01926551 | ACEBUTOLOL HCL | Sectral (Not a Benefit) 200mg Tab | SAV | N/A | N/A | YES | NO | NO |
01926578 | ACEBUTOLOL HCL | Sectral (Not a Benefit) 400mg Tab | SAV | N/A | N/A | YES | NO | NO |
01926543 | ACEBUTOLOL HCL | Sectral (Not a Benefit) 100mg Tab | SAV | N/A | N/A | YES | NO | NO |
02245565 | ALFUZOSIN HYDROCHLORIDE | Xatral 10mg Prolong-Rel Tab | SAV | 1.0900 | 0.2601 | YES | YES | NO |
01926691 | CALCITONIN (SALMON SYNTHETIC) | Calcimar 400IU/2mL Inj Sol-2mL Pk | SAV | 65.4400 | 65.4400 | NO | NO | NO |
02238682 | CLOPIDOGREL BISULFATE | Plavix 75mg Tab | SAV | 2.8180 | 0.2631 | YES | NO | NO |
02330555 | CLOPIDOGREL BISULFATE | Plavix (Off-Formulary Interchangeable) 300mg Tab | SAV | N/A | N/A | YES | NO | NO |
02018144 | DANAZOL | Cyclomen 50mg Cap | SAV | 1.0720 | 1.0720 | NO | NO | NO |
02018160 | DANAZOL | Cyclomen 200mg Cap | SAV | 2.5425 | 2.5425 | NO | NO | NO |
02018152 | DANAZOL | Cyclomen 100mg Cap | SAV | 1.5910 | 1.5910 | NO | NO | NO |
02099136 | DESIPRAMINE | Norpramin (Not a Benefit) 50mg Tab | SAV | N/A | N/A | YES | NO | NO |
02099128 | DESIPRAMINE | Norpramin (Not a Benefit) 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
02236564 | ENOXAPARIN | Lovenox 100mg/mL Inj Sol-3mL Vial Pk | SAV | 68.7500 | 68.7500 | NO | YES | NO |
02012472 | ENOXAPARIN | Lovenox 30mg/0.3mL Pref Syr-0.3mL Pk | SAV | 6.8750 | 6.8750 | NO | YES | NO |
02236883 | ENOXAPARIN | Lovenox 40mg/0.4mL Pref Syr-0.4mL Pk | SAV | 9.1660 | 9.1660 | NO | YES | NO |
02378426 | ENOXAPARIN | Lovenox 60mg/0.6mL Pref Syr-0.6mL Pk | SAV | 13.7490 | 13.7490 | NO | YES | NO |
02378434 | ENOXAPARIN | Lovenox 80mg/0.8mL Pref Syr-0.8mL Pk | SAV | 18.3330 | 18.3330 | NO | YES | NO |
02242692 | ENOXAPARIN | Lovenox HP 120mg/0.8mL Pref Syr-0.8mL Pk | SAV | 27.4990 | 27.4990 | NO | YES | NO |
02378442 | ENOXAPARIN | Lovenox 100mg/mL Pref Syr-1mL Pk | SAV | 22.9160 | 22.9160 | NO | YES | NO |
02378469 | ENOXAPARIN | Lovenox HP 150mg/mL Pref Syr-1mL Pk | SAV | 34.3750 | 34.3750 | NO | YES | NO |
02017598 | ERGOCALCIFEROL | Drisdol (Not a Benefit) 8288IU/mL O/L | SAV | N/A | N/A | YES | NO | NO |
02221993 | FELODIPINE | Renedil (Not a Benefit) 5mg SR Tab | SAV | N/A | N/A | YES | NO | YES |
02222000 | FELODIPINE | Renedil (Not a Benefit) 10mg SR Tab | SAV | N/A | N/A | YES | NO | YES |
02224623 | FRAMYCETIN SULFATE & GRAMICIDIN & DEXAMETHASONE | Sofracort 5mg & 50mcg & 0.5mg/mL Oph/Ot Sol | SAV | 2.1263 | 2.1263 | NO | NO | YES |
02224720 | FUROSEMIDE | Lasix 10mg/mL O/L | SAV | 0.3465 | 0.3465 | NO | NO | NO |
02224704 | FUROSEMIDE | Lasix (Not a Benefit) 40mg Tab | SAV | N/A | N/A | YES | NO | NO |
02224690 | FUROSEMIDE | Lasix (Not a Benefit) 20mg Tab | SAV | N/A | N/A | YES | NO | NO |
02224755 | FUROSEMIDE | Lasix Special 500mg Tab | SAV | 3.5700 | 3.5700 | NO | YES | NO |
02245272 | GLIMEPIRIDE | Amaryl (Off-Formulary Interchangeable) 1mg Tab | SAV | N/A | N/A | YES | NO | NO |
02245274 | GLIMEPIRIDE | Amaryl (Off-Formulary Interchangeable) 4mg Tab | SAV | N/A | N/A | YES | NO | NO |
02245273 | GLIMEPIRIDE | Amaryl (Off-Formulary Interchangeable) 2mg Tab | SAV | N/A | N/A | YES | NO | NO |
02224550 | GLYBURIDE | Diabeta (Not a Benefit) 2.5mg Tab | SAV | N/A | N/A | YES | NO | NO |
02224569 | GLYBURIDE | Diabeta (Not a Benefit) 5mg Tab | SAV | N/A | N/A | YES | NO | NO |
02017709 | HYDROXYCHLOROQUINE SULFATE | Plaquenil 200mg Tab | SAV | 0.6516 | 0.1576 | YES | NO | NO |
02245689 | INSULIN GLARGINE | Lantus-(Vial) 100U/mL Inj Sol-10mL Vial Pk | SAV | 61.6900 | 61.6900 | NO | YES | NO |
02279479 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj 5x3mL Cart ClickStar Pen | SAV | 54.7000 | 54.7000 | NO | NO | YES |
02279460 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj Sol-10mL Vial | SAV | 27.6100 | 27.6100 | NO | NO | YES |
02294346 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj Sol-5x3mL SoloSTAR Pref Pen | SAV | 55.2200 | 55.2200 | NO | NO | YES |
02237925 | IRBESARTAN | Avapro 300mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
