050GEFITINIBApo-Gefitinib (Off-Formulary Interchangeable) 250mg TabAPX62.305062.3050YESNONO
01979574GEMFIBROZILApo-Gemfibrozil 300mg CapAPX0.13400.1340YESNONO
01979582GEMFIBROZILApo-Gemfibrozil (Off-Formulary Interchangeable) 600mg TabAPX0.7520N/AYESNONO
02407124GLICLAZIDEApo-Gliclazide MR 60mg ER TabAPX0.06320.0632YESNONO
02297795GLICLAZIDEApo-Gliclazide MR 30mg SR TabAPX0.09310.0931YESNONO
02245247GLICLAZIDEApo-Gliclazide 80mg TabAPX0.09310.0931YESNONO
02295377GLIMEPIRIDEApo-Glimepiride (Off-Formulary Interchangeable) 1mg TabAPX0.4900N/AYESNONO
02295385GLIMEPIRIDEApo-Glimepiride (Off-Formulary Interchangeable) 2mg TabAPX0.4900N/AYESNONO
02295393GLIMEPIRIDEApo-Glimepiride (Off-Formulary Interchangeable) 4mg TabAPX0.4900N/AYESNONO
01913654GLYBURIDEApo-Glyburide 2.5mg TabAPX0.03210.0321YESNONO
01913662GLYBURIDEApo-Glyburide 5mg TabAPX0.05740.0574YESNONO
02308894GRANISETRON HCLApo-Granisetron 1mg TabAPX9.00009.0000YESYESNO
00701130HEXAVITAMINS USPApo-Hexa (Not a Benefit) TabAPXN/AN/AYESNONO
00441635HYDRALAZINE HCLApo-Hydralazine 50mg TabAPX0.09560.0956YESNONO
00441627HYDRALAZINE HCLApo-Hydralazine 25mg TabAPX0.06090.0609YESNONO
00441619HYDRALAZINE HCLApo-Hydralazine 10mg TabAPX0.03550.0355YESNONO
02327856HYDROCHLOROTHIAZIDEApo-Hydro (Off-Formulary Interchangeable) 12.5mg TabAPX0.0322N/AYESNONO
00326844HYDROCHLOROTHIAZIDEApo-Hydro 25 25mg TabAPX0.01570.0157YESNONO
00312800HYDROCHLOROTHIAZIDEApo-Hydro 50 50mg TabAPX0.02170.0217YESNONO
00441775HYDROCHLOROTHIAZIDE & TRIAMTERENEApo-Triazide 25mg & 50mg TabAPX0.06080.0608YESNONO
02476681HYDROMORPHONE HCLApo-HYDROmorphone CR (Off-Formulary Interchangeable) 30mg CR CapAPX3.92533.9253YESNOYES
02476665HYDROMORPHONE HCLApo-HYDROmorphone CR 18mg CR CapAPX2.25902.2590YESNOYES
02476657HYDROMORPHONE HCLApo-HYDROmorphone CR 12mg CR CapAPX1.56531.5653YESNOYES
02476630HYDROMORPHONE HCLApo-HYDROmorphone CR 6mg CR CapAPX0.90300.9030YESNOYES
02476614HYDROMORPHONE HCLApo-HYDROmorphone CR 3mg CR CapAPX0.60230.6023YESNOYES
02476649HYDROMORPHONE HCLApo-HYDROmorphone CR 9mg CR CapAPX1.19251.1925YESNOYES
02476622HYDROMORPHONE HCLApo-HYDROmorphone CR 4.5mg CR CapAPX0.72750.7275YESNOYES
02476673HYDROMORPHONE HCLApo-HYDROmorphone CR (Off-Formulary Interchangeable) 24mg CR CapAPX3.27683.2768YESNOYES
02364158HYDROMORPHONE HCLApo-Hydromorphone 8mg TabAPX0.35280.3528YESNOYES
02364123HYDROMORPHONE HCLApo-Hydromorphone 2mg TabAPX0.14170.1417YESNOYES
02364115HYDROMORPHONE HCLApo-Hydromorphone 1mg TabAPX0.09590.0959YESNOYES
02364131HYDROMORPHONE HCLApo-Hydromorphone 4mg TabAPX0.22400.2240YESNOYES
02246691HYDROXYCHLOROQUINE SULFATEApo-Hydroxyquine 200mg TabAPX0.15760.1576YESNONO
00646059HYDROXYZINE HCLApo-Hydroxyzine (Not a Benefit) 10mg CapAPXN/AN/AYESNONO
00646024HYDROXYZINE HCLApo-Hydroxyzine (Not a Benefit) 25mg CapAPXN/AN/AYESNONO
00646016HYDROXYZINE HCLApo-Hydroxyzine (Not a Benefit) 50mg CapAPXN/AN/AYESNONO
00585114IBUPROFENApo-Ibuprofen 600mg TabAPX0.13130.1313YESNOYES
00506052IBUPROFENApo-Ibuprofen 400mg TabAPX0.09360.0468YESNOYES
00441651IBUPROFENApo-Ibuprofen 300mg TabAPX0.13770.1377YESNOYES
00441643IBUPROFENApo-Ibuprofen 200mg TabAPX0.05100.0510YESNOYES
02355337IMATINIB MESYLATEApo-Imatinib 100mg TabAPX5.20795.2079YESNOYES
02355345IMATINIB MESYLATEApo-Imatinib 400mg TabAPX20.831420.8314YESNOYES
02407825IMIQUIMODApo-Imiquimod (Off-Formulary Interchangeable) 5% Top Cr 250mg-UD PkAPX11.030011.0300YESNONO
02223678INDAPAMIDEApo-Indapamide 2.5mg TabAPX0.11820.1182YESNONO
02245246INDAPAMIDEApo-Indapamide 1.25mg TabAPX0.07450.0745YESNONO
02126222IPRATROPIUM BROMIDEApo-Ipravent Inhalation Solution 250mcg/mL Inh Sol-20mL PkAPX6.31406.3140YESYESNO
02246084IPRATROPIUM BROMIDEApo-Ipravent (Off-Formulary Interchangeable) 0.06% Nasal SprayAPX1.7387N/AYESNONO
02386976IRBESARTANApo-Irbesartan 150mg TabAPX0.22810.2281YESNONO
02386984IRBESARTANApo-Irbesartan 300mg TabAPX0.22810.2281YESNONO
02386968IRBESARTANApo-Irbesartan 75mg TabAPX0.22810.2281YESNONO
02387662IRBESARTAN & HYDROCHLOROTHIAZIDEApo-Irbesartan/HCTZ 300mg & 25mg TabAPX0.21840.2184YESNONO
02387654IRBESARTAN & HYDROCHLOROTHIAZIDEApo-Irbesartan/HCTZ 300mg & 12.5mg TabAPX0.22810.2281YESNONO
02387646IRBESARTAN & HYDROCHLOROTHIAZIDEApo-Irbesartan/HCTZ 150mg & 12.5mg TabAPX0.22810.2281YESNONO
02272830ISOSORBIDE-5-MONONITRATEApo-ISMN (Off-Formulary Interchangeable) 60mg ER TabAPX0.49500.4950YESNONO
