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Products found: 434New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOHLTC PaysInter- change- ableLimited UseThera- peutic Notes
02458381ABACAVIR SULFATE & LAMIVUDINEPMS-Abacavir-Lamivudine 600mg & 300mg TabPMS5.98755.9875YESNOYES
00816027ACETAMINOPHEN & CODEINE PHOSPHATEPMS-Acetaminophen With Codeine 160mg & 8mg/5mL O/LPMS0.07690.0769YESNOYES
02284006ALENDRONATEPMS-Alendronate-FC 70mg TabPMS2.10142.1014YESNONO
01990403AMANTADINE HCLPMS-Amantadine HCL 100mg CapPMS0.52520.5252YESNOYES
02242472AMIODARONE HCLPMS-Amiodarone 200mg TabPMS0.37060.3706YESNOYES
00654507AMITRIPTYLINEPMS-Amitriptyline 50mg TabPMS0.15400.1540YESNONO
00654515AMITRIPTYLINEPMS-Amitriptyline 25mg TabPMS0.08290.0829YESNONO
02284065AMLODIPINEPMS-Amlodipine 5mg TabPMS0.13430.1343YESNONO
02284073AMLODIPINEPMS-Amlodipine 10mg TabPMS0.19930.1993YESNONO
02469049AMLODIPINEPharma-Amlodipine 10mg TabPMS0.19930.1993YESNONO
02469030AMLODIPINEPharma-Amlodipine 5mg TabPMS0.13430.1343YESNONO
02404222AMLODIPINE BESYLATE & ATORVASTATIN CALCIUMPMS-Amlodipine-Atorvastatin 5mg & 10mg TabPMS0.58020.5802YESNOYES
02230244AMOXICILLINPMS-Amoxicillin 500mg CapPMS0.34170.1308YESNOYES
02230245AMOXICILLINPMS-Amoxicillin 25mg/mL O/LPMS0.03530.0353YESNOYES
02230246AMOXICILLINPMS-Amoxicillin 50mg/mL O/LPMS0.05400.0540YESNOYES
02320738ANASTROZOLEPMS-Anastrozole 1mg TabPMS0.95220.9522YESYESNO
02466694ARIPIPRAZOLEPMS-Aripiprazole 30mg TabPMS1.00171.0017YESNOYES
02466635ARIPIPRAZOLEPMS-Aripiprazole 2mg TabPMS0.80920.8092YESNOYES
02466643ARIPIPRAZOLEPMS-Aripiprazole 5mg TabPMS0.90460.9046YESNOYES
02466651ARIPIPRAZOLEPMS-Aripiprazole 10mg TabPMS1.07541.0754YESNOYES
02466686ARIPIPRAZOLEPMS-Aripiprazole 20mg TabPMS1.00171.0017YESNOYES
02466678ARIPIPRAZOLEPMS-Aripiprazole 15mg TabPMS1.26921.2692YESNOYES
02237600ATENOLOLPMS-Atenolol 50mg TabPMS0.11070.1107YESNONO
02237601ATENOLOLPMS-Atenolol 100mg TabPMS0.18210.1821YESNONO
02381044ATOMOXETINE HCLPMS-Atomoxetine 25mg CapPMS0.64200.6420YESNONO
02381028ATOMOXETINE HCLPMS-Atomoxetine 10mg CapPMS0.51060.5106YESNONO
02381036ATOMOXETINE HCLPMS-Atomoxetine 18mg CapPMS0.57480.5748YESNONO
02381052ATOMOXETINE HCLPMS-Atomoxetine 40mg CapPMS0.73690.7369YESNONO
02381060ATOMOXETINE HCLPMS-Atomoxetine 60mg CapPMS0.80920.8092YESNONO
02399407ATORVASTATIN CALCIUMPMS-Atorvastatin 80mg TabPMS0.23420.2342YESNONO
02399377ATORVASTATIN CALCIUMPMS-Atorvastatin 10mg TabPMS0.17430.1743YESNONO
02399385ATORVASTATIN CALCIUMPMS-Atorvastatin 20mg TabPMS0.21790.2179YESNONO
02399393ATORVASTATIN CALCIUMPMS-Atorvastatin 40mg TabPMS0.23420.2342YESNONO
02418452AZITHROMYCINPMS-Azithromycin 100mg/5mL O/L-15mL PkPMS5.93475.9347YESNOYES
02418460AZITHROMYCINPMS-Azithromycin 200mg/5mL O/L-15mL PkPMS8.40628.4062YESNOYES
09857517AZITHROMYCINPMS-Azithromycin 200mg/5mL O/L-22.5mL PkPMS12.609312.6093YESNOYES
02261642AZITHROMYCINPMS-Azithromycin 600mg TabPMS7.62507.6250YESYESYES
02261634AZITHROMYCINPMS-Azithromycin 250mg TabPMS0.94100.9410YESNOYES
02063735BACLOFENPMS-Baclofen 10mg TabPMS0.15950.1595YESNOYES
02063743BACLOFENPMS-Baclofen 20mg TabPMS0.31040.3104YESNOYES
02239537BENZYDAMINE HCLPMS-Benzydamine (Off-Formulary Interchangeable) 0.15% Oral RinsePMS0.0960N/AYESNONO
02330210BETAHISTINE DIHYDROCHLORIDEPMS-Betahistine (Off-Formulary Interchangeable) 16mg TabPMS0.35570.3557YESNONO
02330237BETAHISTINE DIHYDROCHLORIDEPMS-Betahistine (Off-Formulary Interchangeable) 24mg TabPMS0.4983N/AYESNONO
02275589BICALUTAMIDEPMS-Bicalutamide 50mg TabPMS1.26901.2690YESNONO
02383012BOSENTAN MONOHYDRATEPMS-Bosentan (Off-Formulary Interchangeable) 62.5mg TabPMS32.089332.0893YESNONO
02383020BOSENTAN MONOHYDRATEPMS-Bosentan (Off-Formulary Interchangeable) 125mg TabPMS32.089332.0893YESNONO
02246284BRIMONIDINEPMS-Brimonidine 0.2% Oph SolPMS1.15501.1550YESYESNO
02424878BUPRENORPHINE & NALOXONEPMS-Buprenorphine-Naloxone 8mg & 2mg SL TabPMS1.18251.1825YESNONO
02424851BUPRENORPHINE & NALOXONEPMS-Buprenorphine-Naloxone 2mg & 0.5mg SL TabPMS0.66750.6675YESNONO
02325373BUPROPION HCLPMS-Bupropion SR 100mg TabPMS0.15470.1547YESYESNO
02313421BUPROPION HCLPMS-Bupropion SR 150mg TabPMS0.22980.2298YESYESNO
02230942BUSPIRONE HYDROCHLORIDEPMS-Buspirone (Off-Formulary Interchangeable) 10mg TabPMS0.65210.6521YESNOYES
02391198CANDESARTAN CILEXETILPMS-Candesartan 8mg TabPMS0.22810.2281YESNONO
