Clear Springs - MAPD 2021 Comp



Below is a list of abbreviations that may appear on the following pages in the Requirements/Limits column that tells you if there are any special requirements for coverage of your drug.List of AbbreviationsB/D PA: This prescription drug may be covered under Medicare Part B or D depending upon the circumstances. Information may need to be submitted describing the use and setting of the drug to make the determination.EX: Excluded Drug. This prescription drug is not normally covered in a Medicare prescription drug plan. The amount you pay when you fill a prescription for this drug does not count toward your total drug costs (that is, the amount you pay does not help you qualify for catastrophic coverage). In addition, if you are receiving extra help to pay for your prescriptions, you will not get any extra help to pay for this drug.LA: Limited Availability. This prescription may be available only at certain pharmacies. For more information, please call Customer Service.MO: Mail-Order Drug. This prescription drug is available through our mail-order service, as well as through our retail network pharmacies. Consider using mail order for your long-term (maintenance) medications (such as high blood pressure medications). Retail network pharmacies may be more appropriate for short-term prescriptions (such as antibiotics).PA: Prior Authorization. The Plan requires you or your physician to get prior authorization for certain drugs. This means that you will need to get approval before you fill your prescriptions. If you don’t get approval, we may not cover the drug.QL: Quantity Limit. For certain drugs, the Plan limits the amount of the drug that we will cover.SSM ($35.00): Senior Savings Model. For this select insulin drug, your copay will be the same in all stages until you reach the Catastrophic Coverage Stage. Please refer to Chapter 4 of our Evidence of Coverage for more information. If you receive Extra Help, you do not qualify for this program and your Low Income Subsidy (LIS) copay level will apply.ST: Step Therapy. In some cases, the Plan requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, we may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B.Drug NameDrug TierRequirements/LimitsANTI - INFECTIVESANTIFUNGAL AGENTSABELCETXE "ABELCET"4B/D PA; MOAMBISOMEXE "AMBISOME"5B/D PA; MOamphotericin bXE "amphotericin b"4B/D PA; MOcaspofunginXE "caspofungin"5clotrimazole mucous membraneXE "clotrimazole"4MOCRESEMBA ORALXE "CRESEMBA"5PA; MOfluconazole in nacl (iso-osm) intravenous piggyback 200 mg/100 mlXE "fluconazole in nacl (iso-osm)"3MOfluconazole in nacl (iso-osm) intravenous piggyback 400 mg/200 mlXE "fluconazole in nacl (iso-osm)"3fluconazole oral suspension for reconstitutionXE "fluconazole"3MOfluconazole oral tablet 100 mg, 200 mg, 50 mgXE "fluconazole"3MOfluconazole oral tablet 150 mgXE "fluconazole"1MOflucytosineXE "flucytosine"5MOgriseofulvin microsizeXE "griseofulvin microsize"4MOgriseofulvin ultramicrosizeXE "griseofulvin ultramicrosize"4MOitraconazole oral capsuleXE "itraconazole"4PA; MOitraconazole oral solutionXE "itraconazole"4MOketoconazole oralXE "ketoconazole"3PA; MOMYCAMINEXE "MYCAMINE"5MONOXAFIL ORAL SUSPENSIONXE "NOXAFIL"5MO; QL (630 per 30 days)nystatin oral suspensionXE "nystatin"3MOnystatin oral tabletXE "nystatin"3MOposaconazole oral tablet,delayed release (dr/ec)XE "posaconazole"5MO; QL (93 per 28 days)terbinafine hcl oralXE "terbinafine hcl"1MO; QL (90 per 365 days)voriconazole intravenousXE "voriconazole"5PA; MOvoriconazole oral suspension for reconstitutionXE "voriconazole"5PA; MOvoriconazole oral tablet 200 mgXE "voriconazole"5MOvoriconazole oral tablet 50 mgXE "voriconazole"4MOANTIVIRALSabacavir oral solutionXE "abacavir"4MOabacavir oral tabletXE "abacavir"3MOabacavir-lamivudineXE "abacavir-lamivudine"3MOabacavir-lamivudine-zidovudineXE "abacavir-lamivudine-zidovudine"5MOacyclovir oral capsuleXE "acyclovir"2MOacyclovir oral suspension 200 mg/5 mlXE "acyclovir"4MOacyclovir oral tabletXE "acyclovir"2MOacyclovir sodium intravenous solutionXE "acyclovir sodium"4B/D PA; MOadefovirXE "adefovir"5MOamantadine hcl oral capsuleXE "amantadine hcl"3MO; QL (120 per 30 days)amantadine hcl oral solutionXE "amantadine hcl"2MOamantadine hcl oral tabletXE "amantadine hcl"3MOAPTIVUSXE "APTIVUS"5MOAPTIVUS (WITH VITAMIN E)XE "APTIVUS (WITH VITAMIN E)"5atazanavirXE "atazanavir"4MOATRIPLAXE "ATRIPLA"5MOBARACLUDE ORAL SOLUTIONXE "BARACLUDE"5MOBIKTARVYXE "BIKTARVY"5MOCIMDUOXE "CIMDUO"5MOCOMPLERAXE "COMPLERA"5MOCRIXIVAN ORAL CAPSULE 200 MG, 400 MGXE "CRIXIVAN"4MODELSTRIGOXE "DELSTRIGO"5MODESCOVYXE "DESCOVY"5MOdidanosine oral capsule,delayed release(dr/ec) 250 mg, 400 mgXE "didanosine"4MODOVATOXE "DOVATO"5MOEDURANTXE "EDURANT"5MOefavirenz oral capsule 200 mgXE "efavirenz"5MOefavirenz oral capsule 50 mgXE "efavirenz"4MOefavirenz oral tabletXE "efavirenz"5MOEMTRIVAXE "EMTRIVA"3MOentecavirXE "entecavir"4MOEPCLUSAXE "EPCLUSA"5PA; MOEPIVIR HBV ORAL SOLUTIONXE "EPIVIR HBV"4MOEVOTAZXE "EVOTAZ"5MOfamciclovirXE "famciclovir"3MOfosamprenavirXE "fosamprenavir"5MOFUZEON SUBCUTANEOUS RECON SOLNXE "FUZEON"5MOGENVOYAXE "GENVOYA"5MOHARVONI ORAL TABLET 90-400 MGXE "HARVONI"5PA; MOINTELENCE ORAL TABLET 100 MG, 200 MGXE "INTELENCE"5MOINTELENCE ORAL TABLET 25 MGXE "INTELENCE"4MOINVIRASE ORAL TABLETXE "INVIRASE"5MOISENTRESS HDXE "ISENTRESS HD"5MOISENTRESS ORAL POWDER IN PACKETXE "ISENTRESS"3MOISENTRESS ORAL TABLETXE "ISENTRESS"5MOISENTRESS ORAL TABLET,CHEWABLE 100 MGXE "ISENTRESS"5MOISENTRESS ORAL TABLET,CHEWABLE 25 MGXE "ISENTRESS"3MOJULUCAXE "JULUCA"5MOKALETRA ORAL TABLET 100-25 MGXE "KALETRA"4MOKALETRA ORAL TABLET 200-50 MGXE "KALETRA"5MOlamivudine oral solutionXE "lamivudine"3MOlamivudine oral tablet 100 mgXE "lamivudine"4MOlamivudine oral tablet 150 mg, 300 mgXE "lamivudine"3MOlamivudine-zidovudineXE "lamivudine-zidovudine"4MOLEXIVA ORAL SUSPENSIONXE "LEXIVA"4MOlopinavir-ritonavirXE "lopinavir-ritonavir"4MOMAVYRETXE "MAVYRET"5PA; MOnevirapine oral suspensionXE "nevirapine"4nevirapine oral tabletXE "nevirapine"3MOnevirapine oral tablet extended release 24 hrXE "nevirapine"4MONORVIR ORAL POWDER IN PACKETXE "NORVIR"4MONORVIR ORAL SOLUTIONXE "NORVIR"4MOODEFSEYXE "ODEFSEY"5MOoseltamivir oral capsule 30 mgXE "oseltamivir"3MO; QL (168 per 365 days)oseltamivir oral capsule 45 mg, 75 mgXE "oseltamivir"3MO; QL (84 per 365 days)oseltamivir oral suspension for reconstitutionXE "oseltamivir"3MO; QL (1080 per 365 days)PIFELTROXE "PIFELTRO"5MOPREZCOBIXXE "PREZCOBIX"5MOPREZISTA ORAL SUSPENSIONXE "PREZISTA"5MO; QL (360 per 30 days)PREZISTA ORAL TABLET 150 MGXE "PREZISTA"5MO; QL (240 per 30 days)PREZISTA ORAL TABLET 600 MGXE "PREZISTA"5MO; QL (60 per 30 days)PREZISTA ORAL TABLET 75 MGXE "PREZISTA"4MO; QL (480 per 30 days)PREZISTA ORAL TABLET 800 MGXE "PREZISTA"5MO; QL (30 per 30 days)RELENZA DISKHALERXE "RELENZA DISKHALER"3MO; QL (60 per 180 days)REYATAZ ORAL POWDER IN PACKETXE "REYATAZ"5MOribavirin oral capsuleXE "ribavirin"3MOribavirin oral tablet 200 mgXE "ribavirin"4MOrimantadineXE "rimantadine"3MOritonavirXE "ritonavir"3MOSELZENTRY ORAL SOLUTIONXE "SELZENTRY"3MOSELZENTRY ORAL TABLET 150 MG, 300 MG, 75 MGXE "SELZENTRY"5MOSELZENTRY ORAL TABLET 25 MGXE "SELZENTRY"3MOSOVALDI ORAL TABLET 400 MGXE "SOVALDI"5PA; MO; QL (28 per 28 days)stavudine oral capsuleXE "stavudine"3MOSTRIBILDXE "STRIBILD"5MOSYMFIXE "SYMFI"5MOSYMFI LOXE "SYMFI LO"5MOSYMTUZAXE "SYMTUZA"5MOtenofovir disoproxil fumarateXE "tenofovir disoproxil fumarate"3MOTIVICAY ORAL TABLET 10 MGXE "TIVICAY"3MOTIVICAY ORAL TABLET 25 MG, 50 MGXE "TIVICAY"5MOTRIUMEQXE "TRIUMEQ"5MOTRUVADAXE "TRUVADA"5MO; QL (30 per 30 days)TYBOSTXE "TYBOST"4MOvalacyclovirXE "valacyclovir"3MOvalganciclovirXE "valganciclovir"5MOVEMLIDYXE "VEMLIDY"5MOVIRACEPT ORAL TABLETXE "VIRACEPT"5MOVIREAD ORAL POWDERXE "VIREAD"5MOVIREAD ORAL TABLET 150 MG, 200 MG, 250 MGXE "VIREAD"5MOVOSEVIXE "VOSEVI"5PA; MOzidovudine oral capsuleXE "zidovudine"4MOzidovudine oral syrupXE "zidovudine"4MOzidovudine oral tabletXE "zidovudine"3MOCEPHALOSPORINScefaclor oral capsuleXE "cefaclor"3MOcefaclor oral suspension for reconstitution 125 mg/5 mlXE "cefaclor"4MOcefaclor oral suspension for reconstitution 250 mg/5 ml, 375 mg/5 mlXE "cefaclor"4cefaclor oral tablet extended release 12 hrXE "cefaclor"4MOcefadroxil oral capsuleXE "cefadroxil"2MOcefadroxil oral suspension for reconstitution 250 mg/5 ml, 500 mg/5 mlXE "cefadroxil"3MOcefadroxil oral tabletXE "cefadroxil"4MOcefazolin in dextrose (iso-os) intravenous piggyback 1 gram/50 mlXE "cefazolin in dextrose (iso-os)"3MOcefazolin injection recon soln 1 gram, 500 mgXE "cefazolin"3MOcefazolin injection recon soln 10 gram, 100 gram, 300 gXE "cefazolin"3cefazolin intravenousXE "cefazolin"3cefdinir oral capsuleXE "cefdinir"2MOcefdinir oral suspension for reconstitutionXE "cefdinir"4MOCEFEPIME IN DEXTROSE 5 %XE "CEFEPIME IN DEXTROSE 5 %"4MOcefepime in dextrose,iso-osm intravenous piggyback 1 gram/50 mlXE "cefepime in dextrose,iso-osm"4cefepime in dextrose,iso-osm intravenous piggyback 2 gram/100 mlXE "cefepime in dextrose,iso-osm"4MOcefepime injectionXE "cefepime"4MOcefixime oral suspension for reconstitutionXE "cefixime"4MOcefoxitin in dextrose, iso-osmXE "cefoxitin in dextrose, iso-osm"4cefoxitin intravenous recon soln 1 gram, 2 gramXE "cefoxitin"4MOcefoxitin intravenous recon soln 10 gramXE "cefoxitin"4cefpodoxime oral suspension for reconstitutionXE "cefpodoxime"4MOcefpodoxime oral tabletXE "cefpodoxime"3MOcefprozilXE "cefprozil"3MOCEFTAZIDIME IN D5WXE "CEFTAZIDIME IN D5W"3ceftazidime injection recon soln 1 gram, 2 gramXE "ceftazidime"3MOceftazidime injection recon soln 6 gramXE "ceftazidime"3ceftriaxone in dextrose,iso-osXE "ceftriaxone in dextrose,iso-os"3MOceftriaxone injection recon soln 1 gram, 2 gram, 250 mg, 500 mgXE "ceftriaxone"3MOceftriaxone injection recon soln 10 gramXE "ceftriaxone"3CEFTRIAXONE INJECTION RECON SOLN 100 GRAMXE "CEFTRIAXONE"3ceftriaxone intravenousXE "ceftriaxone"3MOcefuroxime axetil oral tabletXE "cefuroxime axetil"3MOcefuroxime sodium injection recon soln 750 mgXE "cefuroxime sodium"3MOcefuroxime sodium intravenous recon soln 1.5 gramXE "cefuroxime sodium"3MOcefuroxime sodium intravenous recon soln 7.5 gramXE "cefuroxime sodium"3cephalexin oral capsule 250 mg, 500 mgXE "cephalexin"1MOcephalexin oral suspension for reconstitutionXE "cephalexin"3MOtazicef injection recon soln 1 gramXE "tazicef"3tazicef injection recon soln 2 gram, 6 gramXE "tazicef"3MOtazicef intravenousXE "tazicef"3TEFLAROXE "TEFLARO"5MOERYTHROMYCINS / OTHER MACROLIDESazithromycin intravenousXE "azithromycin"3MOazithromycin oral packetXE "azithromycin"3MOazithromycin oral suspension for reconstitutionXE "azithromycin"3MOazithromycin oral tabletXE "azithromycin"1MOclarithromycin oral suspension for reconstitutionXE "clarithromycin"4MOclarithromycin oral tabletXE "clarithromycin"3MOclarithromycin oral tablet extended release 24 hrXE "clarithromycin"3MODIFICIDXE "DIFICID"5MOery-tab oral tablet,delayed release (dr/ec) 250 mg, 333 mgXE "ery-tab"4MOERY-TAB ORAL TABLET,DELAYED RELEASE (DR/EC) 500 MGXE "ERY-TAB"4MOerythrocin (as stearate) oral tablet 250 mgXE "erythrocin (as stearate)"4MOERYTHROCIN INTRAVENOUS RECON SOLN 500 MGXE "ERYTHROCIN"4MOerythromycin ethylsuccinate oral tabletXE "erythromycin ethylsuccinate"4MOerythromycin oralXE "erythromycin"4MOMISCELLANEOUS ANTIINFECTIVESalbendazoleXE "albendazole"5MOALINIAXE "ALINIA"5MOamikacin injection solution 500 mg/2 mlXE "amikacin"4MOatovaquoneXE "atovaquone"5MOatovaquone-proguanilXE "atovaquone-proguanil"4MOaztreonam injection recon soln 1 gramXE "aztreonam"4MOCAYSTONXE "CAYSTON"5PA; MO; LAchloroquine phosphateXE "chloroquine phosphate"3MOclindamycin hclXE "clindamycin hcl"1MOCLINDAMYCIN IN 0.9 % SOD CHLORXE "CLINDAMYCIN IN 0.9 % SOD CHLOR"4clindamycin in 5 % dextroseXE "clindamycin in 5 % dextrose"4MOclindamycin palmitate hclXE "clindamycin palmitate hcl"4MOclindamycin pediatricXE "clindamycin pediatric"4MOclindamycin phosphate injectionXE "clindamycin phosphate"3MOclindamycin phosphate intravenous solution 600 mg/4 mlXE "clindamycin phosphate"3MOCOARTEMXE "COARTEM"4MOcolistin (colistimethate na)XE "colistin (colistimethate na)"4MOdapsone oralXE "dapsone"3MODAPTOMYCIN INTRAVENOUS RECON SOLN 350 MGXE "DAPTOMYCIN"5MOdaptomycin intravenous recon soln 500 mgXE "daptomycin"5MOEMVERMXE "EMVERM"5MO; QL (12 per 365 days)ertapenemXE "ertapenem"4MOethambutolXE "ethambutol"3MOgentamicin in nacl (iso-osm) intravenous piggyback 100 mg/100 ml, 60 mg/50 ml, 80 mg/50 mlXE "gentamicin in nacl (iso-osm)"2MOgentamicin in nacl (iso-osm) intravenous piggyback 80 mg/100 mlXE "gentamicin in nacl (iso-osm)"2gentamicin injection solution 40 mg/mlXE "gentamicin"2MOhydroxychloroquineXE "hydroxychloroquine"3MOimipenem-cilastatinXE "imipenem-cilastatin"3MOisoniazid oral solutionXE "isoniazid"4MOisoniazid oral tabletXE "isoniazid"1MOivermectin oralXE "ivermectin"3MOlinezolid in dextrose 5%XE "linezolid in dextrose 5%"4linezolid oral suspension for reconstitutionXE "linezolid"5MOlinezolid oral tabletXE "linezolid"4MOlinezolid-0.9% sodium chlorideXE "linezolid-0.9% sodium chloride"4mefloquineXE "mefloquine"3MOmeropenemXE "meropenem"4MOMEROPENEM-0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK 1 GRAM/50 MLXE "MEROPENEM-0.9% SODIUM CHLORIDE"4MOMEROPENEM-0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK 500 MG/50 MLXE "MEROPENEM-0.9% SODIUM CHLORIDE"4metro i.v.XE "metro i.v."2MOmetronidazole in nacl (iso-os)XE "metronidazole in nacl (iso-os)"2MOmetronidazole oral tabletXE "metronidazole"2MOneomycinXE "neomycin"2MOparomomycinXE "paromomycin"4MOPASERXE "PASER"4MOpentamidine inhalationXE "pentamidine"4B/D PA; MOpentamidine injectionXE "pentamidine"4MOpraziquantelXE "praziquantel"3MOPRIFTINXE "PRIFTIN"4MOPRIMAQUINEXE "PRIMAQUINE"3MOpyrazinamideXE "pyrazinamide"4MOquinine sulfateXE "quinine sulfate"4PA; MOrifabutinXE "rifabutin"4MOrifampin intravenousXE "rifampin"4MOrifampin oralXE "rifampin"3MORIFATERXE "RIFATER"4MOSIRTURO ORAL TABLET 100 MGXE "SIRTURO"5PA; MO; LASIRTURO ORAL TABLET 20 MGXE "SIRTURO"5PA; LASIVEXTRO INTRAVENOUSXE "SIVEXTRO"5SIVEXTRO ORALXE "SIVEXTRO"5MOSTREPTOMYCINXE "STREPTOMYCIN"5MOtigecyclineXE "tigecycline"5tobramycin in 0.225 % naclXE "tobramycin in 0.225 % nacl"5PA; MOtobramycin sulfate injection recon solnXE "tobramycin sulfate"3tobramycin sulfate injection solutionXE "tobramycin sulfate"3MOTRECATORXE "TRECATOR"4MOVANCOMYCIN INJECTIONXE "VANCOMYCIN"4vancomycin intravenous recon soln 1,000 mg, 10 gram, 500 mg, 750 mgXE "vancomycin"4MOvancomycin oral capsule 125 mgXE "vancomycin"4MO; QL (40 per 10 days)vancomycin oral capsule 250 mgXE "vancomycin"5MO; QL (80 per 10 days)XIFAXAN ORAL TABLET 550 MGXE "XIFAXAN"5PA; MOPENICILLINSamoxicillin oral capsuleXE "amoxicillin"1MOamoxicillin oral suspension for reconstitutionXE "amoxicillin"1MOamoxicillin oral tabletXE "amoxicillin"1MOamoxicillin oral tablet,chewable 125 mg, 250 mgXE "amoxicillin"2MOamoxicillin-pot clavulanate oral suspension for reconstitution 200-28.5 mg/5 ml, 400-57 mg/5 ml, 600-42.9 mg/5 mlXE "amoxicillin-pot clavulanate"3MOamoxicillin-pot clavulanate oral suspension for reconstitution 250-62.5 mg/5 mlXE "amoxicillin-pot clavulanate"4MOamoxicillin-pot clavulanate oral tablet 250-125 mgXE "amoxicillin-pot clavulanate"4MOamoxicillin-pot