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Products found: 457New Search
DIN/ PIN/ NPNGeneric NameBrand Name, Strength & Dosage FormMFRDrug Benefit Price or Unit PriceAmount MOH PaysInter- change- ableLimited UseThera- peutic Notes
02458381ABACAVIR SULFATE & LAMIVUDINEPMS-Abacavir-Lamivudine 600mg & 300mg TabPMS5.98755.9875YESNONO
02501503ABIRATERONE ACETATEPMS-Abiraterone (Off-Formulary Interchangeable) 500mg TabPMS52.062552.0625YESNONO
02492601ABIRATERONE ACETATEPMS-Abiraterone (Off-Formulary Interchangeable) 250mg TabPMS26.031326.0313YESNONO
00816027ACETAMINOPHEN & CODEINE PHOSPHATEPMS-Acetaminophen With Codeine 160mg & 8mg/5mL O/LPMS0.10740.1074YESNOYES
02284006ALENDRONATEPMS-Alendronate-FC 70mg TabPMS1.78041.7804YESNONO
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
02469030AMLODIPINEPharma-Amlodipine 5mg TabPMS0.13430.1343YESNONO
02469049AMLODIPINEPharma-Amlodipine 10mg TabPMS0.19930.1993YESNONO
02274949ANAGRELIDE HCLPMS-Anagrelide 0.5mg CapPMS4.69974.6997YESYESNO
02320738ANASTROZOLEPMS-Anastrozole 1mg TabPMS0.95220.9522YESNONO
02521733APREMILASTPMS-Apremilast (Off-Formulary Interchangeable) 30mg TabPMS18.7238N/AYESNONO
02466678ARIPIPRAZOLEPMS-Aripiprazole 15mg TabPMS1.26921.2692YESNOYES
02466694ARIPIPRAZOLEPMS-Aripiprazole 30mg TabPMS1.00171.0017YESNOYES
02466651ARIPIPRAZOLEPMS-Aripiprazole 10mg TabPMS1.07541.0754YESNOYES
02466686ARIPIPRAZOLEPMS-Aripiprazole 20mg TabPMS1.00171.0017YESNOYES
02466643ARIPIPRAZOLEPMS-Aripiprazole 5mg TabPMS0.90460.9046YESNOYES
02466635ARIPIPRAZOLEPMS-Aripiprazole 2mg TabPMS0.80920.8092YESNOYES
02237600ATENOLOLPMS-Atenolol 50mg TabPMS0.09380.0938YESNONO
02237601ATENOLOLPMS-Atenolol 100mg TabPMS0.15430.1543YESNONO
02381052ATOMOXETINE HCLPMS-Atomoxetine 40mg CapPMS0.73690.7369YESNONO
02381060ATOMOXETINE HCLPMS-Atomoxetine 60mg CapPMS0.80920.8092YESNONO
02381044ATOMOXETINE HCLPMS-Atomoxetine 25mg CapPMS0.64200.6420YESNONO
02381036ATOMOXETINE HCLPMS-Atomoxetine 18mg CapPMS0.57480.5748YESNONO
02381028ATOMOXETINE HCLPMS-Atomoxetine 10mg CapPMS0.51060.5106YESNONO
02477157ATORVASTATIN CALCIUMPMS-Atorvastatin 20mg TabPMS0.21790.2179YESNONO
02477165ATORVASTATIN CALCIUMPMS-Atorvastatin 40mg TabPMS0.23420.2342YESNONO
02477149ATORVASTATIN CALCIUMPMS-Atorvastatin 10mg TabPMS0.17430.1743YESNONO
02507269ATORVASTATIN CALCIUMPMSC-Atorvastatin 80mg TabPMS0.23420.2342YESNONO
02507242ATORVASTATIN CALCIUMPMSC-Atorvastatin 20mg TabPMS0.21790.2179YESNONO
02507250ATORVASTATIN CALCIUMPMSC-Atorvastatin 40mg TabPMS0.23420.2342YESNONO
02507234ATORVASTATIN CALCIUMPMSC-Atorvastatin 10mg TabPMS0.17430.1743YESNONO
02261634AZITHROMYCINPMS-Azithromycin 250mg TabPMS0.94100.9410YESNOYES
02261642AZITHROMYCINPMS-Azithromycin 600mg TabPMS10.665210.6652YESYESYES
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
02383020BOSENTAN MONOHYDRATEPMS-Bosentan (Off-Formulary Interchangeable) 125mg TabPMS32.089332.0893YESNONO
02383012BOSENTAN MONOHYDRATEPMS-Bosentan (Off-Formulary Interchangeable) 62.5mg TabPMS32.089332.0893YESNONO
02246284BRIMONIDINEPMS-Brimonidine 0.2% Oph SolPMS1.15501.1550YESYESNO
02424878BUPRENORPHINE & NALOXONEPMS-Buprenorphine-Naloxone 8mg & 2mg SL TabPMS2.36502.3650YESNONO
02424851BUPRENORPHINE & NALOXONEPMS-Buprenorphine-Naloxone 2mg & 0.5mg SL TabPMS1.33501.3350YESNONO
02230942BUSPIRONE HYDROCHLORIDEPMS-Buspirone 10mg TabPMS0.27130.2713YESNONO
02495899CALCITRIOLPMS-Calcitriol 0.25mcg CapPMS0.23410.2341YESNONO
02495902CALCITRIOLPMS-Calcitriol 0.5mcg CapPMS0.37230.3723YESNONO
02391198CANDESARTAN CILEXETILPMS-Candesartan 8mg TabPMS0.22810.2281YESNONO
02391171CANDESARTAN CILEXETILPMS-Candesartan 4mg TabPMS0.17000.1700YESNONO
02391228CANDESARTAN CILEXETILPMS-Candesartan 32mg TabPMS0.22810.2281YESNONO
02391201CANDESARTAN CILEXETILPMS-Candesartan 16mg TabPMS0.22810.2281YESNONO
02391295CANDESARTAN CILEXETIL & HYDROCHLOROTHIAZIDEPMS-Candesartan-HCTZ 16mg & 12.5mg TabPMS0.21560.2156YESNONO