02391201CANDESARTAN CILEXETILPMS-Candesartan 16mg TabPMS0.22810.2281YESNONO
02391171CANDESARTAN CILEXETILPMS-Candesartan 4mg TabPMS0.17000.1700YESNONO
02391228CANDESARTAN CILEXETILPMS-Candesartan 32mg TabPMS0.22810.2281YESNONO
02391295CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDEPMS-Candesartan-HCTZ 16mg & 12.5mg TabPMS0.21560.2156YESNONO
02231544CARBAMAZEPINEPMS-Carbamazepine CR 400mg LA TabPMS0.18590.1859YESYESNO
02231543CARBAMAZEPINEPMS-Carbamazepine CR 200mg LA TabPMS0.09300.0930YESYESNO
02245916CARVEDILOLPMS-Carvedilol 12.5mg TabPMS0.24310.2431YESYESNO
02245917CARVEDILOLPMS-Carvedilol 25mg TabPMS0.24310.2431YESYESNO
02245915CARVEDILOLPMS-Carvedilol 6.25mg TabPMS0.24310.2431YESYESNO
02245914CARVEDILOLPMS-Carvedilol 3.125mg TabPMS0.24310.2431YESYESNO
02355442CELECOXIBPMS-Celecoxib 100mg CapPMS0.12790.1279YESYESYES
02355450CELECOXIBPMS-Celecoxib 200mg CapPMS0.25580.2558YESYESYES
02177811CEPHALEXIN MONOHYDRATEPMS-Cephalexin 125 (Not a Benefit) 25mg/mL Pd for Oral SuspPMSN/AN/AYESNONO
02177838CEPHALEXIN MONOHYDRATEPMS-Cephalexin 250 (Not a Benefit) 50mg/mL Pd for Oral SuspPMSN/AN/AYESNONO
02177803CEPHALEXIN MONOHYDRATEPMS-Cephalexin (Not a Benefit) 500mg TabPMSN/AN/AYESNONO
02177781CEPHALEXIN MONOHYDRATEPMS-Cephalexin (Not a Benefit) 250mg TabPMSN/AN/AYESNONO
02315955CETIRIZINE HYDROCHLORIDEExtra Strength Allergy Relief (Off-Formulary Interchangeable) 10mg TabPMS0.3938N/AYESNONO
02315963CETIRIZINE HYDROCHLORIDEPMS-Cetirizine (Off-Formulary Interchangeable) 20mg TabPMS0.7535N/AYESNONO
02210320CHOLESTYRAMINE RESINOlestyr 4g/9g Pk Oral Pd-Pouch PkPMS0.52750.5275YESNONO
02248439CIPROFLOXACINPMS-Ciprofloxacin 750mg TabPMS0.92010.9201YESNOYES
02248438CIPROFLOXACINPMS-Ciprofloxacin 500mg TabPMS0.50250.5025YESNOYES
02248437CIPROFLOXACINPMS-Ciprofloxacin 250mg TabPMS0.44540.4454YESNOYES
02416433CIPROFLOXACIN HCL & CIPROFLOXACIN BASEPMS-Ciprofloxacin XL 500mg ER TabPMS2.31102.3110YESYESNO
02248011CITALOPRAM HYDROBROMIDEPMS-Citalopram 40mg TabPMS0.13320.1332YESNONO
02248010CITALOPRAM HYDROBROMIDEPMS-Citalopram 20mg TabPMS0.13320.1332YESNONO
02247573CLARITHROMYCINPMS-Clarithromycin 250mg TabPMS0.41220.4122YESNOYES
02247574CLARITHROMYCINPMS-Clarithromycin (Off-Formulary Interchangeable) 500mg TabPMS2.2009N/AYESNOYES
02309521CLOBETASOL PROPIONATEPMS-Clobetasol 0.05% CrPMS0.22790.2279YESNOYES
02309548CLOBETASOL PROPIONATEPMS-Clobetasol 0.05% OintPMS0.22790.2279YESNOYES
02232195CLOBETASOL PROPIONATEPMS-Clobetasol 0.05% Scalp LotPMS0.19900.1990YESNOYES
02048736CLONAZEPAMPMS-Clonazepam 2mg TabPMS0.07210.0721YESNONO
02048701CLONAZEPAMPMS-Clonazepam 0.5mg TabPMS0.04180.0418YESNONO
02207818CLONAZEPAMPMS-Clonazepam-R 0.5mg TabPMS0.04180.0418YESNONO
02348004CLOPIDOGREL BISULFATEPMS-Clopidogrel 75mg TabPMS0.26310.2631YESNONO
02212048CYCLOBENZAPRINE HCLPMS-Cyclobenzaprine (Not a Benefit) 10mg TabPMSN/AN/AYESNOYES
02229323DESONIDEPMS-Desonide 0.05% OintPMS0.26470.2647YESNONO
01964070DEXAMETHASONEPMS-Dexamethasone 4mg TabPMS0.30460.3046YESNONO
01964976DEXAMETHASONEPMS-Dexamethasone 0.5mg TabPMS0.15640.1564YESNONO
02239753DICLOFENAC POTASSIUMPMS-Diclofenac K (Off-Formulary Interchangeable) 50mg TabPMS0.3937N/AYESNOYES
02302624DICLOFENAC SODIUMPMS-Diclofenac 50mg Ent TabPMS0.20640.2064YESNOYES
02302616DICLOFENAC SODIUMPMS-Diclofenac 25mg Ent TabPMS0.07810.0781YESNOYES
02231505DICLOFENAC SODIUMPMS-Diclofenac-SR 100mg LA TabPMS0.40480.4048YESNOYES
02231504DICLOFENAC SODIUMPMS-Diclofenac-SR 75mg LA TabPMS0.24330.2433YESNOYES
02231506DICLOFENAC SODIUMPMS-Diclofenac 50mg SupPMS0.43390.4339YESNOYES
02231508DICLOFENAC SODIUMPMS-Diclofenac 100mg SupPMS0.58400.5840YESNOYES
02356783DICLOFENAC SODIUMPMS-Diclofenac (Off-Formulary Interchangeable) 1.5% W/W Top SolPMS0.6227N/AYESNONO
02355787DILTIAZEM HCLPMS-Diltiazem CD 300mg LA CapPMS0.79990.7999YESNONO
02355760DILTIAZEM HCLPMS-Diltiazem CD 180mg LA CapPMS0.48240.4824YESNONO
02355752DILTIAZEM HCLPMS-Diltiazem CD 120mg LA CapPMS0.36340.3634YESNONO
02355779DILTIAZEM HCLPMS-Diltiazem CD 240mg LA CapPMS0.63990.6399YESNONO
00586331DIMENHYDRINATEPMS-Dimenhydrinate (Not a Benefit) 50mg TabPMSN/AN/AYESNONO
00664553DOCUSATE CALCIUM (DIOCTYL CALCIUM SULFOSUCCINATE)PMS-Docusate Calcium 240mg CapPMS0.12870.1287YESNONO
01994344DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE)Soflax 100mg CapPMS0.03280.0328YESNONO
