01910159 | ACEBUTOLOL HCL | Rhotral (Not a Benefit) 200mg Tab | SAV | N/A | N/A | YES | NO | NO |
01910140 | ACEBUTOLOL HCL | Rhotral (Not a Benefit) 100mg Tab | SAV | N/A | N/A | YES | NO | NO |
01910167 | ACEBUTOLOL HCL | Rhotral (Not a Benefit) 400mg Tab | SAV | N/A | N/A | YES | NO | NO |
01926551 | ACEBUTOLOL HCL | Sectral (Not a Benefit) 200mg Tab | SAV | N/A | N/A | YES | NO | NO |
01926578 | ACEBUTOLOL HCL | Sectral 400mg Tab | SAV | 1.0695 | 0.2466 | 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 | 1.0758 | 0.2601 | YES | YES | NO |
01926691 | CALCITONIN (SALMON SYNTHETIC) | Calcimar 400IU/2mL Inj Sol-2mL Pk | SAV | 63.0400 | 63.0400 | NO | NO | NO |
02238682 | CLOPIDOGREL BISULFATE | Plavix 75mg Tab | SAV | 2.7125 | 0.2631 | YES | NO | NO |
02330555 | CLOPIDOGREL BISULFATE | Plavix (Off-Formulary Interchangeable) 300mg Tab | SAV | N/A | N/A | YES | NO | NO |
02018160 | DANAZOL | Cyclomen 200mg Cap | SAV | 2.4486 | 2.4486 | NO | NO | NO |
02018152 | DANAZOL | Cyclomen 100mg Cap | SAV | 1.5323 | 1.5323 | NO | NO | NO |
02018144 | DANAZOL | Cyclomen 50mg Cap | SAV | 1.0324 | 1.0324 | NO | NO | NO |
02099128 | DESIPRAMINE | Norpramin (Not a Benefit) 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
02099136 | DESIPRAMINE | Norpramin (Not a Benefit) 50mg Tab | SAV | N/A | N/A | YES | NO | NO |
01931563 | ELECTROLYTE & DEXTROSE | Gastrolyte Oral Pd-1 Sach Pk | SAV | 0.7950 | 0.7950 | NO | NO | NO |
02236564 | ENOXAPARIN | Lovenox 100mg/mL Inj Sol-3mLVial Pk | SAV | 66.1700 | 66.1700 | NO | YES | NO |
02012472 | ENOXAPARIN | Lovenox 30mg/0.3mL Pref Syr-0.3mL Pk | SAV | 6.6170 | 6.6170 | NO | YES | NO |
02236883 | ENOXAPARIN | Lovenox 40mg/0.4mL Pref Syr-0.4mL Pk | SAV | 8.8220 | 8.8220 | NO | YES | NO |
02378426 | ENOXAPARIN | Lovenox 60mg/0.6mL Pref Syr-0.6mL Pk | SAV | 13.2330 | 13.2330 | NO | YES | NO |
02378434 | ENOXAPARIN | Lovenox 80mg/0.8mL Pref Syr-0.8mL Pk | SAV | 17.6450 | 17.6450 | NO | YES | NO |
02242692 | ENOXAPARIN | Lovenox HP 120mg/0.8mL Pref Syr-0.8mL Pk | SAV | 26.4670 | 26.4670 | NO | YES | NO |
02378442 | ENOXAPARIN | Lovenox 100mg/mL Pref Syr-1mL Pk | SAV | 22.0560 | 22.0560 | NO | YES | NO |
02378469 | ENOXAPARIN | Lovenox HP 150mg/mL Pref Syr-1mL Pk | SAV | 33.0850 | 33.0850 | 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 | 0.3340 | 0.3340 | 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 | 3.4410 | 3.4410 | NO | YES | 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 |
02245272 | GLIMEPIRIDE | Amaryl (Off-Formulary Interchangeable) 1mg 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 |
02224550 | GLYBURIDE | Diabeta (Not a Benefit) 2.5mg 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 |
02294338 | INSULIN GLARGINE | Lantus Solostar 100U/mL Inj Sol-5x3mL Pk | SAV | 92.8500 | 92.8500 | NO | YES | NO |
02251930 | INSULIN GLARGINE | Lantus-(Cartridge) 100U/mL Inj Sol-5x3mL Pk | SAV | 92.8500 | 92.8500 | NO | YES | NO |
02279479 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj 5x3mL Cart ClickStar Pen | SAV | 52.6500 | 52.6500 | NO | NO | YES |
02279460 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj Sol-10mL Vial | SAV | 26.5800 | 26.5800 | NO | NO | YES |
02294346 | INSULIN GLULISINE (DNA ORIGIN) | Apidra 100U/mL Inj Sol-5x3mL SoloSTAR Pref Pen | SAV | 53.1500 | 53.1500 | NO | NO | YES |