02237923 | IRBESARTAN | Avapro 75mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
02237924 | IRBESARTAN | Avapro 150mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
02241818 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide 150mg & 12.5mg Tab | SAV | 1.3166 | 0.2281 | YES | NO | NO |
02241819 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide 300mg & 12.5mg Tab | SAV | 1.3166 | 0.2281 | YES | NO | NO |
02280213 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide (Not a Benefit) 300mg & 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
00761680 | KETOPROFEN | Rhodis-EC (Not a Benefit) 100mg Ent Tab | SAV | N/A | N/A | YES | NO | YES |
02241888 | LEFLUNOMIDE | Arava 10mg Tab | SAV | 11.4440 | 2.0000 | YES | NO | NO |
02241889 | LEFLUNOMIDE | Arava 20mg Tab | SAV | 11.4443 | 2.0000 | YES | NO | NO |
02099233 | METFORMIN HCL | Glucophage 500mg Tab | SAV | 0.2821 | 0.0247 | YES | NO | NO |
02162849 | METFORMIN HCL | Glucophage (Off-Formulary Interchangeable) 850mg Tab | SAV | N/A | N/A | YES | NO | NO |
01927671 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 50mg Tab | SAV | N/A | N/A | YES | NO | NO |
01927663 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
01927655 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 5mg Tab | SAV | N/A | N/A | YES | NO | NO |
00888400 | METOLAZONE | Zaroxolyn 2.5mg Tab | SAV | 0.2294 | 0.2294 | NO | NO | NO |
01926861 | METRONIDAZOLE | Flagyl 10% Vag Cr-App | SAV | 0.2740 | 0.2740 | NO | NO | NO |
01926845 | METRONIDAZOLE & NYSTATIN | Flagystatin 500mg & 100000U/g Vag Cr-App | SAV | 0.6076 | 0.6076 | NO | NO | NO |
01926829 | METRONIDAZOLE & NYSTATIN | Flagystatin 500mg & 100000U Vag Sup | SAV | 3.6980 | 3.6980 | NO | NO | NO |
02231441 | NITROGLYCERIN | Nitrolingual Pump Spray 0.4mg/Metered Dose Spray-200 Dose Pk | SAV | 16.0000 | 8.4200 | YES | NO | NO |
02221977 | PENTOXIFYLLINE | Trental (Not a Benefit) 400mg SR Tab | SAV | N/A | N/A | YES | NO | NO |
02026961 | POLYSTYRENE SODIUM SULFONATE | Kayexalate 1mEq/g Oral Pd-454g Pk | SAV | 43.6300 | 29.4175 | YES | NO | NO |
02230619 | PREDNISOLONE SODIUM PHOSPHATE | Pediapred Oral Liquid (Not a Benefit) 6.7mg/5mL O/L | SAV | N/A | N/A | YES | NO | NO |
02221845 | RAMIPRIL | Altace Cap 5mg | SAV | 1.1091 | 0.0817 | YES | NO | NO |
02221829 | RAMIPRIL | Altace Cap 1.25mg | SAV | 0.9608 | 0.0708 | YES | NO | NO |
02221837 | RAMIPRIL | Altace Cap 2.5mg | SAV | 1.0810 | 0.0817 | YES | NO | NO |
02221853 | RAMIPRIL | Altace Cap 10mg | SAV | 1.4249 | 0.1034 | YES | NO | NO |
02281112 | RAMIPRIL | Altace (Off-Formulary Interchangeable) 15mg Cap | SAV | N/A | N/A | YES | NO | NO |
02283158 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT (Not a Benefit) 5mg & 12.5mg Tab | SAV | N/A | N/A | YES | NO | NO |
02283166 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 10mg & 12.5mg Tab | SAV | 0.6525 | 0.2634 | YES | NO | NO |
02283131 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT (Not a Benefit) 2.5mg & 12.5mg Tab | SAV | N/A | N/A | YES | NO | NO |
02283174 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 5mg & 25mg Tab | SAV | 0.4981 | 0.2872 | YES | NO | NO |
02283182 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 10mg & 25mg Tab | SAV | 0.6525 | 0.2634 | YES | NO | NO |
02354586 | SEVELAMER CARBONATE | Renvela (Off-Formulary Interchangeable) 800mg Tab | SAV | 1.3125 | 1.2634 | YES | NO | NO |
01926624 | TAMOXIFEN CITRATE | Tamofen (Not a Benefit) 10mg Tab | SAV | N/A | N/A | YES | NO | NO |
01926632 | TAMOXIFEN CITRATE | Tamofen (Not a Benefit) 20mg Tab | SAV | N/A | N/A | YES | NO | NO |
02221950 | TIAPROFENIC ACID | Surgam (Not a Benefit) 300mg Tab | SAV | N/A | N/A | YES | NO | YES |
01926519 | TRETINOIN | Vitamin A Acid (Not a Benefit) 0.05% Cr | SAV | N/A | N/A | YES | NO | NO |
02216167 | ZOPICLONE | Imovane (Off-Formulary Interchangeable) 5mg Tab | SAV | N/A | N/A | YES | NO | NO |
01926799 | ZOPICLONE | Imovane (Off-Formulary Interchangeable) 7.5mg Tab | SAV | N/A | N/A | YES | NO | NO |