02006758DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE)Soflax Syrup 4mg/mL O/LPMS0.02320.0232YESNONO
02236466DOMPERIDONE MALEATEPMS-Domperidone 10mg TabPMS0.04280.0428YESNONO
02322358DONEPEZIL HCLPMS-Donepezil 10mg TabPMS0.45860.4586YESYESNO
02322331DONEPEZIL HCLPMS-Donepezil 5mg TabPMS0.45860.4586YESYESNO
02442426DORZOLAMIDE HCL & TIMOLOL MALEATEPMS-Dorzolamide-Timolol 2% & 0.5% Oph SolPMS2.09512.0951YESYESNO
02406187DOXYLAMINE SUCCINATE AND PYRIDOXINE HCLPMS-Doxylamine-Pyridoxine 10mg & 10mg SR TabPMS0.64020.6402YESNONO
02429446DULOXETINEPMS-Duloxetine 30mg DR CapPMS0.48140.4814YESNONO
02429454DULOXETINEPMS-Duloxetine 60mg DR CapPMS0.97690.9769YESNONO
02393220DUTASTERIDEPMS-Dutasteride 0.5mg CapPMS0.30270.3027YESYESNO
02434350ELETRIPTANPMS-Eletriptan (Off-Formulary Interchangeable) 40mg TabPMS10.0850N/AYESNONO
02434342ELETRIPTANPMS-Eletriptan (Off-Formulary Interchangeable) 20mg TabPMS10.0850N/AYESNONO
02300109ENALAPRIL MALEATEPMS-Enalapril 20mg TabPMS0.31950.3195YESNOYES
02300095ENALAPRIL MALEATEPMS-Enalapril 10mg TabPMS0.26470.2647YESNOYES
02300087ENALAPRIL MALEATEPMS-Enalapril 5mg TabPMS0.22030.2203YESNOYES
02300079ENALAPRIL MALEATEPMS-Enalapril 2.5mg TabPMS0.18630.1863YESNOYES
02430576ENTECAVIRPMS-Entecavir 0.5mg TabPMS5.50005.5000YESYESNO
02454394ERLOTINIBPMS-Erlotinib (Off-Formulary Interchangeable) 150mg TabPMS71.200071.2000YESNONO
02454386ERLOTINIBPMS-Erlotinib (Off-Formulary Interchangeable) 100mg TabPMS47.466747.4667YESNONO
02303949ESCITALOPRAMPMS-Escitalopram 10mg TabPMS0.31090.3109YESNONO
02303965ESCITALOPRAMPMS-Escitalopram 20mg TabPMS0.33100.3310YESNONO
02469251ESCITALOPRAMPharma-Escitalopram 20mg TabPMS0.33100.3310YESNONO
02469243ESCITALOPRAMPharma-Escitalopram 10mg TabPMS0.31090.3109YESNONO
02379171ESOMEPRAZOLEPMS-Esomeprazole DR Cap (Off-Formulary Interchangeable) 40mgPMS1.8690N/AYESNONO
02416409EZETIMIBEPMS-Ezetimibe 10mg TabPMS0.18110.1811YESYESNO
02278111FAMCICLOVIRPMS-Famciclovir 500mg TabPMS1.34361.3436YESYESNO
02278081FAMCICLOVIRPMS-Famciclovir (Off-Formulary Interchangeable) 125mg TabPMS2.02402.0240YESNONO
02278103FAMCICLOVIRPMS-Famciclovir (Off-Formulary Interchangeable) 250mg TabPMS2.72002.7200YESNONO
02341409FENTANYL TRANSDERMAL SYSTEMPMS-Fentanyl MTX (Off-Formulary Interchangeable) 75mcg/hr Trans PatchPMS9.6817N/AYESNOYES
02341417FENTANYL TRANSDERMAL SYSTEMPMS-Fentanyl MTX (Off-Formulary Interchangeable) 100mcg/hr Trans PatchPMS12.0512N/AYESNOYES
02341395FENTANYL TRANSDERMAL SYSTEMPMS-Fentanyl MTX 50mcg/hr Trans PatchPMS6.88386.8838YESYESYES
02341387FENTANYL TRANSDERMAL SYSTEMPMS-Fentanyl MTX 25mcg/hr Trans PatchPMS3.65823.6582YESYESYES
02341379FENTANYL TRANSDERMAL SYSTEMPMS-Fentanyl MTX (Off-Formulary Interchangeable) 12mcg/hr Trans PatchPMS3.1980N/AYESNOYES
02310112FINASTERIDEPMS-Finasteride 5mg TabPMS0.41380.4138YESYESNO
02320169FINASTERIDEPMS-Finasteride (Off-Formulary Interchangeable) 1mg TabPMS1.1453N/AYESNONO
02245480FLAVOXATE HCLPMS-Flavoxate (Not a Benefit) 200mg TabPMSN/AN/AYESNONO
02282348FLUCONAZOLEPMS-Fluconazole 150mg CapPMS3.94243.9424YESYESYES
02245644FLUCONAZOLEPMS-Fluconazole 100mg TabPMS2.28912.2891YESNONO
02245643FLUCONAZOLEPMS-Fluconazole 50mg TabPMS1.29041.2904YESNONO
00846341FLUNARIZINE HCLSibelium (Not a Benefit) 5mg CapPMSN/AN/AYESNONO
02177587FLUOXETINE HCLPMS-Fluoxetine 20mg CapPMS0.33110.3311YESNOYES
02177579FLUOXETINE HCLPMS-Fluoxetine (Off-Formulary Interchangeable) 10mg CapPMS1.1773N/AYESNOYES
02243446GABAPENTINPMS-Gabapentin 100mg CapPMS0.04160.0416YESNONO
02243448GABAPENTINPMS-Gabapentin 400mg CapPMS0.12060.1206YESNONO
02243447GABAPENTINPMS-Gabapentin 300mg CapPMS0.10120.1012YESNONO
02255898GABAPENTINPMS-Gabapentin (Off-Formulary Interchangeable) 600mg TabPMS1.3045N/AYESNONO
02255901GABAPENTINPMS-Gabapentin (Off-Formulary Interchangeable) 800mg TabPMS1.7393N/AYESNONO
02398397GALANTAMINE HYDROBROMIDEPMS-Galantamine ER 24mg ER CapPMS1.24651.2465YESYESNO
02398389GALANTAMINE HYDROBROMIDEPMS-Galantamine ER 16mg ER CapPMS1.24651.2465YESYESNO
02398370GALANTAMINE HYDROBROMIDEPMS-Galantamine ER 8mg ER CapPMS1.24651.2465YESYESNO
02460661GLATIRAMER ACETATEGlatect 20mg/mL Inj Sol-Pref Syr 1mL PkPMS32.400032.4000NOYESNO
02236734GLYBURIDEPMS-Glyburide 5mg TabPMS0.05740.0574YESNONO