clavulanate oral tablet 500-125 mg, 875-125 mgXE "amoxicillin-pot clavulanate"2MOamoxicillin-pot clavulanate oral tablet extended release 12 hrXE "amoxicillin-pot clavulanate"4MOamoxicillin-pot clavulanate oral tablet,chewableXE "amoxicillin-pot clavulanate"4MOampicillin oral capsule 500 mgXE "ampicillin"2MOampicillin sodium injection recon soln 1 gram, 10 gram, 125 mgXE "ampicillin sodium"4MOampicillin sodium intravenous recon soln 1 gramXE "ampicillin sodium"4ampicillin-sulbactam injection recon soln 1.5 gram, 3 gramXE "ampicillin-sulbactam"4MOampicillin-sulbactam injection recon soln 15 gramXE "ampicillin-sulbactam"4ampicillin-sulbactam intravenous recon soln 1.5 gramXE "ampicillin-sulbactam"4ampicillin-sulbactam intravenous recon soln 3 gramXE "ampicillin-sulbactam"4MOBICILLIN L-AXE "BICILLIN L-A"4MOdicloxacillinXE "dicloxacillin"3MOnafcillin in dextrose iso-osm intravenous piggyback 1 gram/50 mlXE "nafcillin in dextrose iso-osm"4nafcillin in dextrose iso-osm intravenous piggyback 2 gram/100 mlXE "nafcillin in dextrose iso-osm"4MOnafcillin injection recon soln 1 gram, 2 gramXE "nafcillin"4MOnafcillin injection recon soln 10 gramXE "nafcillin"5MOnafcillin intravenousXE "nafcillin"4MOoxacillin injection recon soln 1 gramXE "oxacillin"4oxacillin injection recon soln 10 gramXE "oxacillin"5oxacillin injection recon soln 2 gramXE "oxacillin"4MOPENICILLIN G POT IN DEXTROSE INTRAVENOUS PIGGYBACK 2 MILLION UNIT/50 MLXE "PENICILLIN G POT IN DEXTROSE"4PENICILLIN G POT IN DEXTROSE INTRAVENOUS PIGGYBACK 3 MILLION UNIT/50 MLXE "PENICILLIN G POT IN DEXTROSE"4MOpenicillin g potassiumXE "penicillin g potassium"4MOpenicillin g procaine intramuscular syringe 1.2 million unit/2 mlXE "penicillin g procaine"4MOpenicillin g sodiumXE "penicillin g sodium"4MOpenicillin v potassium oral recon solnXE "penicillin v potassium"2MOpenicillin v potassium oral tabletXE "penicillin v potassium"1MOPIPERACILLIN-TAZOBACTAM INTRAVENOUS RECON SOLN 13.5 GRAMXE "PIPERACILLIN-TAZOBACTAM"4MOpiperacillin-tazobactam intravenous recon soln 2.25 gram, 3.375 gram, 4.5 gram, 40.5 gramXE "piperacillin-tazobactam"4MOQUINOLONESCIPRO ORAL SUSPENSION,MICROCAPSULE RECON 500 MG/5 MLXE "CIPRO"4MOciprofloxacin hcl oral tablet 100 mgXE "ciprofloxacin hcl"4MOciprofloxacin hcl oral tablet 250 mg, 500 mg, 750 mgXE "ciprofloxacin hcl"1MOciprofloxacin in 5 % dextrose intravenous piggyback 200 mg/100 mlXE "ciprofloxacin in 5 % dextrose"3MOlevofloxacin in d5w intravenous piggyback 500 mg/100 ml, 750 mg/150 mlXE "levofloxacin in d5w"3MOlevofloxacin intravenousXE "levofloxacin"4MOlevofloxacin oral solutionXE "levofloxacin"4MOlevofloxacin oral tabletXE "levofloxacin"1MOmoxifloxacin oralXE "moxifloxacin"4MOSULFA'S / RELATED AGENTSsulfadiazineXE "sulfadiazine"4MOsulfamethoxazole-trimethoprim oral suspensionXE "sulfamethoxazole-trimethoprim"3MOsulfamethoxazole-trimethoprim oral tabletXE "sulfamethoxazole-trimethoprim"1MOTETRACYCLINESdoxy-100XE "doxy-100"4MOdoxycycline hyclate intravenousXE "doxycycline hyclate"4doxycycline hyclate oral capsuleXE "doxycycline hyclate"3MOdoxycycline hyclate oral tablet 100 mg, 20 mgXE "doxycycline hyclate"3MOdoxycycline monohydrate oral capsule 100 mg, 50 mgXE "doxycycline monohydrate"2MOdoxycycline monohydrate oral tablet 100 mg, 50 mg, 75 mgXE "doxycycline monohydrate"3MOminocycline oral capsuleXE "minocycline"2MOmondoxyne nl oral capsule 100 mgXE "mondoxyne nl"2MOtetracyclineXE "tetracycline"4MOURINARY TRACT AGENTSmethenamine hippurateXE "methenamine hippurate"3MOnitrofurantoinXE "nitrofurantoin"3MOnitrofurantoin macrocrystal oral capsule 100 mg, 50 mgXE "nitrofurantoin macrocrystal"3MOnitrofurantoin monohyd/m-crystXE "nitrofurantoin monohyd/m-cryst"3MOtrimethoprimXE "trimethoprim"2MOANTINEOPLASTIC / IMMUNOSUPPRESSANT DRUGSADJUNCTIVE AGENTSleucovorin calcium oral tablet 10 mg, 5 mgXE "leucovorin calcium"3MOleucovorin calcium oral tablet 15 mg, 25 mgXE "leucovorin calcium"4MOMESNEX ORALXE "MESNEX"5MOXGEVAXE "XGEVA"5PA; MOANTINEOPLASTIC / IMMUNOSUPPRESSANT DRUGSabirateroneXE "abiraterone"5PA; MOAFINITOR DISPERZ ORAL TABLET FOR SUSPENSION 2 MGXE "AFINITOR DISPERZ"5PA; MO; QL (150 per 30 days)AFINITOR DISPERZ ORAL TABLET FOR SUSPENSION 3 MGXE "AFINITOR DISPERZ"5PA; MO; QL (90 per 30 days)AFINITOR DISPERZ ORAL TABLET FOR SUSPENSION 5 MGXE "AFINITOR DISPERZ"5PA; MO; QL (60 per 30 days)AFINITOR ORAL TABLET 10 MGXE "AFINITOR"5PA; MO; QL (30 per 30 days)ALECENSAXE "ALECENSA"5PA; MO; LAALUNBRIGXE "ALUNBRIG"5PA; MO; LAanastrozoleXE "anastrozole"1MOAYVAKITXE "AYVAKIT"5PA; MO; LA; QL (30 per 30 days)azathioprineXE "azathioprine"3B/D PA; MOBALVERSAXE "BALVERSA"5PA; MO; LAbexaroteneXE "bexarotene"5PA; MObicalutamideXE "bicalutamide"2MOBOSULIFXE "BOSULIF"5PA; MOBRAFTOVI ORAL CAPSULE 75 MGXE "BRAFTOVI"5PA; MO; LABRUKINSAXE "BRUKINSA"5PA; MO; LACABOMETYXXE "CABOMETYX"5PA; MO; LA; QL (30 per 30 days)CALQUENCEXE "CALQUENCE"5PA; MO; LACAPRELSA ORAL TABLET 100 MGXE "CAPRELSA"5PA; LACAPRELSA ORAL TABLET 300 MGXE "CAPRELSA"5PA; MO; LACOMETRIQXE "COMETRIQ"5PA; MO; LACOPIKTRAXE "COPIKTRA"5PA; MO; LACOTELLICXE "COTELLIC"5PA; MO; LAcyclophosphamide oral capsuleXE "cyclophosphamide"3B/D PA; MOcyclosporine modifiedXE "cyclosporine modified"4B/D PA; MOcyclosporine oral capsuleXE "cyclosporine"4B/D PA; MODAURISMOXE "DAURISMO"5PA; MO; LADROXIAXE "DROXIA"3MOEMCYTXE "EMCYT"4MOERIVEDGEXE "ERIVEDGE"5PA; MO; LAERLEADAXE "ERLEADA"5PA; MO; LAerlotinib oral tablet 100 mg, 150 mgXE "erlotinib"5PA; MO; QL (30 per 30 days)erlotinib oral tablet 25 mgXE "erlotinib"5PA; MO; QL (90 per 30 days)everolimus (antineoplastic)XE "everolimus (antineoplastic)"5PA; MO; QL (30 per 30 days)everolimus (immunosuppressive)XE "everolimus (immunosuppressive)"5B/D PA; MOexemestaneXE "exemestane"4MOFARYDAK ORAL CAPSULE 10 MG, 20 MGXE "FARYDAK"5PA; MO; LAflutamideXE "flutamide"3MOgengraf oral capsule 100 mg, 25 mgXE "gengraf"4B/D PA; MOgengraf oral solutionXE "gengraf"4B/D PA; MOGILOTRIFXE "GILOTRIF"5PA; MO; LAhydroxyureaXE "hydroxyurea"2MOIBRANCE ORAL CAPSULEXE "IBRANCE"5PA; MO; LA; QL (21 per 28 days)IBRANCE ORAL TABLETXE "IBRANCE"5PA; MO; QL (21 per 28 days)ICLUSIGXE "ICLUSIG"5PA; LAIDHIFAXE "IDHIFA"5PA; MO; LA; QL (30 per 30 days)imatinib oral tablet 100 mgXE "imatinib"5PA; MO; QL (90 per 30 days)imatinib oral tablet 400 mgXE "imatinib"5PA; MO; QL (60 per 30 days)IMBRUVICAXE "IMBRUVICA"5PA; MO; LAINLYTA ORAL TABLET 1 MGXE "INLYTA"5PA; MO; LA; QL (180 per 30 days)INLYTA ORAL TABLET 5 MGXE "INLYTA"5PA; MO; LA; QL (120 per 30 days)INREBICXE "INREBIC"5PA; MO; LAIRESSAXE "IRESSA"5PA; MO; LAJAKAFIXE "JAKAFI"5PA; MO; LA; QL (60 per 30 days)KISQALIXE "KISQALI"5PA; MOKISQALI FEMARA CO-PACKXE "KISQALI FEMARA CO-PACK"5PA; MOLENVIMAXE "LENVIMA"5PA; MO; LAletrozoleXE "letrozole"1MOLEUKERANXE "LEUKERAN"5MOleuprolide subcutaneous kitXE "leuprolide"3PA; MOLONSURFXE "LONSURF"5PA; MOLORBRENAXE "LORBRENA"5PA; MO; LALUPRON DEPOT (3 MONTH) INTRAMUSCULAR SYRINGE KIT 11.25 MGXE "LUPRON DEPOT (3 MONTH)"5PA; MOLUPRON DEPOT (3 MONTH) INTRAMUSCULAR SYRINGE KIT 22.5 MGXE "LUPRON DEPOT (3 MONTH)"5MOLUPRON DEPOT (4 MONTH)XE "LUPRON DEPOT (4 MONTH)"5MOLUPRON DEPOT (6 MONTH)XE "LUPRON DEPOT (6 MONTH)"5MOLUPRON DEPOT INTRAMUSCULAR SYRINGE KIT 3.75 MGXE "LUPRON DEPOT"5PA; MOLUPRON DEPOT INTRAMUSCULAR SYRINGE KIT 7.5 MGXE "LUPRON DEPOT"5MOLUPRON DEPOT-PED (3 MONTH) INTRAMUSCULAR SYRINGE KIT 11.25 MGXE "LUPRON DEPOT-PED (3 MONTH)"5PA; MOLUPRON DEPOT-PED INTRAMUSCULAR KIT 7.5 MG (PED)XE "LUPRON DEPOT-PED"5MOLYNPARZA ORAL TABLETXE "LYNPARZA"5PA; MO; LALYSODRENXE "LYSODREN"3MOMATULANEXE "MATULANE"5MO; LAmegestrol oral suspension 400 mg/10 ml (10 ml)XE "megestrol"3megestrol oral suspension 400 mg/10 ml (40 mg/ml)XE "megestrol"3MOmegestrol oral suspension 625 mg/5 ml (125 mg/ml)XE "megestrol"4PA; MOmegestrol oral tabletXE "megestrol"3MOMEKINISTXE "MEKINIST"5PA; MO; LAMEKTOVIXE "MEKTOVI"5PA; MO; LAmercaptopurineXE "mercaptopurine"3MOmethotrexate sodium (pf) injection solutionXE "methotrexate sodium (pf)"2B/D PA; MOmethotrexate sodium injectionXE "methotrexate sodium"2B/D PA; MOmethotrexate sodium oralXE "methotrexate sodium"3MOmycophenolate mofetil oral capsuleXE "mycophenolate mofetil"3B/D PA; MOmycophenolate mofetil oral suspension for reconstitutionXE "mycophenolate mofetil"5B/D PA; MOmycophenolate mofetil oral tabletXE "mycophenolate mofetil"3B/D PA; MOmycophenolate sodiumXE "mycophenolate sodium"4B/D PA; MONERLYNXXE "NERLYNX"5PA; MO; LANEXAVARXE "NEXAVAR"5PA; MO; LAnilutamideXE "nilutamide"5MONINLAROXE "NINLARO"5PA; MONUBEQAXE "NUBEQA"5PA; MO; LAoctreotide acetate injection solution 1,000 mcg/ml, 500 mcg/mlXE "octreotide acetate"5PA; MOoctreotide acetate injection solution 100 mcg/ml, 200 mcg/ml, 50 mcg/mlXE "octreotide acetate"4PA; MOODOMZOXE "ODOMZO"5PA; MO; LAPEMAZYREXE "PEMAZYRE"5PA; MO; QL (14 per 21 days)PIQRAYXE "PIQRAY"5PA; MOPOMALYSTXE "POMALYST"5PA; MO; LA; QL (21 per 28 days)PROGRAF ORAL GRANULES IN PACKETXE "PROGRAF"4B/D PA; MOPURIXANXE "PURIXAN"5QINLOCKXE "QINLOCK"5PA; MO; LA; QL (90 per 30 days)RETEVMO ORAL CAPSULE 40 MGXE "RETEVMO"5PA; MO; QL (180 per 30 days)RETEVMO ORAL CAPSULE 80 MGXE "RETEVMO"5PA; MO; QL (120 per 30 days)REVLIMIDXE "REVLIMID"5PA; MO; LA; QL (28 per 28 days)ROZLYTREKXE "ROZLYTREK"5PA; MO; LARUBRACAXE "RUBRACA"5PA; MO; LARYDAPTXE "RYDAPT"5PA; MOSANDIMMUNE ORAL SOLUTIONXE "SANDIMMUNE"3B/D PA; MOSIGNIFORXE "SIGNIFOR"5PA; MO; LAsirolimus oral solutionXE "sirolimus"5B/D PA; MOsirolimus oral tablet 0.5 mg, 1 mgXE "sirolimus"4B/D PA; MOsirolimus oral tablet 2 mgXE "sirolimus"5B/D PA; MOSOLTAMOXXE "SOLTAMOX"5MOSOMATULINE DEPOTXE "SOMATULINE DEPOT"5PA; MOSPRYCELXE "SPRYCEL"5PA; MOSTIVARGAXE "STIVARGA"5PA; MO; LASUTENTXE "SUTENT"5PA; MO; QL (30 per 30 days)SYNRIBOXE "SYNRIBO"5PA; MOTABLOIDXE "TABLOID"5MOTABRECTAXE "TABRECTA"5PA; MOtacrolimus oralXE "tacrolimus"4B/D PA; MOTAFINLARXE "TAFINLAR"5PA; MO; LATAGRISSOXE "TAGRISSO"5PA; MO; LA; QL (30 per 30 days)TALZENNAXE "TALZENNA"5PA; MO; LAtamoxifenXE "tamoxifen"1MOTARGRETIN TOPICALXE "TARGRETIN"5PA; MO; QL (60 per 30 days)TASIGNAXE "TASIGNA"5PA; MOTAZVERIKXE "TAZVERIK"5PA; MO; LATHALOMID ORAL CAPSULE 100 MG, 50 MGXE "THALOMID"5PA; MO; QL (28 per 28 days)THALOMID ORAL CAPSULE 150 MG, 200 MGXE "THALOMID"5PA; MO; QL (56 per 28 days)TIBSOVOXE "TIBSOVO"5PA; MO; LAtoremifeneXE "toremifene"5MOTRELSTAR INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION 11.25 MG, 3.75 MGXE "TRELSTAR"5PA; MOtretinoin (antineoplastic)XE "tretinoin (antineoplastic)"5MOTUKYSA ORAL TABLET 150 MGXE "TUKYSA"5PA; MO; QL (120 per 30 days)TUKYSA ORAL TABLET 50 MGXE "TUKYSA"5PA; MO; QL (300 per 30 days)TURALIOXE "TURALIO"5PA; MO; LATYKERBXE "TYKERB"5PA; MO; LAVENCLEXTA ORAL TABLET 10 MGXE "VENCLEXTA"4PA; MO; LAVENCLEXTA ORAL TABLET 100 MG, 50 MGXE "VENCLEXTA"5PA; MO; LAVENCLEXTA STARTING PACKXE "VENCLEXTA STARTING PACK"5PA; MO; LAVERZENIOXE "VERZENIO"5PA; MO; LAVITRAKVIXE "VITRAKVI"5PA; MO; LAVIZIMPROXE "VIZIMPRO"5PA; MO; LAVOTRIENTXE "VOTRIENT"5PA; MO; LAXALKORIXE "XALKORI"5PA; MO; LAXATMEPXE "XATMEP"4B/D PA; MOXOSPATAXE "XOSPATA"5PA; MO; LAXPOVIO ORAL TABLET 100 MG/WEEK (20 MG X 5), 40MG TWICE WEEK (80 MG/WEEK), 60 MG/WEEK (20 MG X 3), 80 MG/WEEK (20 MG X 4), 80MG TWICE WEEK (160 MG/WEEK)XE "XPOVIO"5PA; MO; LAXTANDIXE "XTANDI"5PA; MO; LAZEJULAXE "ZEJULA"5PA; MO; LAZELBORAFXE "ZELBORAF"5PA; MO; LAZOLINZAXE "ZOLINZA"5PA; MOZORTRESSXE "ZORTRESS"5B/D PA; MOZYDELIGXE "ZYDELIG"5PA; MO; LAZYKADIA ORAL TABLETXE "ZYKADIA"5PA; MO; LAZYTIGA ORAL TABLET 500 MGXE "ZYTIGA"5PA; MO; LAAUTONOMIC / CNS DRUGS, NEUROLOGY / PSYCHANTICONVULSANTSAPTIOMXE "APTIOM"5MO; QL (60 per 30 days)BANZELXE "BANZEL"5PA; MOBRIVIACT ORALXE "BRIVIACT"5PA; MOcarbamazepine oral capsule, er multiphase 12 hrXE "carbamazepine"4MOcarbamazepine oral suspension 100 mg/5 mlXE "carbamazepine"4MOcarbamazepine oral tabletXE "carbamazepine"3MOcarbamazepine oral tablet extended release 12 hrXE "carbamazepine"4MOcarbamazepine oral tablet,chewableXE "carbamazepine"3MOCELONTIN ORAL CAPSULE 300 MGXE "CELONTIN"4MOclobazamXE "clobazam"4PA; MOclonazepam oral tablet 0.5 mg, 1 mgXE "clonazepam"2MO; QL (90 per 30 days)clonazepam oral tablet 2 mgXE "clonazepam"2MO; QL (300 per 30 days)clonazepam oral tablet,disintegrating 0.125 mg, 0.25 mg, 0.5 mg, 1 mgXE "clonazepam"3MO; QL (90 per 30 days)clonazepam oral tablet,disintegrating 2 mgXE "clonazepam"3MO; QL (300 per 30 days)DIASTATXE "DIASTAT"4MODIASTAT ACUDIALXE "DIASTAT ACUDIAL"4MOdiazepam rectalXE "diazepam"4MODILANTIN 30 MGXE "DILANTIN 30 MG"3MODILANTIN EXTENDED 100 MGXE "DILANTIN EXTENDED 100 MG"3MODILANTIN INFATABS 50 MGXE "DILANTIN INFATABS 50 MG"3MODILANTIN-125 125 MG/5 MLXE "DILANTIN-125 125 MG/5 ML"4MOdivalproex oral capsule, delayed rel sprinkleXE "divalproex"4MOdivalproex oral tablet extended release 24 hrXE "divalproex"3MOdivalproex oral tablet,delayed release (dr/ec)XE "divalproex"3MOEPIDIOLEXXE "EPIDIOLEX"5PA; MO; LA; QL (600 per 30 days)epitolXE "epitol"3MOethosuximideXE "ethosuximide"2MOfelbamate oral suspensionXE "felbamate"5MOfelbamate oral tabletXE "felbamate"4MOFYCOMPA ORAL SUSPENSIONXE "FYCOMPA"5PA; MO; QL (720 per 30 days)FYCOMPA ORAL TABLET 10 MG, 12 MG, 8 MGXE "FYCOMPA"5PA; MO; QL (30 per 30 days)FYCOMPA ORAL TABLET 2 MGXE "FYCOMPA"4PA; MO; QL (60 per 30 days)FYCOMPA ORAL TABLET 4 MG, 6 MGXE "FYCOMPA"5PA; MO; QL (60 per 30 days)gabapentin oral capsule 100 mg, 400 mgXE "gabapentin"2MO; QL (270 per 30 days)gabapentin oral capsule 300 mgXE "gabapentin"2MO; QL (360 per 30 days)gabapentin oral solution 250 mg/5 mlXE "gabapentin"3MO; QL (2160 per 30 days)gabapentin oral solution 250 mg/5 ml (5 ml), 300 mg/6 ml (6 ml)XE "gabapentin"3QL (2160 per 30 days)gabapentin oral tablet 600 mgXE "gabapentin"3MO; QL (180 per 30 days)gabapentin oral tablet 800 mgXE "gabapentin"3MO; QL (120 per 30 days)lamotrigine oral tabletXE "lamotrigine"1MOlamotrigine oral tablet extended release 24hrXE "lamotrigine"4MOlamotrigine oral tablet, chewable dispersibleXE "lamotrigine"3MOlevetiracetam oral solution 100 mg/mlXE "levetiracetam"3MOlevetiracetam oral solution 500 mg/5 ml (5 ml)XE "levetiracetam"3levetiracetam oral tabletXE "levetiracetam"2MOlevetiracetam oral tablet extended release 24 hrXE "levetiracetam"3MOLYRICA CR ORAL TABLET EXTENDED RELEASE 24 HR 165 MG, 82.5 MGXE "LYRICA CR"3PA; MO; QL (30 per 30 days)LYRICA CR ORAL TABLET EXTENDED RELEASE 24 HR 330 MGXE "LYRICA CR"3PA; MO; QL (60 per 30 days)NAYZILAMXE "NAYZILAM"4MOoxcarbazepine oral suspensionXE "oxcarbazepine"4MOoxcarbazepine oral tabletXE "oxcarbazepine"3MOPEGANONEXE "PEGANONE"4MOphenobarbital oral elixirXE "phenobarbital"4PA; MOphenobarbital oral tabletXE "phenobarbital"3PA; MOPHENYTEKXE "PHENYTEK"3MOphenytoin oral suspension 100 mg/4 mlXE "phenytoin"3phenytoin oral suspension 125 mg/5 mlXE "phenytoin"3MOphenytoin oral tablet,chewableXE "phenytoin"3MOphenytoin sodium extendedXE "phenytoin sodium extended"3MOpregabalin oral capsule 100 mg, 150 mg, 200 mg, 25 mg, 50 mg, 75 mgXE "pregabalin"3PA; MO; QL (90 per 30 days)pregabalin oral capsule 225 mg, 300 mgXE "pregabalin"3PA; MO; QL (60 per 30 days)pregabalin oral solutionXE "pregabalin"4PA; MO; QL (900 per 30 days)primidoneXE "primidone"2MOroweepraXE "roweepra"2MOroweepra xrXE "roweepra xr"3SPRITAMXE "SPRITAM"4MOSYMPAZAN ORAL FILM 10 MG, 20 MGXE "SYMPAZAN"5PA; MOSYMPAZAN ORAL FILM 5 MGXE "SYMPAZAN"4PA; MOtiagabineXE "tiagabine"4MOtopiramate oral