02245917CARVEDILOLPMS-Carvedilol 25mg TabPMS0.20600.2060YESYESNO
02245916CARVEDILOLPMS-Carvedilol 12.5mg TabPMS0.20600.2060YESYESNO
02245915CARVEDILOLPMS-Carvedilol 6.25mg TabPMS0.20600.2060YESYESNO
02245914CARVEDILOLPMS-Carvedilol 3.125mg TabPMS0.20600.2060YESYESNO
02355450CELECOXIBPMS-Celecoxib 200mg CapPMS0.25580.2558YESYESYES
02355442CELECOXIBPMS-Celecoxib 100mg CapPMS0.12790.1279YESYESYES
02517116CELECOXIBPMSC-Celecoxib 100mg CapPMS0.12790.1279YESYESYES
02517124CELECOXIBPMSC-Celecoxib 200mg CapPMS0.25580.2558YESYESYES
02315955CETIRIZINE HYDROCHLORIDEExtra Strength Allergy Relief (Off-Formulary Interchangeable) 10mg TabPMS0.3938N/AYESNONO
02315963CETIRIZINE HYDROCHLORIDEPMS-Cetirizine (Off-Formulary Interchangeable) 20mg TabPMS0.7535N/AYESNONO
02517604CINACALCETPMS-Cinacalcet (Off-Formulary Interchangeable) 30mg TabPMS10.194710.1947YESNONO
02517612CINACALCETPMS-Cinacalcet (Off-Formulary Interchangeable) 60mg TabPMS18.590018.5900YESNONO
02517620CINACALCETPMS-Cinacalcet (Off-Formulary Interchangeable) 90mg TabPMS27.051727.0517YESNONO
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
02248010CITALOPRAM HYDROBROMIDEPMS-Citalopram 20mg TabPMS0.13320.1332YESNONO
02248011CITALOPRAM HYDROBROMIDEPMS-Citalopram 40mg 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
02048701CLONAZEPAMPMS-Clonazepam 0.5mg TabPMS0.04180.0418YESNONO
02048736CLONAZEPAMPMS-Clonazepam 2mg TabPMS0.07210.0721YESNONO
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
02531569DAPAGLIFLOZINPMS-Dapagliflozin 10mg TabPMS0.68250.6825YESNOYES
02531550DAPAGLIFLOZINPMS-Dapagliflozin 5mg TabPMS0.68250.6825YESNOYES
02528290DEFERASIROXPMS-Deferasirox (Type J) 90mg TabPMS2.63032.6303YESNONO
02528312DEFERASIROXPMS-Deferasirox (Type J) 360mg TabPMS10.522810.5228YESNONO
02528304DEFERASIROXPMS-Deferasirox (Type J) 180mg TabPMS5.26105.2610YESNONO
02304368DESMOPRESSIN ACETATEPMS-Desmopressin 0.1mg TabPMS0.66090.6609YESNONO
02304376DESMOPRESSIN ACETATEPMS-Desmopressin 0.2mg TabPMS1.32171.3217YESNONO
01964976DEXAMETHASONEPMS-Dexamethasone 0.5mg TabPMS0.15640.1564YESNONO
01964070DEXAMETHASONEPMS-Dexamethasone 4mg TabPMS0.61120.6112YESNONO
02239753DICLOFENAC POTASSIUMPMS-Diclofenac K (Off-Formulary Interchangeable) 50mg TabPMS0.3937N/AYESNOYES
02302616DICLOFENAC SODIUMPMS-Diclofenac 25mg Ent TabPMS0.07810.0781YESNOYES
02302624DICLOFENAC SODIUMPMS-Diclofenac 50mg Ent TabPMS0.20640.2064YESNOYES
02231508DICLOFENAC SODIUMPMS-Diclofenac 100mg SupPMS0.58400.5840YESNOYES
02356783DICLOFENAC SODIUMPMS-Diclofenac (Off-Formulary Interchangeable) 1.5% W/W Top SolPMS0.6227N/AYESNONO
02413477DICLOFENAC SODIUM & MISOPROSTOLPMS-Diclofenac-Misoprostol 75mg & 200mcg TabPMS0.42860.4286YESNOYES
02413469DICLOFENAC SODIUM & MISOPROSTOLPMS-Diclofenac-Misoprostol 50mg & 200mcg TabPMS0.31490.3149YESNOYES
02242320DIGOXINPMS-Digoxin 0.05mg/mL O/LPMS0.36920.3692NONOYES
02335727DIGOXINPMS-Digoxin 0.25mg TabPMS0.20600.2060NONOYES
02335700DIGOXINPMS-Digoxin 0.0625mg TabPMS0.18500.1850YESNOYES
02335719DIGOXINPMS-Digoxin 0.125mg TabPMS0.17510.1751YESNOYES
02355779DILTIAZEM HCLPMS-Diltiazem CD 240mg LA CapPMS0.63990.6399YESNONO
02355760DILTIAZEM HCLPMS-Diltiazem CD 180mg LA CapPMS0.48240.4824YESNONO
02355752DILTIAZEM HCLPMS-Diltiazem CD 120mg LA CapPMS0.36340.3634YESNONO
02355787DILTIAZEM HCLPMS-Diltiazem CD 300mg LA CapPMS0.79990.7999YESNONO
00586331DIMENHYDRINATEPMS-Dimenhydrinate (Not a Benefit) 50mg TabPMSN/AN/AYESNONO
02497034DIMETHYL FUMARATEPMS-Dimethyl Fumarate (Off-Formulary Interchangeable) 240mg DR CapPMS18.386718.3867YESNONO
02497026DIMETHYL FUMARATEPMS-Dimethyl Fumarate (Off-Formulary Interchangeable) 120mg DR CapPMS9.19339.1933YESNONO
01994344DOCUSATE SODIUM (DIOCTYL SODIUM SULFOSUCCINATE)Soflax 100mg CapPMS0.03280.0328YESNONO
02236466DOMPERIDONE MALEATEPMS-Domperidone 10mg TabPMS0.04280.0428YESNONO
02322331DONEPEZIL HCLPMS-Donepezil 5mg TabPMS0.45860.4586YESYESNO
