02325462 | ESTRADIOL 17-B | Vagifem 10 10mcg Vag Tab with Applicator | NOO | 4.8056 | 4.8056 | NO | NO | NO |
02333627 | GLUCAGON RDNA ORIGIN | GlucaGen HypoKit 1mg/Vial Inj Pd-Syr Pk | NOO | 112.6700 | 112.6700 | NO | NO | NO |
02333619 | GLUCAGON RDNA ORIGIN | GlucaGen 1mg/Vial Inj Pd-Vial Pk | NOO | 108.3300 | 108.3300 | NO | NO | NO |
02024217 | INSULIN (30% NEUTRAL & 70% ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge 30/70 1000U/10mL Inj Susp-10mL Pk | NOO | 25.9100 | 25.9100 | NO | NO | NO |
09853812 | INSULIN (30% NEUTRAL & 70% ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge 30/70 Penfill 100U/mL Inj Susp-5x3mL Pk | NOO | 48.9900 | 48.9900 | NO | NO | NO |
02024225 | INSULIN (ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge NPH 1000U/10mL Inj Susp-10mL Pk | NOO | 25.7800 | 25.7800 | NO | NO | NO |
09853782 | INSULIN (ISOPHANE) HUMAN BIOSYNTHETIC | Novolin ge NPH Penfill 100U/mL Inj Susp-5x3mL Pk | NOO | 50.6900 | 50.6900 | NO | NO | NO |
02245397 | INSULIN ASPART | NovoRapid 100U/mL Inj Sol-10mL Pk | NOO | 31.9500 | 31.9500 | NO | YES | NO |
02265435 | INSULIN ASPART 30% & INSULIN ASPART PROTAMINE 70% | NovoMix 30 Penfill 100U/mL Inj Susp-5x3mL Pk | NOO | 59.4300 | 59.4300 | NO | NO | NO |
02467860 | INSULIN DEGLUDEC | Tresiba 100U/mL Inj Sol-3X5mL Cart Pk | NOO | 114.1700 | 114.1700 | NO | NO | NO |
02467887 | INSULIN DEGLUDEC | Tresiba 200U/mL Inj Sol-Flextouch Pref Pen 3x3mL Pk | NOO | 137.0100 | 137.0100 | NO | NO | NO |
02467879 | INSULIN DEGLUDEC | Tresiba 100U/mL Inj Sol-Flextouch Pref Pen 5x3mL Pk | NOO | 114.1700 | 114.1700 | NO | NO | NO |
02271842 | INSULIN DETEMIR | Levemir Penfill 100U/mL Inj Sol-5x3mL Pk | NOO | 114.3600 | 114.3600 | NO | NO | NO |
02412829 | INSULIN DETEMIR | Levemir Flextouch 100U/mL Inj Sol-Pref Disp Pen 5X3mL Pk | NOO | 115.2900 | 115.2900 | NO | NO | NO |
02024233 | INSULIN HUMAN BIOSYNTHETIC | Novolin ge Toronto 1000U/10mL Inj Sol-10mL Pk | NOO | 25.2100 | 25.2100 | NO | NO | NO |
09853774 | INSULIN HUMAN BIOSYNTHETIC | Novolin ge Toronto Penfill 100U/mL Inj Sol-5x3mL Pk | NOO | 49.5200 | 49.5200 | NO | NO | NO |
02239924 | REPAGLINIDE | GlucoNorm (Off-Formulary Interchangeable) 0.5mg Tab | NOO | N/A | N/A | YES | NO | NO |
02239925 | REPAGLINIDE | GlucoNorm (Off-Formulary Interchangeable) 1mg Tab | NOO | N/A | N/A | YES | NO | NO |
02239926 | REPAGLINIDE | GlucoNorm (Off-Formulary Interchangeable) 2mg Tab | NOO | N/A | N/A | YES | NO | NO |
02540258 | SEMAGLUTIDE | Ozempic 0.68mg/mL Inj Sol - Pref Pen 3mL Pk | NOO | 223.2600 | 223.2600 | NO | YES | NO |
02471477 | SEMAGLUTIDE | Ozempic 1.34mg/mL Inj Sol-Pref Pen 1.5mL Pk | NOO | 223.2600 | 223.2600 | NO | YES | NO |
02471469 | SEMAGLUTIDE | Ozempic 1.34mg/mL Inj Sol-Pref Pen 3mL Pk | NOO | 223.2600 | 223.2600 | NO | YES | NO |
02497611 | SEMAGLUTIDE | Rybelsus 14mg Tab | NOO | 7.3757 | 7.3757 | NO | YES | NO |
02497581 | SEMAGLUTIDE | Rybelsus 3mg Tab | NOO | 7.3757 | 7.3757 | NO | YES | NO |
02497603 | SEMAGLUTIDE | Rybelsus 7mg Tab | NOO | 7.3757 | 7.3757 | NO | YES | NO |