capsule, sprinkleXE "topiramate"3MOtopiramate oral tabletXE "topiramate"2MOvalproic acidXE "valproic acid"3MOvalproic acid (as sodium salt) oral solution 250 mg/5 mlXE "valproic acid (as sodium salt)"3MOvalproic acid (as sodium salt) oral solution 250 mg/5 ml (5 ml), 500 mg/10 ml (10 ml)XE "valproic acid (as sodium salt)"3VALTOCOXE "VALTOCO"4MOvigabatrinXE "vigabatrin"5PA; MO; LA; QL (180 per 30 days)vigadroneXE "vigadrone"5PA; MO; LA; QL (180 per 30 days)VIMPAT ORAL SOLUTIONXE "VIMPAT"5MO; QL (1200 per 30 days)VIMPAT ORAL TABLET 100 MG, 150 MG, 200 MGXE "VIMPAT"5MO; QL (60 per 30 days)VIMPAT ORAL TABLET 50 MGXE "VIMPAT"4MO; QL (60 per 30 days)XCOPRI MAINTENANCE PACKXE "XCOPRI MAINTENANCE PACK"5MO; QL (56 per 28 days)XCOPRI ORAL TABLET 100 MGXE "XCOPRI"4MO; QL (120 per 30 days)XCOPRI ORAL TABLET 150 MGXE "XCOPRI"4MO; QL (60 per 30 days)XCOPRI ORAL TABLET 200 MGXE "XCOPRI"5MO; QL (60 per 30 days)XCOPRI ORAL TABLET 50 MGXE "XCOPRI"4MO; QL (240 per 30 days)XCOPRI TITRATION PACKXE "XCOPRI TITRATION PACK"4MO; QL (56 per 28 days)zonisamideXE "zonisamide"2MOANTIPARKINSONISM AGENTSAPOKYNXE "APOKYN"5PA; MO; LA; QL (60 per 30 days)benztropine oralXE "benztropine"3PA; MObromocriptineXE "bromocriptine"4MOcarbidopaXE "carbidopa"4MOcarbidopa-levodopa oral tabletXE "carbidopa-levodopa"2MOcarbidopa-levodopa oral tablet extended releaseXE "carbidopa-levodopa"3MOcarbidopa-levodopa oral tablet,disintegratingXE "carbidopa-levodopa"4MOcarbidopa-levodopa-entacaponeXE "carbidopa-levodopa-entacapone"4MOentacaponeXE "entacapone"4MONEUPROXE "NEUPRO"4MOpramipexole oral tabletXE "pramipexole"1MOrasagilineXE "rasagiline"4MOropinirole oral tabletXE "ropinirole"2MOselegiline hclXE "selegiline hcl"3MOtrihexyphenidylXE "trihexyphenidyl"3PA; MOMIGRAINE / CLUSTER HEADACHE THERAPYAIMOVIG AUTOINJECTORXE "AIMOVIG AUTOINJECTOR"3PA; MO; QL (1 per 30 days)dihydroergotamine nasalXE "dihydroergotamine"5PA; MO; QL (8 per 28 days)eletriptanXE "eletriptan"4MO; QL (18 per 28 days)EMGALITY PENXE "EMGALITY PEN"3PA; MO; QL (2 per 30 days)EMGALITY SYRINGE SUBCUTANEOUS SYRINGE 120 MG/MLXE "EMGALITY SYRINGE"3PA; MO; QL (2 per 30 days)ergotamine-caffeineXE "ergotamine-caffeine"2MOnaratriptanXE "naratriptan"3MO; QL (18 per 28 days)rizatriptanXE "rizatriptan"3MO; QL (36 per 28 days)sumatriptan nasal spray,non-aerosol 20 mg/actuationXE "sumatriptan"4MO; QL (18 per 28 days)sumatriptan nasal spray,non-aerosol 5 mg/actuationXE "sumatriptan"4MO; QL (36 per 28 days)sumatriptan succinate oralXE "sumatriptan succinate"2MO; QL (18 per 28 days)sumatriptan succinate subcutaneous cartridge 4 mg/0.5 mlXE "sumatriptan succinate"4MO; QL (9 per 30 days)sumatriptan succinate subcutaneous cartridge 6 mg/0.5 mlXE "sumatriptan succinate"4MO; QL (8 per 28 days)sumatriptan succinate subcutaneous pen injector 4 mg/0.5 mlXE "sumatriptan succinate"4MO; QL (9 per 30 days)sumatriptan succinate subcutaneous pen injector 6 mg/0.5 mlXE "sumatriptan succinate"4MO; QL (8 per 28 days)sumatriptan succinate subcutaneous solutionXE "sumatriptan succinate"4MO; QL (8 per 28 days)sumatriptan succinate subcutaneous syringe 6 mg/0.5 mlXE "sumatriptan succinate"4MO; QL (8 per 28 days)zolmitriptanXE "zolmitriptan"4MO; QL (18 per 28 days)MISCELLANEOUS NEUROLOGICAL THERAPYAUSTEDO ORAL TABLET 12 MG, 9 MGXE "AUSTEDO"5PA; MO; QL (120 per 30 days)AUSTEDO ORAL TABLET 6 MGXE "AUSTEDO"5PA; MO; QL (60 per 30 days)dalfampridineXE "dalfampridine"5PA; MOdonepezil oral tablet 10 mgXE "donepezil"2MOdonepezil oral tablet 5 mgXE "donepezil"2MO; QL (30 per 30 days)donepezil oral tablet,disintegrating 10 mgXE "donepezil"2MOdonepezil oral tablet,disintegrating 5 mgXE "donepezil"2MO; QL (30 per 30 days)galantamine oral capsule,ext rel. pellets 24 hrXE "galantamine"3MO; QL (30 per 30 days)galantamine oral solutionXE "galantamine"4MOgalantamine oral tabletXE "galantamine"3MO; QL (60 per 30 days)GILENYA ORAL CAPSULE 0.5 MGXE "GILENYA"5PA; MO; QL (28 per 28 days)glatiramer subcutaneous syringe 20 mg/mlXE "glatiramer"5PA; MO; QL (30 per 30 days)glatiramer subcutaneous syringe 40 mg/mlXE "glatiramer"5PA; MO; QL (12 per 28 days)glatopa subcutaneous syringe 20 mg/mlXE "glatopa"5PA; MO; QL (30 per 30 days)glatopa subcutaneous syringe 40 mg/mlXE "glatopa"5PA; MO; QL (12 per 28 days)memantine oral capsule,sprinkle,er 24hrXE "memantine"4PA; MOmemantine oral solutionXE "memantine"4PA; MOmemantine oral tabletXE "memantine"3PA; MOMEMANTINE ORAL TABLETS,DOSE PACKXE "MEMANTINE"4PA; MONAMZARICXE "NAMZARIC"4MONUEDEXTAXE "NUEDEXTA"4PA; MO; QL (60 per 30 days)rivastigmineXE "rivastigmine"4MO; QL (30 per 30 days)rivastigmine tartrate oral capsule 1.5 mg, 3 mgXE "rivastigmine tartrate"4MO; QL (90 per 30 days)rivastigmine tartrate oral capsule 4.5 mg, 6 mgXE "rivastigmine tartrate"4MO; QL (60 per 30 days)TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC) 120 MGXE "TECFIDERA"5PA; MO; QL (14 per 30 days)TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC) 120 MG (14)- 240 MG (46)XE "TECFIDERA"5PA; MO; QL (120 per 180 days)TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC) 240 MGXE "TECFIDERA"5PA; MO; QL (60 per 30 days)tetrabenazine oral tablet 12.5 mgXE "tetrabenazine"5PA; MO; QL (240 per 30 days)tetrabenazine oral tablet 25 mgXE "tetrabenazine"5PA; MO; QL (120 per 30 days)MUSCLE RELAXANTS / ANTISPASMODIC THERAPYbaclofen oral tablet 10 mg, 20 mgXE "baclofen"3MOcyclobenzaprine oral tablet 10 mg, 5 mgXE "cyclobenzaprine"3PA; MOdantrolene oralXE "dantrolene"4MOmethocarbamol oralXE "methocarbamol"3PA; MOpyridostigmine bromide oral syrupXE "pyridostigmine bromide"5MOpyridostigmine bromide oral tablet 60 mgXE "pyridostigmine bromide"3MOpyridostigmine bromide oral tablet extended releaseXE "pyridostigmine bromide"3MOtizanidine oral tabletXE "tizanidine"2MONARCOTIC ANALGESICSacetaminophen-codeine oral solution 120 mg-12 mg /5 ml (5 ml), 300 mg-30 mg /12.5 mlXE "acetaminophen-codeine"2QL (4500 per 30 days)acetaminophen-codeine oral solution 120-12 mg/5 mlXE "acetaminophen-codeine"2MO; QL (4500 per 30 days)acetaminophen-codeine oral tablet 300-15 mg, 300-30 mgXE "acetaminophen-codeine"2MO; QL (360 per 30 days)acetaminophen-codeine oral tablet 300-60 mgXE "acetaminophen-codeine"2MO; QL (180 per 30 days)buprenorphine hcl sublingualXE "buprenorphine hcl"3PA; MO; QL (90 per 30 days)endocet oral tablet 10-325 mg, 5-325 mg, 7.5-325 mgXE "endocet"3MO; QL (360 per 30 days)fentanyl citrate buccal lozenge on a handleXE "fentanyl citrate"5PA; MO; QL (120 per 30 days)fentanyl transdermal patch 72 hour 100 mcg/hr, 12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hrXE "fentanyl"4PA; MO; QL (10 per 30 days)hydrocodone-acetaminophen oral solution 7.5-325 mg/15 mlXE "hydrocodone-acetaminophen"4MO; QL (2700 per 30 days)hydrocodone-acetaminophen oral tablet 10-325 mg, 7.5-325 mgXE "hydrocodone-acetaminophen"3MO; QL (180 per 30 days)hydrocodone-acetaminophen oral tablet 5-325 mgXE "hydrocodone-acetaminophen"3MO; QL (240 per 30 days)hydrocodone-ibuprofen oral tablet 7.5-200 mgXE "hydrocodone-ibuprofen"3MO; QL (50 per 30 days)hydromorphone (pf) injection solution 10 (mg/ml) (5 ml), 10 mg/mlXE "hydromorphone (pf)"4B/D PA; MOhydromorphone oral liquidXE "hydromorphone"4MO; QL (600 per 30 days)hydromorphone oral tabletXE "hydromorphone"3MO; QL (180 per 30 days)HYSINGLA ERXE "HYSINGLA ER"3PA; MO; QL (30 per 30 days)lorcet (hydrocodone)XE "lorcet (hydrocodone)"3MO; QL (240 per 30 days)lorcet hdXE "lorcet hd"3MO; QL (180 per 30 days)lorcet plus oral tablet 7.5-325 mgXE "lorcet plus"3MO; QL (180 per 30 days)methadone oral solutionXE "methadone"3PA; MO; QL (450 per 30 days)methadone oral tabletXE "methadone"3PA; MO; QL (90 per 30 days)morphine concentrate oral solutionXE "morphine concentrate"3MO; QL (180 per 30 days)morphine oral solutionXE "morphine"3MO; QL (900 per 30 days)morphine oral tabletXE "morphine"3MO; QL (180 per 30 days)morphine oral tablet extended releaseXE "morphine"3PA; MO; QL (90 per 30 days)oxycodone oral capsuleXE "oxycodone"4MO; QL (180 per 30 days)oxycodone oral concentrateXE "oxycodone"4MO; QL (180 per 30 days)oxycodone oral solutionXE "oxycodone"4MO; QL (900 per 30 days)oxycodone oral tabletXE "oxycodone"3MO; QL (180 per 30 days)oxycodone-acetaminophen oral tablet 10-325 mgXE "oxycodone-acetaminophen"3MO; QL (180 per 30 days)oxycodone-acetaminophen oral tablet 2.5-325 mg, 5-325 mgXE "oxycodone-acetaminophen"3MO; QL (360 per 30 days)oxycodone-acetaminophen oral tablet 7.5-325 mgXE "oxycodone-acetaminophen"3MO; QL (240 per 30 days)OXYCONTIN ORAL TABLET,ORAL ONLY,EXT.REL.12 HRXE "OXYCONTIN"4PA; MO; QL (90 per 30 days)NON-NARCOTIC ANALGESICSbuprenorphine-naloxone sublingual film 12-3 mgXE "buprenorphine-naloxone"4MO; QL (60 per 30 days)buprenorphine-naloxone sublingual film 2-0.5 mg, 4-1 mg, 8-2 mgXE "buprenorphine-naloxone"4MO; QL (90 per 30 days)buprenorphine-naloxone sublingual tabletXE "buprenorphine-naloxone"2MO; QL (90 per 30 days)celecoxib oral capsule 100 mg, 200 mg, 50 mgXE "celecoxib"3MO; QL (60 per 30 days)celecoxib oral capsule 400 mgXE "celecoxib"3MO; QL (30 per 30 days)diclofenac potassiumXE "diclofenac potassium"3MO; QL (120 per 30 days)diclofenac sodium oral tablet extended release 24 hrXE "diclofenac sodium"3MOdiclofenac sodium oral tablet,delayed release (dr/ec)XE "diclofenac sodium"2MOdiclofenac sodium topical gel 1 %XE "diclofenac sodium"3MO; QL (1000 per 30 days)diflunisalXE "diflunisal"3MOec-naproxenXE "ec-naproxen"2MOetodolacXE "etodolac"3MOflurbiprofen oral tablet 100 mgXE "flurbiprofen"2MOibu oral tablet 600 mg, 800 mgXE "ibu"1MOibuprofen oral suspensionXE "ibuprofen"3MOibuprofen oral tablet 400 mg, 600 mg, 800 mgXE "ibuprofen"1MOmeloxicam oral tabletXE "meloxicam"1MOnabumetoneXE "nabumetone"2MOnaloxone injection solutionXE "naloxone"2MOnaloxone injection syringeXE "naloxone"2MOnaltrexoneXE "naltrexone"3MOnaproxen oral tabletXE "naproxen"1MOnaproxen oral tablet,delayed release (dr/ec)XE "naproxen"2MOnaproxen sodium oral tablet 275 mg, 550 mgXE "naproxen sodium"3MONARCAN NASAL SPRAY,NON-AEROSOL 4 MG/ACTUATIONXE "NARCAN"3MONUCYNTA ERXE "NUCYNTA ER"3PA; MO; QL (60 per 30 days)piroxicamXE "piroxicam"3MOsulindacXE "sulindac"2MOtramadol oral tablet 50 mgXE "tramadol"2MO; QL (240 per 30 days)tramadol-acetaminophenXE "tramadol-acetaminophen"3MO; QL (240 per 30 days)VIVITROLXE "VIVITROL"5MOPSYCHOTHERAPEUTIC DRUGSABILIFY MAINTENAXE "ABILIFY MAINTENA"5MO; QL (1 per 28 days)alprazolam oral tablet 0.25 mg, 0.5 mg, 1 mgXE "alprazolam"2MO; QL (90 per 30 days)alprazolam oral tablet 2 mgXE "alprazolam"2MO; QL (150 per 30 days)amitriptylineXE "amitriptyline"3MOamoxapineXE "amoxapine"3MOaripiprazole oral solutionXE "aripiprazole"5MO; QL (900 per 30 days)aripiprazole oral tabletXE "aripiprazole"4MO; QL (30 per 30 days)aripiprazole oral tablet,disintegratingXE "aripiprazole"5MO; QL (60 per 30 days)ARISTADA INITIOXE "ARISTADA INITIO"5MOARISTADA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING 1,064 MG/3.9 MLXE "ARISTADA"5MO; QL (3.9 per 56 days)ARISTADA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING 441 MG/1.6 MLXE "ARISTADA"5MO; QL (1.6 per 28 days)ARISTADA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING 662 MG/2.4 MLXE "ARISTADA"5MO; QL (2.4 per 28 days)ARISTADA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING 882 MG/3.2 MLXE "ARISTADA"5MO; QL (3.2 per 28 days)armodafinil oral tablet 150 mg, 200 mg, 250 mgXE "armodafinil"3PA; MO; QL (30 per 30 days)armodafinil oral tablet 50 mgXE "armodafinil"3PA; MO; QL (90 per 30 days)atomoxetine oral capsule 10 mg, 18 mg, 25 mgXE "atomoxetine"4MO; QL (120 per 30 days)atomoxetine oral capsule 100 mg, 60 mg, 80 mgXE "atomoxetine"4MO; QL (30 per 30 days)atomoxetine oral capsule 40 mgXE "atomoxetine"4MO; QL (60 per 30 days)bupropion hcl oral tabletXE "bupropion hcl"3MObupropion hcl oral tablet extended release 24 hr 150 mg, 300 mgXE "bupropion hcl"3MObupropion hcl oral tablet sustained-release 12 hrXE "bupropion hcl"2MObuspirone oral tablet 10 mg, 15 mg, 5 mgXE "buspirone"1MObuspirone oral tablet 30 mg, 7.5 mgXE "buspirone"3MOCAPLYTAXE "CAPLYTA"5MO; QL (30 per 30 days)chlorpromazine oralXE "chlorpromazine"4MOcitalopram oral solutionXE "citalopram"3MOcitalopram oral tabletXE "citalopram"1MOclomipramineXE "clomipramine"4PA; MOclorazepate dipotassium oral tablet 15 mg, 7.5 mgXE "clorazepate dipotassium"4PA; MO; QL (180 per 30 days)clorazepate dipotassium oral tablet 3.75 mgXE "clorazepate dipotassium"4PA; MO; QL (90 per 30 days)clozapine oral tablet 100 mgXE "clozapine"4MO; QL (270 per 30 days)clozapine oral tablet 200 mgXE "clozapine"4MO; QL (135 per 30 days)clozapine oral tablet 25 mg, 50 mgXE "clozapine"3MOclozapine oral tablet,disintegrating 100 mgXE "clozapine"4PA; QL (270 per 30 days)clozapine oral tablet,disintegrating 12.5 mg, 25 mgXE "clozapine"4PACLOZAPINE ORAL TABLET,DISINTEGRATING 150 MGXE "CLOZAPINE"4PA; QL (180 per 30 days)CLOZAPINE ORAL TABLET,DISINTEGRATING 200 MGXE "CLOZAPINE"4PA; QL (135 per 30 days)desipramineXE "desipramine"4MOdesvenlafaxine succinateXE "desvenlafaxine succinate"4PA; MO; QL (30 per 30 days)dexmethylphenidate oral tablet 10 mgXE "dexmethylphenidate"3MO; QL (60 per 30 days)dexmethylphenidate oral tablet 2.5 mg, 5 mgXE "dexmethylphenidate"3MO; QL (120 per 30 days)dextroamphetamine-amphetamine oral capsule,extended release 24hr 10 mg, 15 mgXE "dextroamphetamine-amphetamine"4MO; QL (30 per 30 days)dextroamphetamine-amphetamine oral capsule,extended release 24hr 20 mg, 25 mg, 30 mg, 5 mgXE "dextroamphetamine-amphetamine"4MO; QL (60 per 30 days)dextroamphetamine-amphetamine oral tablet 10 mg, 12.5 mg, 5 mg, 7.5 mgXE "dextroamphetamine-amphetamine"3MO; QL (120 per 30 days)dextroamphetamine-amphetamine oral tablet 15 mg, 20 mgXE "dextroamphetamine-amphetamine"3MO; QL (90 per 30 days)dextroamphetamine-amphetamine oral tablet 30 mgXE "dextroamphetamine-amphetamine"3MO; QL (60 per 30 days)diazepam intensolXE "diazepam intensol"3PA; MO; QL (240 per 30 days)diazepam oral concentrateXE "diazepam"3PA; MO; QL (240 per 30 days)diazepam oral solution 5 mg/5 ml (1 mg/ml)XE "diazepam"3PA; MO; QL (1200 per 30 days)diazepam oral tabletXE "diazepam"2PA; MO; QL (120 per 30 days)doxepin oral capsuleXE "doxepin"3MOdoxepin oral concentrateXE "doxepin"3MOdoxepin oral tabletXE "doxepin"3MO; QL (30 per 30 days)DRIZALMA SPRINKLE ORAL CAPSULE, DELAYED REL SPRINKLE 20 MG, 30 MG, 60 MGXE "DRIZALMA SPRINKLE"4PA; MO; QL (60 per 30 days)DRIZALMA SPRINKLE ORAL CAPSULE, DELAYED REL SPRINKLE 40 MGXE "DRIZALMA SPRINKLE"4PA; MO; QL (90 per 30 days)duloxetine oral capsule,delayed release(dr/ec) 20 mg, 30 mg, 60 mgXE "duloxetine"3MO; QL (60 per 30 days)EMSAMXE "EMSAM"5PA; MO; QL (30 per 30 days)escitalopram oxalate oral solutionXE "escitalopram oxalate"4MOescitalopram oxalate oral tabletXE "escitalopram oxalate"1MOeszopicloneXE "eszopiclone"3PA; MO; QL (30 per 30 days)FANAPT ORAL TABLETXE "FANAPT"4PA; MO; QL (60 per 30 days)FANAPT ORAL TABLETS,DOSE PACKXE "FANAPT"4PA; MOFETZIMA ORAL CAPSULE,EXT REL 24HR DOSE PACKXE "FETZIMA"4PA; MOFETZIMA ORAL CAPSULE,EXTENDED RELEASE 24 HRXE "FETZIMA"4PA; MO; QL (30 per 30 days)fluoxetine oral capsule 10 mg, 20 mgXE "fluoxetine"1MOfluoxetine oral capsule 40 mgXE "fluoxetine"2MOfluoxetine oral solutionXE "fluoxetine"2MOfluphenazine decanoateXE "fluphenazine decanoate"4MOfluphenazine hclXE "fluphenazine hcl"4MOfluvoxamine