02322358DONEPEZIL HCLPMS-Donepezil 10mg 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 CapPMS0.48140.3611YESNONO
02429454DULOXETINEPMS-Duloxetine 60mg DR CapPMS0.97690.7327YESNONO
02393220DUTASTERIDEPMS-Dutasteride 0.5mg CapPMS0.25650.2565YESYESNO
02487284EFAVIRENZ/TENOFOVIR DISOPROXIL FUMARATE/EMTRICITABINEPMS-Efavirenz-Emtricitabine-Tenofovir 600mg/300mg/200mg TabPMS11.330011.3300YESNONO
02434350ELETRIPTANPMS-Eletriptan (Off-Formulary Interchangeable) 40mg TabPMS10.0850N/AYESNONO
02434342ELETRIPTANPMS-Eletriptan (Off-Formulary Interchangeable) 20mg TabPMS10.0850N/AYESNONO
02461110EMTRICITABINE & TENOFOVIR DISOPROXIL FUMARATEPMS-Emtricitabine/Tenofovir 200mg & 300mg TabPMS7.30357.3035YESNONO
02430576ENTECAVIRPMS-Entecavir 0.5mg TabPMS5.50004.4000YESYESNO
02454386ERLOTINIBPMS-Erlotinib (Off-Formulary Interchangeable) 100mg TabPMS47.466747.4667YESNONO
02454394ERLOTINIBPMS-Erlotinib (Off-Formulary Interchangeable) 150mg TabPMS71.200071.2000YESNONO
02469251ESCITALOPRAMPMS-Escitalopram 20mg TabPMS0.33100.3310YESNONO
02469243ESCITALOPRAMPMS-Escitalopram 10mg TabPMS0.31090.3109YESNONO
02528487ESOMEPRAZOLEPMSC-Esomeprazole DR (Off-Formulary Interchangeable) 40mgPMS1.8690N/AYESNONO
02528479ESOMEPRAZOLEPMSC-Esomeprazole DR (Off-Formulary Interchangeable) 20mg DR TabPMS1.8690N/AYESNONO
02504693EVEROLIMUSPMS-Everolimus (Off-Formulary Interchangeable) 10mg TabPMS172.2559172.2559YESNONO
02504685EVEROLIMUSPMS-Everolimus (Off-Formulary Interchangeable) 5mg TabPMS172.2559172.2559YESNONO
02504677EVEROLIMUSPMS-Everolimus (Off-Formulary Interchangeable) 2.5mg TabPMS172.2559172.2559YESNONO
02416409EZETIMIBEPMS-Ezetimibe 10mg TabPMS0.18110.1811YESYESNO
02278103FAMCICLOVIRPMS-Famciclovir (Off-Formulary Interchangeable) 250mg TabPMS2.72002.7200YESNONO
02278081FAMCICLOVIRPMS-Famciclovir (Off-Formulary Interchangeable) 125mg TabPMS2.02402.0240YESNONO
02496216FAMPRIDINEPMS-Fampridine (Off-Formulary Interchangeable) 10mg ER TabPMS8.4730N/AYESNONO
02320169FINASTERIDEPMS-Finasteride (Off-Formulary Interchangeable) 1mg TabPMS1.1453N/AYESNONO
02310112FINASTERIDEPMS-Finasteride 5mg TabPMS0.35060.3506YESYESNO
02469782FINGOLIMODPMS-Fingolimod (Off-Formulary Interchangeable) 0.5mg CapPMS73.909673.9096YESNONO
02245644FLUCONAZOLEPMS-Fluconazole 100mg TabPMS2.28912.2891YESNONO
02245643FLUCONAZOLEPMS-Fluconazole 50mg TabPMS1.29041.2904YESNONO
00846341FLUNARIZINE HCLSibelium (Not a Benefit) 5mg CapPMSN/AN/AYESNONO
02177579FLUOXETINE HCLPMS-Fluoxetine (Off-Formulary Interchangeable) 10mg CapPMS1.1773N/AYESNOYES
02177587FLUOXETINE HCLPMS-Fluoxetine 20mg CapPMS0.33110.3311YESNOYES
02464659FLUOXETINE HCLPMS-Fluoxetine 60mg CapPMS0.99330.9933NONOYES
02464640FLUOXETINE HCLPMS-Fluoxetine 40mg CapPMS0.66220.6622NONOYES
02503131FLUTICASONE PROPIONATEPMS-Fluticasone 250mcg/Metered Dose Inh-120 Dose PkPMS45.020045.0200YESNONO
02503123FLUTICASONE PROPIONATEPMS-Fluticasone HFA 125mcg/Metered Dose Inh-120 Dose PkPMS23.410023.4100YESNONO
02503115FLUTICASONE PROPIONATEPMS-Fluticasone HFA 50mcg/Metered Dose Inh-120 Dose PkPMS21.315021.3150YESNONO
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 PkPMS35.000035.0000NOYESNO
02236734GLYBURIDEPMS-Glyburide 5mg TabPMS0.05740.0573YESNONO
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 SolPMS0.08270.0827YESNOYES
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
02431114IMATINIB MESYLATEPMS-Imatinib 100mg TabPMS5.20795.2079YESNOYES
02431122IMATINIB MESYLATEPMS-Imatinib 400mg TabPMS20.831420.8314YESNOYES
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 SprayPMS0.86930.8693YESYESNO
02317060IRBESARTANPMS-Irbesartan 75mg TabPMS0.22810.2281YESNONO
02317087IRBESARTANPMS-Irbesartan 300mg TabPMS0.22810.2281YESNONO
02317079IRBESARTANPMS-Irbesartan 150mg TabPMS0.22810.2281YESNONO
02328518IRBESARTAN & HYDROCHLOROTHIAZIDEPMS-Irbesartan-HCTZ 150mg & 12.5mg TabPMS0.22810.2281YESNONO