02237924 | IRBESARTAN | Avapro 150mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
02237923 | IRBESARTAN | Avapro 75mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
02237925 | IRBESARTAN | Avapro 300mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
02241818 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide 150mg & 12.5mg Tab | SAV | 1.2671 | 0.2281 | YES | NO | NO |
02280213 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide (Not a Benefit) 300mg & 25mg Tab | SAV | N/A | N/A | YES | NO | NO |
02241819 | IRBESARTAN & HYDROCHLOROTHIAZIDE | Avalide 300mg & 12.5mg Tab | SAV | 1.2671 | 0.2281 | 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 |
02162849 | METFORMIN HCL | Glucophage (Off-Formulary Interchangeable) 850mg Tab | SAV | N/A | N/A | YES | NO | NO |
02099233 | METFORMIN HCL | Glucophage 500mg Tab | SAV | 0.2716 | 0.0247 | YES | NO | NO |
01927698 | METHOTRIMEPRAZINE | Nozinan 25mg/mL Inj Sol-1mL Pk | SAV | 3.8060 | 3.8060 | NO | NO | NO |
01927655 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 5mg 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 |
01927671 | METHOTRIMEPRAZINE | Nozinan (Not a Benefit) 50mg Tab | SAV | N/A | N/A | YES | NO | NO |
00888400 | METOLAZONE | Zaroxolyn 2.5mg Tab | SAV | 0.2209 | 0.2209 | NO | NO | NO |
01926861 | METRONIDAZOLE | Flagyl 10% Vag Cr-App | SAV | 0.2645 | 0.2645 | 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 | 3.5610 | 3.5610 | NO | NO | NO |
02231441 | NITROGLYCERIN | Nitrolingual Pump Spray 0.4mg/Metered Dose Spray-200 Dose Pk | SAV | 15.7600 | 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 | 42.0200 | 29.4175 | YES | NO | NO |
02230619 | PREDNISOLONE SODIUM PHOSPHATE | Pediapred Oral Liquid 6.7mg/5mL O/L | SAV | 0.1446 | 0.0900 | YES | NO | NO |
02221853 | RAMIPRIL | Altace Cap 10mg | SAV | 1.3701 | 0.1034 | YES | NO | NO |
02221845 | RAMIPRIL | Altace Cap 5mg | SAV | 1.0664 | 0.0817 | YES | NO | NO |
02221829 | RAMIPRIL | Altace Cap 1.25mg | SAV | 0.9239 | 0.0708 | YES | NO | NO |
02221837 | RAMIPRIL | Altace Cap 2.5mg | SAV | 1.0394 | 0.0817 | YES | NO | NO |
02281112 | RAMIPRIL | Altace (Off-Formulary Interchangeable) 15mg Cap | SAV | N/A | N/A | YES | NO | NO |
02283182 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 10mg & 25mg Tab | SAV | 0.6274 | 0.2634 | YES | NO | NO |
02283166 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 10mg & 12.5mg Tab | SAV | 0.6274 | 0.2634 | YES | NO | NO |
02283158 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 5mg & 12.5mg Tab | SAV | 0.4790 | 0.3016 | YES | NO | NO |
02283131 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 2.5mg & 12.5mg Tab | SAV | 0.3739 | 0.2242 | YES | NO | NO |
02283174 | RAMIPRIL & HYDROCHLOROTHIAZIDE | Altace HCT 5mg & 25mg Tab | SAV | 0.4790 | 0.2872 | YES | NO | NO |
02354586 | SEVELAMER CARBONATE | Renvela (Off-Formulary Interchangeable) 800mg Tab | SAV | 1.2634 | 1.2634 | YES | NO | NO |
01926632 | TAMOXIFEN CITRATE | Tamofen (Not a Benefit) 20mg Tab | SAV | N/A | N/A | YES | NO | NO |
01926624 | TAMOXIFEN CITRATE | Tamofen (Not a Benefit) 10mg 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 |
02213834 | TRIAMCINOLONE ACETONIDE | Nasacort AQ (Off-Formulary Interchangeable) 55mcg/Metered Dose Nas Sp-120 Dose Pk (with Preservative) | SAV | N/A | N/A | YES | NO | YES |
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 |