02247387HYDROCHLOROTHIAZIDEPMS-Hydrochlorothiazide 50mg TabPMS0.02170.0217YESNONO
02247386HYDROCHLOROTHIAZIDEPMS-Hydrochlorothiazide 25mg TabPMS0.01570.0157YESNONO
02274086HYDROCHLOROTHIAZIDEPMS-Hydrochlorothiazide (Off-Formulary Interchangeable) 12.5mg TabPMSN/AN/AYESNONO
02324253HYDROCODONE BITARTRATEPMS-Hydrocodone 1mg/mL O/LPMS0.05700.0570YESNONO
01916386HYDROMORPHONE HCLPMS-HYDROmorphone 1mg/mL Oral SolPMS0.06980.0698YESNOYES
00885401HYDROMORPHONE HCLPMS-HYDROmorphone 4mg TabPMS0.22400.2240YESNOYES
00885436HYDROMORPHONE HCLPMS-HYDROmorphone 2mg TabPMS0.14170.1417YESNOYES
00885444HYDROMORPHONE HCLPMS-HYDROmorphone 1mg TabPMS0.09590.0959YESNOYES
00885428HYDROMORPHONE HCLPMS-HYDROmorphone 8mg TabPMS0.35280.3528YESNOYES
02431122IMATINIB MESYLATEPMS-Imatinib 400mg TabPMS20.831420.8314YESNOYES
02431114IMATINIB MESYLATEPMS-Imatinib 100mg TabPMS5.20795.2079YESNOYES
02239619INDAPAMIDEPMS-Indapamide 1.25mg TabPMS0.07450.0745YESNONO
02231136IPRATROPIUM BROMIDEPMS-Ipratropium 250mcg/mL Inh Sol-20mL PkPMS6.31406.3140YESYESNO
02231135IPRATROPIUM BROMIDEPMS-Ipratropium 125mcg/mL Inh Sol-2mL UDV PkPMS1.15051.1505YESYESNO
02231245IPRATROPIUM BROMIDEPMS-Ipratropium 250mcg/mL Inh Sol-2mL UDV PkPMS1.31801.3180YESYESNO
02239627IPRATROPIUM BROMIDEPMS-Ipratropium 0.03% Nasal SprayPMS0.75670.7567YESYESNO
02317087IRBESARTANPMS-Irbesartan 300mg TabPMS0.22810.2281YESNONO
02317060IRBESARTANPMS-Irbesartan 75mg TabPMS0.22810.2281YESNONO
02317079IRBESARTANPMS-Irbesartan 150mg TabPMS0.22810.2281YESNONO
02328534IRBESARTAN & HYDROCHLOROTHIAZIDEPMS-Irbesartan-HCTZ 300mg & 25mg TabPMS0.21840.2184YESNONO
02328518IRBESARTAN & HYDROCHLOROTHIAZIDEPMS-Irbesartan-HCTZ 150mg & 12.5mg TabPMS0.22810.2281YESNONO
02328526IRBESARTAN & HYDROCHLOROTHIAZIDEPMS-Irbesartan-HCTZ 300mg & 12.5mg TabPMS0.22810.2281YESNONO
02301288ISOSORBIDE-5-MONONITRATEPMS-ISMN (Off-Formulary Interchangeable) 60mg ER TabPMS0.49500.4950YESNONO
02478218LACOSAMIDEPharma-Lacosamide 100mg TabPMS0.87500.8750YESYESNO
02478226LACOSAMIDEPharma-Lacosamide 150mg TabPMS1.17631.1763YESYESNO
02478196LACOSAMIDEPharma-Lacosamide 50mg TabPMS0.63130.6313YESYESNO
02478234LACOSAMIDEPharma-Lacosamide 200mg TabPMS1.45001.4500YESYESNO
00703486LACTULOSEPMS-Lactulose 667mg/mL O/LPMS0.01470.0147NONONO
02469391LACTULOSEPMS-Lactulose-Pharma 667mg/mL O/LPMS0.01450.0145YESNONO
02246898LAMOTRIGINEPMS-Lamotrigine 100mg TabPMS0.27870.2787YESNONO
02246899LAMOTRIGINEPMS-Lamotrigine 150mg TabPMS0.41070.4107YESNONO
02246897LAMOTRIGINEPMS-Lamotrigine 25mg TabPMS0.06980.0698YESNONO
02433001LANSOPRAZOLELansoprazole 15mg DR CapPMS0.50000.5000YESYESNO
02433028LANSOPRAZOLELansoprazole 30mg DR CapPMS0.50000.5000YESYESNO
02288265LEFLUNOMIDEPMS-Leflunomide 10mg TabPMS2.64332.6433YESNONO
02288273LEFLUNOMIDEPMS-Leflunomide 20mg TabPMS2.64332.6433YESNONO
02309114LETROZOLEPMS-Letrozole 2.5mg TabPMS1.37801.3780YESYESNO
02454661LEVETIRACETAMLevetiracetam 500mg TabPMS0.39110.3911YESYESNO
02454688LEVETIRACETAMLevetiracetam 750mg TabPMS0.54160.5416YESYESNO
02454653LEVETIRACETAMLevetiracetam 250mg TabPMS0.32100.3210YESYESNO
02421488LEVODOPA & CARBIDOPAPMS-Levocarb CR 100mg & 25mg CR TabPMS0.38570.3857YESYESNO
02421496LEVODOPA & CARBIDOPAPMS-Levocarb CR 200mg & 50mg CR TabPMS0.71150.7115YESYESNO
02284677LEVOFLOXACINPMS-Levofloxacin 250mg TabPMS1.20381.2038YESNONO
02284685LEVOFLOXACINPMS-Levofloxacin 500mg TabPMS1.37181.3718YESNONO
02305585LEVOFLOXACINPMS-Levofloxacin (Off-Formulary Interchangeable) 750mg TabPMS6.5484N/AYESNONO
02292211LISINOPRILPMS-Lisinopril 10mg TabPMS0.16190.1619YESNONO
02292238LISINOPRILPMS-Lisinopril 20mg TabPMS0.19450.1945YESNONO
02292203LISINOPRILPMS-Lisinopril 5mg TabPMS0.13470.1347YESNONO
02216132LITHIUM CARBONATEPMS-Lithium Carbonate 150mg CapPMS0.06670.0667YESNONO
02216140LITHIUM CARBONATEPMS-Lithium Carbonate 300mg CapPMS0.06570.0657YESNONO
02229552LOPERAMIDE HCLDiarr-eze (Not a Benefit) 2mg CapletPMSN/AN/AYESNONO
02228351LOPERAMIDE HCLPMS-Loperamide 2mg CapletPMS0.09520.0952YESYESNO
00728209LORAZEPAMPMS-Lorazepam 2mg TabPMS0.06990.0699YESNONO
00728187LORAZEPAMPMS-Lorazepam 0.5mg TabPMS0.03590.0359YESNONO
00728195LORAZEPAMPMS-Lorazepam 1mg TabPMS0.04470.0447YESNONO
02309777LOSARTAN POTASSIUMPMS-Losartan 100mg TabPMS0.31470.3147YESNONO
02309750LOSARTAN POTASSIUMPMS-Losartan 25mg TabPMS0.31470.3147YESNONO
02309769LOSARTAN POTASSIUMPMS-Losartan 50mg TabPMS0.31470.3147YESNONO