02328534IRBESARTAN & HYDROCHLOROTHIAZIDEPMS-Irbesartan-HCTZ 300mg & 25mg TabPMS0.21840.2184YESNONO
02328526IRBESARTAN & HYDROCHLOROTHIAZIDEPMS-Irbesartan-HCTZ 300mg & 12.5mg TabPMS0.22810.2281YESNONO
02502917IRON SUCROSEPMS-Iron Sucrose (Off-Formulary Interchangeable) 20mg/mL Inj Sol-5mL Pk (Preservative-Free)PMS27.500027.5000YESNONO
02301288ISOSORBIDE-5-MONONITRATEPMS-ISMN (Off-Formulary Interchangeable) 60mg ER TabPMS0.49500.4950YESNONO
02478234LACOSAMIDEPharma-Lacosamide 200mg TabPMS1.45001.4500YESYESNO
02478218LACOSAMIDEPharma-Lacosamide 100mg TabPMS0.87500.8750YESYESNO
02478196LACOSAMIDEPharma-Lacosamide 50mg TabPMS0.63130.6313YESYESNO
02478226LACOSAMIDEPharma-Lacosamide 150mg TabPMS1.17631.1763YESYESNO
00703486LACTULOSEPMS-Lactulose 667mg/mL O/LPMS0.01470.0147NONONO
02469391LACTULOSEPMS-Lactulose-Pharma 667mg/mL O/LPMS0.01450.0145YESNONO
02247383LACTULOSEPharma-Lactulose 667mg/mL O/LPMS0.01450.0145YESNONO
02246899LAMOTRIGINEPMS-Lamotrigine 150mg TabPMS0.41070.4107YESNONO
02246898LAMOTRIGINEPMS-Lamotrigine 100mg TabPMS0.27870.2787YESNONO
02246897LAMOTRIGINEPMS-Lamotrigine 25mg TabPMS0.06980.0698YESNONO
02433001LANSOPRAZOLELansoprazole 15mg DR CapPMS0.50000.5000YESYESNO
02433028LANSOPRAZOLELansoprazole 30mg DR CapPMS0.50000.5000YESYESNO
02288265LEFLUNOMIDEPMS-Leflunomide 10mg TabPMS2.64332.0000YESNONO
02288273LEFLUNOMIDEPMS-Leflunomide 20mg TabPMS2.64332.0000YESNONO
02309114LETROZOLEPMS-Letrozole 2.5mg TabPMS1.37801.3780YESNONO
02454688LEVETIRACETAMLevetiracetam 750mg TabPMS0.54160.5416YESYESNO
02454653LEVETIRACETAMLevetiracetam 250mg TabPMS0.32100.3210YESYESNO
02454661LEVETIRACETAMLevetiracetam 500mg TabPMS0.39110.3911YESYESNO
02296101LEVETIRACETAMPMS-Levetiracetam 250mg TabPMS0.32100.3210YESYESNO
02296128LEVETIRACETAMPMS-Levetiracetam 500mg TabPMS0.39110.3911YESYESNO
02296136LEVETIRACETAMPMS-Levetiracetam 750mg TabPMS0.54160.5416YESYESNO
02216140LITHIUM CARBONATEPMS-Lithium Carbonate 300mg CapPMS0.06570.0657YESNONO
02216132LITHIUM CARBONATEPMS-Lithium Carbonate 150mg CapPMS0.06670.0667YESNONO
02228351LOPERAMIDE HCLPMS-Loperamide 2mg CapletPMS0.09520.0952YESYESNO
00728195LORAZEPAMPMS-Lorazepam 1mg TabPMS0.04470.0447YESNONO
00728209LORAZEPAMPMS-Lorazepam 2mg TabPMS0.06990.0699YESNONO
00728187LORAZEPAMPMS-Lorazepam 0.5mg TabPMS0.03590.0359YESNONO
02309750LOSARTAN POTASSIUMPMS-Losartan 25mg TabPMS0.31470.3147YESNONO
02309769LOSARTAN POTASSIUMPMS-Losartan 50mg TabPMS0.31470.3147YESNONO
02309777LOSARTAN POTASSIUMPMS-Losartan 100mg TabPMS0.31470.3147YESNONO
02392240LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDEPMS-Losartan-HCTZ 100mg & 25mg 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
02505908LURASIDONE HYDROCHLORIDEPMS-Lurasidone 80mg TabPMS1.22501.2250YESNOYES
02505894LURASIDONE HYDROCHLORIDEPMS-Lurasidone 60mg TabPMS1.22501.2250YESNOYES
02505886LURASIDONE HYDROCHLORIDEPMS-Lurasidone 40mg TabPMS1.22501.2250YESNOYES
02505878LURASIDONE HYDROCHLORIDEPMS-Lurasidone 20mg TabPMS1.22501.2250YESNOYES
02505916LURASIDONE HYDROCHLORIDEPMS-Lurasidone 120mg TabPMS1.22501.2250YESNOYES
02248268MELOXICAMPMS-Meloxicam 15mg TabPMS0.23110.2311YESNOYES
02248267MELOXICAMPMS-Meloxicam 7.5mg TabPMS0.20030.2003YESNOYES
02321130MEMANTINE HCLPMS-Memantine (Off-Formulary Interchangeable) 10mg TabPMS1.6357N/AYESNONO
02242589METFORMIN HCLPMS-Metformin (Off-Formulary Interchangeable) 850mg TabPMS0.2090N/AYESNONO
02223562METFORMIN HCLPMS-Metformin 500mg TabPMS0.02470.0247YESNONO
02520303METFORMIN HCLPMSC-Metformin 500mg TabPMS0.02470.0247YESNONO
02520311METFORMIN HCLPMSC-Metformin (Off-Formulary Interchangeable) 850mg TabPMS0.2090N/AYESNONO
02247699METHADONE HCLMetadol (Off-Formulary Interchangeable) 5mg TabPMS0.46590.4659YESNOYES
02247700METHADONE HCLMetadol (Off-Formulary Interchangeable) 10mg TabPMS0.74540.7454YESNOYES
02247698METHADONE HCLMetadol (Off-Formulary Interchangeable) 1mg TabPMS0.13990.1399YESNOYES