02237235KETOCONAZOLEApo-Ketoconazole 200mg TabAPX0.93930.9393YESNOYES
02229080KETOROLAC TROMETHAMINEApo-Ketorolac (Off-Formulary Interchangeable) 10mg TabAPX0.6028N/AYESNOYES
02242814LACTULOSEApo-Lactulose Solution 667mg/mL O/LAPX0.01450.0145YESNONO
02369060LAMIVUDINEApo-Lamivudine 300mg TabAPX7.25387.2538YESNOYES
02369052LAMIVUDINEApo-Lamivudine 150mg TabAPX3.62693.6269YESNOYES
02393239LAMIVUDINEApo-Lamivudine HBV 100mg TabAPX3.53163.5316YESYESNO
02375540LAMIVUDINE & ZIDOVUDINEApo-Lamivudine-Zidovudine 150mg & 300mg TabAPX2.61032.6103YESNOYES
02245208LAMOTRIGINEApo-Lamotrigine 25mg TabAPX0.06980.0698YESNONO
02245210LAMOTRIGINEApo-Lamotrigine 150mg TabAPX0.41070.4107YESNONO
02245209LAMOTRIGINEApo-Lamotrigine 100mg TabAPX0.27870.2787YESNONO
02293811LANSOPRAZOLEApo-Lansoprazole 15mg DR CapAPX0.50000.5000YESYESNO
02293838LANSOPRAZOLEApo-Lansoprazole 30mg DR CapAPX0.50000.5000YESYESNO
02470780LANSOPRAZOLE & CLARITHROMYCIN & AMOXICILLINApoLansoprazoleAmoxicillinClarithromycin 30mg & 500mg & 500mg Tab/Cap PkAPX67.910067.9100YESYESNO
02296527LATANOPROSTApo-Latanoprost 0.005% Oph Sol-2.5mL PkAPX9.58309.5830YESYESNO
02414155LATANOPROST & TIMOLOL MALEATEApo-Latanoprost-Timop 50mcg/mL & 5mg/mL Oph Sol-2.5mL PkAPX11.070011.0700YESYESNO
02256509LEFLUNOMIDEApo-Leflunomide 20mg TabAPX2.64332.6433YESNONO
02256495LEFLUNOMIDEApo-Leflunomide 10mg TabAPX2.64332.6433YESNONO
02358514LETROZOLEApo-Letrozole 2.5mg TabAPX1.37801.3780YESYESNO
02285924LEVETIRACETAMApo-Levetiracetam 250mg TabAPX0.32100.3210YESYESNO
02285932LEVETIRACETAMApo-Levetiracetam 500mg TabAPX0.39110.3911YESYESNO
02285940LEVETIRACETAMApo-Levetiracetam 750mg TabAPX0.54160.5416YESYESNO
02272873LEVODOPA & CARBIDOPAApo-Levocarb CR 100mg & 25mg CR TabAPX0.38570.3857YESYESNO
02245211LEVODOPA & CARBIDOPAApo-Levocarb CR 200mg & 50mg CR TabAPX0.71150.7115YESYESNO
02195933LEVODOPA & CARBIDOPAApo-Levocarb 100mg & 10mg TabAPX0.14790.1479YESNONO
02195968LEVODOPA & CARBIDOPAApo-Levocarb 250mg & 25mg TabAPX0.24660.2466YESNONO
02195941LEVODOPA & CARBIDOPAApo-Levocarb 100mg & 25mg TabAPX0.22090.2209YESNONO
02284715LEVOFLOXACINApo-Levofloxacin 500mg TabAPX1.37181.3718YESNONO
02325942LEVOFLOXACINApo-Levofloxacin (Off-Formulary Interchangeable) 750mg TabAPX6.5484N/AYESNONO
02284707LEVOFLOXACINApo-Levofloxacin 250mg TabAPX1.20381.2038YESNONO
02433532LEVONORGESTRELBackup Plan Onestep 1.5mg Tab-1 Tab PkAPX8.60008.6000YESNONO
02426552LINEZOLIDApo-Linezolid 600mg TabAPX38.608338.6083YESYESNO
09853685LISINOPRILApo-Lisinopril 5mg TabAPX0.14280.1428YESNONO
09854010LISINOPRILApo-Lisinopril 20mg TabAPX0.20630.2063YESNONO
09853960LISINOPRILApo-Lisinopril 10mg TabAPX0.17160.1716YESNONO
02217481LISINOPRILApo-Lisinopril 5mg TabAPX0.13470.1347YESNONO
02217503LISINOPRILApo-Lisinopril 10mg TabAPX0.16190.1619YESNONO
02217511LISINOPRILApo-Lisinopril 20mg TabAPX0.19450.1945YESNONO
02242837LITHIUM CARBONATEApo-Lithium Carbonate 150mg CapAPX0.06670.0667YESNONO
02242838LITHIUM CARBONATEApo-Lithium Carbonate 300mg CapAPX0.06570.0657YESNONO
09857540LITHIUM CARBONATEApo-Lithium Carbonate 300mg CapAPX0.06570.0657YESNONO
09857532LITHIUM CARBONATEApo-Lithium Carbonate 150mg CapAPX0.06670.0667YESNONO
02212005LOPERAMIDE HCLApo-Loperamide 2mg CapletAPX0.09520.0952YESYESNO
02243880LORATADINEApo-Loratadine (Off-Formulary Interchangeable) 10mg TabAPX0.62670.6267YESNONO
00655767LORAZEPAMApo-Lorazepam 2mg TabAPX0.06990.0699YESNONO
00655740LORAZEPAMApo-Lorazepam 0.5mg TabAPX0.03590.0359YESNONO
00655759LORAZEPAMApo-Lorazepam 1mg TabAPX0.04470.0447YESNONO
02353512LOSARTAN POTASSIUMApo-Losartan 100mg TabAPX0.31480.3147YESNONO
02353504LOSARTAN POTASSIUMApo-Losartan 50mg TabAPX0.31480.3147YESNONO
02379058LOSARTAN POTASSIUMApo-Losartan 25mg TabAPX0.31480.3147YESNONO
02371251LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDEApo-Losartan/HCTZ 100mg & 25mg TabAPX0.31480.3147YESNONO
02371243LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDEApo-Losartan/HCTZ 100mg & 12.5mg TabAPX0.30820.3082YESNONO
02371235LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDEApo-Losartan/HCTZ 50mg & 12.5mg TabAPX0.31480.3147YESNONO
02220172LOVASTATINApo-Lovastatin 20mg TabAPX0.49190.4919YESNONO
02220180LOVASTATINApo-Lovastatin 40mg TabAPX0.89850.8985YESNONO
02244726MEDROXYPROGESTERONE ACETATEApo-Medroxy 2.5mg TabAPX0.04160.0416YESNONO
