02248128 | ALMOTRIPTAN | Axert (Off-Formulary Interchangeable) 6.25mg Tab | JNO | N/A | N/A | YES | NO | NO |
02248129 | ALMOTRIPTAN | Axert (Off-Formulary Interchangeable) 12.5mg Tab | JNO | N/A | N/A | YES | NO | NO |
01937413 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 100 (Off-Formulary Interchangeable) 100mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
02280345 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 12 (Off-Formulary Interchangeable) 12mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
01937383 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 25 (Not a Benefit) 25mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
01937391 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 50 (Not a Benefit) 50mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
01937405 | FENTANYL TRANSDERMAL SYSTEM | Duragesic 75 (Off-Formulary Interchangeable) 75mcg/hr Trans Patch | JNO | N/A | N/A | YES | NO | YES |
00590665 | LITHIUM CARBONATE | Duralith (Off-Formulary Interchangeable) 300mg ER Tab | JNO | N/A | N/A | YES | NO | NO |
01924753 | OXYBUTYNIN CHLORIDE | Ditropan (Not a Benefit) 1mg/mL O/L | JNO | N/A | N/A | YES | NO | NO |
02239907 | TOPIRAMATE | Topamax Sprinkle 15mg Sprinkle Cap | JNO | 1.9800 | 1.9800 | NO | YES | NO |
02239908 | TOPIRAMATE | Topamax Sprinkle 25mg Sprinkle Cap | JNO | 2.0700 | 2.0700 | NO | YES | NO |
02230893 | TOPIRAMATE | Topamax 25mg Tab | JNO | 2.0797 | 0.2433 | YES | NO | NO |
02230894 | TOPIRAMATE | Topamax 100mg Tab | JNO | 3.9000 | 0.4583 | YES | NO | NO |
02230896 | TOPIRAMATE | Topamax 200mg Tab | JNO | 5.7585 | 0.6748 | YES | NO | NO |