02247701METHADONE HCLMetadol (Off-Formulary Interchangeable) 25mg TabPMS1.38501.3850YESNOYES
02539624METHOTREXATEPMS-Methotrexate Injection 15mg/0.3mL Inj Sol-Pref SyrPMS16.380016.3800YESNONO
02539608METHOTREXATEPMS-Methotrexate Injection 10mg/0.2mL Inj Sol-Pref SyrPMS22.230022.2300YESNONO
02539616METHOTREXATEPMS-Methotrexate Injection 12.5mg/0.25mL Inj Sol-Pref SyrPMS23.400023.4000YESNONO
02539667METHOTREXATEPMS-Methotrexate Injection 25mg/0.5mL Inj Sol-Pref SyrPMS19.500019.5000YESNONO
02539659METHOTREXATEPMS-Methotrexate Injection 22.5mg/0.45mL Inj Sol-Pref SyrPMS17.500017.5000YESNONO
02539640METHOTREXATEPMS-Methotrexate Injection 20mg/0.4mL Inj Sol-Pref SyrPMS17.500017.5000YESNONO
02539632METHOTREXATEPMS-Methotrexate Injection 17.5mg/0.35mL Inj Sol-Pref SyrPMS16.000016.0000YESNONO
02170698METHOTREXATEPMS-Methotrexate 2.5mg TabPMS0.25130.2513YESNONO
02537036METHYLPHENIDATE HCLPMS-Methylphenidate CR 80mg ER CapPMS3.08833.0883YESNOYES
02537001METHYLPHENIDATE HCLPMS-Methylphenidate CR 50mg ER CapPMS2.01302.0130YESNOYES
02536994METHYLPHENIDATE HCLPMS-Methylphenidate CR 40mg ER CapPMS1.65881.6588YESNOYES
02536986METHYLPHENIDATE HCLPMS-Methylphenidate CR 30mg ER CapPMS1.30211.3021YESNOYES
02536978METHYLPHENIDATE HCLPMS-Methylphenidate CR 20mg ER CapPMS0.94770.9477YESNOYES
02536951METHYLPHENIDATE HCLPMS-Methylphenidate CR 15mg ER CapPMS0.73540.7354YESNOYES
02536943METHYLPHENIDATE HCLPMS-Methylphenidate CR 10mg ER CapPMS0.51280.5128YESNOYES
02537028METHYLPHENIDATE HCLPMS-Methylphenidate CR 60mg ER CapPMS2.34252.3425YESNOYES
00585009METHYLPHENIDATE HCLPMS-Methylphenidate (Off-Formulary Interchangeable) 20mg TabPMS0.3536N/AYESNOYES
00584991METHYLPHENIDATE HCLPMS-Methylphenidate 10mg TabPMS0.22160.2216YESNOYES
02230431METOCLOPRAMIDE HCLPMS-Metoclopramide Tablets 5mg TabPMS0.05140.0514YESNONO
02230432METOCLOPRAMIDE HCLPMS-Metoclopramide Tablets 10mg TabPMS0.06590.0659YESNONO
02230804METOPROLOL TARTRATEPMS-Metoprolol-L 100mg TabPMS0.13610.1361YESNONO
02230803METOPROLOL TARTRATEPMS-Metoprolol-L 50mg TabPMS0.06240.0624YESNONO
00783137METRONIDAZOLEPMS-Metronidazole 500mg CapPMS0.27390.2739YESNONO
02248762MIRTAZAPINEPMS-Mirtazapine 30mg TabPMS0.31000.3100YESNONO
02440415MIXED SALT AMPHETAMINEPMS-Amphetamines XR 30mg ER CapPMS0.90380.9038YESNOYES
02440393MIXED SALT AMPHETAMINEPMS-Amphetamines XR 20mg ER CapPMS0.75720.7572YESNOYES
02440385MIXED SALT AMPHETAMINEPMS-Amphetamines XR 15mg ER CapPMS0.68380.6838YESNOYES
02440377MIXED SALT AMPHETAMINEPMS-Amphetamines XR 10mg ER CapPMS0.61050.6105YESNOYES
02440369MIXED SALT AMPHETAMINEPMS-Amphetamines XR 5mg ER CapPMS0.53720.5372YESNOYES
02440407MIXED SALT AMPHETAMINEPMS-Amphetamines XR 25mg ER CapPMS0.83050.8305YESNOYES
02354977MONTELUKAST SODIUMPMS-Montelukast 4mg Chew TabPMS0.27580.2758YESYESNO
02354985MONTELUKAST SODIUMPMS-Montelukast (Off-Formulary Interchangeable) 5mg Chew TabPMS1.20751.2075YESNONO
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 CapPMS1.88861.8886YESNONO
02380919NABILONEPMS-Nabilone 1mg CapPMS3.66693.6669YESNONO
02380897NABILONEPMS-Nabilone (Off-Formulary Interchangeable) 0.25mg CapPMS1.4660N/AYESNONO
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
02455676NITROFURANTOIN MONO/MICRO CRYSTALSPMS-Nitrofurantoin 100mg CapPMS0.59740.5974YESNONO
02303191OLANZAPINEPMS-Olanzapine ODT 5mg Rapid Dissolve TabPMS0.35740.3574YESNONO
02303213OLANZAPINEPMS-Olanzapine ODT 15mg Rapid Dissolve TabPMS1.07111.0711YESNONO
02303205OLANZAPINEPMS-Olanzapine ODT 10mg Rapid Dissolve TabPMS0.71430.7143YESNONO
02303116OLANZAPINEPMS-Olanzapine 2.5mg TabPMS0.17720.1772YESNONO
02303159OLANZAPINEPMS-Olanzapine 5mg TabPMS0.35440.3544YESNONO
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
02519453ONDANSETRON HYDROCHLORIDEPMS-Ondansetron ODT Tablet 8mgPMS4.99303.8840YESYESNO
02519445ONDANSETRON HYDROCHLORIDEPMS-Ondansetron ODT Tablet 4mgPMS3.27202.5450YESYESNO