oral tabletXE "fluvoxamine"2MOGEODON INTRAMUSCULARXE "GEODON"4MO; QL (6 per 3 days)guanfacine oral tablet extended release 24 hrXE "guanfacine"3PA; MOhaloperidolXE "haloperidol"3MOhaloperidol decanoate intramuscular solution 100 mg/ml, 100 mg/ml (1 ml), 50 mg/mlXE "haloperidol decanoate"3MOhaloperidol decanoate intramuscular solution 50 mg/ml(1ml)XE "haloperidol decanoate"2MOhaloperidol lactate injectionXE "haloperidol lactate"3MOhaloperidol lactate oralXE "haloperidol lactate"2MOimipramine hclXE "imipramine hcl"2MOINVEGA SUSTENNA INTRAMUSCULAR SYRINGE 117 MG/0.75 MLXE "INVEGA SUSTENNA"5MO; QL (0.75 per 28 days)INVEGA SUSTENNA INTRAMUSCULAR SYRINGE 156 MG/MLXE "INVEGA SUSTENNA"5MO; QL (1 per 28 days)INVEGA SUSTENNA INTRAMUSCULAR SYRINGE 234 MG/1.5 MLXE "INVEGA SUSTENNA"5MO; QL (1.5 per 28 days)INVEGA SUSTENNA INTRAMUSCULAR SYRINGE 39 MG/0.25 MLXE "INVEGA SUSTENNA"4MO; QL (0.25 per 28 days)INVEGA SUSTENNA INTRAMUSCULAR SYRINGE 78 MG/0.5 MLXE "INVEGA SUSTENNA"5MO; QL (0.5 per 28 days)INVEGA TRINZA INTRAMUSCULAR SYRINGE 273 MG/0.875 MLXE "INVEGA TRINZA"5MO; QL (0.875 per 90 days)INVEGA TRINZA INTRAMUSCULAR SYRINGE 410 MG/1.315 MLXE "INVEGA TRINZA"5MO; QL (1.315 per 90 days)INVEGA TRINZA INTRAMUSCULAR SYRINGE 546 MG/1.75 MLXE "INVEGA TRINZA"5MO; QL (1.75 per 90 days)INVEGA TRINZA INTRAMUSCULAR SYRINGE 819 MG/2.625 MLXE "INVEGA TRINZA"5MO; QL (2.625 per 90 days)LATUDA ORAL TABLET 120 MG, 20 MG, 40 MG, 60 MGXE "LATUDA"4MO; QL (30 per 30 days)LATUDA ORAL TABLET 80 MGXE "LATUDA"4MO; QL (60 per 30 days)lithium carbonate oral capsuleXE "lithium carbonate"1MOlithium carbonate oral tabletXE "lithium carbonate"2MOlithium carbonate oral tablet extended releaseXE "lithium carbonate"2MOlithium citrate oral solution 8 meq/5 mlXE "lithium citrate"4MOlorazepam intensolXE "lorazepam intensol"3MO; QL (150 per 30 days)lorazepam oral concentrateXE "lorazepam"3MO; QL (150 per 30 days)lorazepam oral tablet 0.5 mg, 1 mgXE "lorazepam"2MO; QL (90 per 30 days)lorazepam oral tablet 2 mgXE "lorazepam"2MO; QL (150 per 30 days)loxapine succinateXE "loxapine succinate"3MOmaprotilineXE "maprotiline"3MOMARPLANXE "MARPLAN"4MO; QL (180 per 30 days)methylphenidate hcl oral solution 10 mg/5 mlXE "methylphenidate hcl"4MO; QL (900 per 30 days)methylphenidate hcl oral solution 5 mg/5 mlXE "methylphenidate hcl"4MO; QL (1800 per 30 days)methylphenidate hcl oral tabletXE "methylphenidate hcl"3MO; QL (90 per 30 days)methylphenidate hcl oral tablet extended releaseXE "methylphenidate hcl"4MO; QL (90 per 30 days)mirtazapine oral tablet 15 mg, 30 mg, 45 mgXE "mirtazapine"1MOmirtazapine oral tablet 7.5 mgXE "mirtazapine"3MOmirtazapine oral tablet,disintegratingXE "mirtazapine"3MOmolindoneXE "molindone"4MOnefazodoneXE "nefazodone"4MOnortriptyline oral capsuleXE "nortriptyline"2MOnortriptyline oral solutionXE "nortriptyline"4MONUPLAZID ORAL CAPSULEXE "NUPLAZID"5PA; MO; LA; QL (30 per 30 days)NUPLAZID ORAL TABLET 10 MGXE "NUPLAZID"5PA; MO; LA; QL (30 per 30 days)olanzapine intramuscularXE "olanzapine"4MO; QL (3 per 1 day)olanzapine oral tablet 10 mg, 2.5 mg, 5 mgXE "olanzapine"2MO; QL (60 per 30 days)olanzapine oral tablet 15 mg, 20 mg, 7.5 mgXE "olanzapine"2MO; QL (30 per 30 days)olanzapine oral tablet,disintegrating 10 mgXE "olanzapine"4MO; QL (60 per 30 days)olanzapine oral tablet,disintegrating 15 mg, 20 mg, 5 mgXE "olanzapine"4MO; QL (30 per 30 days)paliperidone oral tablet extended release 24hr 1.5 mg, 3 mg, 9 mgXE "paliperidone"4MO; QL (30 per 30 days)paliperidone oral tablet extended release 24hr 6 mgXE "paliperidone"4MO; QL (60 per 30 days)paroxetine hcl oral tabletXE "paroxetine hcl"2MOPAXIL ORAL SUSPENSIONXE "PAXIL"4MO; QL (900 per 30 days)perphenazineXE "perphenazine"3MOPERSERISXE "PERSERIS"5MO; QL (1 per 28 days)phenelzineXE "phenelzine"3MOpimozideXE "pimozide"4MOprotriptylineXE "protriptyline"4MOquetiapine oral tabletXE "quetiapine"2MOquetiapine oral tablet extended release 24 hr 150 mg, 200 mgXE "quetiapine"4PA; MO; QL (30 per 30 days)quetiapine oral tablet extended release 24 hr 300 mg, 400 mg, 50 mgXE "quetiapine"4PA; MO; QL (60 per 30 days)REXULTIXE "REXULTI"5MO; QL (30 per 30 days)RISPERDAL CONSTA INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON 12.5 MG/2 ML, 25 MG/2 MLXE "RISPERDAL CONSTA"4MO; QL (2 per 28 days)RISPERDAL CONSTA INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON 37.5 MG/2 ML, 50 MG/2 MLXE "RISPERDAL CONSTA"5MO; QL (2 per 28 days)risperidone oral solutionXE "risperidone"3MO; QL (240 per 30 days)risperidone oral tabletXE "risperidone"2MOrisperidone oral tablet,disintegrating 0.25 mg, 0.5 mgXE "risperidone"4MO; QL (90 per 30 days)risperidone oral tablet,disintegrating 1 mg, 2 mg, 3 mgXE "risperidone"4MO; QL (60 per 30 days)risperidone oral tablet,disintegrating 4 mgXE "risperidone"4MO; QL (120 per 30 days)SAPHRISXE "SAPHRIS"4MO; QL (60 per 30 days)SECUADOXE "SECUADO"4QL (30 per 30 days)sertraline oral concentrateXE "sertraline"4MOsertraline oral tabletXE "sertraline"1MOthioridazineXE "thioridazine"3MOthiothixeneXE "thiothixene"4MOtranylcypromineXE "tranylcypromine"4MOtrazodone oral tablet 100 mg, 150 mg, 50 mgXE "trazodone"1MOtrifluoperazineXE "trifluoperazine"3MOtrimipramine oral capsule 100 mgXE "trimipramine"4MO; QL (60 per 30 days)trimipramine oral capsule 25 mgXE "trimipramine"4MO; QL (240 per 30 days)trimipramine oral capsule 50 mgXE "trimipramine"4MO; QL (120 per 30 days)TRINTELLIXXE "TRINTELLIX"4MO; QL (30 per 30 days)venlafaxine oral capsule,extended release 24hrXE "venlafaxine"2MOvenlafaxine oral tabletXE "venlafaxine"2MOVERSACLOZXE "VERSACLOZ"5PA; QL (600 per 30 days)VIIBRYD ORAL TABLETXE "VIIBRYD"4MO; QL (30 per 30 days)VIIBRYD ORAL TABLETS,DOSE PACK 10 MG (7)- 20 MG (23)XE "VIIBRYD"4MOVRAYLAR ORAL CAPSULEXE "VRAYLAR"5PA; MO; QL (30 per 30 days)VRAYLAR ORAL CAPSULE,DOSE PACKXE "VRAYLAR"4PA; MOXYREMXE "XYREM"5PA; MO; LA; QL (540 per 30 days)zaleplonXE "zaleplon"2PA; MO; QL (60 per 30 days)ziprasidone hclXE "ziprasidone hcl"4MO; QL (60 per 30 days)ziprasidone mesylateXE "ziprasidone mesylate"2zolpidem oral tabletXE "zolpidem"2PA; MO; QL (30 per 30 days)ZYPREXA RELPREVV INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION 210 MGXE "ZYPREXA RELPREVV"4PA; MO; QL (2 per 28 days)CARDIOVASCULAR, HYPERTENSION / LIPIDSANTIARRHYTHMIC AGENTSamiodarone oral tablet 100 mg, 400 mgXE "amiodarone"4MOamiodarone oral tablet 200 mgXE "amiodarone"1MOdisopyramide phosphate oral capsuleXE "disopyramide phosphate"4MOdofetilideXE "dofetilide"4MOflecainideXE "flecainide"3MOpacerone oral tablet 100 mg, 400 mgXE "pacerone"4MOpacerone oral tablet 200 mgXE "pacerone"1MOpropafenone oral capsule,extended release 12 hrXE "propafenone"4MOpropafenone oral tabletXE "propafenone"2MOquinidine sulfate oral tabletXE "quinidine sulfate"2MOsorine oral tablet 120 mg, 160 mg, 80 mgXE "sorine"2MOsorine oral tablet 240 mgXE "sorine"2sotalol af oral tablet 120 mgXE "sotalol af"2MOsotalol oralXE "sotalol"2MOSOTYLIZEXE "SOTYLIZE"4MOANTIHYPERTENSIVE THERAPYacebutololXE "acebutolol"2MOaliskirenXE "aliskiren"4MOamilorideXE "amiloride"2MOamiloride-hydrochlorothiazideXE "amiloride-hydrochlorothiazide"2MOamlodipineXE "amlodipine"1MOamlodipine-benazeprilXE "amlodipine-benazepril"1MOamlodipine-olmesartanXE "amlodipine-olmesartan"1MOamlodipine-valsartanXE "amlodipine-valsartan"1MOamlodipine-valsartan-hcthiazidXE "amlodipine-valsartan-hcthiazid"1MOatenololXE "atenolol"1MOatenolol-chlorthalidoneXE "atenolol-chlorthalidone"2MObenazeprilXE "benazepril"1MObenazepril-hydrochlorothiazideXE "benazepril-hydrochlorothiazide"1MObetaxolol oralXE "betaxolol"3MObisoprolol fumarateXE "bisoprolol fumarate"2MObisoprolol-hydrochlorothiazideXE "bisoprolol-hydrochlorothiazide"1MObumetanideXE "bumetanide"3MOBYSTOLIC ORAL TABLET 10 MG, 2.5 MG, 5 MGXE "BYSTOLIC"4MO; QL (30 per 30 days)BYSTOLIC ORAL TABLET 20 MGXE "BYSTOLIC"4MO; QL (60 per 30 days)candesartanXE "candesartan"1MOcandesartan-hydrochlorothiazidXE "candesartan-hydrochlorothiazid"1MOcaptoprilXE "captopril"1MOcaptopril-hydrochlorothiazideXE "captopril-hydrochlorothiazide"1MOcartia xtXE "cartia xt"2MOcarvedilolXE "carvedilol"1MOchlorthalidone oral tablet 25 mg, 50 mgXE "chlorthalidone"2MOclonidineXE "clonidine"4MOclonidine hcl oral tabletXE "clonidine hcl"1MODEMSERXE "DEMSER"5PA; MOdiltiazem hcl oral capsule,extended release 12 hrXE "diltiazem hcl"4MOdiltiazem hcl oral capsule,extended release 24 hrXE "diltiazem hcl"2MOdiltiazem hcl oral capsule,extended release 24hrXE "diltiazem hcl"2MOdiltiazem hcl oral tabletXE "diltiazem hcl"2MOdilt-xrXE "dilt-xr"2MOdoxazosinXE "doxazosin"2MOenalapril maleateXE "enalapril maleate"1MOenalapril-hydrochlorothiazideXE "enalapril-hydrochlorothiazide"1MOeplerenoneXE "eplerenone"3MOfelodipineXE "felodipine"2MOfosinoprilXE "fosinopril"1MOfosinopril-hydrochlorothiazideXE "fosinopril-hydrochlorothiazide"1MOfurosemide injectionXE "furosemide"2MOfurosemide oral solution 10 mg/ml, 40 mg/5 ml (8 mg/ml)XE "furosemide"2MOfurosemide oral tabletXE "furosemide"1MOhydralazine oralXE "hydralazine"2MOhydrochlorothiazideXE "hydrochlorothiazide"1MOindapamideXE "indapamide"2MOirbesartanXE "irbesartan"1MOirbesartan-hydrochlorothiazideXE "irbesartan-hydrochlorothiazide"1MOisradipineXE "isradipine"3MOlabetalol oralXE "labetalol"3MOlisinoprilXE "lisinopril"1MOlisinopril-hydrochlorothiazideXE "lisinopril-hydrochlorothiazide"1MOlosartanXE "losartan"1MOlosartan-hydrochlorothiazideXE "losartan-hydrochlorothiazide"1MOmethyldopaXE "methyldopa"4MOmetolazoneXE "metolazone"3MOmetoprolol succinateXE "metoprolol succinate"2MOmetoprolol ta-hydrochlorothiazXE "metoprolol ta-hydrochlorothiaz"3MOmetoprolol tartrate oral tablet 100 mg, 25 mg, 50 mgXE "metoprolol tartrate"1MOminoxidil oralXE "minoxidil"2MOmoexiprilXE "moexipril"1MOnadololXE "nadolol"3MOnicardipine oralXE "nicardipine"4MOnifedipine oral tablet extended releaseXE "nifedipine"2MOnifedipine oral tablet extended release 24hrXE "nifedipine"2MOnimodipineXE "nimodipine"4MOolmesartanXE "olmesartan"1MOolmesartan-amlodipin-hcthiazidXE "olmesartan-amlodipin-hcthiazid"1MOolmesartan-hydrochlorothiazideXE "olmesartan-hydrochlorothiazide"1MOperindopril erbumineXE "perindopril erbumine"1MOpindololXE "pindolol"3MOprazosinXE "prazosin"3MOpropranolol oral capsule,extended release 24 hrXE "propranolol"3MOpropranolol oral solutionXE "propranolol"3MOpropranolol oral tabletXE "propranolol"2MOpropranolol-hydrochlorothiazidXE "propranolol-hydrochlorothiazid"3MOquinaprilXE "quinapril"1MOquinapril-hydrochlorothiazideXE "quinapril-hydrochlorothiazide"1MOramiprilXE "ramipril"1MOspironolactoneXE "spironolactone"1MOspironolacton-hydrochlorothiazXE "spironolacton-hydrochlorothiaz"3MOtaztia xtXE "taztia xt"2MOtelmisartanXE "telmisartan"1MOtelmisartan-amlodipineXE "telmisartan-amlodipine"1MOtelmisartan-hydrochlorothiazidXE "telmisartan-hydrochlorothiazid"1MOterazosin oral capsule 1 mg, 2 mg, 5 mgXE "terazosin"1MOterazosin oral capsule 10 mgXE "terazosin"2MOtiadylt erXE "tiadylt er"2MOtimolol maleate oralXE "timolol maleate"3MOtorsemide oralXE "torsemide"2MOtrandolaprilXE "trandolapril"1MOtriamterene-hydrochlorothiazid oral capsule 37.5-25 mgXE "triamterene-hydrochlorothiazid"1MOtriamterene-hydrochlorothiazid oral tabletXE "triamterene-hydrochlorothiazid"1MOUPTRAVIXE "UPTRAVI"4PA; MOvalsartanXE "valsartan"1MOvalsartan-hydrochlorothiazideXE "valsartan-hydrochlorothiazide"1MOverapamil oral capsule, 24 hr er pellet ctXE "verapamil"4MOverapamil oral capsule,ext rel. pellets 24 hr 120 mg, 180 mg, 240 mgXE "verapamil"3MOverapamil oral capsule,ext rel. pellets 24 hr 360 mgXE "verapamil"4MOverapamil oral tabletXE "verapamil"1MOverapamil oral tablet extended releaseXE "verapamil"2MOCOAGULATION THERAPYaspirin-dipyridamoleXE "aspirin-dipyridamole"4MOBRILINTAXE "BRILINTA"3MOcilostazolXE "cilostazol"2MOclopidogrel oral tablet 75 mgXE "clopidogrel"1MOELIQUIS DVT-PE TREAT 30D STARTXE "ELIQUIS DVT-PE TREAT 30D START"3MO; QL (74 per 30 days)ELIQUIS ORAL TABLET 2.5 MGXE "ELIQUIS"3MO; QL (60 per 30 days)ELIQUIS ORAL TABLET 5 MGXE "ELIQUIS"3MO; QL (74 per 30 days)enoxaparin subcutaneous syringeXE "enoxaparin"4MOfondaparinux subcutaneous syringe 10 mg/0.8 ml, 5 mg/0.4 ml, 7.5 mg/0.6 mlXE "fondaparinux"5MOfondaparinux subcutaneous syringe 2.5 mg/0.5 mlXE "fondaparinux"4MOheparin (porcine) injection solutionXE "heparin (porcine)"3B/D PA; MOjantovenXE "jantoven"1MOpentoxifyllineXE "pentoxifylline"2MOPRADAXAXE "PRADAXA"4MO; QL (60 per 30 days)prasugrelXE "prasugrel"3MOPROMACTA ORAL POWDER IN PACKET 12.5 MGXE "PROMACTA"5PA; MO; LA; QL (180 per 30 days)PROMACTA ORAL TABLET 12.5 MG, 25 MG, 50 MGXE "PROMACTA"5PA; MO; LA; QL (30 per 30 days)PROMACTA ORAL TABLET 75 MGXE "PROMACTA"5PA; MO; LA; QL (60 per 30 days)warfarinXE "warfarin"1MOXARELTO DVT-PE TREAT 30D STARTXE "XARELTO DVT-PE TREAT 30D START"3MO; QL (51 per 30 days)XARELTO ORAL TABLET 10 MG, 15 MG, 20 MGXE "XARELTO"3MO; QL (30 per 30 days)XARELTO ORAL TABLET 2.5 MGXE "XARELTO"3MO; QL (60 per 30 days)LIPID/CHOLESTEROL LOWERING AGENTSatorvastatinXE "atorvastatin"1MOcholestyramine (with sugar)XE "cholestyramine (with sugar)"3MOcholestyramine lightXE "cholestyramine light"3MOcolesevelamXE "colesevelam"4MOcolestipol oral granulesXE "colestipol"4MOcolestipol oral packetXE "colestipol"4MOcolestipol oral tabletXE "colestipol"3MOezetimibeXE "ezetimibe"3MOezetimibe-simvastatinXE "ezetimibe-simvastatin"1MOfenofibrate micronized oral capsule 134 mg, 200 mg, 67 mgXE "fenofibrate micronized"3MOfenofibrate nanocrystallized oral tablet 145 mg, 48 mgXE "fenofibrate nanocrystallized"3MOfenofibrate oral tablet 160 mg, 54 mgXE "fenofibrate"3MOgemfibrozilXE "gemfibrozil"1MOJUXTAPIDXE "JUXTAPID"5PA; MO; LAlovastatinXE "lovastatin"1MOniacin oral tablet extended release 24 hr 1,000 mg, 750 mgXE "niacin"4MOniacin oral tablet extended release 24 hr 500 mgXE "niacin"4MO; QL (60 per 30 days)NIACORXE "NIACOR"4MOPRALUENT PENXE "PRALUENT PEN"3PA; MOpravastatinXE "pravastatin"1MOprevaliteXE "prevalite"4MOrosuvastatinXE "rosuvastatin"1MO; QL (30 per 30 days)simvastatin oral tablet 10 mg, 20 mg, 40 mg, 5 mgXE "simvastatin"1MOsimvastatin oral tablet 80 mgXE "simvastatin"1MO; QL (30 per 30 days)VASCEPAXE "VASCEPA"4MOMISCELLANEOUS CARDIOVASCULAR AGENTSCORLANOR ORAL SOLUTIONXE "CORLANOR"4CORLANOR ORAL TABLETXE "CORLANOR"4MOdigitek oral tablet 125 mcg (0.125 mg)XE "digitek"2MO; QL (30 per 30 days)digitek oral tablet 250 mcg (0.25 mg)XE "digitek"2PA; MOdigox oral tablet 125 mcg (0.125 mg)XE "digox"2MO; QL (30 per 30 days)digox oral tablet 250 mcg (0.25 mg)XE "digox"2PA; MOdigoxin oral solution 50 mcg/ml (0.05 mg/ml)XE "digoxin"4PA; MOdigoxin oral tablet 125 mcg (0.125 mg)XE "digoxin"2MO; QL (30 per 30 days)digoxin oral tablet 250 mcg (0.25 mg)XE "digoxin"2PA; MOENTRESTOXE "ENTRESTO"3MOranolazineXE "ranolazine"4MONITRATESisosorbide dinitrate oral tablet 10 mg, 20 mg, 30 mg, 5 mgXE "isosorbide dinitrate"3MOisosorbide mononitrate oral tabletXE "isosorbide mononitrate"2MOisosorbide mononitrate oral tablet extended release 24 hrXE "isosorbide mononitrate"1MOMINITRANXE "MINITRAN"2MOnitro-bidXE "nitro-bid"3MONITRO-DUR TRANSDERMAL PATCH 24 HOUR 0.3 MG/HR, 0.8 MG/HRXE "NITRO-DUR"4MOnitroglycerin sublingualXE "nitroglycerin"3MOnitroglycerin transdermal patch 24 hourXE "nitroglycerin"2MOnitroglycerin translingual spray,non-aerosolXE "nitroglycerin"4MODERMATOLOGICALS/TOPICAL