02267640MEDROXYPROGESTERONE ACETATEApo-Medroxy 100mg TabAPX1.20571.2057YESNONO
02277298MEDROXYPROGESTERONE ACETATEApo-Medroxy 10mg TabAPX0.16700.1670YESNONO
02244727MEDROXYPROGESTERONE ACETATEApo-Medroxy 5mg TabAPX0.08230.0823YESNONO
02248973MELOXICAMApo-Meloxicam 7.5mg TabAPX0.20030.2003YESNOYES
02248974MELOXICAMApo-Meloxicam 15mg TabAPX0.23110.2311YESNOYES
02366487MEMANTINE HCLApo-Memantine (Off-Formulary Interchangeable) 10mg TabAPX1.6357N/AYESNONO
02460653METFORMIN HCLApo-Metformin ER (Off-Formulary Interchangeable) 1000mg ER TabAPX1.0153N/AYESNONO
02305062METFORMIN HCLApo-Metformin ER (Off-Formulary Interchangeable) 500mg ER TabAPX0.5158N/AYESNONO
02167786METFORMIN HCLApo-Metformin 500mg TabAPX0.02470.0247YESNONO
02229785METFORMIN HCLApo-Metformin (Off-Formulary Interchangeable) 850mg TabAPX0.2090N/AYESNONO
02182963METHOTREXATEApo-Methotrexate 2.5mg TabAPX0.63250.6325YESNONO
02266687METHYLPHENIDATE HCLApo-Methylphenidate SR 20mg ER TabAPX0.28200.2820YESNOYES
02452731METHYLPHENIDATE HCLApo-Methylphenidate ER 18mg SR TabAPX0.52460.5246YESNOYES
02330377METHYLPHENIDATE HCLApo-Methylphenidate ER 54mg SR TabAPX0.84790.8479YESNOYES
02452766METHYLPHENIDATE HCLApo-Methylphenidate ER 36mg SR TabAPX0.68630.6863YESNOYES
02452758METHYLPHENIDATE HCLApo-Methylphenidate ER 27mg SR TabAPX0.60550.6055YESNOYES
02249324METHYLPHENIDATE HCLApo-Methylphenidate 10mg TabAPX0.08160.0816YESNOYES
02249332METHYLPHENIDATE HCLApo-Methylphenidate (Off-Formulary Interchangeable) 20mg TabAPX0.3536N/AYESNOYES
02285169METOPROLOL TARTRATEApo-Metoprolol SR 100mg LA TabAPX0.14150.1415YESNONO
02285177METOPROLOL TARTRATEApo-Metoprolol SR 200mg LA TabAPX0.25680.2568YESNONO
00618632METOPROLOL TARTRATEApo-Metoprolol 50mg TabAPX0.06240.0624YESNONO
00618640METOPROLOL TARTRATEApo-Metoprolol 100mg TabAPX0.13610.1361YESNONO
00751170METOPROLOL TARTRATEApo-Metoprolol (Type L) 100mg TabAPX0.13610.1361YESNONO
00749354METOPROLOL TARTRATEApo-Metoprolol (Type L) 50mg TabAPX0.06240.0624YESNONO
02248562METRONIDAZOLEApo-Metronidazole 500mg CapAPX0.54790.5479YESNONO
02278685MIDODRINE HCLApo-Midodrine 5mg TabAPX0.38420.3842YESYESNO
02278677MIDODRINE HCLApo-Midodrine 2.5mg TabAPX0.23050.2305YESYESNO
02084104MINOCYCLINE HCLApo-Minocycline 100mg CapAPX0.21250.2125YESNONO
02084090MINOCYCLINE HCLApo-Minocycline 50mg CapAPX0.11010.1101YESNONO
02286629MIRTAZAPINEApo-Mirtazapine 30mg TabAPX0.31000.3100YESNONO
02445514MIXED SALT AMPHETAMINEApo-Amphetamine XR 15mg ER CapAPX0.68380.6838YESNOYES
02445549MIXED SALT AMPHETAMINEApo-Amphetamine XR 30mg ER CapAPX0.90380.9038YESNOYES
02445492MIXED SALT AMPHETAMINEApo-Amphetamine XR 5mg ER CapAPX0.53720.5372YESNOYES
02445506MIXED SALT AMPHETAMINEApo-Amphetamine XR 10mg ER CapAPX0.61050.6105YESNOYES
02445522MIXED SALT AMPHETAMINEApo-Amphetamine XR 20mg ER CapAPX0.75720.7572YESNOYES
02445530MIXED SALT AMPHETAMINEApo-Amphetamine XR 25mg ER CapAPX0.83050.8305YESNOYES
02285398MODAFINILApo-Modafinil (Off-Formulary Interchangeable) 100mg TabAPX0.92930.9293YESNOYES
02403587MOMETASONE FUROATEApo-Mometasone (Off-Formulary Interchangeable) 50mcg/Dose Nas Sp-140 Dose PkAPX21.6900N/AYESNOYES
02377608MONTELUKAST SODIUMApo-Montelukast 4mg Chew TabAPX0.27580.2758YESYESNO
02377616MONTELUKAST SODIUMApo-Montelukast (Off-Formulary Interchangeable) 5mg Chew TabAPX1.20751.2075YESNONO
02374609MONTELUKAST SODIUMApo-Montelukast (Off-Formulary Interchangeable) 10mg TabAPX1.77351.7735YESNONO
02406373MOXIFLOXACIN HYDROCHLORIDEApo-Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free)APX11.2700N/AYESNONO
02404923MOXIFLOXACIN HYDROCHLORIDEApo-Moxifloxacin 400mg TabAPX1.52301.5230YESNONO
02352559MYCOPHENOLATE MOFETILApo-Mycophenolate 250mg CapAPX0.37120.3712YESNONO
02352567MYCOPHENOLATE MOFETILApo-Mycophenolate 500mg TabAPX0.74230.7423YESNONO
02372746MYCOPHENOLATE SODIUMApo-Mycophenolic Acid 360mg Ent TabAPX2.99652.9965YESNONO
02372738MYCOPHENOLATE SODIUMApo-Mycophenolic Acid 180mg Ent TabAPX1.49831.4983YESNONO
02444275NALTREXONE HCLApo-Naltrexone 50mg TabAPX2.80752.8075YESYESNO
02246699NAPROXENApo-Naproxen EC (Off-Formulary Interchangeable) 250mg Ent TabAPX0.2835N/AYESNOYES
02246701NAPROXENApo-Naproxen EC (Off-Formulary Interchangeable) 500mg Ent TabAPX0.6894N/AYESNOYES
02246700NAPROXENApo-Naproxen EC (Off-Formulary Interchangeable) 375mg Ent TabAPX0.3675N/AYESNOYES
00600806NAPROXENApo-Naproxen 375mg TabAPX0.14580.1458YESNOYES