02258188ONDANSETRON HYDROCHLORIDEPMS-Ondansetron 4mg TabPMS3.34952.5450YESYESNO
02258196ONDANSETRON HYDROCHLORIDEPMS-Ondansetron 8mg TabPMS5.11103.8840YESYESNO
02223376OXYBUTYNIN CHLORIDEPMS-Oxybutynin 1mg/mL O/LPMS0.09700.0970YESNONO
02240550OXYBUTYNIN CHLORIDEPMS-Oxybutynin 5mg TabPMS0.09860.0986YESNONO
02319985OXYCODONE HCLPMS-Oxycodone (Off-Formulary Interchangeable) 10mg TabPMS0.34510.3451YESNOYES
02319993OXYCODONE HCLPMS-Oxycodone (Off-Formulary Interchangeable) 20mg TabPMS0.60010.6001YESNOYES
02319977OXYCODONE HCLPMS-Oxycodone (Off-Formulary Interchangeable) 5mg TabPMS0.23330.2333YESNOYES
02307871PANTOPRAZOLE SODIUMPMS-Pantoprazole 40mg Ent TabPMS0.20160.2016YESYESNO
02247752PAROXETINE HCLPMS-Paroxetine 30mg TabPMS0.34530.3453YESNONO
02247751PAROXETINE HCLPMS-Paroxetine 20mg TabPMS0.32500.3250YESNONO
02247750PAROXETINE HCLPMS-Paroxetine (Off-Formulary Interchangeable) 10mg TabPMS1.0430N/AYESNONO
02525666PAZOPANIBPMS-Pazopanib (Off-Formulary Interchangeable) 200mg TabPMS30.965530.9655YESNONO
02541726PERINDOPRIL ARGININE & AMLODIPINE BESYLATEPMS-Perindopril-Amlodipine (Off-Formulary Interchangeable) 14mg & 10mg TabPMS0.9775N/AYESNONO
02541718PERINDOPRIL ARGININE & AMLODIPINE BESYLATEPMS-Perindopril-Amlodipine (Off-Formulary Interchangeable) 7mg & 5mg TabPMS0.8925N/AYESNONO
02541696PERINDOPRIL ARGININE & AMLODIPINE BESYLATEPMS-Perindopril-Amlodipine (Off-Formulary Interchangeable) 3.5mg & 2.5mg TabPMS0.8075N/AYESNONO
02470691PERINDOPRIL ERBUMINEPMS-Perindopril 8mg TabPMS0.28310.2831YESNONO
02470683PERINDOPRIL ERBUMINEPMS-Perindopril 4mg TabPMS0.20420.2042YESNONO
02470675PERINDOPRIL ERBUMINEPMS-Perindopril 2mg TabPMS0.16320.1632YESNONO
02537982PERINDOPRIL ERBUMINE & INDAPAMIDEPMS-Perindopril-Indapamide 8mg & 2.5mg TabPMS0.28590.2859YESNONO
02537990PERINDOPRIL ERBUMINE & INDAPAMIDEPMS-Perindopril-Indapamide 2mg & 0.625mg TabPMS0.42270.4227YESNONO
02538008PERINDOPRIL ERBUMINE & INDAPAMIDEPMS-Perindopril-Indapamide 4mg & 1.25mg TabPMS0.25560.2556YESNONO
02303140PIOGLITAZONE HCLPMS-Pioglitazone (Off-Formulary Interchangeable) 45mg TabPMS3.31053.3105YESNONO
02303124PIOGLITAZONE HCLPMS-Pioglitazone (Off-Formulary Interchangeable) 15mg TabPMS1.57161.5716YESNONO
02303132PIOGLITAZONE HCLPMS-Pioglitazone (Off-Formulary Interchangeable) 30mg TabPMS2.20172.2017YESNONO
02531534PIRFENIDONEPMS-Pirfenidone (Off-Formulary Interchangeable) 801mg TabPMS20.136020.1360YESNONO
02531526PIRFENIDONEPMS-Pirfenidone (Off-Formulary Interchangeable) 267mg TabPMS6.71206.7120YESNONO
02247656PRAVASTATIN SODIUMPMS-Pravastatin 20mg TabPMS0.34400.3440YESNONO
02247655PRAVASTATIN SODIUMPMS-Pravastatin 10mg TabPMS0.29160.2916YESNONO
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
02294559PROPAFENONE HCLPMS-Propafenone 150mg TabPMS0.29660.2966YESNONO
02294575PROPAFENONE HCLPMS-Propafenone 300mg TabPMS0.52270.5227YESNONO
02296594QUETIAPINEPMS-Quetiapine 200mg TabPMS0.26470.2647YESNONO
02296578QUETIAPINEPMS-Quetiapine 100mg TabPMS0.13180.1318YESNONO
02296551QUETIAPINEPMS-Quetiapine 25mg TabPMS0.04940.0494YESNONO
02296608QUETIAPINEPMS-Quetiapine 300mg TabPMS0.38630.3863YESNONO
02340577QUINAPRILPMS-Quinapril 20mg TabPMS0.23210.2321YESNONO
02340569QUINAPRILPMS-Quinapril 10mg TabPMS0.23210.2321YESNONO
02340550QUINAPRILPMS-Quinapril 5mg TabPMS0.46420.4642YESNONO
02340585QUINAPRILPMS-Quinapril 40mg TabPMS0.23210.2321YESNONO
02310813RABEPRAZOLE SODIUMPMS-Rabeprazole EC 20mg TabPMS0.13380.1338YESNONO
02310805RABEPRAZOLE SODIUMPMS-Rabeprazole EC 10mg TabPMS0.06690.0669YESNONO
02247919RAMIPRILPMS-Ramipril Cap 10mgPMS0.10340.1034YESNONO
02247917RAMIPRILPMS-Ramipril Cap 2.5mgPMS0.08170.0817YESNONO
02247918RAMIPRILPMS-Ramipril Cap 5mgPMS0.08170.0817YESNONO
02295369RAMIPRILPMS-Ramipril Cap 1.25mgPMS0.07080.0708YESNONO
02469073RAMIPRILPharma-Ramipril 5mgPMS0.08170.0817YESNONO
02469057RAMIPRILPharma-Ramipril 1.25mgPMS0.07080.0708YESNONO