02392224LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDEPMS-Losartan-HCTZ 50mg & 12.5mg TabPMS0.31470.3147YESNONO
02392232LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDEPMS-Losartan-HCTZ 100mg & 12.5mg TabPMS0.30820.3082YESNONO
02392240LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDEPMS-Losartan-HCTZ 100mg & 25mg TabPMS0.31470.3147YESNONO
02246014LOVASTATINPMS-Lovastatin 40mg TabPMS0.89850.8985YESNONO
02246013LOVASTATINPMS-Lovastatin 20mg TabPMS0.49190.4919YESNONO
02248268MELOXICAMPMS-Meloxicam 15mg TabPMS0.23110.2311YESNOYES
02248267MELOXICAMPMS-Meloxicam 7.5mg TabPMS0.20030.2003YESNOYES
02321130MEMANTINE HCLPMS-Memantine (Off-Formulary Interchangeable) 10mg TabPMS1.6357N/AYESNONO
02223562METFORMIN HCLPMS-Metformin 500mg TabPMS0.02470.0247YESNONO
02242589METFORMIN HCLPMS-Metformin (Off-Formulary Interchangeable) 850mg TabPMS0.2090N/AYESNONO
02170698METHOTREXATEPMS-Methotrexate 2.5mg TabPMS0.63250.6325YESNONO
02413744METHYLPHENIDATE HCLPMS-Methylphenidate ER 36mg SR TabPMS0.68630.6863YESNOYES
02413752METHYLPHENIDATE HCLPMS-Methylphenidate ER 54mg SR TabPMS0.84790.8479YESNOYES
02413736METHYLPHENIDATE HCLPMS-Methylphenidate ER 27mg SR TabPMS0.60550.6055YESNOYES
02413728METHYLPHENIDATE HCLPMS-Methylphenidate ER 18mg SR TabPMS0.52460.5246YESNOYES
00584991METHYLPHENIDATE HCLPMS-Methylphenidate 10mg TabPMS0.08160.0816YESNOYES
00585009METHYLPHENIDATE HCLPMS-Methylphenidate (Off-Formulary Interchangeable) 20mg TabPMS0.3536N/AYESNOYES
02230803METOPROLOL TARTRATEPMS-Metoprolol-L 50mg TabPMS0.06240.0624YESNONO
02230804METOPROLOL TARTRATEPMS-Metoprolol-L 100mg TabPMS0.13610.1361YESNONO
02294419MINOCYCLINE HCLPMS-Minocycline 50mg CapPMS0.11010.1101YESNONO
02248762MIRTAZAPINEPMS-Mirtazapine 30mg TabPMS0.31000.3100YESNONO
02440369MIXED SALT AMPHETAMINEPMS-Amphetamines XR 5mg ER CapPMS0.53720.5372YESNOYES
02440377MIXED SALT AMPHETAMINEPMS-Amphetamines XR 10mg ER CapPMS0.61050.6105YESNOYES
02440415MIXED SALT AMPHETAMINEPMS-Amphetamines XR 30mg ER CapPMS0.90380.9038YESNOYES
02440407MIXED SALT AMPHETAMINEPMS-Amphetamines XR 25mg ER CapPMS0.83050.8305YESNOYES
02440393MIXED SALT AMPHETAMINEPMS-Amphetamines XR 20mg ER CapPMS0.75720.7572YESNOYES
02440385MIXED SALT AMPHETAMINEPMS-Amphetamines XR 15mg ER CapPMS0.68380.6838YESNOYES
02354985MONTELUKAST SODIUMPMS-Montelukast (Off-Formulary Interchangeable) 5mg Chew TabPMS1.20751.2075YESNONO
02354977MONTELUKAST SODIUMPMS-Montelukast 4mg Chew TabPMS0.27580.2758YESYESNO
02373947MONTELUKAST SODIUMPMS-Montelukast FC (Off-Formulary Interchangeable) 10mg TabPMS1.77351.7735YESNONO
02432218MOXIFLOXACIN HYDROCHLORIDEPMS-Moxifloxacin (Off-Formulary Interchangeable) 0.5% Oph Sol-3mL Pk (Preservative-Free)PMS11.2701N/AYESNONO
02380900NABILONEPMS-Nabilone 0.5mg CapPMS0.77570.7757YESNONO
02380919NABILONEPMS-Nabilone 1mg CapPMS1.55131.5513YESNONO
02294702NAPROXENPMS-Naproxen EC (Off-Formulary Interchangeable) 375mg Ent TabPMS0.3675N/AYESNOYES
02294710NAPROXENPMS-Naproxen EC (Off-Formulary Interchangeable) 500mg Ent TabPMS0.6894N/AYESNOYES
02017237NAPROXENPMS-Naproxen 500mg SupPMS0.95670.9567YESNOYES
02405776NEVIRAPINEPMS-Nevirapine 200mg TabPMS1.23461.2346YESNOYES
02455676NITROFURANTOIN MONO/MICRO CRYSTALSPMS-Nitrofurantoin 100mg CapPMS0.59740.5974YESNONO
02303205OLANZAPINEPMS-Olanzapine ODT 10mg Rapid Dissolve TabPMS0.71430.7143YESNONO
02303191OLANZAPINEPMS-Olanzapine ODT 5mg Rapid Dissolve TabPMS0.35740.3574YESNONO
02423944OLANZAPINEPMS-Olanzapine ODT (Off-Formulary Interchangeable) 20mg Rapid Dissolve TabPMS7.5977N/AYESNONO
02303213OLANZAPINEPMS-Olanzapine ODT 15mg Rapid Dissolve TabPMS1.07111.0711YESNONO
02303159OLANZAPINEPMS-Olanzapine 5mg TabPMS0.35440.3544YESNONO
02303116OLANZAPINEPMS-Olanzapine 2.5mg TabPMS0.17720.1772YESNONO
02367483OLANZAPINEPMS-Olanzapine (Off-Formulary Interchangeable) 20mg TabPMS10.3093N/AYESNONO
02303175OLANZAPINEPMS-Olanzapine 10mg TabPMS0.70880.7088YESNONO
02303183OLANZAPINEPMS-Olanzapine 15mg TabPMS1.06311.0631YESNONO
02303167OLANZAPINEPMS-Olanzapine 7.5mg TabPMS0.53160.5316YESNONO
02461307OLMESARTAN MEDOXOMILPMS-Olmesartan 20mg TabPMS0.30190.3019YESNONO
02461315OLMESARTAN MEDOXOMILPMS-Olmesartan 40mg TabPMS0.30190.3019YESNONO
09857342OMEPRAZOLEPMS-Omeprazole DR Cap 20mgPMS0.22870.2287YESYESNO