THERAPYANTIPSORIATIC / ANTISEBORRHEICacitretinXE "acitretin"4PA; MOcalcipotriene scalpXE "calcipotriene"4PA; MO; QL (120 per 30 days)calcipotriene topical creamXE "calcipotriene"4PA; MO; QL (120 per 30 days)calcipotriene topical ointmentXE "calcipotriene"4PA; MO; QL (120 per 30 days)COSENTYXXE "COSENTYX"5PA; MO; QL (5 per 28 days)COSENTYX (2 SYRINGES)XE "COSENTYX (2 SYRINGES)"5PA; MO; QL (5 per 28 days)COSENTYX PENXE "COSENTYX PEN"5PA; MO; QL (5 per 28 days)COSENTYX PEN (2 PENS)XE "COSENTYX PEN (2 PENS)"5PA; MO; QL (5 per 28 days)ENSTILARXE "ENSTILAR"4PA; MO; QL (120 per 30 days)selenium sulfide topical lotionXE "selenium sulfide"2MOSKYRIZI SUBCUTANEOUS SYRINGE KITXE "SKYRIZI"5PA; MO; QL (1 per 28 days)STELARA SUBCUTANEOUS SOLUTIONXE "STELARA"5PA; MO; LA; QL (0.5 per 28 days)STELARA SUBCUTANEOUS SYRINGE 45 MG/0.5 MLXE "STELARA"5PA; MO; QL (0.5 per 28 days)STELARA SUBCUTANEOUS SYRINGE 90 MG/MLXE "STELARA"5PA; MO; QL (1 per 28 days)MISCELLANEOUS DERMATOLOGICALSammonium lactate topical creamXE "ammonium lactate"2MOammonium lactate topical lotionXE "ammonium lactate"3MODUPIXENT SYRINGE SUBCUTANEOUS SYRINGE 200 MG/1.14 MLXE "DUPIXENT SYRINGE"5PA; MO; QL (4.56 per 28 days)DUPIXENT SYRINGE SUBCUTANEOUS SYRINGE 300 MG/2 MLXE "DUPIXENT SYRINGE"5PA; MO; QL (8 per 28 days)fluorouracil topical cream 5 %XE "fluorouracil"4MO; QL (40 per 30 days)fluorouracil topical solutionXE "fluorouracil"3MO; QL (10 per 30 days)imiquimod topical cream in packetXE "imiquimod"3MO; QL (24 per 30 days)lidocaine hcl laryngotrachealXE "lidocaine hcl"3PA; MO; QL (50 per 30 days)lidocaine hcl mucous membrane jellyXE "lidocaine hcl"3PA; MO; QL (30 per 30 days)lidocaine hcl mucous membrane jelly in applicatorXE "lidocaine hcl"3PA; MO; QL (30 per 30 days)lidocaine hcl mucous membrane solution 4 % (40 mg/ml)XE "lidocaine hcl"3PA; MO; QL (50 per 30 days)lidocaine topical adhesive patch,medicated 5 %XE "lidocaine"4PA; MO; QL (3 per 1 day)lidocaine topical ointmentXE "lidocaine"4PA; MO; QL (50 per 30 days)lidocaine viscousXE "lidocaine viscous"2MOlidocaine-prilocaine topical creamXE "lidocaine-prilocaine"3PA; MO; QL (30 per 30 days)PICATO TOPICAL GEL 0.015 %XE "PICATO"4MO; QL (3 per 30 days)PICATO TOPICAL GEL 0.05 %XE "PICATO"4MO; QL (2 per 30 days)podofiloxXE "podofilox"3MOREGRANEXXE "REGRANEX"5PA; MO; QL (30 per 30 days)SANTYLXE "SANTYL"4MOsilver sulfadiazineXE "silver sulfadiazine"2MOssdXE "ssd"2MOtacrolimus topicalXE "tacrolimus"4MO; QL (100 per 30 days)VALCHLORXE "VALCHLOR"5PA; MO; LA; QL (60 per 30 days)THERAPY FOR ACNEamnesteemXE "amnesteem"4PA; MOavita topical creamXE "avita"4PA; MO; QL (45 per 30 days)AVITA TOPICAL GELXE "AVITA"4PA; MO; QL (45 per 30 days)claravisXE "claravis"4PA; MOclindamycin phosphate topical gelXE "clindamycin phosphate"4MO; QL (75 per 30 days)CLINDAMYCIN PHOSPHATE TOPICAL GEL, ONCE DAILYXE "CLINDAMYCIN PHOSPHATE"4MO; QL (75 per 30 days)clindamycin phosphate topical lotionXE "clindamycin phosphate"3MOclindamycin phosphate topical solutionXE "clindamycin phosphate"4MO; QL (60 per 30 days)ery padsXE "ery pads"3MOerythromycin with ethanol topical gelXE "erythromycin with ethanol"4MOerythromycin with ethanol topical solutionXE "erythromycin with ethanol"3MOerythromycin-benzoyl peroxideXE "erythromycin-benzoyl peroxide"4MOisotretinoinXE "isotretinoin"4PA; MOmetronidazole topical creamXE "metronidazole"4MOmetronidazole topical gel 0.75 %XE "metronidazole"4MOmetronidazole topical lotionXE "metronidazole"4MOmyorisanXE "myorisan"4PA; MOtazaroteneXE "tazarotene"3PA; MO; QL (60 per 30 days)TAZORAC TOPICAL CREAM 0.05 %XE "TAZORAC"4PA; MO; QL (60 per 30 days)tretinoin topical creamXE "tretinoin topical"4PA; MO; QL (45 per 30 days)tretinoin topical gel 0.01 %, 0.025 %XE "tretinoin topical"4PA; MO; QL (45 per 30 days)zenataneXE "zenatane"4PA; MOTOPICAL ANTIBACTERIALSgentamicin topical creamXE "gentamicin"4MOgentamicin topical ointmentXE "gentamicin"3MOmupirocinXE "mupirocin"2MO; QL (220 per 30 days)sulfacetamide sodium (acne)XE "sulfacetamide sodium (acne)"4MOSULFAMYLON TOPICAL CREAMXE "SULFAMYLON"4MOTOPICAL ANTIFUNGALSciclopirox topical creamXE "ciclopirox"3MO; QL (90 per 30 days)ciclopirox topical suspensionXE "ciclopirox"3MO; QL (60 per 30 days)clotrimazole topical creamXE "clotrimazole"3MOclotrimazole topical solutionXE "clotrimazole"3MO; QL (30 per 30 days)clotrimazole-betamethasone topical creamXE "clotrimazole-betamethasone"3MOketoconazole topical creamXE "ketoconazole"3MO; QL (60 per 30 days)ketoconazole topical shampooXE "ketoconazole"2MOnyamycXE "nyamyc"3MO; QL (60 per 30 days)nystatin topical creamXE "nystatin"3MOnystatin topical ointmentXE "nystatin"3MOnystatin topical powderXE "nystatin"3MO; QL (60 per 30 days)nystopXE "nystop"3MO; QL (60 per 30 days)TOPICAL CORTICOSTEROIDSala-cort topical cream 1 %XE "ala-cort"1MOalclometasone topical creamXE "alclometasone"4MOalclometasone topical ointmentXE "alclometasone"3MObetamethasone dipropionate topical creamXE "betamethasone dipropionate"3MObetamethasone dipropionate topical lotionXE "betamethasone dipropionate"3MObetamethasone dipropionate topical ointmentXE "betamethasone dipropionate"4MObetamethasone valerate topical creamXE "betamethasone valerate"3MObetamethasone valerate topical lotionXE "betamethasone valerate"3MObetamethasone valerate topical ointmentXE "betamethasone valerate"3MObetamethasone, augmented topical creamXE "betamethasone, augmented"3MObetamethasone, augmented topical gelXE "betamethasone, augmented"4MObetamethasone, augmented topical lotionXE "betamethasone, augmented"4MObetamethasone, augmented topical ointmentXE "betamethasone, augmented"4MOfluocinolone and shower capXE "fluocinolone and shower cap"4MOfluocinolone topical creamXE "fluocinolone"3MOfluocinolone topical oilXE "fluocinolone"4MOfluocinolone topical ointmentXE "fluocinolone"3MOfluocinolone topical solutionXE "fluocinolone"4MO; QL (90 per 30 days)fluocinonide topical gelXE "fluocinonide"4MO; QL (60 per 30 days)fluocinonide topical ointmentXE "fluocinonide"4MO; QL (60 per 30 days)fluocinonide topical solutionXE "fluocinonide"4MO; QL (60 per 30 days)fluocinonide-eXE "fluocinonide-e"4MO; QL (120 per 30 days)fluocinonide-emollientXE "fluocinonide-emollient"4MO; QL (120 per 30 days)fluticasone propionate topical creamXE "fluticasone propionate"3MOfluticasone propionate topical ointmentXE "fluticasone propionate"3MOhalobetasol propionate topical creamXE "halobetasol propionate"4MO; QL (50 per 30 days)halobetasol propionate topical ointmentXE "halobetasol propionate"4MO; QL (50 per 30 days)hydrocortisone butyrate topical creamXE "hydrocortisone butyrate"4MO; QL (45 per 30 days)hydrocortisone butyrate topical ointmentXE "hydrocortisone butyrate"4MO; QL (45 per 30 days)hydrocortisone butyr-emollientXE "hydrocortisone butyr-emollient"4MO; QL (45 per 30 days)hydrocortisone topical cream 1 %XE "hydrocortisone"1MOhydrocortisone topical cream 2.5 %XE "hydrocortisone"2MOhydrocortisone topical lotion 2.5 %XE "hydrocortisone"3MOhydrocortisone topical ointment 2.5 %XE "hydrocortisone"2MOmometasone topicalXE "mometasone"3MOTEXACORTXE "TEXACORT"4MOtriamcinolone acetonide topical cream 0.025 %, 0.5 %XE "triamcinolone acetonide"2MOtriamcinolone acetonide topical cream 0.1 %XE "triamcinolone acetonide"2MO; QL (454 per 30 days)triamcinolone acetonide topical lotionXE "triamcinolone acetonide"3MOtriamcinolone acetonide topical ointment 0.025 %, 0.1 %, 0.5 %XE "triamcinolone acetonide"2MOTOPICAL SCABICIDES / PEDICULICIDESmalathionXE "malathion"4MOpermethrin topical creamXE "permethrin"3MODIAGNOSTICS / MISCELLANEOUS AGENTSMISCELLANEOUS AGENTSacamprosateXE "acamprosate"4MOanagrelideXE "anagrelide"4MOARALAST NPXE "ARALAST NP"5PA; MO; LAAURYXIAXE "AURYXIA"5PA; MO; QL (360 per 30 days)CARBAGLUXE "CARBAGLU"5PA; MO; LAcevimelineXE "cevimeline"4MOCHEMETXE "CHEMET"4MOCLINIMIX 4.25%/D5W SULFIT FREEXE "CLINIMIX 4.25%/D5W SULFIT FREE"4B/D PAd10 %-0.45 % sodium chlorideXE "d10 %-0.45 % sodium chloride"2d2.5 %-0.45 % sodium chlorideXE "d2.5 %-0.45 % sodium chloride"2d5 % and 0.9 % sodium chlorideXE "d5 % and 0.9 % sodium chloride"2MOd5 %-0.45 % sodium chlorideXE "d5 %-0.45 % sodium chloride"2MOdeferasirox oral tablet 180 mgXE "deferasirox"5MOdeferasirox oral tablet 360 mg, 90 mgXE "deferasirox"5PA; MOdeferasirox oral tablet, dispersibleXE "deferasirox"5PA; MOdextrose 10 % and 0.2 % naclXE "dextrose 10 % and 0.2 % nacl"3dextrose 10 % in water (d10w)XE "dextrose 10 % in water (d10w)"2MOdextrose 5 % in water (d5w)XE "dextrose 5 % in water (d5w)"2MOdextrose 5%-0.2 % sod chlorideXE "dextrose 5%-0.2 % sod chloride"2dextrose with sodium chlorideXE "dextrose with sodium chloride"2disulfiramXE "disulfiram"3MOENDARIXE "ENDARI"5PA; MO; LAINCRELEXXE "INCRELEX"5PA; MO; LAJADENU SPRINKLEXE "JADENU SPRINKLE"5PA; MOkionex (with sorbitol)XE "kionex (with sorbitol)"3MOlevocarnitine (with sugar)XE "levocarnitine (with sugar)"4B/D PA; MOlevocarnitine oral solution 100 mg/mlXE "levocarnitine"4B/D PA; MOlevocarnitine oral tabletXE "levocarnitine"4B/D PA; MOLOKELMAXE "LOKELMA"3MOmidodrineXE "midodrine"3MOnitisinoneXE "nitisinone"5PA; MONORTHERAXE "NORTHERA"5MOORFADIN ORAL CAPSULE 20 MGXE "ORFADIN"5PA; MO; LAORFADIN ORAL SUSPENSIONXE "ORFADIN"5PA; MO; LApilocarpine hcl oralXE "pilocarpine hcl"4MOPROLASTIN-C INTRAVENOUS RECON SOLNXE "PROLASTIN-C"5PA; LAPROLASTIN-C INTRAVENOUS SOLUTIONXE "PROLASTIN-C"5PA; MO; LAriluzoleXE "riluzole"3MOsevelamer carbonate oral powder in packet 0.8 gramXE "sevelamer carbonate"5MO; QL (540 per 30 days)sevelamer carbonate oral powder in packet 2.4 gramXE "sevelamer carbonate"5MO; QL (180 per 30 days)sevelamer carbonate oral tabletXE "sevelamer carbonate"4MO; QL (540 per 30 days)sodium chloride 0.9 % intravenousXE "sodium chloride 0.9 %"3MOsodium chloride irrigationXE "sodium chloride"2MOsodium phenylbutyrateXE "sodium phenylbutyrate"5PA; MOsodium polystyrene (sorb free)XE "sodium polystyrene (sorb free)"3MOsodium polystyrene sulfonate oral powderXE "sodium polystyrene sulfonate"3MOsps (with sorbitol) oralXE "sps (with sorbitol)"3MOsps (with sorbitol) rectalXE "sps (with sorbitol)"3trientineXE "trientine"5PA; MOVELTASSAXE "VELTASSA"4PA; MO; LAZEMAIRAXE "ZEMAIRA"5PA; MO; LASMOKING DETERRENTSbupropion hcl (smoking deter)XE "bupropion hcl (smoking deter)"3MOCHANTIXXE "CHANTIX"4MOCHANTIX CONTINUING MONTH BOXXE "CHANTIX CONTINUING MONTH BOX"4MOCHANTIX STARTING MONTH BOXXE "CHANTIX STARTING MONTH BOX"4MONICOTROLXE "NICOTROL"4MONICOTROL NSXE "NICOTROL NS"4MOEAR, NOSE / THROAT MEDICATIONSMISCELLANEOUS AGENTSazelastine nasalXE "azelastine"3MOchlorhexidine gluconate mucous membraneXE "chlorhexidine gluconate"1MOipratropium bromide nasalXE "ipratropium bromide"3MOparoex oral rinseXE "paroex oral rinse"1MOtriamcinolone acetonide dentalXE "triamcinolone acetonide"3MOMISCELLANEOUS OTIC PREPARATIONSacetic acid otic (ear)XE "acetic acid"3MOflac otic oilXE "flac otic oil"4fluocinolone acetonide oilXE "fluocinolone acetonide oil"4MOofloxacin otic (ear)XE "ofloxacin"4MOOTIC STEROID / ANTIBIOTICCIPRODEXXE "CIPRODEX"3MOneomycin-polymyxin-hc otic (ear)XE "neomycin-polymyxin-hc"3MOENDOCRINE/DIABETESADRENAL HORMONEScortisoneXE "cortisone"4MOdexamethasone intensolXE "dexamethasone intensol"4MOdexamethasone oral elixirXE "dexamethasone"3MOdexamethasone oral solutionXE "dexamethasone"3MOdexamethasone oral tabletXE "dexamethasone"2MOfludrocortisoneXE "fludrocortisone"2MOhydrocortisone oralXE "hydrocortisone"3MOmethylprednisolone oral tabletXE "methylprednisolone"3B/D PA; MOmethylprednisolone oral tablets,dose packXE "methylprednisolone"2MOprednisolone oral solution 15 mg/5 mlXE "prednisolone"2B/D PA; MOprednisolone sodium phosphate oral solution 15 mg/5 ml (3 mg/ml)XE "prednisolone sodium phosphate"2B/D PA; MOprednisolone sodium phosphate oral solution 15 mg/5 ml (5 ml)XE "prednisolone sodium phosphate"2B/D PAprednisolone sodium phosphate oral solution 25 mg/5 ml (5 mg/ml), 5 mg base/5 ml (6.7 mg/5 ml)XE "prednisolone sodium phosphate"4B/D PA; MOprednisone intensolXE "prednisone intensol"4B/D PA; MOprednisone oral solutionXE "prednisone"4B/D PA; MOprednisone oral tabletXE "prednisone"1B/D PA; MOprednisone oral tablets,dose packXE "prednisone"3MOANTITHYROID AGENTSmethimazole oral tablet 10 mg, 5 mgXE "methimazole"1MOpropylthiouracilXE "propylthiouracil"3MODIABETES THERAPYacarboseXE "acarbose"3MOalcohol padsXE "alcohol pads"3MOBASAGLAR KWIKPEN U-100 INSULINXE "BASAGLAR KWIKPEN U-100 INSULIN"3MOBYDUREON BCISEXE "BYDUREON BCISE"3MO; QL (3.4 per 28 days)BYDUREON SUBCUTANEOUS PEN INJECTORXE "BYDUREON"3MO; QL (4 per 28 days)BYETTA SUBCUTANEOUS PEN INJECTOR 10 MCG/DOSE(250 MCG/ML) 2.4 MLXE "BYETTA"4MO; QL (2.4 per 30 days)BYETTA SUBCUTANEOUS PEN INJECTOR 5 MCG/DOSE (250 MCG/ML) 1.2 MLXE "BYETTA"4MO; QL (1.2 per 30 days)diazoxideXE "diazoxide"2MOFARXIGAXE "FARXIGA"3MO; QL (30 per 30 days)FIASP FLEXTOUCH U-100 INSULINXE "FIASP FLEXTOUCH U-100 INSULIN"3MO; SSM ($35.00)FIASP PENFILL U-100 INSULINXE "FIASP PENFILL U-100 INSULIN"3MO; SSM ($35.00)FIASP U-100 INSULINXE "FIASP U-100 INSULIN"3MO; SSM ($35.00)GAUZE PADS 2 X 2XE "GAUZE PAD"3MOglimepiride oral tablet 1 mg, 2 mgXE "glimepiride"2MO; QL (90 per 30 days)glimepiride oral tablet 4 mgXE "glimepiride"2MO; QL (60 per 30 days)glipizide oral tablet 10 mgXE "glipizide"1MO; QL (120 per 30 days)glipizide oral tablet 5 mgXE "glipizide"1MO; QL (240 per 30 days)glipizide oral tablet extended release 24hr 10 mgXE "glipizide"1MO; QL (60 per 30 days)glipizide oral tablet extended release 24hr 2.5 mg, 5 mgXE "glipizide"1MO; QL (90 per 30 days)glipizide-metformin oral tablet 2.5-250 mgXE "glipizide-metformin"1MO; QL (240 per 30 days)glipizide-metformin oral tablet 2.5-500 mg, 5-500 mgXE "glipizide-metformin"1MO; QL (120 per 30 days)GLUCAGEN HYPOKITXE "GLUCAGEN HYPOKIT"3MOGLUCAGON (HCL) EMERGENCY KITXE "GLUCAGON (HCL) EMERGENCY KIT"3GLUCAGON EMERGENCY KIT (HUMAN)XE "GLUCAGON EMERGENCY KIT (HUMAN)"3MOglyburide micronized oral tablet 1.5 mgXE "glyburide micronized"2PA; MO; QL (240 per 30 days)glyburide micronized oral tablet 3 mgXE "glyburide micronized"2PA; MO; QL (120 per 30 days)glyburide micronized oral tablet 6 mgXE "glyburide micronized"2PA; MO; QL (60 per 30 days)glyburide oral tablet 1.25 mgXE "glyburide"2PA; MO; QL (480 per 30 days)glyburide oral tablet 2.5 mgXE "glyburide"2PA; MO; QL (240 per 30 days)glyburide oral tablet 5 mgXE "glyburide"2PA; MO; QL (120 per 30 days)glyburide-metformin oral tablet 1.25-250 mgXE "glyburide-metformin"2PA; MO; QL (240 per 30 days)glyburide-metformin oral tablet 2.5-500 mg, 5-500 mgXE "glyburide-metformin"2PA; MO; QL (120 per 30 days)GLYXAMBIXE "GLYXAMBI"3MO; QL (30 per 30 days)GVOKE HYPOPEN 1-PACKXE "GVOKE HYPOPEN 1-PACK"3MOGVOKE HYPOPEN 2-PACKXE "GVOKE HYPOPEN 2-PACK"3MOGVOKE PFS 1-PACK SYRINGEXE "GVOKE PFS 1-PACK SYRINGE"3MOGVOKE PFS 2-PACK SYRINGEXE "GVOKE PFS 2-PACK SYRINGE"3MOHUMULIN R U-500 (CONC) INSULINXE "HUMULIN R U-500 (CONC) INSULIN"5B/D PA; MOHUMULIN R U-500 (CONC) KWIKPENXE "HUMULIN R U-500 (CONC) KWIKPEN"5MOINSULIN PEN NEEDLEXE "INSULIN PEN NEEDLE"3MOINSULIN SYRINGE (DISP) U-100 0.3 ML, 1 ML, 1/2 MLXE "INSULIN SYRINGE (DISP) U-100"3MOJANUMETXE "JANUMET"3MO; QL (60 per 30 days)JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 100-1,000 MG, 50-500 MGXE "JANUMET XR"3MO; QL (30 per 30 days)JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 