00522678NAPROXENApo-Naproxen 125mg TabAPX0.07810.0781YESNOYES
00522651NAPROXENApo-Naproxen 250mg TabAPX0.10680.1068YESNOYES
00592277NAPROXENApo-Naproxen 500mg TabAPX0.22440.2244YESNOYES
00784354NAPROXEN SODIUMApo-Napro-Na (Off-Formulary Interchangeable) 275mg TabAPX0.3422N/AYESNOYES
01940309NAPROXEN SODIUMApo-Napro-Na DS (Off-Formulary Interchangeable) 550mg TabAPX0.6667N/AYESNOYES
02365499NARATRIPTAN HYDROCHLORIDEApo-Naratriptan (Off-Formulary Interchangeable) 1mg TabAPX11.903811.9038YESNONO
02365502NARATRIPTAN HYDROCHLORIDEApo-Naratriptan (Off-Formulary Interchangeable) 2.5mg TabAPX8.21258.2125YESNONO
02427931NEVIRAPINEApo-Nevirapine XR 400mg ER TabAPX1.85191.8519YESNOYES
02393433NITROGLYCERINApo-Nitroglycerin 0.4mg/Metered Dose Spray-200 Dose PkAPX10.95008.4200YESNONO
02401967NORGESTIMATE & ETHINYL ESTRADIOLTricira Lo (21 Day) 3 Phase Tab-21 PkAPX9.47259.4725YESNONO
02401975NORGESTIMATE & ETHINYL ESTRADIOLTricira Lo (28 Day) 3 Phase Tab-28 PkAPX9.47259.4725YESNONO
02248398OFLOXACINApo-Ofloxacin 0.3% Oph SolAPX0.85610.8561YESYESNO
02360632OLANZAPINEApo-Olanzapine ODT 15mg Rapid Dissolve TabAPX1.07111.0711YESNONO
02360640OLANZAPINEApo-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve TabAPX7.5977N/AYESNONO
02360616OLANZAPINEApo-Olanzapine ODT 5mg Rapid Dissolve TabAPX0.35740.3574YESNONO
02360624OLANZAPINEApo-Olanzapine ODT 10mg Rapid Dissolve TabAPX0.71430.7143YESNONO
02281791OLANZAPINEApo-Olanzapine 2.5mg TabAPX0.17720.1772YESNONO
02281805OLANZAPINEApo-Olanzapine 5mg TabAPX0.35440.3544YESNONO
02333015OLANZAPINEApo-Olanzapine (Off-Formulary Interchangeable) 20mg TabAPX10.3093N/AYESNONO
02281821OLANZAPINEApo-Olanzapine 10mg TabAPX0.70880.7088YESNONO
02281848OLANZAPINEApo-Olanzapine 15mg TabAPX1.06311.0631YESNONO
02281813OLANZAPINEApo-Olanzapine 7.5mg TabAPX0.53160.5316YESNONO
02453460OLMESARTAN MEDOXOMILApo-Olmesartan 40mg TabAPX0.30190.3019YESNONO
02453452OLMESARTAN MEDOXOMILApo-Olmesartan 20mg TabAPX0.30190.3019YESNONO
02453622OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEApo-Olmesartan/HCTZ 40mg & 25mg TabAPX0.30190.3019YESNONO
02453606OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEApo-Olmesartan/HCTZ 20mg & 12.5mg TabAPX0.30190.3019YESNONO
02453614OLMESARTAN MEDOXOMIL & HYDROCHLOROTHIAZIDEApo-Olmesartan/HCTZ 40mg & 12.5mg TabAPX0.30190.3019YESNONO
02402823OLOPATADINE HCLApo-Olopatadine (Off-Formulary Interchangeable) 0.2% Oph Sol-2.5mL PkAPX26.1300N/AYESNONO
02305054OLOPATADINE HCLApo-Olopatadine (Off-Formulary Interchangeable) 0.1% Oph Sol-5mL PkAPX26.1300N/AYESNONO
02245058OMEPRAZOLEApo-Omeprazole Cap 20mgAPX0.22870.2287YESYESNO
09857285OMEPRAZOLEApo-Omeprazole Cap 20mgAPX0.22870.2287YESYESNO
02288184ONDANSETRON HYDROCHLORIDEApo-Ondansetron 4mg TabAPX3.34953.3495YESYESNO
02288192ONDANSETRON HYDROCHLORIDEApo-Ondansetron 8mg TabAPX5.11105.1110YESYESNO
02243661OXAPROZIN.Apo-Oxaprozin (Off-Formulary Interchangeable) 600mg TabAPX0.6892N/AYESNOYES
00402737OXAZEPAMApo-Oxazepam 30mg TabAPX0.07500.0750YESNONO
00402745OXAZEPAMApo-Oxazepam 15mg TabAPX0.05500.0550YESNONO
00402680OXAZEPAMApo-Oxazepam 10mg TabAPX0.03500.0350YESNONO
02284316OXCARBAZEPINEApo-Oxcarbazepine (Off-Formulary Interchangeable) 600mg TabAPX1.82041.8204YESNONO
02284294OXCARBAZEPINEApo-Oxcarbazepine (Off-Formulary Interchangeable) 150mg TabAPX0.62090.6209YESNONO
02284308OXCARBAZEPINEApo-Oxcarbazepine (Off-Formulary Interchangeable) 300mg TabAPX0.91020.9102YESNONO
02163543OXYBUTYNIN CHLORIDEApo-Oxybutynin 5mg TabAPX0.09860.0986YESNONO
02324628OXYCODONE HCL & ACETAMINOPHENApo-Oxycodone/Acet 5mg & 325mg TabAPX0.12850.1285YESNOYES
02292912PANTOPRAZOLE SODIUMApo-Pantoprazole (Off-Formulary Interchangeable) 20mg Ent TabAPX1.2750N/AYESNONO
02292920PANTOPRAZOLE SODIUMApo-Pantoprazole 40mg Ent TabAPX0.20160.2016YESYESNO
02240908PAROXETINE HCLApo-Paroxetine 20mg TabAPX0.32500.3250YESNONO
02240907PAROXETINE HCLApo-Paroxetine (Off-Formulary Interchangeable) 10mg TabAPX1.0430N/AYESNONO
02240909PAROXETINE HCLApo-Paroxetine 30mg TabAPX0.34530.3453YESNONO
02474565PEGFILGRASTIMLapelga 10mg/mL Inj Sol-Pref Syr - 0.6mL Pk (Preservative Free)APX1878.73001878.7300NONONO
00642223PENICILLIN V (POTASSIUM)Apo-Pen V-K 25mg/mL O/LAPX0.05350.0535YESNONO
02468581PERINDOPRIL ARGININE & AMLODIPINE BESYLATEApo-Perindopril/Amlodipine (Off-Formulary Interchangeable) 14mg & 10mg TabAPX0.9775N/AYESNONO