02320851OMEPRAZOLEPMS-Omeprazole DR Cap 20mgPMS0.22870.2287YESYESNO
02310260OMEPRAZOLEPMS-Omeprazole DR Tab 20mgPMS0.22870.2287YESYESNO
02258188ONDANSETRON HYDROCHLORIDEPMS-Ondansetron 4mg TabPMS3.34953.3495YESYESNO
02258196ONDANSETRON HYDROCHLORIDEPMS-Ondansetron 8mg TabPMS5.11105.1110YESYESNO
02223376OXYBUTYNIN CHLORIDEPMS-Oxybutynin 1mg/mL O/LPMS0.09700.0970YESNONO
02240550OXYBUTYNIN CHLORIDEPMS-Oxybutynin 5mg TabPMS0.09860.0986YESNONO
02319977OXYCODONE HCLPMS-Oxycodone (Off-Formulary Interchangeable) 5mg TabPMS0.23330.2333YESNOYES
02319985OXYCODONE HCLPMS-Oxycodone (Off-Formulary Interchangeable) 10mg TabPMS0.34510.3451YESNOYES
02319993OXYCODONE HCLPMS-Oxycodone (Off-Formulary Interchangeable) 20mg TabPMS0.60010.6001YESNOYES
02307871PANTOPRAZOLE SODIUMPMS-Pantoprazole 40mg Ent TabPMS0.20160.2016YESYESNO
02437945PANTOPRAZOLE SODIUMPantoprazole 40mg Ent TabPMS0.20160.2016YESYESNO
02247750PAROXETINE HCLPMS-Paroxetine (Off-Formulary Interchangeable) 10mg TabPMS1.0430N/AYESNONO
02247752PAROXETINE HCLPMS-Paroxetine 30mg TabPMS0.34530.3453YESNONO
02247751PAROXETINE HCLPMS-Paroxetine 20mg TabPMS0.32500.3250YESNONO
02470691PERINDOPRIL ERBUMINEPMS-Perindopril 8mg TabPMS0.28310.2831YESNONO
02470683PERINDOPRIL ERBUMINEPMS-Perindopril 4mg TabPMS0.20420.2042YESNONO
02470675PERINDOPRIL ERBUMINEPMS-Perindopril 2mg TabPMS0.16320.1632YESNONO
02231537PINDOLOLPMS-Pindolol 10mg TabPMS0.23230.2323YESNONO
02231536PINDOLOLPMS-Pindolol 5mg TabPMS0.13610.1361YESNONO
02303140PIOGLITAZONE HCLPMS-Pioglitazone (Off-Formulary Interchangeable) 45mg TabPMS3.31053.3105YESNONO
02303132PIOGLITAZONE HCLPMS-Pioglitazone (Off-Formulary Interchangeable) 30mg TabPMS2.20172.2017YESNONO
02303124PIOGLITAZONE HCLPMS-Pioglitazone (Off-Formulary Interchangeable) 15mg TabPMS1.57161.5716YESNONO
02154463PIROXICAMPMS-Piroxicam 20mg SupPMS1.64601.6460YESNOYES
02238604POTASSIUM CHLORIDEPMS-Potassium Chloride 1.33mEq/mL O/LPMS0.01020.0102YESNONO
02290146PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEPMS-Pramipexole 1mg TabPMS0.39010.3901YESNOYES
02290138PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEPMS-Pramipexole (Off-Formulary Interchangeable) 0.5mg TabPMS1.3860N/AYESNONO
02290111PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEPMS-Pramipexole 0.25mg TabPMS0.19500.1950YESNOYES
02290154PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATEPMS-Pramipexole 1.5mg TabPMS0.39010.3901YESNOYES
02247655PRAVASTATIN SODIUMPMS-Pravastatin 10mg TabPMS0.29160.2916YESNONO
02247656PRAVASTATIN SODIUMPMS-Pravastatin 20mg TabPMS0.34400.3440YESNONO
02247657PRAVASTATIN SODIUMPMS-Pravastatin 40mg TabPMS0.41430.4143YESNONO
02245532PREDNISOLONE SODIUM PHOSPHATEPMS-Prednisolone 6.7mg/5mL O/LPMS0.09000.0900YESNONO
02359642PREGABALINPMS-Pregabalin 300mg CapPMS0.41450.4145YESNONO
02398079PREGABALINPMS-Pregabalin (Off-Formulary Interchangeable) 225mg CapPMS1.7270N/AYESNONO
02359634PREGABALINPMS-Pregabalin 150mg CapPMS0.41450.4145YESNONO
02359626PREGABALINPMS-Pregabalin 75mg CapPMS0.30070.3007YESNONO
02359596PREGABALINPMS-Pregabalin 25mg CapPMS0.14810.1481YESNONO
02359618PREGABALINPMS-Pregabalin 50mg CapPMS0.23240.2324YESNONO
02476576PROGESTERONEPMS-Progesterone (Off-Formulary Interchangeable) 100mg CapPMS1.43581.4358YESNONO
00583979PROMETHAZINE HCLPMS-Promethazine (Not a Benefit) 2mg/mL O/LPMSN/AN/AYESNONO
02294575PROPAFENONE HCLPMS-Propafenone 300mg TabPMS0.52270.5227YESNONO
02294559PROPAFENONE HCLPMS-Propafenone 150mg TabPMS0.29660.2966YESNONO
00599875PSYLLIUM MUCILLOIDMucillium Oral PdPMS0.01750.0175YESNONO
02296551QUETIAPINEPMS-Quetiapine 25mg TabPMS0.04940.0494YESNONO
02296608QUETIAPINEPMS-Quetiapine 300mg TabPMS0.38630.3863YESNONO
02296594QUETIAPINEPMS-Quetiapine 200mg TabPMS0.26470.2647YESNONO
02296578QUETIAPINEPMS-Quetiapine 100mg TabPMS0.13180.1318YESNONO
02310805RABEPRAZOLE SODIUMPMS-Rabeprazole EC 10mg TabPMS0.06690.0669YESNONO
02310813RABEPRAZOLE SODIUMPMS-Rabeprazole EC 20mg TabPMS0.13380.1338YESNONO
02358921RALOXIFENE HCLPMS-Raloxifene 60mg TabPMS0.47010.4701YESYESNO
02247917RAMIPRILPMS-Ramipril Cap 2.5mgPMS0.08170.0817YESNONO
02247918RAMIPRILPMS-Ramipril Cap 5mgPMS0.08170.0817YESNONO
02295369RAMIPRILPMS-Ramipril Cap 1.25mgPMS0.07080.0708YESNONO
02247919RAMIPRILPMS-Ramipril Cap 10mgPMS0.10340.1034YESNONO
02469081RAMIPRILPharma-Ramipril 10mgPMS0.10340.1034YESNONO