50-1,000 MGXE "JANUMET XR"3MO; QL (60 per 30 days)JANUVIAXE "JANUVIA"3MO; QL (30 per 30 days)JARDIANCEXE "JARDIANCE"3MO; QL (30 per 30 days)JENTADUETOXE "JENTADUETO"3MO; QL (60 per 30 days)JENTADUETO XR ORAL TABLET, IR - ER, BIPHASIC 24HR 2.5-1,000 MGXE "JENTADUETO XR"3MO; QL (60 per 30 days)JENTADUETO XR ORAL TABLET, IR - ER, BIPHASIC 24HR 5-1,000 MGXE "JENTADUETO XR"3MO; QL (30 per 30 days)LEVEMIR FLEXTOUCH U-100 INSULNXE "LEVEMIR FLEXTOUCH U-100 INSULN"3MO; SSM ($35.00)LEVEMIR U-100 INSULINXE "LEVEMIR U-100 INSULIN"3MO; SSM ($35.00)metformin oral tablet 1,000 mgXE "metformin"1MO; QL (75 per 30 days)metformin oral tablet 500 mgXE "metformin"1MO; QL (150 per 30 days)metformin oral tablet 850 mgXE "metformin"1MO; QL (90 per 30 days)metformin oral tablet extended release 24 hr 500 mgXE "metformin"1MO; QL (120 per 30 days)metformin oral tablet extended release 24 hr 750 mgXE "metformin"1MO; QL (60 per 30 days)nateglinideXE "nateglinide"1MO; QL (90 per 30 days)NEEDLES, INSULIN DISP.,SAFETYXE "NEEDLES, INSULIN DISP.,SAFETY"3MONOVOLIN 70/30 U-100 INSULINXE "NOVOLIN 70/30 U-100 INSULIN"3MO; SSM ($35.00)NOVOLIN N FLEXPENXE "NOVOLIN N FLEXPEN"3MO; SSM ($35.00)NOVOLIN N NPH U-100 INSULINXE "NOVOLIN N NPH U-100 INSULIN"3MO; SSM ($35.00)NOVOLIN R FLEXPENXE "NOVOLIN R FLEXPEN"3MO; SSM ($35.00)NOVOLIN R REGULAR U-100 INSULNXE "NOVOLIN R REGULAR U-100 INSULN"3MO; SSM ($35.00)NOVOLOG FLEXPEN U-100 INSULINXE "NOVOLOG FLEXPEN U-100 INSULIN"3MO; SSM ($35.00)NOVOLOG MIX 70-30 U-100 INSULNXE "NOVOLOG MIX 70-30 U-100 INSULN"3MO; SSM ($35.00)NOVOLOG MIX 70-30FLEXPEN U-100XE "NOVOLOG MIX 70-30FLEXPEN U-100"3MO; SSM ($35.00)NOVOLOG PENFILL U-100 INSULINXE "NOVOLOG PENFILL U-100 INSULIN"3MO; SSM ($35.00)NOVOLOG U-100 INSULIN ASPARTXE "NOVOLOG U-100 INSULIN ASPART"3MO; SSM ($35.00)OZEMPIC SUBCUTANEOUS PEN INJECTOR 0.25 MG OR 0.5 MG(2 MG/1.5 ML)XE "OZEMPIC"3MO; QL (1.5 per 28 days)OZEMPIC SUBCUTANEOUS PEN INJECTOR 1 MG/DOSE (2 MG/1.5 ML)XE "OZEMPIC"3MO; QL (3 per 28 days)pioglitazoneXE "pioglitazone"1MO; QL (30 per 30 days)repaglinide oral tablet 0.5 mg, 1 mgXE "repaglinide"1MO; QL (120 per 30 days)repaglinide oral tablet 2 mgXE "repaglinide"1MO; QL (240 per 30 days)SOLIQUA 100/33XE "SOLIQUA 100/33"3MO; SSM ($35.00); QL (15 per 30 days)SYNJARDYXE "SYNJARDY"3MO; QL (60 per 30 days)SYNJARDY XR ORAL TABLET, IR - ER, BIPHASIC 24HR 10-1,000 MG, 12.5-1,000 MG, 5-1,000 MGXE "SYNJARDY XR"3MO; QL (60 per 30 days)SYNJARDY XR ORAL TABLET, IR - ER, BIPHASIC 24HR 25-1,000 MGXE "SYNJARDY XR"3MO; QL (30 per 30 days)TRADJENTAXE "TRADJENTA"3MO; QL (30 per 30 days)TRESIBA FLEXTOUCH U-100XE "TRESIBA FLEXTOUCH U-100"3MO; SSM ($35.00)TRESIBA FLEXTOUCH U-200XE "TRESIBA FLEXTOUCH U-200"3MO; SSM ($35.00)TRESIBA U-100 INSULINXE "TRESIBA U-100 INSULIN"3MO; SSM ($35.00)TRULICITYXE "TRULICITY"3MO; QL (2 per 28 days)VICTOZA 2-PAKXE "VICTOZA 2-PAK"3MO; QL (9 per 30 days)VICTOZA 3-PAKXE "VICTOZA 3-PAK"3MO; QL (9 per 30 days)XIGDUO XR ORAL TABLET, IR - ER, BIPHASIC 24HR 10-1,000 MG, 10-500 MGXE "XIGDUO XR"3MO; QL (30 per 30 days)XIGDUO XR ORAL TABLET, IR - ER, BIPHASIC 24HR 2.5-1,000 MG, 5-1,000 MG, 5-500 MGXE "XIGDUO XR"3MO; QL (60 per 30 days)XULTOPHY 100/3.6XE "XULTOPHY 100/3.6"3MO; SSM ($35.00); QL (15 per 30 days)MISCELLANEOUS HORMONESANADROL-50XE "ANADROL-50"5PA; MOANDRODERMXE "ANDRODERM"4PA; MO; QL (30 per 30 days)cabergolineXE "cabergoline"3MOcalcitonin (salmon)XE "calcitonin (salmon)"3B/D PA; MOcalcitriol oral capsuleXE "calcitriol"2B/D PA; MOcalcitriol oral solutionXE "calcitriol"4B/D PA; MOCERDELGAXE "CERDELGA"5PA; MOcinacalcet oral tablet 30 mgXE "cinacalcet"4B/D PA; MO; QL (60 per 30 days)cinacalcet oral tablet 60 mgXE "cinacalcet"5B/D PA; MO; QL (60 per 30 days)cinacalcet oral tablet 90 mgXE "cinacalcet"5B/D PA; MO; QL (120 per 30 days)danazolXE "danazol"4MOdesmopressin nasal spray with pumpXE "desmopressin"4MOdesmopressin nasal spray,non-aerosolXE "desmopressin"4MOdesmopressin oralXE "desmopressin"3MOKORLYMXE "KORLYM"5PA; MO; LAKUVANXE "KUVAN"5PA; MO; LAmiglustatXE "miglustat"5PA; MONATPARAXE "NATPARA"5PA; MOoxandrolone oral tablet 10 mgXE "oxandrolone"4PA; MOoxandrolone oral tablet 2.5 mgXE "oxandrolone"2PA; MOparicalcitol oralXE "paricalcitol"4B/D PA; MORAYALDEEXE "RAYALDEE"5MOSAMSCAXE "SAMSCA"5PA; MOSOMAVERTXE "SOMAVERT"5PA; MO; LASTIMATEXE "STIMATE"5MOSYNARELXE "SYNAREL"5MOtestosterone cypionate intramuscular oil 100 mg/ml, 200 mg/ml, 200 mg/ml (1 ml)XE "testosterone cypionate"3PA; MOtestosterone enanthateXE "testosterone enanthate"3PA; MOtestosterone transdermal gelXE "testosterone"4PA; MO; QL (300 per 30 days)TESTOSTERONE TRANSDERMAL GEL IN METERED-DOSE PUMP 12.5 MG/ 1.25 GRAM (1 %)XE "TESTOSTERONE"4PA; MO; QL (300 per 30 days)testosterone transdermal gel in packet 1 % (25 mg/2.5gram), 1 % (50 mg/5 gram)XE "testosterone"4PA; MO; QL (300 per 30 days)THYROID HORMONESeuthyroxXE "euthyrox"2MOlevo-tXE "levo-t"2levothyroxine oralXE "levothyroxine"2MOlevoxyl oral tablet 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 50 mcg, 75 mcg, 88 mcgXE "levoxyl"2MOliothyronine oralXE "liothyronine"3MOSYNTHROIDXE "SYNTHROID"4MOunithroid oral tablet 100 mcg, 112 mcg, 125 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 mcgXE "unithroid"2MOGASTROENTEROLOGYANTIDIARRHEALS / ANTISPASMODICSdicyclomine oral capsuleXE "dicyclomine"3MOdicyclomine oral solutionXE "dicyclomine"4MOdicyclomine oral tabletXE "dicyclomine"3MOdiphenoxylate-atropine oral liquidXE "diphenoxylate-atropine"4MOdiphenoxylate-atropine oral tabletXE "diphenoxylate-atropine"3MOglycopyrrolate oral tablet 1 mg, 2 mgXE "glycopyrrolate"3MOloperamide oral capsuleXE "loperamide"3MOMISCELLANEOUS GASTROINTESTINAL AGENTSalosetronXE "alosetron"5PA; MOAMITIZAXE "AMITIZA"3MO; QL (60 per 30 days)aprepitantXE "aprepitant"4B/D PA; MObalsalazideXE "balsalazide"3MObudesonide oral capsule,delayed,extend.releaseXE "budesonide"4MObudesonide oral tablet,delayed and ext.releaseXE "budesonide"5MOcomproXE "compro"4MOconstuloseXE "constulose"3MOCREONXE "CREON"3MOcromolyn oralXE "cromolyn"5MOCYSTADANEXE "CYSTADANE"5MO; LAdronabinolXE "dronabinol"4B/D PA; MO; QL (60 per 30 days)EMEND ORAL SUSPENSION FOR RECONSTITUTIONXE "EMEND"4B/D PA; MOenuloseXE "enulose"3MOGATTEX 30-VIALXE "GATTEX 30-VIAL"5PA; MO; LAGATTEX ONE-VIALXE "GATTEX ONE-VIAL"5PA; MOgavilyte-cXE "gavilyte-c"2MOgavilyte-gXE "gavilyte-g"2MOgavilyte-nXE "gavilyte-n"2MOgenerlacXE "generlac"3MOGOLYTELYXE "GOLYTELY"3MOgranisetron hcl oralXE "granisetron hcl"4B/D PA; MOhydrocortisone rectalXE "hydrocortisone"4MOhydrocortisone topical cream with perineal applicator 1 %XE "hydrocortisone"1MOhydrocortisone topical cream with perineal applicator 2.5 %XE "hydrocortisone"2MOlactulose oral solutionXE "lactulose"3MOLINZESSXE "LINZESS"4MO; QL (30 per 30 days)meclizine oral tablet 12.5 mg, 25 mgXE "meclizine"2MOmesalamine oral capsule (with del rel tablets)XE "mesalamine"2MOmesalamine oral tablet,delayed release (dr/ec) 1.2 gramXE "mesalamine"4MOmesalamine rectal enemaXE "mesalamine"2MOmesalamine rectal suppositoryXE "mesalamine"4MOmesalamine with cleansing wipeXE "mesalamine with cleansing wipe"2MOmetoclopramide hcl oral solutionXE "metoclopramide hcl"2MOmetoclopramide hcl oral tabletXE "metoclopramide hcl"1MOMOVANTIKXE "MOVANTIK"3MO; QL (30 per 30 days)NULYTELY LEMON-LIMEXE "NULYTELY LEMON-LIME"3MONULYTELY WITH FLAVOR PACKSXE "NULYTELY WITH FLAVOR PACKS"3MOOCALIVAXE "OCALIVA"5PA; MO; QL (30 per 30 days)ondansetronXE "ondansetron"2B/D PA; MOondansetron hcl oral solutionXE "ondansetron hcl"4B/D PA; MOondansetron hcl oral tablet 24 mgXE "ondansetron hcl"3B/D PAondansetron hcl oral tablet 4 mg, 8 mgXE "ondansetron hcl"3B/D PA; MOpeg 3350-electrolytes oral recon soln 236-22.74-6.74 -5.86 gramXE "peg 3350-electrolytes"2MOpeg-electrolyteXE "peg-electrolyte"2PENTASAXE "PENTASA"4MOPLENVUXE "PLENVU"4MOprochlorperazineXE "prochlorperazine"4MOprochlorperazine maleate oralXE "prochlorperazine maleate oral"2MOprocto-med hcXE "procto-med hc"3MOprocto-pakXE "procto-pak"3MOproctosol hc topicalXE "proctosol hc"3MOproctozone-hcXE "proctozone-hc"3MORECTIVXE "RECTIV"4MO; QL (30 per 30 days)RELISTOR SUBCUTANEOUS SOLUTIONXE "RELISTOR"5PA; MORELISTOR SUBCUTANEOUS SYRINGEXE "RELISTOR"5PA; MOscopolamine baseXE "scopolamine base"4PA; MO; QL (10 per 30 days)sulfasalazine oral tabletXE "sulfasalazine"2MOsulfasalazine oral tablet,delayed release (dr/ec)XE "sulfasalazine"3MOSUPREP BOWEL PREP KITXE "SUPREP BOWEL PREP KIT"4MOtrilyte with flavor packetsXE "trilyte with flavor packets"2MOursodiol oral capsuleXE "ursodiol"3MOursodiol oral tabletXE "ursodiol"4MOVIOKACEXE "VIOKACE"4MOZENPEP ORAL CAPSULE,DELAYED RELEASE(DR/EC) 10,000-32,000 -42,000 UNIT, 15,000-47,000 -63,000 UNIT, 20,000-63,000- 84,000 UNIT, 25,000-79,000- 105,000 UNIT, 3,000-10,000 -14,000-UNIT, 40,000-126,000- 168,000 UNIT, 5,000-17,000- 24,000 UNITXE "ZENPEP"4MOULCER THERAPYDEXILANTXE "DEXILANT"4MO; QL (30 per 30 days)esomeprazole magnesium oral capsule,delayed release(dr/ec)XE "esomeprazole magnesium"4ST; MO; QL (30 per 30 days)famotidine oral suspensionXE "famotidine"4MOfamotidine oral tablet 20 mg, 40 mgXE "famotidine"1MOlansoprazole oral capsule,delayed release(dr/ec)XE "lansoprazole"3MO; QL (30 per 30 days)misoprostolXE "misoprostol"3MOnizatidine oral capsuleXE "nizatidine"3MOomeprazole oral capsule,delayed release(dr/ec)XE "omeprazole"1MOpantoprazole oral tablet,delayed release (dr/ec)XE "pantoprazole"1MOrabeprazole oral tablet,delayed release (dr/ec)XE "rabeprazole"3MO; QL (30 per 30 days)sucralfate oral tabletXE "sucralfate"2MOIMMUNOLOGY, VACCINES / BIOTECHNOLOGYBIOTECHNOLOGY DRUGSACTIMMUNEXE "ACTIMMUNE"5PA; MO; LAARCALYSTXE "ARCALYST"5PA; MOBETASERON SUBCUTANEOUS KITXE "BETASERON"5PA; MO; QL (14 per 28 days)GENOTROPINXE "GENOTROPIN"5PA; MOGENOTROPIN MINIQUICK SUBCUTANEOUS SYRINGE 0.2 MG/0.25 MLXE "GENOTROPIN MINIQUICK"3PA; MOGENOTROPIN MINIQUICK SUBCUTANEOUS SYRINGE 0.4 MG/0.25 ML, 0.6 MG/0.25 ML, 0.8 MG/0.25 ML, 1 MG/0.25 ML, 1.2 MG/0.25 ML, 1.4 MG/0.25 ML, 1.6 MG/0.25 ML, 1.8 MG/0.25 ML, 2 MG/0.25 MLXE "GENOTROPIN MINIQUICK"5PA; MOINTRON A INJECTIONXE "INTRON A"5B/D PA; MONEULASTAXE "NEULASTA"4MOPEGASYSXE "PEGASYS"5PA; MOPEGASYS PROCLICK SUBCUTANEOUS PEN INJECTOR 180 MCG/0.5 MLXE "PEGASYS PROCLICK"5PAPROCRIT INJECTION SOLUTION 10,000 UNIT/ML, 2,000 UNIT/ML, 3,000 UNIT/ML, 4,000 UNIT/MLXE "PROCRIT"3PA; MOPROCRIT INJECTION SOLUTION 20,000 UNIT/ML, 40,000 UNIT/MLXE "PROCRIT"5PA; MOSYLATRON SUBCUTANEOUS KIT 200 MCG, 300 MCGXE "SYLATRON"5PA; MOZARXIOXE "ZARXIO"5PA; MOZIEXTENZOXE "ZIEXTENZO"5PA; MOVACCINES / MISCELLANEOUS IMMUNOLOGICALSACTHIB (PF)XE "ACTHIB (PF)"3MOADACEL(TDAP ADOLESN/ADULT)(PF)XE "ADACEL(TDAP ADOLESN/ADULT)(PF)"3MOBCG VACCINE, LIVE (PF)XE "BCG VACCINE, LIVE (PF)"3MOBEXSEROXE "BEXSERO"3MOBOOSTRIX TDAPXE "BOOSTRIX TDAP"3MODAPTACEL (DTAP PEDIATRIC) (PF)XE "DAPTACEL (DTAP PEDIATRIC) (PF)"3MOENGERIX-B (PF) INTRAMUSCULAR SYRINGEXE "ENGERIX-B (PF)"3B/D PA; MOENGERIX-B PEDIATRIC (PF) INTRAMUSCULAR SYRINGEXE "ENGERIX-B PEDIATRIC (PF)"3B/D PA; MOGAMMAGARD LIQUIDXE "GAMMAGARD LIQUID"5PA; MOGAMMAGARD S-D (IGA < 1 MCG/ML)XE "GAMMAGARD S-D (IGA < 1 MCG/ML)"5PA; MOGAMMAKED INJECTION SOLUTION 1 GRAM/10 ML (10 %)XE "GAMMAKED"5PA; MOGAMMAPLEXXE "GAMMAPLEX"5PA; MOGAMMAPLEX (WITH SORBITOL)XE "GAMMAPLEX (WITH SORBITOL)"5PA; MOGAMUNEX-C INJECTION SOLUTION 1 GRAM/10 ML (10 %)XE "GAMUNEX-C"5PA; MOGARDASIL 9 (PF)XE "GARDASIL 9 (PF)"3MOHAVRIX (PF) INTRAMUSCULAR SUSPENSION 1,440 ELISA UNIT/MLXE "HAVRIX (PF)"3MOHAVRIX (PF) INTRAMUSCULAR SYRINGEXE "HAVRIX (PF)"3MOHIBERIX (PF)XE "HIBERIX (PF)"3MOIMOVAX RABIES VACCINE (PF)XE "IMOVAX RABIES VACCINE (PF)"3B/D PA; MOINFANRIX (DTAP) (PF) INTRAMUSCULAR SUSPENSIONXE "INFANRIX (DTAP) (PF)"3MOIPOLXE "IPOL"3MOIXIARO (PF)XE "IXIARO (PF)"3MOKINRIX (PF) INTRAMUSCULAR SUSPENSIONXE "KINRIX (PF)"3KINRIX (PF) INTRAMUSCULAR SYRINGEXE "KINRIX (PF)"3MOMENACTRA (PF) INTRAMUSCULAR SOLUTIONXE "MENACTRA (PF)"3MOMENVEO A-C-Y-W-135-DIP (PF)XE "MENVEO A-C-Y-W-135-DIP (PF)"3MOM-M-R II (PF)XE "M-M-R II (PF)"3MOOCTAGAMXE "OCTAGAM"5PA; MOPANZYGAXE "PANZYGA"5PA; MOPEDIARIX (PF)XE "PEDIARIX (PF)"3MOPEDVAX HIB (PF)XE "PEDVAX HIB (PF)"3MOPRIVIGENXE "PRIVIGEN"5PA; MOPROQUAD (PF)XE "PROQUAD (PF)"3MOQUADRACEL (PF)XE "QUADRACEL (PF)"3MORABAVERT (PF)XE "RABAVERT (PF)"3B/D PA; MORECOMBIVAX HB (PF) INTRAMUSCULAR SUSPENSION 10 MCG/ML, 40 MCG/MLXE "RECOMBIVAX HB (PF)"3B/D PA; MORECOMBIVAX HB (PF) INTRAMUSCULAR SYRINGE 10 MCG/MLXE "RECOMBIVAX HB (PF)"3B/D PA; MORECOMBIVAX HB (PF) INTRAMUSCULAR SYRINGE 5 MCG/0.5 MLXE "RECOMBIVAX HB (PF)"3B/D PAROTARIXXE "ROTARIX"3ROTATEQ VACCINEXE "ROTATEQ VACCINE"3MOSHINGRIX (PF)XE "SHINGRIX (PF)"3MO; QL (2 per 999 days)TDVAXXE "TDVAX"3MOTENIVAC (PF) INTRAMUSCULAR SYRINGEXE "TENIVAC (PF)"3B/D PA; MOTETANUS,DIPHTHERIA TOX PED(PF)XE "TETANUS,DIPHTHERIA TOX PED(PF)"3B/D PA; MOTRUMENBAXE "TRUMENBA"3MOTWINRIX (PF) INTRAMUSCULAR SYRINGEXE "TWINRIX (PF)"3MOTYPHIM VI INTRAMUSCULAR SOLUTIONXE "TYPHIM VI"3TYPHIM VI INTRAMUSCULAR SYRINGEXE "TYPHIM VI"3MOVAQTA (PF)XE "VAQTA (PF)"3MOVARIVAX (PF)XE "VARIVAX (PF)"3MOYF-VAX (PF)XE "YF-VAX (PF)"3MOZOSTAVAX (PF)XE "ZOSTAVAX (PF)"3MO; QL (1 per 999 days)MUSCULOSKELETAL / RHEUMATOLOGYGOUT THERAPYallopurinolXE "allopurinol"2MOCOLCRYSXE "COLCRYS"3MO; QL (120 per 30 days)febuxostatXE "febuxostat"3MOMITIGAREXE "MITIGARE"3MO; QL (60 per 30 days)probenecidXE "probenecid"2MOprobenecid-colchicineXE "probenecid-colchicine"3MOOSTEOPOROSIS THERAPYalendronate oral solutionXE "alendronate"4MOalendronate oral tablet 10 mg, 35 mg, 70 mgXE "alendronate"1MOibandronate oralXE "ibandronate"3B/D PA; MOPROLIAXE "PROLIA"4MO; QL (1 per 180 days)raloxifeneXE "raloxifene"3MOrisedronate oral tablet 150 mg, 35 mg, 35 mg (12 pack), 35 mg (4 pack), 5 mgXE "risedronate"4MOrisedronate oral tablet,delayed release (dr/ec)XE "risedronate"4MOTERIPARATIDEXE "TERIPARATIDE"5PA; MO; QL (2.48 per 28 days)TYMLOSXE "TYMLOS"5PA; MOOTHER RHEUMATOLOGICALSBENLYSTA SUBCUTANEOUSXE "BENLYSTA"5PA; MOENBREL MINIXE "ENBREL MINI"5PA; MO; QL (8 per 28 days)ENBREL SUBCUTANEOUS RECON SOLNXE "ENBREL"5PA; MO; QL (8 per 28 days)ENBREL SUBCUTANEOUS SYRINGEXE "ENBREL"5PA; MO; QL (8 per 28 days)ENBREL SURECLICKXE "ENBREL SURECLICK"5PA; MO; QL (8 per 28 days)HUMIRA PENXE "HUMIRA PEN"5PA; MO; QL (4 per 28 days)HUMIRA PEN CROHNS-UC-HS STARTXE "HUMIRA PEN CROHNS-UC-HS START"5PA; MOHUMIRA PEN PSOR-UVEITS-ADOL HSXE "HUMIRA PEN PSOR-UVEITS-ADOL HS"5PA; MOHUMIRA SUBCUTANEOUS SYRINGE KIT 10 MG/0.2 ML, 20 MG/0.4 MLXE "HUMIRA"5PA; MO; QL (2 per 28 days)HUMIRA SUBCUTANEOUS SYRINGE KIT 40 MG/0.8 MLXE "HUMIRA"5PA; MO; QL (4 per 28 days)HUMIRA(CF) PEDI CROHNS STARTERXE "HUMIRA(CF) PEDI CROHNS STARTER"5PA; MOHUMIRA(CF) PEN CROHNS-UC-HSXE "HUMIRA(CF) PEN CROHNS-UC-HS"5PA; MOHUMIRA(CF) PEN PSOR-UV-ADOL HSXE "HUMIRA(CF) PEN PSOR-UV-ADOL HS"5PA; MOHUMIRA(CF) SUBCUTANEOUS SYRINGE KIT 10 MG/0.1 ML, 20 MG/0.2 MLXE "HUMIRA(CF)"5PA; MO; QL (2 per 28 days)HUMIRA(CF) SUBCUTANEOUS SYRINGE KIT 40 MG/0.4 MLXE "HUMIRA(CF)"5PA; MO; QL (4 per 28 days)leflunomideXE "leflunomide"3MO; QL (30 per 30 days)penicillamine oral tabletXE "penicillamine"5MORINVOQXE "RINVOQ"5PA; MO; QL (30 per 30 days)XELJANZXE "XELJANZ"5PA; MO; QL (60 per 30 days)XELJANZ XRXE "XELJANZ XR"5PA; MO; QL (30 per 30 days)OBSTETRICS / GYNECOLOGYESTROGENS / PROGESTINScamilaXE "camila"2MOdeblitaneXE "deblitane"2MODELESTROGEN INTRAMUSCULAR OIL 10 