02468573PERINDOPRIL ARGININE & AMLODIPINE BESYLATEApo-Perindopril/Amlodipine (Off-Formulary Interchangeable) 7mg & 5mg TabAPX0.8925N/AYESNONO
02468565PERINDOPRIL ARGININE & AMLODIPINE BESYLATEApo-Perindopril/Amlodipine (Off-Formulary Interchangeable) 3.5mg & 2.5mg TabAPX0.8075N/AYESNONO
02289288PERINDOPRIL ERBUMINEApo-Perindopril 4mg TabAPX0.20420.2042YESNONO
02289296PERINDOPRIL ERBUMINEApo-Perindopril 8mg TabAPX0.28310.2831YESNONO
02289261PERINDOPRIL ERBUMINEApo-Perindopril 2mg TabAPX0.16320.1632YESNONO
02460912PHENYTOIN (DIPHENYLHYDANTOIN) SODIUMApo-Phenytoin Sodium 100mg CapAPX0.06650.0665YESNONO
02469677PINAVERIUM BROMIDEApo-Pinaverium (Off-Formulary Interchangeable) 50mg TabAPX0.30660.3066YESNONO
02469685PINAVERIUM BROMIDEApo-Pinaverium (Off-Formulary Interchangeable) 100mg TabAPX0.53460.5346YESNONO
00755877PINDOLOLApo-Pindol 5mg TabAPX0.13610.1361YESNONO
00755893PINDOLOLApo-Pindol 15mg TabAPX0.88940.8894YESNONO
00755885PINDOLOLApo-Pindol 10mg TabAPX0.23230.2323YESNONO
02302950PIOGLITAZONE HCLApo-Pioglitazone (Off-Formulary Interchangeable) 30mg TabAPX2.20172.2017YESNONO
02302977PIOGLITAZONE HCLApo-Pioglitazone (Off-Formulary Interchangeable) 45mg TabAPX3.31053.3105YESNONO
02302942PIOGLITAZONE HCLApo-Pioglitazone (Off-Formulary Interchangeable) 15mg TabAPX1.57161.5716YESNONO
02308444PIPERACILLIN SODIUM & TAZOBACTAM SODIUMPiperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 2g & 250mg Inj Pd-2.25g Vial PkAPX10.130010.1300YESNONO
02308452PIPERACILLIN SODIUM & TAZOBACTAM SODIUMPiperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 3g & 375mg Inj Pd-3.375g Vial PkAPX15.200015.2000YESNONO
02308460PIPERACILLIN SODIUM & TAZOBACTAM SODIUMPiperacillin & Tazobactam for Injection (Off-Formulary Interchangeable) 4g & 500mg Inj Pd-4.5g Vial PkAPX20.270020.2700YESNONO
00642894PIROXICAMApo-Piroxicam 20mg CapAPX0.74220.7422YESNOYES
00642886PIROXICAMApo-Piroxicam 10mg CapAPX0.44260.4426YESNOYES
02292408PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEApo-Pramipexole 1.5mg TabAPX0.39010.3901YESNOYES
02292378PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEApo-Pramipexole 0.25mg TabAPX0.19500.1950YESNOYES
02292386PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEApo-Pramipexole (Off-Formulary Interchangeable) 0.5mg TabAPX1.3860N/AYESNONO
02292394PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEApo-Pramipexole 1mg TabAPX0.39010.3901YESNOYES
02243508PRAVASTATIN SODIUMApo-Pravastatin 40mg TabAPX0.41430.4143YESNONO
02243507PRAVASTATIN SODIUMApo-Pravastatin 20mg TabAPX0.34400.3440YESNONO
02243506PRAVASTATIN SODIUMApo-Pravastatin 10mg TabAPX0.29160.2916YESNONO
00882828PRAZOSIN HCLApo-Prazo 2mg TabAPX0.37250.3725YESNONO
00882836PRAZOSIN HCLApo-Prazo 5mg TabAPX0.51210.5121YESNONO
00882801PRAZOSIN HCLApo-Prazo 1mg TabAPX0.27430.2743YESNONO
00550957PREDNISONEApo-Prednisone 50mg TabAPX0.17350.1735YESNONO
00312770PREDNISONEApo-Prednisone 5mg TabAPX0.02200.0220YESNONO
02394278PREGABALINApo-Pregabalin 150mg CapAPX0.41450.4145YESNONO
02394251PREGABALINApo-Pregabalin 75mg CapAPX0.30070.3007YESNONO
02394243PREGABALINApo-Pregabalin 50mg CapAPX0.23240.2324YESNONO
02394235PREGABALINApo-Pregabalin 25mg CapAPX0.14810.1481YESNONO
02394286PREGABALINApo-Pregabalin (Off-Formulary Interchangeable) 225mg CapAPX1.7270N/AYESNONO
02394294PREGABALINApo-Pregabalin 300mg CapAPX0.41450.4145YESNONO
00886432PROCHLORPERAZINEApo-Prochlorazine 10mg TabAPX0.20250.2025YESNONO
00886440PROCHLORPERAZINEApo-Prochlorazine 5mg TabAPX0.16590.1659YESNONO
02243324PROPAFENONE HCLApo-Propafenone 150mg TabAPX0.29660.2966YESNONO
02243325PROPAFENONE HCLApo-Propafenone 300mg TabAPX0.52270.5227YESNONO
02457261QUETIAPINEApo-Quetiapine XR 400mg ER TabAPX1.32701.3270YESNONO
02457253QUETIAPINEApo-Quetiapine XR 300mg ER TabAPX0.97760.9776YESNONO
02457245QUETIAPINEApo-Quetiapine XR 200mg ER TabAPX0.66610.6661YESNONO
02457237QUETIAPINEApo-Quetiapine XR 150mg ER TabAPX0.49260.4926YESNONO
02457229QUETIAPINEApo-Quetiapine XR 50mg ER TabAPX0.25010.2501YESNONO
02313936QUETIAPINEApo-Quetiapine 200mg TabAPX0.26470.2647YESNONO
02313944QUETIAPINEApo-Quetiapine 300mg TabAPX0.38630.3863YESNONO
02313928QUETIAPINEApo-Quetiapine 100mg TabAPX0.13180.1318YESNONO
02313901QUETIAPINEApo-Quetiapine 25mg TabAPX0.04940.0494YESNONO
02248502QUINAPRILApo-Quinapril 40mg TabAPX0.23210.2321YESNOYES
