01947931 | BETHANECHOL CHLORIDE | Duvoid 25mg Tab | PAL | 0.7534 | 0.7534 | NO | NO | NO |
01947958 | BETHANECHOL CHLORIDE | Duvoid 10mg Tab | PAL | 0.4653 | 0.4653 | NO | NO | NO |
01947923 | BETHANECHOL CHLORIDE | Duvoid 50mg Tab | PAL | 0.9921 | 0.9921 | NO | NO | NO |
02290308 | CYPROTERONE ACETATE & ETHINYL ESTRADIOL | Cyestra-35 (Off-Formulary Interchangeable) 2mg & 0.035mg Tab-21 Pk | PAL | 23.3394 | N/A | YES | NO | NO |
01924567 | DEXTROAMPHETAMINE SULFATE | Dexedrine Spansules 15mg SR Cap | PAL | 1.4489 | 0.9898 | YES | NO | YES |
01924559 | DEXTROAMPHETAMINE SULFATE | Dexedrine Spansules 10mg SR Cap | PAL | 1.1851 | 0.8096 | YES | NO | YES |
01924516 | DEXTROAMPHETAMINE SULFATE | Dexedrine 5mg Tab | PAL | 0.8026 | 0.5081 | YES | NO | YES |
02247265 | DICLOFENAC SODIUM | Pennsaid (Off-Formulary Interchangeable) 1.5% W/W Top Sol | PAL | N/A | N/A | YES | NO | NO |
00728179 | FLAVOXATE HCL | Urispas (Not a Benefit) 200mg Tab | PAL | N/A | N/A | YES | NO | NO |
02086026 | FLUDROCORTISONE ACETATE | Florinef 0.1mg Tab | PAL | 0.5526 | 0.5526 | NO | NO | NO |
02240335 | FOSFOMYCIN TROMETHAMINE | Monurol Sachet-3g Pk | PAL | 21.6700 | 14.0250 | YES | NO | YES |
02106272 | LABETALOL HCL | Trandate 100mg Tab | PAL | 0.4044 | 0.1983 | YES | NO | NO |
02106280 | LABETALOL HCL | Trandate 200mg Tab | PAL | 0.7148 | 0.3504 | YES | NO | NO |
02244290 | METHADONE HCL | Metadol-D 10mg/mL Oral Concentrate | PAL | 0.1553 | 0.1553 | NO | NO | YES |
00015741 | METHIMAZOLE | Tapazole 5mg Tab | PAL | 0.3696 | 0.1531 | YES | NO | NO |
02296039 | METHIMAZOLE | Tapazole (Off-Formulary Interchangeable) 10mg Tab | PAL | N/A | N/A | YES | NO | NO |
02230734 | NITROGLYCERIN | Trinipatch 0.6mg/Hr/21 Sq Cm Patch | PAL | 0.8517 | 0.8517 | NO | NO | NO |
02230733 | NITROGLYCERIN | Trinipatch 0.4mg/Hr/14 Sq Cm Patch | PAL | 0.8517 | 0.8517 | NO | NO | NO |
02280248 | TESTOSTERONE | Testim 1% Top Gel-5g Pk | PAL | 4.3180 | 4.3180 | NO | YES | NO |
02296381 | TRAMADOL HCL | Tridural (Off-Formulary Interchangeable) 100mg ER Tab | PAL | N/A | N/A | YES | NO | YES |
02296403 | TRAMADOL HCL | Tridural (Off-Formulary Interchangeable) 200mg ER Tab | PAL | N/A | N/A | YES | NO | YES |
02296411 | TRAMADOL HCL | Tridural (Off-Formulary Interchangeable) 300mg ER Tab | PAL | N/A | N/A | YES | NO | YES |