02469065RAMIPRILPharma-Ramipril 2.5mgPMS0.08170.0817YESNONO
02469057RAMIPRILPharma-Ramipril 1.25mgPMS0.07080.0708YESNONO
02469073RAMIPRILPharma-Ramipril 5mgPMS0.08170.0817YESNONO
02342146RAMIPRIL & HYDROCHLOROTHIAZIDEPMS-Ramipril-HCTZ 5mg & 12.5mg TabPMS0.20110.2011YESNONO
02342170RAMIPRIL & HYDROCHLOROTHIAZIDEPMS-Ramipril-HCTZ 10mg & 25mg TabPMS0.13170.1317YESNONO
02342162RAMIPRIL & HYDROCHLOROTHIAZIDEPMS-Ramipril-HCTZ 5mg & 25mg TabPMS0.20690.1915YESNONO
02342154RAMIPRIL & HYDROCHLOROTHIAZIDEPMS-Ramipril-HCTZ 10mg & 12.5mg TabPMS0.13170.1317YESNONO
02342138RAMIPRIL & HYDROCHLOROTHIAZIDEPMS-Ramipril-HCTZ 2.5mg & 12.5mg TabPMS0.20930.1495YESNONO
02242453RANITIDINE HCLPMS-Ranitidine 150mg TabPMS0.11970.1197YESNONO
02242454RANITIDINE HCLPMS-Ranitidine 300mg TabPMS0.22530.2253YESNONO
02354942REPAGLINIDEPMS-Repaglinide (Off-Formulary Interchangeable) 2mg TabPMS0.24410.2441YESNONO
02354934REPAGLINIDEPMS-Repaglinide (Off-Formulary Interchangeable) 1mg TabPMS0.21650.2165YESNONO
02424177RISEDRONATE SODIUMPMS-Risedronate 150mg TabPMS11.187511.1875YESNONO
02302209RISEDRONATE SODIUMPMS-Risedronate 35mg TabPMS1.97871.9787YESNONO
02279266RISPERIDONEPMS-Risperidone 1mg/mL O/LPMS0.48020.4802YESNONO
02370700RISPERIDONEPMS-Risperidone ODT 4mg Orally Disintegrating TabPMS2.04252.0425YESNONO
02370697RISPERIDONEPMS-Risperidone ODT 3mg Orally Disintegrating TabPMS1.52751.5275YESNONO
02291797RISPERIDONEPMS-Risperidone ODT 2mg Orally Disintegrating TabPMS1.01881.0188YESNONO
02291789RISPERIDONEPMS-Risperidone ODT 1mg Orally Disintegrating TabPMS0.51500.5150YESNONO
02252058RISPERIDONEPMS-Risperidone 3mg TabPMS0.71800.7180YESNONO
02252066RISPERIDONEPMS-Risperidone 4mg TabPMS0.95740.9574YESNONO
02252031RISPERIDONEPMS-Risperidone 2mg TabPMS0.47950.4795YESNONO
02252023RISPERIDONEPMS-Risperidone 1mg TabPMS0.23970.2397YESNONO
02252015RISPERIDONEPMS-Risperidone 0.5mg TabPMS0.17350.1735YESNONO
02252007RISPERIDONEPMS-Risperidone 0.25mg TabPMS0.10360.1036YESNONO
02306034RIVASTIGMINEPMS-Rivastigmine 1.5mg CapPMS0.65150.6514YESYESNO
02306050RIVASTIGMINEPMS-Rivastigmine 4.5mg CapPMS0.65150.6514YESYESNO
02306042RIVASTIGMINEPMS-Rivastigmine 3mg CapPMS0.65150.6514YESYESNO
02393379RIZATRIPTANPMS-Rizatriptan RDT (Off-Formulary Interchangeable) 10mg Orally Disintegrating TabPMS11.115011.1150YESNONO
02393360RIZATRIPTANPMS-Rizatriptan RDT (Off-Formulary Interchangeable) 5mg Orally Disintegrating TabPMS11.115011.1150YESNONO
02326590ROPINIROLEPMS-Ropinirole 0.25mg TabPMS0.07100.0710YESNONO
02326612ROPINIROLEPMS-Ropinirole 1mg TabPMS0.28380.2838YESNONO
02326620ROPINIROLEPMS-Ropinirole 2mg TabPMS0.31220.3122YESNONO
02326639ROPINIROLEPMS-Ropinirole 5mg TabPMS0.85960.8596YESNONO
02378531ROSUVASTATIN CALCIUMPMS-Rosuvastatin 10mg TabPMS0.13540.1354YESNONO
02378558ROSUVASTATIN CALCIUMPMS-Rosuvastatin 20mg TabPMS0.16920.1692YESNONO
02378566ROSUVASTATIN CALCIUMPMS-Rosuvastatin 40mg TabPMS0.19900.1990YESNONO
02378523ROSUVASTATIN CALCIUMPMS-Rosuvastatin 5mg TabPMS0.12840.1284YESNONO
02208237SALBUTAMOLPMS-Salbutamol 2mg/mL Inh Sol- 2.5mL PkPMS0.67500.6750YESYESNO
02208229SALBUTAMOLPMS-Salbutamol 1mg/mL Inh Sol- 2.5mL PkPMS0.36170.3617YESYESNO
02244838SERTRALINE HCLPMS-Sertraline 25mg CapPMS0.15160.1516YESNOYES
02244839SERTRALINE HCLPMS-Sertraline 50mg CapPMS0.30320.3032YESNOYES
02244840SERTRALINE HCLPMS-Sertraline 100mg CapPMS0.33030.3303YESNOYES
02412179SILDENAFILPMS-Sildenafil R (Off-Formulary Interchangeable) 20mg TabPMS7.29407.2940YESNONO
02317559SILDENAFILSildenafil (Off-Formulary Interchangeable) 25mg TabPMS8.2894N/AYESNONO
02317583SILDENAFILSildenafil (Off-Formulary Interchangeable) 100mg TabPMS9.2006N/AYESNONO
02317575SILDENAFILSildenafil (Off-Formulary Interchangeable) 50mg TabPMS8.8481N/AYESNONO
02269279SIMVASTATINPMS-Simvastatin 20mg TabPMS0.25010.2501YESNONO
02269260SIMVASTATINPMS-Simvastatin 10mg TabPMS0.20230.2023YESNONO
02269287SIMVASTATINPMS-Simvastatin 40mg TabPMS0.25010.2501YESNONO
02269295SIMVASTATINPMS-Simvastatin 80mg TabPMS0.25010.2501YESNONO
02269252SIMVASTATINPMS-Simvastatin 5mg TabPMS0.10230.1023YESNONO
02469979SIMVASTATINPharma-Simvastatin 5mg TabPMS0.10230.1023YESNONO
02470012SIMVASTATINPharma-Simvastatin 80mg TabPMS0.25010.2501YESNONO
02470004SIMVASTATINPharma-Simvastatin 40mg TabPMS0.25010.2501YESNONO
02469995SIMVASTATINPharma-Simvastatin 20mg TabPMS0.25010.2501YESNONO