02248499QUINAPRILApo-Quinapril 5mg TabAPX0.23210.2321YESNOYES
02248501QUINAPRILApo-Quinapril 20mg TabAPX0.23210.2321YESNOYES
02248500QUINAPRILApo-Quinapril 10mg TabAPX0.23210.2321YESNOYES
02408775QUINAPRIL & HYDROCHLOROTHIAZIDEApo-Quinapril/HCTZ 20mg & 12.5mg TabAPX0.47860.4786YESNONO
02408767QUINAPRIL & HYDROCHLOROTHIAZIDEApo-Quinapril/HCTZ 10mg & 12.5mg TabAPX0.47860.4786YESNONO
02408783QUINAPRIL & HYDROCHLOROTHIAZIDEApo-Quinapril/HCTZ 20mg & 25mg TabAPX0.46020.4602YESNONO
02345579RABEPRAZOLE SODIUMApo-Rabeprazole 10mg TabAPX0.06690.0669YESNONO
02345587RABEPRAZOLE SODIUMApo-Rabeprazole 20mg TabAPX0.13380.1338YESNONO
02279215RALOXIFENE HCLApo-Raloxifene 60mg TabAPX0.91680.4701YESYESNO
02251582RAMIPRILApo-Ramipril Cap 10mgAPX0.10340.1034YESNONO
02251574RAMIPRILApo-Ramipril Cap 5mgAPX0.08170.0817YESNONO
02251515RAMIPRILApo-Ramipril Cap 1.25mgAPX0.07080.0708YESNONO
02251531RAMIPRILApo-Ramipril Cap 2.5mgAPX0.08170.0817YESNONO
02325381RAMIPRILApo-Ramipril (Off-Formulary Interchangeable) 15mg CapAPX0.8550N/AYESNONO
02280833RANITIDINE HCLApo-Ranitidine 15mg/mL Oral SolAPX0.14800.1480YESNONO
00733059RANITIDINE HCLApo-Ranitidine 150mg TabAPX0.11970.1197YESNONO
00733067RANITIDINE HCLApo-Ranitidine 300mg TabAPX0.22530.2253YESNONO
02404699RASAGILINE MESYLATEApo-Rasagiline (Off-Formulary Interchangeable) 1mg TabAPX6.12856.1285YESNONO
02404680RASAGILINE MESYLATEApo-Rasagiline (Off-Formulary Interchangeable) 0.5mg TabAPX6.12856.1285YESNONO
02355663REPAGLINIDEApo-Repaglinide (Off-Formulary Interchangeable) 0.5mg TabAPX0.20830.2083YESNONO
02355671REPAGLINIDEApo-Repaglinide (Off-Formulary Interchangeable) 1mg TabAPX0.21650.2165YESNONO
02355698REPAGLINIDEApo-Repaglinide (Off-Formulary Interchangeable) 2mg TabAPX0.24410.2441YESNONO
02352583RILUZOLEApo-Riluzole (Off-Formulary Interchangeable) 50mg TabAPX7.36307.3630YESNONO
02377721RISEDRONATE SODIUMApo-Risedronate 150mg TabAPX11.187511.1875YESNONO
02353687RISEDRONATE SODIUMApo-Risedronate 35mg TabAPX1.97871.9787YESNONO
02280396RISPERIDONEApo-Risperidone 1mg/mL O/LAPX0.48020.4802YESNONO
02282135RISPERIDONEApo-Risperidone 1mg TabAPX0.23970.2397YESNONO
02282151RISPERIDONEApo-Risperidone 3mg TabAPX0.71800.7180YESNONO
02282143RISPERIDONEApo-Risperidone 2mg TabAPX0.47950.4795YESNONO
02282127RISPERIDONEApo-Risperidone 0.5mg TabAPX0.17350.1735YESNONO
02282119RISPERIDONEApo-Risperidone 0.25mg TabAPX0.10360.1036YESNONO
02282178RISPERIDONEApo-Risperidone 4mg TabAPX0.95740.9574YESNONO
02336758RIVASTIGMINEApo-Rivastigmine 6mg CapAPX0.65150.6514YESYESNO
02336723RIVASTIGMINEApo-Rivastigmine 3mg CapAPX0.65150.6514YESYESNO
02336715RIVASTIGMINEApo-Rivastigmine 1.5mg CapAPX0.65150.6514YESYESNO
02336731RIVASTIGMINEApo-Rivastigmine 4.5mg CapAPX0.65150.6514YESYESNO
02393492RIZATRIPTANApo-Rizatriptan RPD (Off-Formulary Interchangeable) 10mg Orally Disintegrating TabAPX11.115011.1150YESNONO
02393484RIZATRIPTANApo-Rizatriptan RPD (Off-Formulary Interchangeable) 5mg Orally Disintegrating TabAPX11.115011.1150YESNONO
02393468RIZATRIPTANApo-Rizatriptan (Off-Formulary Interchangeable) 5mg TabAPX11.115011.1150YESNONO
02393476RIZATRIPTANApo-Rizatriptan (Off-Formulary Interchangeable) 10mg TabAPX11.115011.1150YESNONO
02337800ROPINIROLEApo-Ropinirole 5mg TabAPX0.85960.8596YESNONO
02337770ROPINIROLEApo-Ropinirole 2mg TabAPX0.31220.3122YESNONO
02337746ROPINIROLEApo-Ropinirole 0.25mg TabAPX0.07100.0710YESNONO
02337762ROPINIROLEApo-Ropinirole 1mg TabAPX0.28380.2838YESNONO
02403382ROSIGLITAZONEApo-Rosiglitazone (Off-Formulary Interchangeable) 8mg TabAPX2.62352.6235YESNONO
02403374ROSIGLITAZONEApo-Rosiglitazone (Off-Formulary Interchangeable) 4mg TabAPX1.83461.8346YESNONO
02403366ROSIGLITAZONEApo-Rosiglitazone (Off-Formulary Interchangeable) 2mg TabAPX1.16921.1692YESNONO
02337983ROSUVASTATIN CALCIUMApo-Rosuvastatin 10mg TabAPX0.13540.1354YESNONO
02337991ROSUVASTATIN CALCIUMApo-Rosuvastatin 20mg TabAPX0.16920.1692YESNONO
02338009ROSUVASTATIN CALCIUMApo-Rosuvastatin 40mg TabAPX0.19900.1990YESNONO
02337975ROSUVASTATIN CALCIUMApo-Rosuvastatin 5mg TabAPX0.12840.1284YESNONO
00790419SALBUTAMOLApo-Salvent (Not a Benefit) 100mcg/Metered Dose Inh-200 dose PkAPXN/AN/AYESNONO
02245669SALBUTAMOLApo-Salvent CFC Free 100mcg/Metered Dose Inh-200 dose PkAPX5.00005.0000YESNONO
02146843SALBUTAMOLApo-Salvent 2mg TabAPX0.12740.1274YESNONO
02146851SALBUTAMOLApo-Salvent 4mg TabAPX0.21340.2134YESNONO
