| 02041685 | AMOXICILLIN | Amoxil Chewable (Off-Formulary Interchangeable) 125mg Chew Tab | AYE | N/A | N/A | YES | NO | NO |
| 02041286 | AMOXICILLIN | Amoxil Chewable (Off-Formulary Interchangeable) 250mg Chew Tab | AYE | N/A | N/A | YES | NO | NO |
| 00002003 | AMPICILLIN | Penbritin (Not a Benefit) 250mg Cap | AYE | N/A | N/A | YES | NO | YES |
| 00002011 | AMPICILLIN | Penbritin (Not a Benefit) 500mg Cap | AYE | N/A | N/A | YES | NO | YES |
| 00002038 | CLOFIBRATE | Atromid-S (Not a Benefit) 500mg Cap | AYE | N/A | N/A | YES | NO | NO |
| 00002046 | CLOXACILLIN | Orbenin (Not a Benefit) 250mg Cap | AYE | N/A | N/A | YES | NO | NO |
| 00002054 | CLOXACILLIN | Orbenin (Not a Benefit) 500mg Cap | AYE | N/A | N/A | YES | NO | NO |
| 02042207 | PROPRANOLOL | Inderal-40 (Not a Benefit) 40mg Tab | AYE | N/A | N/A | YES | NO | NO |