02469987SIMVASTATINPharma-Simvastatin 10mg TabPMS0.20230.2023YESNONO
02046113SODIUM CROMOGLYCATEPMS-Sodium Cromoglycate 1% Inh Sol-2mL PkPMS0.78000.7800YESNONO
02417731SOLIFENACIN SUCCINATEPMS-Solifenacin 10mg TabPMS0.30410.3041YESYESNO
02417723SOLIFENACIN SUCCINATEPMS-Solifenacin 5mg TabPMS0.30410.3041YESYESNO
02238326SOTALOL HCLPMS-Sotalol (Off-Formulary Interchangeable) 80mg TabPMS0.59320.5932YESNONO
02238327SOTALOL HCLPMS-Sotalol 160mg TabPMS0.16230.1623YESNONO
00598488SULFASALAZINEPMS-Sulfasalazine-E.C. 500mg Ent TabPMS0.28160.2816YESNONO
00598461SULFASALAZINEPMS-Sulfasalazine 500mg TabPMS0.18040.1804YESNONO
02256436SUMATRIPTAN SUCCINATEPMS-Sumatriptan (Off-Formulary Interchangeable) 50mg TabPMS9.06509.0650YESNONO
02256444SUMATRIPTAN SUCCINATEPMS-Sumatriptan (Off-Formulary Interchangeable) 100mg TabPMS9.98679.9867YESNONO
02256428SUMATRIPTAN SUCCINATEPMS-Sumatriptan (Off-Formulary Interchangeable) 25mg TabPMS8.99008.9900YESNONO
02409429TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 5mg TabPMS3.6471N/AYESNONO
02409437TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 10mg TabPMS11.9255N/AYESNONO
02409445TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 20mg TabPMS12.3569N/AYESNONO
02409410TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 2.5mg TabPMS3.6471N/AYESNONO
02432897TELMISARTANTelmisartan 40mg TabPMS0.21610.2161YESNONO
02432900TELMISARTANTelmisartan 80mg TabPMS0.21610.2161YESNONO
02453940TENOFOVIR DISOPROXILPMS-Tenofovir 300mg TabPMS4.88844.8884YESYESNO
02243518TERAZOSIN HCLPMS-Terazosin 1mg TabPMS0.18350.1835YESNONO
02243521TERAZOSIN HCLPMS-Terazosin 10mg TabPMS0.46370.4637YESNONO
02243520TERAZOSIN HCLPMS-Terazosin 5mg TabPMS0.31680.3168YESNONO
02243519TERAZOSIN HCLPMS-Terazosin 2mg TabPMS0.23330.2333YESNONO
02294273TERBINAFINE HCLPMS-Terbinafine 250mg TabPMS0.77140.7714YESNONO
02322498TESTOSTERONE UNDECANOATEPMS-Testosterone 40mg CapPMS0.47000.4700YESYESNO
02402424TETRABENAZINEPMS-Tetrabenazine (Off-Formulary Interchangeable) 25mg TabPMS4.85514.8551YESNONO
02230828TIAPROFENIC ACIDPMS-Tiaprofenic (Not a Benefit) 300mg TabPMSN/AN/AYESNOYES
02083345TIMOLOL MALEATEPMS-Timolol 0.5% Oph SolPMS1.21451.2145YESNOYES
02083353TIMOLOL MALEATEPMS-Timolol 0.25% Oph SolPMS0.96780.9678YESNOYES
02262991TOPIRAMATEPMS-Topiramate 25mg TabPMS0.24330.2433YESNONO
02263017TOPIRAMATEPMS-Topiramate 200mg TabPMS0.67480.6748YESNONO
02263009TOPIRAMATEPMS-Topiramate 100mg TabPMS0.45830.4583YESNONO
02401657TRAMADOL HCL & ACETAMINOPHENPMS-Tramadol-Acet (Off-Formulary Interchangeable) 37.5mg & 325mg TabPMS0.6264N/AYESNOYES
02357798TRANDOLAPRILPMS-Trandolapril 4mg CapPMS0.24980.2498YESNONO
02357771TRANDOLAPRILPMS-Trandolapril 2mg CapPMS0.20250.2025YESNONO
02357755TRANDOLAPRILPMS-Trandolapril (Off-Formulary Interchangeable) 0.5mg CapPMS0.2372N/AYESNONO
02357763TRANDOLAPRILPMS-Trandolapril 1mg CapPMS0.17620.1762YESNONO
01937227TRAZODONE HYDROCHLORIDEPMS-Trazodone 50mg TabPMS0.05540.0554YESNONO
01937235TRAZODONE HYDROCHLORIDEPMS-Trazodone 100mg TabPMS0.09890.0989YESNONO
02273500URSODIOLPMS-Ursodiol C 500mg TabPMS0.72420.7242YESYESNO
02273497URSODIOLPMS-Ursodiol C 250mg TabPMS0.38180.3818YESYESNO
02298457VALACYCLOVIRPMS-Valacyclovir 500mg TabPMS0.61980.6198YESNONO
02381230VALACYCLOVIRPMS-Valacyclovir (Off-Formulary Interchangeable) 1000mg TabPMS5.8537N/AYESNONO
02236807VALPROATE SODIUMPMS-Valproic Acid 50mg/mL O/LPMS0.03980.0398YESNONO
02230768VALPROIC ACIDPMS-Valproic Acid 250mg CapPMS0.29050.2905YESNONO
02229628VALPROIC ACIDPMS-Valproic Acid 500mg Ent CapPMS0.63560.6356YESNONO
02313006VALSARTANPMS-Valsartan 80mg TabPMS0.21590.2159YESNONO
02312999VALSARTANPMS-Valsartan (Off-Formulary Interchangeable) 40mg TabPMS0.5823N/AYESNONO
02278561VENLAFAXINE HCLPMS-Venlafaxine XR 150mg ER CapPMS0.19270.1927YESNONO
02278545VENLAFAXINE HCLPMS-Venlafaxine XR 37.5mg ER CapPMS0.09130.0913YESNONO
02278553VENLAFAXINE HCLPMS-Venlafaxine XR 75mg ER CapPMS0.18250.1825YESNONO
02237791VERAPAMIL HCLPMS-Verapamil SR 240mg LA TabPMS0.50750.5075YESNONO
02324768ZOLMITRIPTANPMS-Zolmitriptan ODT (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating TabPMS6.86256.8625YESNONO
02324229ZOLMITRIPTANPMS-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg TabPMS6.85866.8586YESNONO
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