02230641SELEGILINE HCLApo-Selegiline 5mg TabAPX0.50210.5021YESNONO
02238280SERTRALINE HCLApo-Sertraline 25mg CapAPX0.15160.1516YESNOYES
02238282SERTRALINE HCLApo-Sertraline 100mg CapAPX0.33030.3303YESNOYES
02238281SERTRALINE HCLApo-Sertraline 50mg CapAPX0.30320.3032YESNOYES
02248202SILDENAFILApo-Sildenafil (Off-Formulary Interchangeable) 50mg TabAPX8.8481N/AYESNONO
02248201SILDENAFILApo-Sildenafil (Off-Formulary Interchangeable) 25mg TabAPX8.2894N/AYESNONO
02248203SILDENAFILApo-Sildenafil (Off-Formulary Interchangeable) 100mg TabAPX9.2006N/AYESNONO
02418118SILDENAFILApo-Sildenafil R (Off-Formulary Interchangeable) 20mg TabAPX7.29407.2940YESNONO
02247014SIMVASTATINApo-Simvastatin 40mg TabAPX0.25010.2501YESNONO
02247015SIMVASTATINApo-Simvastatin 80mg TabAPX0.25010.2501YESNONO
02247013SIMVASTATINApo-Simvastatin 20mg TabAPX0.25010.2501YESNONO
02247012SIMVASTATINApo-Simvastatin 10mg TabAPX0.20230.2023YESNONO
02247011SIMVASTATINApo-Simvastatin 5mg TabAPX0.10230.1023YESNONO
02423375SOLIFENACIN SUCCINATEApo-Solifenacin 5mg TabAPX0.30410.3041YESYESNO
02423383SOLIFENACIN SUCCINATEApo-Solifenacin 10mg TabAPX0.30410.3041YESYESNO
02210428SOTALOL HCLApo-Sotalol (Off-Formulary Interchangeable) 80mg TabAPX0.59320.5932YESNONO
02167794SOTALOL HCLApo-Sotalol 160mg TabAPX0.16230.1623YESNONO
02125250SUCRALFATEApo-Sucralfate 1g TabAPX0.30890.3089YESNONO
00445274SULFAMETHOXAZOLE & TRIMETHOPRIMApo-Sulfatrim 400mg & 80mg TabAPX0.10770.1077YESNOYES
00445282SULFAMETHOXAZOLE & TRIMETHOPRIMApo-Sulfatrim-DS 800mg & 160mg TabAPX0.14710.1471YESNOYES
02268396SUMATRIPTAN SUCCINATEApo-Sumatriptan (Off-Formulary Interchangeable) 100mg TabAPX9.98679.9867YESNONO
02268388SUMATRIPTAN SUCCINATEApo-Sumatriptan (Off-Formulary Interchangeable) 50mg TabAPX9.06509.0650YESNONO
02422085TADALAFILApo-Tadalafil (Off-Formulary Interchangeable) 2.5mg TabAPX3.6470N/AYESNONO
02422115TADALAFILApo-Tadalafil (Off-Formulary Interchangeable) 20mg TabAPX12.3575N/AYESNONO
02422107TADALAFILApo-Tadalafil (Off-Formulary Interchangeable) 10mg TabAPX11.9250N/AYESNONO
02422093TADALAFILApo-Tadalafil (Off-Formulary Interchangeable) 5mg TabAPX3.6470N/AYESNONO
02421933TADALAFILApo-Tadalafil PAH (Off-Formulary Interchangeable) 20mg TabAPX11.472511.4725YESNONO
00812390TAMOXIFEN CITRATEApo-Tamox 20mg TabAPX0.35000.3500YESNONO
00812404TAMOXIFEN CITRATEApo-Tamox 10mg TabAPX0.17500.1750YESNONO
02362406TAMSULOSIN HCLApo-Tamsulosin CR Tab 0.4mgAPX0.15000.1500YESNOYES
02420082TELMISARTANApo-Telmisartan 40mg TabAPX0.21610.2161YESNONO
02420090TELMISARTANApo-Telmisartan 80mg TabAPX0.21610.2161YESNONO
02420023TELMISARTAN & HYDROCHLOROTHIAZIDEApo-Telmisartan/HCTZ 80mg & 12.5mg TabAPX0.20980.2098YESNONO
02420031TELMISARTAN & HYDROCHLOROTHIAZIDEApo-Telmisartan/HCTZ 80mg & 25mg TabAPX0.20980.2098YESNONO
02451980TENOFOVIR DISOPROXILApo-Tenofovir 300mg TabAPX4.88844.8884YESYESNO
02234505TERAZOSIN HCLApo-Terazosin 10mg TabAPX0.46370.4637YESNONO
02234504TERAZOSIN HCLApo-Terazosin 5mg TabAPX0.31680.3168YESNONO
02234502TERAZOSIN HCLApo-Terazosin 1mg TabAPX0.18350.1835YESNONO
02234503TERAZOSIN HCLApo-Terazosin 2mg TabAPX0.23330.2333YESNONO
02239893TERBINAFINE HCLApo-Terbinafine 250mg TabAPX0.77140.7714YESNONO
02407590TETRABENAZINEApo-Tetrabenazine (Off-Formulary Interchangeable) 25mg TabAPX4.85514.8551YESNONO
02409356TIGECYCLINETigecycline (Off-Formulary Interchangeable) 50mg/Vial Pd for Inj-5mLVial Pk (Preservative-Free)APX71.422571.4225YESNONO
02290812TIMOLOL MALEATEApo-Timop Gel 0.5% Oph Gellan SolAPX2.73002.7300YESNOYES
00755834TIMOLOL MALEATEApo-Timop 0.5% Oph SolAPX1.21451.2145YESNOYES
00755826TIMOLOL MALEATEApo-Timop 0.25% Oph SolAPX0.96780.9678YESNOYES
02415305TIMOLOL MALEATE & TRAVOPROSTApo-Travoprost-Timop 0.5% & 0.004% Oph SolAPX8.84258.8425YESYESNO
02259893TIZANIDINE HCLApo-Tizanidine (Off-Formulary Interchangeable) 4mg TabAPX0.76940.7694YESNOYES
02369699TOLTERODINE L-TARTRATEApo-Tolterodine 2mg TabAPX0.24550.2455YESYESNO
02369680TOLTERODINE L-TARTRATEApo-Tolterodine 1mg TabAPX0.24550.2455YESYESNO
02279614TOPIRAMATEApo-Topiramate 25mg TabAPX0.24330.2433YESNONO
02279630TOPIRAMATEApo-Topiramate 100mg TabAPX0.45830.4583YESNONO
02279649TOPIRAMATEApo-Topiramate 200mg TabAPX0.67480.6748YESNONO
02336790TRAMADOL HCL & ACETAMINOPHENApo-Tramadol/Acet (Off-Formulary Interchangeable) 37.5mg & 325mg TabAPX0.6264N/AYESNOYES