02469065RAMIPRILPharma-Ramipril 2.5mgPMS0.08170.0817YESNONO
02469081RAMIPRILPharma-Ramipril 10mgPMS0.10340.1034YESNONO
02342154RAMIPRIL & HYDROCHLOROTHIAZIDEPMS-Ramipril-HCTZ 10mg & 12.5mg TabPMS0.26340.2634YESNONO
02342170RAMIPRIL & HYDROCHLOROTHIAZIDEPMS-Ramipril-HCTZ 10mg & 25mg TabPMS0.26340.2634YESNONO
02242453RANITIDINE HCLPMS-Ranitidine 150mg TabPMS0.11970.1197YESNONO
02242454RANITIDINE HCLPMS-Ranitidine 300mg TabPMS0.22530.2253YESNONO
02302209RISEDRONATE SODIUMPMS-Risedronate 35mg TabPMS1.67641.6764YESNONO
02424177RISEDRONATE SODIUMPMS-Risedronate 150mg TabPMS11.187511.1875YESNONO
02279266RISPERIDONEPMS-Risperidone 1mg/mL O/LPMS0.70800.7080YESNONO
02252015RISPERIDONEPMS-Risperidone 0.5mg TabPMS0.14700.1470YESNONO
02252023RISPERIDONEPMS-Risperidone 1mg TabPMS0.20310.2031YESNONO
02252007RISPERIDONEPMS-Risperidone 0.25mg TabPMS0.08780.0878YESNONO
02252031RISPERIDONEPMS-Risperidone 2mg TabPMS0.40620.4062YESNONO
02252058RISPERIDONEPMS-Risperidone 3mg TabPMS0.60830.6083YESNONO
02252066RISPERIDONEPMS-Risperidone 4mg TabPMS0.81110.8111YESNONO
02512076RIVAROXABANPMS-Rivaroxaban 20mg TabPMS0.71750.7175YESYESNO
02527537RIVAROXABANPMS-Rivaroxaban 2.5mg TabPMS0.35500.3550YESYESNO
02512041RIVAROXABANPMS-Rivaroxaban 10mg TabPMS0.71750.7175YESYESNO
02512068RIVAROXABANPMS-Rivaroxaban 15mg TabPMS0.71750.7175YESYESNO
02306034RIVASTIGMINEPMS-Rivastigmine 1.5mg CapPMS0.65150.6514YESYESNO
02306050RIVASTIGMINEPMS-Rivastigmine 4.5mg CapPMS0.65150.6514YESYESNO
02393360RIZATRIPTANPMS-Rizatriptan RDT (Off-Formulary Interchangeable) 5mg Orally Disintegrating TabPMS11.115011.1150YESNONO
02393379RIZATRIPTANPMS-Rizatriptan RDT (Off-Formulary Interchangeable) 10mg Orally Disintegrating TabPMS11.115011.1150YESNONO
02326620ROPINIROLEPMS-Ropinirole 2mg TabPMS0.31220.3122YESNONO
02326612ROPINIROLEPMS-Ropinirole 1mg TabPMS0.28380.2838YESNONO
02326590ROPINIROLEPMS-Ropinirole 0.25mg TabPMS0.07100.0710YESNONO
02378558ROSUVASTATIN CALCIUMPMS-Rosuvastatin 20mg TabPMS0.16920.1692YESNONO
02378531ROSUVASTATIN CALCIUMPMS-Rosuvastatin 10mg TabPMS0.13540.1354YESNONO
02378566ROSUVASTATIN CALCIUMPMS-Rosuvastatin 40mg TabPMS0.19900.1990YESNONO
02378523ROSUVASTATIN CALCIUMPMS-Rosuvastatin 5mg TabPMS0.12840.1284YESNONO
02208229SALBUTAMOLPMS-Salbutamol 1mg/mL Inh Sol- 2.5mL PkPMS0.36170.3617YESYESNO
02208237SALBUTAMOLPMS-Salbutamol 2mg/mL Inh Sol- 2.5mL PkPMS0.67500.6750YESYESNO
02494523SALMETEROL XINAFOATE & FLUTICASONE PROPIONATEPMS-FluticasonePropionateSalmeterol DPI 50/500mcg Inh-60 Dose PkPMS72.060072.0600YESYESNO
02494507SALMETEROL XINAFOATE & FLUTICASONE PROPIONATEPMS-FluticasonePropionateSalmeterol DPI 50/100mcg Inh-60 Dose PkPMS42.405042.4050YESYESNO
02494515SALMETEROL XINAFOATE & FLUTICASONE PROPIONATEPMS-FluticasonePropionateSalmeterol DPI 50/250mcg Inh-60 Dose PkPMS50.760050.7600YESYESNO
02244839SERTRALINE HCLPMS-Sertraline 50mg CapPMS0.30320.3032YESNOYES
02244840SERTRALINE HCLPMS-Sertraline 100mg CapPMS0.33030.3303YESNOYES
02244838SERTRALINE HCLPMS-Sertraline 25mg CapPMS0.15160.1516YESNOYES
02412179SILDENAFILPMS-Sildenafil R (Off-Formulary Interchangeable) 20mg TabPMS7.29407.2940YESNONO
02317583SILDENAFILSildenafil (Off-Formulary Interchangeable) 100mg TabPMS9.20069.2006YESNONO
02317575SILDENAFILSildenafil (Off-Formulary Interchangeable) 50mg TabPMS8.84818.8481YESNONO
02317559SILDENAFILSildenafil (Off-Formulary Interchangeable) 25mg TabPMS8.28948.2894YESNONO
02517787SILODOSINPMS-Silodosin 8mg CapPMS0.47420.4742YESYESNO
02517779SILODOSINPMS-Silodosin 4mg CapPMS0.47420.4742YESYESNO
02269260SIMVASTATINPMS-Simvastatin 10mg TabPMS0.20230.2023YESNONO
02269295SIMVASTATINPMS-Simvastatin 80mg TabPMS0.25010.2501YESNONO
02269287SIMVASTATINPMS-Simvastatin 40mg TabPMS0.25010.2501YESNONO
02269252SIMVASTATINPMS-Simvastatin 5mg TabPMS0.10230.1023YESNONO
02269279SIMVASTATINPMS-Simvastatin 20mg TabPMS0.25010.2501YESNONO
02469987SIMVASTATINPharma-Simvastatin 10mg TabPMS0.20230.2023YESNONO
02470012SIMVASTATINPharma-Simvastatin 80mg TabPMS0.25010.2501YESNONO
02469979SIMVASTATINPharma-Simvastatin 5mg TabPMS0.10230.1023YESNONO
02470004SIMVASTATINPharma-Simvastatin 40mg TabPMS0.25010.2501YESNONO
02469995SIMVASTATINPharma-Simvastatin 20mg TabPMS0.25010.2501YESNONO
02417723SOLIFENACIN SUCCINATEPMS-Solifenacin 5mg TabPMS0.30410.3041YESYESNO
02417731SOLIFENACIN SUCCINATEPMS-Solifenacin 10mg TabPMS0.30410.3041YESYESNO
02238326SOTALOL HCLPMS-Sotalol 80mg TabPMS0.29660.2966YESNONO
02238327SOTALOL HCLPMS-Sotalol 160mg TabPMS0.16230.1623YESNONO
00598488SULFASALAZINEPMS-Sulfasalazine-E.C. 500mg Ent TabPMS0.38630.3863YESNONO
00598461SULFASALAZINEPMS-Sulfasalazine 500mg TabPMS0.25330.2533YESNONO
02256428SUMATRIPTAN SUCCINATEPMS-Sumatriptan (Off-Formulary Interchangeable) 25mg TabPMS8.99008.9900YESNONO
02256436SUMATRIPTAN SUCCINATEPMS-Sumatriptan (Off-Formulary Interchangeable) 50mg TabPMS9.06509.0650YESNONO
02256444SUMATRIPTAN SUCCINATEPMS-Sumatriptan (Off-Formulary Interchangeable) 100mg TabPMS9.98679.9867YESNONO
02409429TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 5mg TabPMS3.64713.6471YESNONO
02409437TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 10mg TabPMS11.925511.9255YESNONO
02409445TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 20mg TabPMS12.356912.3569YESNONO
02409410TADALAFILPMS-Tadalafil (Off-Formulary Interchangeable) 2.5mg TabPMS3.64713.6471YESNONO
02499630TELMISARTANPMS-Telmisartan 80mg TabPMS0.21610.2161YESNONO
02499622TELMISARTANPMS-Telmisartan 40mg TabPMS0.21610.2161YESNONO
02432900TELMISARTANTelmisartan 80mg TabPMS0.21610.2161YESNONO
02432897TELMISARTANTelmisartan 40mg TabPMS0.21610.2161YESNONO
02453940TENOFOVIR DISOPROXILPMS-Tenofovir 300mg TabPMS4.88844.8884YESYESNO
02243519TERAZOSIN HCLPMS-Terazosin 2mg TabPMS0.50050.5005YESNONO
02243518TERAZOSIN HCLPMS-Terazosin 1mg TabPMS0.39380.3938YESNONO
02243520TERAZOSIN HCLPMS-Terazosin 5mg TabPMS0.31680.3168YESNONO
02243521TERAZOSIN HCLPMS-Terazosin 10mg TabPMS0.99500.9950YESNONO
02294273TERBINAFINE HCLPMS-Terbinafine 250mg TabPMS0.77140.7714YESNONO
02500434TERIFLUNOMIDEPMS-Teriflunomide 14mg TabPMS14.930014.9300YESYESNO
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
02522799TOFACITINIBPMS-Tofacitinib 5mg TabPMS5.98975.9897YESYESNO
02263009TOPIRAMATEPMS-Topiramate 100mg TabPMS0.45830.4583YESNONO
02263017TOPIRAMATEPMS-Topiramate 200mg TabPMS0.67480.6748YESNONO
02262991TOPIRAMATEPMS-Topiramate 25mg TabPMS0.24330.2433YESNONO
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
01937235TRAZODONE HYDROCHLORIDEPMS-Trazodone 100mg TabPMS0.09890.0989YESNONO
01937227TRAZODONE HYDROCHLORIDEPMS-Trazodone 50mg TabPMS0.05540.0554YESNONO
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 CapPMS0.81020.8102YESNONO
02278545VENLAFAXINE HCLPMS-Venlafaxine XR 37.5mg ER CapPMS0.09130.0913YESNONO
02278561VENLAFAXINE HCLPMS-Venlafaxine XR 150mg ER CapPMS0.19270.1927YESNONO
02278553VENLAFAXINE HCLPMS-Venlafaxine XR 75mg ER CapPMS0.18250.1825YESNONO
02521482VENLAFAXINE HCLPMSC-Venlafaxine XR 75mg ER CapPMS0.18250.1825YESNONO
02521466VENLAFAXINE HCLPMSC-Venlafaxine XR 37.5mg ER CapPMS0.09130.0913YESNONO
02521474VENLAFAXINE HCLPMSC-Venlafaxine XR 150mg ER CapPMS0.19270.1927YESNONO
02324768ZOLMITRIPTANPMS-Zolmitriptan ODT (Off-Formulary Interchangeable) 2.5mg Orally Disintegrating TabPMS6.86256.8625YESNONO
02324229ZOLMITRIPTANPMS-Zolmitriptan (Off-Formulary Interchangeable) 2.5mg TabPMS6.85866.8586YESNONO
02436183ZOLPIDEM TARTRATEPMS-Zolpidem ODT (Off-Formulary Interchangeable) 10mg SL TabPMS1.1883N/AYESNONO
02436175ZOLPIDEM TARTRATEPMS-Zolpidem ODT (Off-Formulary Interchangeable) 5mg SL TabPMS1.1827N/AYESNONO
02240606ZOPICLONEPMS-Zopiclone (Off-Formulary Interchangeable) 7.5mg TabPMS0.46850.4685YESNONO
02243426ZOPICLONEPMS-Zopiclone (Off-Formulary Interchangeable) 5mg TabPMS0.22310.2231YESNONO