02415739TRAVOPROSTApo-Travoprost Z 0.004% Oph Sol-5mL PkAPX20.132020.1320YESYESNO
02147637TRAZODONE HYDROCHLORIDEApo-Trazodone 50mg TabAPX0.05540.0554YESNONO
02147645TRAZODONE HYDROCHLORIDEApo-Trazodone 100mg TabAPX0.09890.0989YESNONO
02147653TRAZODONE HYDROCHLORIDEApo-Trazodone D 150mg TabAPX0.14530.1453YESNONO
02437635TRIAMCINOLONE ACETONIDEApo-Triamcinolone AQ (Off-Formulary Interchangeable) 55mcg/Metered Dose Nas Sp-120 Dose Pk (with Preservative)APX20.808020.8080YESNOYES
00740799TRIMIPRAMINEApo-Trimip 12.5mg TabAPX0.21560.2156YESNONO
02248540TRYPTOPHANApo-Tryptophan (Off-Formulary Interchangeable) 500mg CapAPX0.4987N/AYESNONO
02248539TRYPTOPHANApo-Tryptophan (Off-Formulary Interchangeable) 1g TabAPX0.8978N/AYESNONO
02458721TRYPTOPHANApo-Tryptophan (Off-Formulary Interchangeable) 750mg TabAPX0.9889N/AYESNONO
02248538TRYPTOPHANApo-Tryptophan (Off-Formulary Interchangeable) 500mg TabAPX0.4987N/AYESNONO
02295822VALACYCLOVIRApo-Valacyclovir 500mg TabAPX0.61980.6198YESNONO
02354705VALACYCLOVIRApo-Valacyclovir (Off-Formulary Interchangeable) 1000mg TabAPX5.8537N/AYESNONO
02238370VALPROATE SODIUMApo-Valproic 50mg/mL O/LAPX0.06050.0398YESNONO
02238048VALPROIC ACIDApo-Valproic 250mg CapAPX0.29050.2905YESNONO
02371510VALSARTANApo-Valsartan (Off-Formulary Interchangeable) 40mg TabAPX0.5823N/AYESNONO
02371545VALSARTANApo-Valsartan 320mg TabAPX0.20980.2098YESNONO
02371537VALSARTANApo-Valsartan 160mg TabAPX0.21590.2159YESNONO
02371529VALSARTANApo-Valsartan 80mg TabAPX0.21590.2159YESNONO
02382598VALSARTAN & HYDROCHLOROTHIAZIDEApo-Valsartan/HCTZ 320mg & 25mg TabAPX0.22310.2231YESNONO
02382563VALSARTAN & HYDROCHLOROTHIAZIDEApo-Valsartan/HCTZ 160mg & 25mg TabAPX0.22380.2238YESNONO
02382571VALSARTAN & HYDROCHLOROTHIAZIDEApo-Valsartan/HCTZ 320mg & 12.5mg TabAPX0.22350.2235YESNONO
02382555VALSARTAN & HYDROCHLOROTHIAZIDEApo-Valsartan/HCTZ 160mg & 12.5mg TabAPX0.22400.2240YESNONO
02382547VALSARTAN & HYDROCHLOROTHIAZIDEApo-Valsartan/HCTZ 80mg & 12.5mg TabAPX0.22130.2213YESNONO
02471663VARDENAFIL HCLApo-Vardenafil (Off-Formulary Interchangeable) 20mg TabAPX11.6811N/AYESNONO
02471655VARDENAFIL HCLApo-Vardenafil (Off-Formulary Interchangeable) 10mg TabAPX10.3976N/AYESNONO
02471647VARDENAFIL HCLApo-Vardenafil (Off-Formulary Interchangeable) 5mg TabAPX9.3203N/AYESNONO
02419882VARENICLINE TARTRATEApo-Varenicline 0.5mg TabAPX0.92370.9237YESYESNO
02419890VARENICLINE TARTRATEApo-Varenicline 1.0mg TabAPX0.92350.9235YESYESNO
02435675VARENICLINE TARTRATEApo-Varenicline 0.5mg & 1.0mg Tab (Starter Pack-53 Tabs)APX48.775948.7759YESYESNO
02331691VENLAFAXINE HCLApo-Venlafaxine XR 75mg ER CapAPX0.18250.1825YESNONO
02331683VENLAFAXINE HCLApo-Venlafaxine XR 37.5mg ER CapAPX0.09130.0913YESNONO
02331705VENLAFAXINE HCLApo-Venlafaxine XR 150mg ER CapAPX0.19270.1927YESNONO
02246895VERAPAMIL HCLApo-Verap SR 240mg LA TabAPX0.50750.5075YESNONO
02246894VERAPAMIL HCLApo-Verap SR 180mg LA TabAPX0.52040.5204YESNONO
02246893VERAPAMIL HCLApo-Verap SR (Off-Formulary Interchangeable) 120mg LA TabAPX0.6900N/AYESNONO
00782491VERAPAMIL HCLApo-Verap 120mg TabAPX0.42500.4250YESNONO
00782483VERAPAMIL HCLApo-Verap 80mg TabAPX0.27350.2735YESNONO
02409674VORICONAZOLEApo-Voriconazole 50mg TabAPX3.24653.2465YESYESNO
02242924WARFARINApo-Warfarin 1mg TabAPX0.07960.0796YESNOYES
02242925WARFARINApo-Warfarin 2mg TabAPX0.08410.0841YESNOYES
02242926WARFARINApo-Warfarin 2.5mg TabAPX0.06740.0674YESNOYES
02242929WARFARINApo-Warfarin 10mg TabAPX0.12110.1211YESNOYES
02242927WARFARINApo-Warfarin 4mg TabAPX0.10430.1043YESNOYES
02242928WARFARINApo-Warfarin 5mg TabAPX0.06750.0675YESNOYES
02245618WARFARINApo-Warfarin 3mg TabAPX0.10430.1043YESNOYES
01946323ZIDOVUDINEApo-Zidovudine (Off-Formulary Interchangeable) 100mg CapAPX1.3977N/AYESNONO
02381575ZOLMITRIPTANApo-Zolmitriptan Rapid (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating TabAPX6.86336.8633YESNONO
02380951ZOLMITRIPTANApo-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg TabAPX6.85836.8583YESNONO
02436159ZOLPIDEM TARTRATEApo-Zolpidem ODT (Off-Formulary Interchangeable) 5mg SL TabAPX1.1825N/AYESNOYES
02434946ZOLPIDEM TARTRATEApo-Zolpidem ODT (Off-Formulary Interchangeable) 10mg SL TabAPX1.1884N/AYESNOYES
02218313ZOPICLONEApo-Zopiclone (Off-Formulary Interchangeable) 7.5mg TabAPX0.46850.4685YESNOYES
02245077ZOPICLONEApo-Zopiclone (Off-Formulary Interchangeable) 5mg TabAPX0.22310.2231YESNOYES