MG/MLXE "DELESTROGEN"4MODEPO-PROVERA INTRAMUSCULAR SUSPENSION 400 MG/MLXE "DEPO-PROVERA"4B/D PA; MOerrinXE "errin"2MOestradiol oralXE "estradiol"2MOestradiol transdermal patch weeklyXE "estradiol"3MOestradiol vaginal creamXE "estradiol"3MOestradiol vaginal tabletXE "estradiol"4MOestradiol valerate intramuscular oil 20 mg/ml, 40 mg/mlXE "estradiol valerate"4MOfyavolvXE "fyavolv"3MOincassiaXE "incassia"2MOjinteliXE "jinteli"3MOlyzaXE "lyza"2MOmedroxyprogesterone intramuscularXE "medroxyprogesterone"2MOmedroxyprogesterone oralXE "medroxyprogesterone"1MOnora-beXE "nora-be"2MOnorethindrone (contraceptive)XE "norethindrone (contraceptive)"2MOnorethindrone acetateXE "norethindrone acetate"3MOnorethindrone ac-eth estradiol oral tablet 0.5-2.5 mg-mcg, 1-5 mg-mcgXE "norethindrone ac-eth estradiol"3MOsharobelXE "sharobel"2MOyuvafemXE "yuvafem"4MOMISCELLANEOUS OB/GYNclindamycin phosphate vaginalXE "clindamycin phosphate"3MOeluryngXE "eluryng"4MOetonogestrel-ethinyl estradiolXE "etonogestrel-ethinyl estradiol"4MOmetronidazole vaginalXE "metronidazole"4MOOSPHENAXE "OSPHENA"3PA; MOterconazoleXE "terconazole"3MOtranexamic acid oralXE "tranexamic acid"3MOvandazoleXE "vandazole"4MOxulaneXE "xulane"4MOORAL CONTRACEPTIVES / RELATED AGENTSaltavera (28)XE "altavera (28)"2MOalyacen 1/35 (28)XE "alyacen 1/35 (28)"2MOamethiaXE "amethia"3MOapriXE "apri"2MOaranelle (28)XE "aranelle (28)"3MOashlynaXE "ashlyna"3MOaubraXE "aubra"2MOaubra eqXE "aubra eq"2MOavianeXE "aviane"2MObalziva (28)XE "balziva (28)"3MOblisovi 24 feXE "blisovi 24 fe"3MOblisovi fe 1.5/30 (28)XE "blisovi fe 1.5/30 (28)"2MObriellynXE "briellyn"3MOcamrese loXE "camrese lo"3MOcaziant (28)XE "caziant (28)"2MOcryselle (28)XE "cryselle (28)"2MOcyclafem 1/35 (28)XE "cyclafem 1/35 (28)"2MOcyclafem 7/7/7 (28)XE "cyclafem 7/7/7 (28)"2MOcyredXE "cyred"2MOcyred eqXE "cyred eq"2MOdesog-e.estradiol/e.estradiolXE "desog-e.estradiol/e.estradiol"3MOdrospirenone-e.estradiol-lm.fa oral tablet 3-0.02-0.451 mg (24) (4)XE "drospirenone-e.estradiol-lm.fa"4MOdrospirenone-ethinyl estradiolXE "drospirenone-ethinyl estradiol"3MOemoquetteXE "emoquette"2MOenpresseXE "enpresse"2MOenskyceXE "enskyce"2MOestaryllaXE "estarylla"2MOethynodiol diac-eth estradiol oral tablet 1-35 mg-mcgXE "ethynodiol diac-eth estradiol"2ethynodiol diac-eth estradiol oral tablet 1-50 mg-mcgXE "ethynodiol diac-eth estradiol"3falmina (28)XE "falmina (28)"2MOfayosimXE "fayosim"3MOfemynorXE "femynor"2MOgianvi (28)XE "gianvi (28)"3MOhailey 24 feXE "hailey 24 fe"3MOintrovaleXE "introvale"3MOisibloomXE "isibloom"2MOjasmiel (28)XE "jasmiel (28)"3MOjuleberXE "juleber"2MOjunel 1.5/30 (21)XE "junel 1.5/30 (21)"2MOjunel 1/20 (21)XE "junel 1/20 (21)"2MOjunel fe 1.5/30 (28)XE "junel fe 1.5/30 (28)"2MOjunel fe 1/20 (28)XE "junel fe 1/20 (28)"2MOjunel fe 24XE "junel fe 24"3MOkaitlib feXE "kaitlib fe"4MOkariva (28)XE "kariva (28)"3MOkelnor 1/35 (28)XE "kelnor 1/35 (28)"2MOkelnor 1-50XE "kelnor 1-50"3MOkurvelo (28)XE "kurvelo (28)"2MOl norgest/e.estradiol-e.estradXE "l norgest/e.estradiol-e.estrad"3MOlarin 1.5/30 (21)XE "larin 1.5/30 (21)"2MOlarin 1/20 (21)XE "larin 1/20 (21)"2MOlarin fe 1.5/30 (28)XE "larin fe 1.5/30 (28)"2MOlarin fe 1/20 (28)XE "larin fe 1/20 (28)"2MOlarissiaXE "larissia"2MOlayolis feXE "layolis fe"4MOleena 28XE "leena 28"3MOlessinaXE "lessina"2MOlevonest (28)XE "levonest (28)"2MOlevonorgestrel-ethinyl estrad oral tablet 0.1-20 mg-mcg, 0.15-0.03 mgXE "levonorgestrel-ethinyl estrad"2MOlevonorgestrel-ethinyl estrad oral tablets,dose pack,3 monthXE "levonorgestrel-ethinyl estrad"3MOlevonorg-eth estrad triphasicXE "levonorg-eth estrad triphasic"2MOlevora-28XE "levora-28"2MOloryna (28)XE "loryna (28)"3MOlow-ogestrel (28)XE "low-ogestrel (28)"2MOlutera (28)XE "lutera (28)"2MOmarlissa (28)XE "marlissa (28)"2MOmelodetta 24 feXE "melodetta 24 fe"4MOmibelas 24 feXE "mibelas 24 fe"4MOmicrogestin 1.5/30 (21)XE "microgestin 1.5/30 (21)"2MOmicrogestin 1/20 (21)XE "microgestin 1/20 (21)"2MOmicrogestin fe 1.5/30 (28)XE "microgestin fe 1.5/30 (28)"2MOmicrogestin fe 1/20 (28)XE "microgestin fe 1/20 (28)"2MOmiliXE "mili"2MOnecon 0.5/35 (28)XE "necon 0.5/35 (28)"3MOnikki (28)XE "nikki (28)"3MOnoreth-ethinyl estradiol-iron oral tablet,chewable 0.4mg-35mcg(21) and 75 mg (7)XE "noreth-ethinyl estradiol-iron"3MOnoreth-ethinyl estradiol-iron oral tablet,chewable 0.8mg-25mcg(24) and 75 mg (4)XE "noreth-ethinyl estradiol-iron"4MOnorethindrone ac-eth estradiol oral tablet 1-20 mg-mcgXE "norethindrone ac-eth estradiol"2MOnorethindrone-e.estradiol-iron oral tablet,chewableXE "norethindrone-e.estradiol-iron"4MOnorgestimate-ethinyl estradiol oral tablet 0.18/0.215/0.25 mg-25 mcgXE "norgestimate-ethinyl estradiol"3MOnorgestimate-ethinyl estradiol oral tablet 0.18/0.215/0.25 mg-35 mcg (28), 0.25-35 mg-mcgXE "norgestimate-ethinyl estradiol"2MOnortrel 0.5/35 (28)XE "nortrel 0.5/35 (28)"3MOnortrel 1/35 (21)XE "nortrel 1/35 (21)"2MOnortrel 1/35 (28)XE "nortrel 1/35 (28)"2MOnortrel 7/7/7 (28)XE "nortrel 7/7/7 (28)"2MOocellaXE "ocella"3MOorsythiaXE "orsythia"2MOpimtrea (28)XE "pimtrea (28)"3MOpirmella oral tablet 1-35 mg-mcgXE "pirmella"2MOportia 28XE "portia 28"2MOprevifemXE "previfem"2MOreclipsen (28)XE "reclipsen (28)"2MOrivelsaXE "rivelsa"3MOsetlakinXE "setlakin"3MOsprintec (28)XE "sprintec (28)"2MOsronyxXE "sronyx"2MOsyedaXE "syeda"3MOtarina 24 feXE "tarina 24 fe"3MOtarina fe 1/20 (28)XE "tarina fe 1/20 (28)"2MOtarina fe 1-20 eq (28)XE "tarina fe 1-20 eq (28)"2MOtri-estaryllaXE "tri-estarylla"2MOtri-legest feXE "tri-legest fe"3MOtri-lo-estaryllaXE "tri-lo-estarylla"3MOtri-lo-sprintecXE "tri-lo-sprintec"3MOtri-miliXE "tri-mili"2MOtri-previfem (28)XE "tri-previfem (28)"2MOtri-sprintec (28)XE "tri-sprintec (28)"2MOtrivora (28)XE "trivora (28)"2MOtri-vylibraXE "tri-vylibra"2MOtri-vylibra loXE "tri-vylibra lo"3MOtydemyXE "tydemy"4MOvelivet triphasic regimen (28)XE "velivet triphasic regimen (28)"2MOvienvaXE "vienva"2MOvyfemla (28)XE "vyfemla (28)"3MOvylibraXE "vylibra"2MOwymzya feXE "wymzya fe"3MOzarahXE "zarah"3MOzovia 1/35e (28)XE "zovia 1/35e (28)"2MOOPHTHALMOLOGYANTIBIOTICSak-poly-bacXE "ak-poly-bac"2MOAZASITEXE "AZASITE"4MObacitracin ophthalmic (eye)XE "bacitracin"3MObacitracin-polymyxin b ophthalmic (eye)XE "bacitracin-polymyxin b"2MOBESIVANCEXE "BESIVANCE"3MOCILOXAN OPHTHALMIC (EYE) OINTMENTXE "CILOXAN"3MOciprofloxacin hcl ophthalmic (eye)XE "ciprofloxacin hcl"2MOerythromycin ophthalmic (eye)XE "erythromycin"2MOgatifloxacinXE "gatifloxacin"3MOgentak ophthalmic (eye) ointmentXE "gentak"2MOgentamicin ophthalmic (eye) dropsXE "gentamicin"2MOMOXEZAXE "MOXEZA"3MOmoxifloxacin ophthalmic (eye)XE "moxifloxacin"3MONATACYNXE "NATACYN"4MOneomycin-bacitracin-polymyxinXE "neomycin-bacitracin-polymyxin"3MOneomycin-polymyxin-gramicidinXE "neomycin-polymyxin-gramicidin"3MOofloxacin ophthalmic (eye)XE "ofloxacin"2MOpolymyxin b sulf-trimethoprimXE "polymyxin b sulf-trimethoprim"2MOtobramycinXE "tobramycin"2MOANTIVIRALStrifluridineXE "trifluridine"3MOZIRGANXE "ZIRGAN"4MOBETA-BLOCKERSbetaxolol ophthalmic (eye)XE "betaxolol"3MOBETOPTIC SXE "BETOPTIC S"3MOcarteololXE "carteolol"2MOlevobunolol ophthalmic (eye) drops 0.5 %XE "levobunolol"2MOtimolol maleate ophthalmic (eye) dropsXE "timolol maleate"1MOtimolol maleate ophthalmic (eye) drops, once dailyXE "timolol maleate"4MOtimolol maleate ophthalmic (eye) gel forming solutionXE "timolol maleate"4MOMISCELLANEOUS OPHTHALMOLOGICSatropine ophthalmic (eye) dropsXE "atropine"3MOazelastine ophthalmic (eye)XE "azelastine"3MOBEPREVEXE "BEPREVE"3MOBLEPHAMIDE S.O.P.XE "BLEPHAMIDE S.O.P."4MOcromolyn ophthalmic (eye)XE "cromolyn"1MOCYSTARANXE "CYSTARAN"5PA; MO; LALASTACAFTXE "LASTACAFT"4MOolopatadine ophthalmic (eye) drops 0.2 %XE "olopatadine"4MOPAZEOXE "PAZEO"3MOPHOSPHOLINE IODIDEXE "PHOSPHOLINE IODIDE"4MOpilocarpine hcl ophthalmic (eye) drops 1 %, 2 %, 4 %XE "pilocarpine hcl"3MORESTASISXE "RESTASIS"3MO; QL (60 per 30 days)RESTASIS MULTIDOSEXE "RESTASIS MULTIDOSE"3MO; QL (60 per 30 days)sulfacetamide sodium ophthalmic (eye)XE "sulfacetamide sodium"3MOsulfacetamide-prednisoloneXE "sulfacetamide-prednisolone"2MONON-STEROIDAL ANTI-INFLAMMATORY AGENTSbromfenacXE "bromfenac"4MOBROMSITEXE "BROMSITE"4MOdiclofenac sodium ophthalmic (eye)XE "diclofenac sodium"3MOflurbiprofen sodiumXE "flurbiprofen sodium"3MOILEVROXE "ILEVRO"3MOketorolac ophthalmic (eye) drops 0.4 %XE "ketorolac"3MOketorolac ophthalmic (eye) drops 0.5 %XE "ketorolac"2MOPROLENSAXE "PROLENSA"3MOORAL DRUGS FOR GLAUCOMAacetazolamide oral capsule, extended releaseXE "acetazolamide"4MOacetazolamide oral tabletXE "acetazolamide"3MOmethazolamideXE "methazolamide"4MOOTHER GLAUCOMA DRUGSAZOPTXE "AZOPT"3MOCOMBIGANXE "COMBIGAN"3MOdorzolamideXE "dorzolamide"2MOdorzolamide-timololXE "dorzolamide-timolol"2MOlatanoprostXE "latanoprost"2MOLUMIGAN OPHTHALMIC (EYE) DROPS 0.01 %XE "LUMIGAN"3MORHOPRESSAXE "RHOPRESSA"3MOSIMBRINZAXE "SIMBRINZA"3MOtravoprostXE "travoprost"4MOSTEROID-ANTIBIOTIC COMBINATIONSneomycin-bacitracin-poly-hcXE "neomycin-bacitracin-poly-hc"3MOneomycin-polymyxin b-dexamethXE "neomycin-polymyxin b-dexameth"2MOneomycin-polymyxin-hc ophthalmic (eye)XE "neomycin-polymyxin-hc"4MOTOBRADEX OPHTHALMIC (EYE) OINTMENTXE "TOBRADEX"3MOTOBRADEX STXE "TOBRADEX ST"3MOtobramycin-dexamethasoneXE "tobramycin-dexamethasone"4MOZYLETXE "ZYLET"3MOSTEROIDSALREXXE "ALREX"3MOdexamethasone sodium phosphate ophthalmic (eye)XE "dexamethasone sodium phosphate"3MODUREZOLXE "DUREZOL"3MOfluorometholoneXE "fluorometholone"3MOLOTEMAX OPHTHALMIC (EYE) DROPS,GELXE "LOTEMAX"3MOLOTEMAX OPHTHALMIC (EYE) OINTMENTXE "LOTEMAX"3MOloteprednol etabonateXE "loteprednol etabonate"3MOprednisolone acetateXE "prednisolone acetate"3MOprednisolone sodium phosphate ophthalmic (eye)XE "prednisolone sodium phosphate"3MOSYMPATHOMIMETICSALPHAGAN P OPHTHALMIC (EYE) DROPS 0.1 %XE "ALPHAGAN P"3MOapraclonidineXE "apraclonidine"2MObrimonidine ophthalmic (eye) drops 0.15 %XE "brimonidine"4MObrimonidine ophthalmic (eye) drops 0.2 %XE "brimonidine"1MORESPIRATORY AND ALLERGYANTIHISTAMINE / ANTIALLERGENIC AGENTScetirizine oral solution 1 mg/mlXE "cetirizine"2MOcyproheptadineXE "cyproheptadine"3PA; MOEPINEPHRINE INJECTION AUTO-INJECTOR 0.15 MG/0.15 ML, 0.3 MG/0.3 MLXE "EPINEPHRINE"3MOepinephrine injection auto-injector 0.15 mg/0.3 ml, 0.3 mg/0.3 mlXE "epinephrine"3MOhydroxyzine hcl oral solution 10 mg/5 mlXE "hydroxyzine hcl"3PA; MOhydroxyzine hcl oral tabletXE "hydroxyzine hcl"2PA; MOhydroxyzine pamoate oral capsule 25 mg, 50 mgXE "hydroxyzine pamoate"2PA; MOlevocetirizine oral solutionXE "levocetirizine"4MOlevocetirizine oral tabletXE "levocetirizine"2MOpromethazine oralXE "promethazine"2PA; MOSYMJEPIXE "SYMJEPI"4MOPULMONARY AGENTSacetylcysteineXE "acetylcysteine"3B/D PA; MOADEMPASXE "ADEMPAS"5PA; MO; LA; QL (90 per 30 days)ADVAIR DISKUSXE "ADVAIR DISKUS"3MO; QL (60 per 30 days)ADVAIR HFAXE "ADVAIR HFA"3MO; QL (12 per 30 days)albuterol sulfate inhalation hfa aerosol inhaler 90 mcg/actuationXE "albuterol sulfate"3MO; QL (17 per 30 days)ALBUTEROL SULFATE INHALATION HFA AEROSOL INHALER 90 MCG/ACTUATION (NDA020983)XE "ALBUTEROL SULFATE"3MO; QL (36 per 30 days)albuterol sulfate inhalation solution for nebulization 0.63 mg/3 ml, 1.25 mg/3 ml, 2.5 mg/0.5 ml, 5 mg/mlXE "albuterol sulfate"3B/D PA; MOalbuterol sulfate inhalation solution for nebulization 2.5 mg /3 ml (0.083 %)XE "albuterol sulfate"2B/D PA; MOalbuterol sulfate oral syrupXE "albuterol sulfate"2MOalbuterol sulfate oral tabletXE "albuterol sulfate"4MOalbuterol sulfate oral tablet extended release 12 hrXE "albuterol sulfate"3MOambrisentanXE "ambrisentan"5PA; MO; LA; QL (30 per 30 days)ANORO ELLIPTAXE "ANORO ELLIPTA"3MO; QL (60 per 30 days)ARNUITY ELLIPTAXE "ARNUITY ELLIPTA"3MO; QL (30 per 30 days)ATROVENT HFAXE "ATROVENT HFA"4MO; QL (25.8 per 30 days)BERINERT INTRAVENOUS KITXE "BERINERT"5PA; MO; LA; QL (24 per 30 days)BEVESPI AEROSPHEREXE "BEVESPI AEROSPHERE"3MO; QL (10.7 per 30 days)bosentan oral tablet 125 mgXE "bosentan"5PA; MO; LA; QL (60 per 30 days)bosentan oral tablet 62.5 mgXE "bosentan"5PA; MO; LA; QL (120 per 30 days)BREO ELLIPTAXE "BREO ELLIPTA"3MO; QL (60 per 30 days)BROVANAXE "BROVANA"4B/D PA; MObudesonide inhalation suspension for nebulization 0.25 mg/2 ml, 0.5 mg/2 mlXE "budesonide"4B/D PA; MOCOMBIVENT RESPIMATXE "COMBIVENT RESPIMAT"4MO; QL (8 per 30 days)cromolyn inhalationXE "cromolyn"3B/D PA; MODALIRESPXE "DALIRESP"4MOESBRIETXE "ESBRIET"5PA; MOFASENRAXE "FASENRA"5PA; MO; LAFASENRA PENXE "FASENRA PEN"5PA; MO; LAFLOVENT DISKUS INHALATION BLISTER WITH DEVICE 100 MCG/ACTUATION, 50 MCG/ACTUATIONXE "FLOVENT DISKUS"3MO; QL (60 per 30 days)FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 250 MCG/ACTUATIONXE "FLOVENT DISKUS"3MO; QL (240 per 30 days)FLOVENT HFA AEROSOL INHALER 110 MCG/ACTUATIONXE "FLOVENT HFA"3MO; QL (12 per 30 days)FLOVENT HFA AEROSOL INHALER 220 MCG/ACTUATIONXE "FLOVENT HFA"3MO; QL (24 per 30 days)FLOVENT HFA AEROSOL INHALER 44 MCG/ACTUATIONXE "FLOVENT HFA"3MO; QL (10.6 per 30 days)flunisolide nasal spray,non-aerosol 25 mcg (0.025 %)XE "flunisolide"3MO; QL (75 per 30 days)fluticasone propionate nasalXE "fluticasone propionate"2MO; QL (16 per 30 days)HAEGARDA SUBCUTANEOUS RECON SOLN 2,000 UNITXE "HAEGARDA"5PA; MO; LA; QL (30 per 30 days)HAEGARDA SUBCUTANEOUS RECON SOLN 3,000 UNITXE "HAEGARDA"5PA; MO; LA; QL (20 per 30 days)icatibantXE "icatibant"5PA; MO; QL (270 per 30 days)INCRUSE ELLIPTAXE "INCRUSE ELLIPTA"3MO; QL (30 per 30 days)ipratropium bromide inhalationXE "ipratropium bromide"2B/D PA; MOipratropium-albuterolXE "ipratropium-albuterol"3B/D PA; MOKALYDECOXE "KALYDECO"5PA; MOlevalbuterol hclXE "levalbuterol hcl"4B/D PA; MOLEVALBUTEROL TARTRATEXE "LEVALBUTEROL TARTRATE"3MO; QL (30 per 30 days)montelukast oral granules in packetXE "montelukast"4MOmontelukast oral tabletXE "montelukast"1MOmontelukast oral tablet,chewableXE "montelukast"2MONUCALAXE "NUCALA"5PA; MO; LAOFEVXE "OFEV"5PA; MOOPSUMITXE "OPSUMIT"5PA; MO; LA; QL (30 per 30 days)ORKAMBIXE "ORKAMBI"5PA; MOPULMICORT FLEXHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 180 MCG/ACTUATIONXE "PULMICORT FLEXHALER"4MO; QL (2 per 30 days)PULMICORT FLEXHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 90 MCG/ACTUATIONXE "PULMICORT FLEXHALER"4MO; QL (1 per 30 days)PULMOZYMEXE "PULMOZYME"5PA; MOSEREVENT DISKUSXE "SEREVENT DISKUS"3MO; QL (60 per 30 days)sildenafil (pulmonary arterial hypertension) oral tabletXE "sildenafil (pulmonary arterial hypertension)"3PA; MO; QL (90 per 30 days)SYMBICORTXE "SYMBICORT"3MO; QL (10.2 per 30 days)SYMDEKOXE "SYMDEKO"5PA; MO; LAterbutaline oralXE "terbutaline"4MOTHEO-24XE "THEO-24"4MOtheophylline oral elixirXE "theophylline"4theophylline oral solutionXE "theophylline"4MOtheophylline oral tablet extended release 12 hr 300 mgXE "theophylline"4MOtheophylline oral tablet extended release 24 hrXE "theophylline"3MOTRELEGY ELLIPTAXE "TRELEGY ELLIPTA"3MO; QL (60 per 30 days)TRIKAFTAXE "TRIKAFTA"5PA; MO; LAVENTAVISXE "VENTAVIS"5PA; MOVENTOLIN HFAXE "VENTOLIN HFA"3MO; QL (36 per 30 days)XOLAIRXE "XOLAIR"5PA; MO; LAzafirlukastXE "zafirlukast"3MOUROLOGICALSANTICHOLINERGICS / ANTISPASMODICSMYRBETRIQXE "MYRBETRIQ"4MO; QL (30 per 30 days)oxybutynin chloride oral syrupXE "oxybutynin chloride"3MOoxybutynin chloride oral tabletXE "oxybutynin chloride"3MOoxybutynin chloride oral tablet extended release 24hr 10 mg, 15 mgXE "oxybutynin chloride"3MO; QL (60 per 30 days)oxybutynin chloride oral tablet extended release 24hr 5 mgXE "oxybutynin chloride"3MO; QL (30 per 30 days)tolterodine oral capsule,extended release 24hrXE "tolterodine"4ST; MO; QL (30 per 30 days)tolterodine oral tabletXE "tolterodine"4ST; MOTOVIAZXE "TOVIAZ"3MO; QL (30 per 30 days)trospium oral tabletXE "trospium"3MO; QL (60 per 30 days)BENIGN PROSTATIC HYPERPLASIA(BPH) THERAPYalfuzosinXE "alfuzosin"2MO; QL (30 per 30 days)dutasterideXE "dutasteride"3MO; QL (30 per 30 days)dutasteride-tamsulosinXE "dutasteride-tamsulosin"4MO; QL (30 per 30 days)finasteride oral tablet 5 mgXE "finasteride"1MOtamsulosinXE "tamsulosin"2MOMISCELLANEOUS UROLOGICALSbethanechol chlorideXE "bethanechol chloride"3MOCYSTAGONXE "CYSTAGON"4PA; MO; LAELMIRONXE "ELMIRON"4MOpotassium citrateXE "potassium citrate"4MOsildenafilXE "sildenafil"2MO; EX; QL (6 per 30 days)VITAMINS, HEMATINICS / ELECTROLYTESELECTROLYTEScalcium acetate(phosphat bind)XE "calcium acetate(phosphat bind)"3MO; QL (360 per 30 days)klor-conXE "klor-con"4MOklor-con 10XE "klor-con 10"2MOklor-con 8XE "klor-con 8"2MOklor-con m10XE "klor-con m10"2MOklor-con m15XE "klor-con m15"2MOklor-con m20XE "klor-con m20"2MOmagnesium sulfate injection solutionXE "magnesium sulfate"3MOmagnesium sulfate injection syringeXE "magnesium sulfate"3NORMOSOL-RXE "NORMOSOL-R"4MONORMOSOL-R IN 5 % DEXTROSEXE "NORMOSOL-R IN 5 % DEXTROSE"4potassium chlorid-d5-0.45%nacl intravenous parenteral solution 10 meq/l, 30 meq/l, 40 meq/lXE "potassium chlorid-d5-0.45%nacl"3potassium chlorid-d5-0.45%nacl intravenous parenteral solution 20 meq/lXE "potassium chlorid-d5-0.45%nacl"3MOpotassium chloride in 0.9%nacl intravenous parenteral solution 20 meq/l, 40 meq/lXE "potassium chloride in 0.9%nacl"2potassium chloride in 5 % dex intravenous parenteral solution 20 meq/l, 40 meq/lXE "potassium chloride in 5 % dex"2potassium chloride in water intravenous piggyback 10 meq/100 mlXE "potassium chloride in water"2MOpotassium chloride in water intravenous piggyback 20 meq/100 ml, 40 meq/100 mlXE "potassium chloride in water"2potassium chloride intravenousXE "potassium chloride"2MOpotassium chloride oral capsule, extended releaseXE "potassium chloride"3MOpotassium chloride oral liquidXE "potassium chloride"4MOpotassium chloride oral packetXE "potassium chloride"4MOpotassium chloride oral tablet extended releaseXE "potassium chloride"2MOpotassium chloride oral tablet,er particles/crystalsXE "potassium chloride"2MOpotassium chloride-0.45 % naclXE "potassium chloride-0.45 % nacl"2potassium chloride-d5-0.2%nacl intravenous parenteral solution 20 meq/lXE "potassium chloride-d5-0.2%nacl"3MOpotassium chloride-d5-0.9%nacl intravenous parenteral solution 20 meq/lXE "potassium chloride-d5-0.9%nacl"3MOpotassium chloride-d5-0.9%nacl intravenous parenteral solution 40 meq/lXE "potassium chloride-d5-0.9%nacl"4sodium chloride 0.45 % intravenous parenteral solutionXE "sodium chloride 0.45 %"3MOsodium chloride 3 %XE "sodium chloride 3 %"3MOsodium chloride 5 %XE "sodium chloride 5 %"3MOTPN ELECTROLYTESXE "TPN ELECTROLYTES"4B/D PAMISCELLANEOUS NUTRITION PRODUCTSAMINOSYN II 10 %XE "AMINOSYN II 10 %"4B/D PAAMINOSYN-PF 10 %XE "AMINOSYN-PF 10 %"4PAAMINOSYN-PF 7 % (SULFITE-FREE)XE "AMINOSYN-PF 7 % (SULFITE-FREE)"4B/D PACLINIMIX 5%/D15W SULFITE FREEXE "CLINIMIX 5%/D15W SULFITE FREE"4B/D PACLINIMIX 4.25%/D10W SULF FREEXE "CLINIMIX 4.25%/D10W SULF FREE"4B/D PACLINIMIX 5%-D20W(SULFITE-FREE)XE "CLINIMIX 5%-D20W(SULFITE-FREE)"4B/D PACLINISOL SF 15 %XE "CLINISOL SF 15 %"4B/D PA; MOFREAMINE HBC 6.9 %XE "FREAMINE HBC 6.9 %"4B/D PAHEPATAMINE 8%XE "HEPATAMINE 8%"4B/D PAintralipid intravenous emulsion 20 %XE "intralipid"4B/D PAINTRALIPID INTRAVENOUS EMULSION 30 %XE "INTRALIPID"4B/D PAISOLYTE S PH 7.4XE "ISOLYTE S PH 7.4"4ISOLYTE-P IN 5 % DEXTROSEXE "ISOLYTE-P IN 5 % DEXTROSE"4ISOLYTE-SXE "ISOLYTE-S"4NEPHRAMINE 5.4 %XE "NEPHRAMINE 5.4 %"4B/D PANORMOSOL-M IN 5 % DEXTROSEXE "NORMOSOL-M IN 5 % DEXTROSE"4NORMOSOL-R PH 7.4XE "NORMOSOL-R PH 7.4"4NUTRILIPIDXE "NUTRILIPID"4B/D PAPLASMA-LYTE 148XE "PLASMA-LYTE 148"4PLASMA-LYTE AXE "PLASMA-LYTE A"4plenamineXE "plenamine"4B/D PApremasol 10 %XE "premasol 10 %"4B/D PA; MOPROCALAMINE 3%XE "PROCALAMINE 3%"4B/D PAPROSOL 20 %XE "PROSOL 20 %"4B/D PA; MOtravasol 10 %XE "travasol 10 %"4B/D PA; MOTROPHAMINE 10 %XE "TROPHAMINE 10 %"4B/D PA; MOVITAMINS / HEMATINICSfluoride (sodium) oral tabletXE "fluoride (sodium)"2MOfluoride (sodium) oral tablet,chewable 1 mg (2.2 mg sod. fluoride)XE "fluoride (sodium)"2MOprenatal vitamin oral tabletXE "prenatal vitamin oral tablet"3MOIndexINDEX \e "" \c "3" \h "A" \z "1033" Aabacavir2abacavir-lamivudine2abacavir-lamivudine-zidovudine2ABELCET2ABILIFY MAINTENA24abiraterone12acamprosate40acarbose42acebutolol31acetaminophen-codeine22acetazolamide58acetic acid41acetylcysteine60acitretin36ACTHIB (PF)50ACTIMMUNE50acyclovir2, 3acyclovir sodium3ADACEL(TDAP ADOLESN/ADULT)(PF)50adefovir3ADEMPAS60ADVAIR DISKUS60ADVAIR HFA60AFINITOR12AFINITOR DISPERZ12AIMOVIG AUTOINJECTOR20ak-poly-bac57ala-cort38albendazole7albuterol sulfate60ALBUTEROL SULFATE60alclometasone38alcohol pads42ALECENSA12alendronate52alfuzosin62ALINIA7aliskiren31allopurinol52alosetron47ALPHAGAN P59alprazolam24ALREX59altavera (28)54ALUNBRIG12alyacen 1/35 (28)54amantadine hcl3AMBISOME2ambrisentan60amethia54amikacin7amiloride31amiloride-hydrochlorothiazide31AMINOSYN II 10 %64AMINOSYN-PF 10 %64AMINOSYN-PF 7 % (SULFITE-FREE)64amiodarone31AMITIZA47amitriptyline24amlodipine31amlodipine-benazepril31amlodipine-olmesartan31amlodipine-valsartan31amlodipine-valsartan-hcthiazid31ammonium lactate36amnesteem37amoxapine24amoxicillin9amoxicillin-pot clavulanate9, 10amphotericin b2ampicillin10ampicillin sodium10ampicillin-sulbactam10ANADROL-5046anagrelide40anastrozole12ANDRODERM46ANORO ELLIPTA60APOKYN19apraclonidine59aprepitant47apri54APTIOM17APTIVUS3APTIVUS (WITH VITAMIN E)3ARALAST NP40aranelle (28)54ARCALYST50aripiprazole24, 25ARISTADA25ARISTADA INITIO25armodafinil25ARNUITY ELLIPTA60ashlyna54aspirin-dipyridamole33atazanavir3atenolol31atenolol-chlorthalidone31atomoxetine25atorvastatin34atovaquone7atovaquone-proguanil7ATRIPLA3atropine58ATROVENT HFA60aubra54aubra eq54AURYXIA40AUSTEDO21aviane54avita37AVITA37AYVAKIT12AZASITE57azathioprine12azelastine41, 58azithromycin7AZOPT58aztreonam7Bbacitracin57bacitracin-polymyxin b57baclofen22balsalazide47BALVERSA12balziva (28)54BANZEL17BARACLUDE3BASAGLAR KWIKPEN U-100 INSULIN42BCG VACCINE, LIVE (PF)50benazepril31benazepril-hydrochlorothiazide31BENLYSTA53benztropine19BEPREVE58BERINERT60BESIVANCE57betamethasone dipropionate38betamethasone valerate38, 39betamethasone, augmented39BETASERON50betaxolol31, 57bethanechol chloride63BETOPTIC S57BEVESPI AEROSPHERE60bexarotene12BEXSERO50bicalutamide12BICILLIN L-A10BIKTARVY3bisoprolol fumarate31bisoprolol-hydrochlorothiazide31BLEPHAMIDE S.O.P.58blisovi 24 fe54blisovi fe 1.5/30 (28)54BOOSTRIX TDAP50bosentan60BOSULIF12BRAFTOVI12BREO ELLIPTA60briellyn54BRILINTA33brimonidine59BRIVIACT17bromfenac58bromocriptine19BROMSITE58BROVANA60BRUKINSA13budesonide47, 60bumetanide31buprenorphine hcl22buprenorphine-naloxone23bupropion hcl25bupropion hcl (smoking deter)41buspirone25BYDUREON42BYDUREON BCISE42BYETTA43BYSTOLIC31Ccabergoline46CABOMETYX13calcipotriene36calcitonin (salmon)46calcitriol46calcium acetate(phosphat bind)63CALQUENCE13camila53camrese lo54candesartan31candesartan-hydrochlorothiazid31CAPLYTA25CAPRELSA13captopril31captopril-hydrochlorothiazide31CARBAGLU40carbamazepine17carbidopa19carbidopa-levodopa19, 20carbidopa-levodopa-entacapone20carteolol57cartia xt31carvedilol32caspofungin2CAYSTON7caziant (28)54cefaclor5cefadroxil5cefazolin6cefazolin in dextrose (iso-os)6cefdinir6cefepime6CEFEPIME IN DEXTROSE 5 %6cefepime in dextrose,iso-osm6cefixime6cefoxitin6cefoxitin in dextrose, iso-osm6cefpodoxime6cefprozil6ceftazidime6CEFTAZIDIME IN D5W6ceftriaxone6CEFTRIAXONE6ceftriaxone in dextrose,iso-os6cefuroxime axetil6cefuroxime sodium6, 7celecoxib24CELONTIN17cephalexin7CERDELGA46cetirizine59cevimeline40CHANTIX41CHANTIX CONTINUING MONTH BOX41CHANTIX STARTING MONTH BOX41CHEMET40chlorhexidine gluconate41chloroquine phosphate7chlorpromazine25chlorthalidone32cholestyramine (with sugar)34cholestyramine light34ciclopirox38cilostazol33CILOXAN57CIMDUO3cinacalcet46CIPRO11CIPRODEX42ciprofloxacin hcl11, 57ciprofloxacin in 5 % dextrose11citalopram25claravis37clarithromycin7clindamycin hcl7CLINDAMYCIN IN 0.9 % SOD CHLOR7clindamycin in 5 % dextrose8clindamycin palmitate hcl8clindamycin pediatric8clindamycin phosphate8, 37, 54CLINDAMYCIN PHOSPHATE37CLINIMIX 5%/D15W SULFITE FREE64CLINIMIX 4.25%/D10W SULF FREE64CLINIMIX 4.25%/D5W SULFIT FREE40CLINIMIX 5%-D20W(SULFITE-FREE)64CLINISOL SF 15 %64clobazam17clomipramine25clonazepam17clonidine32clonidine hcl32clopidogrel33clorazepate dipotassium25clotrimazole2, 38clotrimazole-betamethasone38clozapine25, 26CLOZAPINE26COARTEM8COLCRYS52colesevelam34colestipol34colistin (colistimethate na)8COMBIGAN58COMBIVENT RESPIMAT60COMETRIQ13COMPLERA3compro47constulose47COPIKTRA13CORLANOR35cortisone42COSENTYX36COSENTYX (2 SYRINGES)36COSENTYX PEN36COSENTYX PEN (2 PENS)36COTELLIC13CREON47CRESEMBA2CRIXIVAN3cromolyn47, 58, 60cryselle (28)54cyclafem 1/35 (28)54cyclafem 7/7/7 (28)54cyclobenzaprine22cyclophosphamide13cyclosporine13cyclosporine modified13cyproheptadine59cyred54cyred eq54CYSTADANE47CYSTAGON63CYSTARAN58Dd10 %-0.45 % sodium chloride40d2.5 %-0.45 % sodium chloride40d5 % and 0.9 % sodium chloride40d5 %-0.45 % sodium chloride40dalfampridine21DALIRESP60danazol46dantrolene22dapsone8DAPTACEL (DTAP PEDIATRIC) (PF)50daptomycin8DAPTOMYCIN8DAURISMO13deblitane53deferasirox40DELESTROGEN53DELSTRIGO3DEMSER32DEPO-PROVERA53DESCOVY3desipramine26desmopressin46desog-e.estradiol/e.estradiol55desvenlafaxine succinate26dexamethasone42dexamethasone intensol42dexamethasone sodium phosphate59DEXILANT49dexmethylphenidate26dextroamphetamine-amphetamine26dextrose 10 % and 0.2 % nacl40dextrose 10 % in water (d10w)40dextrose 5 % in water (d5w)40dextrose 5%-0.2 % sod chloride40dextrose with sodium chloride40DIASTAT17DIASTAT ACUDIAL17diazepam17, 26diazepam intensol26diazoxide43diclofenac potassium24diclofenac sodium24, 58dicloxacillin10dicyclomine47didanosine3DIFICID7diflunisal24digitek35digox35digoxin35dihydroergotamine20DILANTIN 30 MG17DILANTIN EXTENDED 100 MG17DILANTIN INFATABS 50 MG17DILANTIN-125 125 MG/5 ML17diltiazem hcl32dilt-xr32diphenoxylate-atropine47disopyramide phosphate31disulfiram40divalproex17dofetilide31donepezil21dorzolamide58dorzolamide-timolol58DOVATO3doxazosin32doxepin26doxy-10011doxycycline hyclate11doxycycline monohydrate12DRIZALMA SPRINKLE26dronabinol47drospirenone-e.estradiol-lm.fa55drospirenone-ethinyl estradiol55DROXIA13duloxetine27DUPIXENT SYRINGE36DUREZOL59dutasteride62dutasteride-tamsulosin62Eec-naproxen24EDURANT3efavirenz3eletriptan20ELIQUIS34ELIQUIS DVT-PE TREAT 30D START34ELMIRON63eluryng54EMCYT13EMEND47EMGALITY PEN20EMGALITY SYRINGE20emoquette55EMSAM27EMTRIVA3EMVERM8enalapril maleate32enalapril-hydrochlorothiazide32ENBREL53ENBREL MINI53ENBREL SURECLICK53ENDARI40endocet22ENGERIX-B (PF)51ENGERIX-B PEDIATRIC (PF)51enoxaparin34enpresse55enskyce55ENSTILAR36entacapone20entecavir3ENTRESTO35enulose47EPCLUSA3EPIDIOLEX17epinephrine59EPINEPHRINE59epitol17EPIVIR HBV3eplerenone32ergotamine-caffeine20ERIVEDGE13ERLEADA13erlotinib13errin53ertapenem8ery pads37ery-tab7ERY-TAB7ERYTHROCIN7erythrocin (as stearate)7erythromycin7, 57erythromycin ethylsuccinate7erythromycin with ethanol37erythromycin-benzoyl peroxide37ESBRIET61escitalopram oxalate27esomeprazole magnesium49estarylla55estradiol53, 54estradiol valerate54eszopiclone27ethambutol8ethosuximide17ethynodiol diac-eth estradiol55etodolac24etonogestrel-ethinyl estradiol54euthyrox47everolimus (antineoplastic)13everolimus (immunosuppressive)13EVOTAZ3exemestane13ezetimibe34ezetimibe-simvastatin34Ffalmina (28)55famciclovir3famotidine49FANAPT27FARXIGA43FARYDAK13FASENRA61FASENRA PEN61fayosim55febuxostat52felbamate17felodipine32femynor55fenofibrate34fenofibrate micronized34fenofibrate nanocrystallized34fentanyl22fentanyl citrate22FETZIMA27FIASP FLEXTOUCH U-100 INSULIN43FIASP PENFILL U-100 INSULIN43FIASP U-100 INSULIN43finasteride63flac otic oil41flecainide31FLOVENT DISKUS61FLOVENT HFA61fluconazole2fluconazole in nacl (iso-osm)2flucytosine2fludrocortisone42flunisolide61fluocinolone39fluocinolone acetonide oil42fluocinolone and shower cap39fluocinonide39fluocinonide-e39fluocinonide-emollient39fluoride (sodium)65fluorometholone59fluorouracil36fluoxetine27fluphenazine decanoate27fluphenazine hcl27flurbiprofen24flurbiprofen sodium58flutamide13fluticasone propionate39, 61fluvoxamine27fondaparinux34fosamprenavir3fosinopril32fosinopril-hydrochlorothiazide32FREAMINE HBC 6.9 %64furosemide32FUZEON3fyavolv54FYCOMPA17, 18Ggabapentin18galantamine21GAMMAGARD LIQUID51GAMMAGARD S-D (IGA < 1 MCG/ML)51GAMMAKED51GAMMAPLEX51GAMMAPLEX (WITH SORBITOL)51GAMUNEX-C51GARDASIL 9 (PF)51gatifloxacin57GATTEX 30-VIAL47GATTEX ONE-VIAL47GAUZE PAD43gavilyte-c47gavilyte-g48gavilyte-n48gemfibrozil34generlac48gengraf13GENOTROPIN50GENOTROPIN MINIQUICK50gentak57gentamicin8, 38, 57gentamicin in nacl (iso-osm)8GENVOYA3GEODON27gianvi (28)55GILENYA21GILOTRIF13glatiramer21glatopa21glimepiride43glipizide43glipizide-metformin43GLUCAGEN HYPOKIT43GLUCAGON (HCL) EMERGENCY KIT43GLUCAGON EMERGENCY KIT (HUMAN)43glyburide43glyburide micronized43glyburide-metformin43glycopyrrolate47GLYXAMBI44GOLYTELY48granisetron hcl48griseofulvin microsize2griseofulvin ultramicrosize2guanfacine27GVOKE HYPOPEN 1-PACK44GVOKE HYPOPEN 2-PACK44GVOKE PFS 1-PACK SYRINGE44GVOKE PFS 2-PACK SYRINGE44HHAEGARDA61hailey 24 fe55halobetasol propionate39haloperidol27haloperidol decanoate27haloperidol lactate27HARVONI3HAVRIX (PF)51heparin (porcine)34HEPATAMINE 8%64HIBERIX (PF)51HUMIRA53HUMIRA PEN53HUMIRA PEN CROHNS-UC-HS START53HUMIRA PEN PSOR-UVEITS-ADOL HS53HUMIRA(CF)53HUMIRA(CF) PEDI CROHNS STARTER53HUMIRA(CF) PEN CROHNS-UC-HS53HUMIRA(CF) PEN PSOR-UV-ADOL HS53HUMULIN R U-500 (CONC) INSULIN44HUMULIN R U-500 (CONC) KWIKPEN44hydralazine32hydrochlorothiazide32hydrocodone-acetaminophen22, 23hydrocodone-ibuprofen23hydrocortisone39, 42, 48hydrocortisone butyrate39hydrocortisone butyr-emollient39hydromorphone23hydromorphone (pf)23hydroxychloroquine8hydroxyurea13hydroxyzine hcl59hydroxyzine pamoate59HYSINGLA ER23Iibandronate52IBRANCE13ibu24ibuprofen24icatibant61ICLUSIG13IDHIFA13ILEVRO58imatinib13IMBRUVICA13imipenem-cilastatin8imipramine hcl27imiquimod36IMOVAX RABIES VACCINE (PF)51incassia54INCRELEX40INCRUSE ELLIPTA61indapamide32INFANRIX (DTAP) (PF)51INLYTA13INREBIC13INSULIN PEN NEEDLE44INSULIN SYRINGE (DISP) U-10044INTELENCE3intralipid64INTRALIPID64INTRON A50introvale55INVEGA SUSTENNA27, 28INVEGA TRINZA28INVIRASE3IPOL51ipratropium bromide41, 61ipratropium-albuterol61irbesartan32irbesartan-hydrochlorothiazide32IRESSA13ISENTRESS3, 4ISENTRESS HD3isibloom55ISOLYTE S PH 7.464ISOLYTE-P IN 5 % DEXTROSE64ISOLYTE-S64isoniazid8isosorbide dinitrate35isosorbide mononitrate35isotretinoin37isradipine32itraconazole2ivermectin8IXIARO (PF)51JJADENU SPRINKLE40JAKAFI14jantoven34JANUMET44JANUMET XR44JANUVIA44JARDIANCE44jasmiel (28)55JENTADUETO44JENTADUETO XR44jinteli54juleber55JULUCA4junel 1.5/30 (21)55junel 1/20 (21)55junel fe 1.5/30 (28)55junel fe 1/20 (28)55junel fe 2455JUXTAPID34Kkaitlib fe55KALETRA4KALYDECO61kariva (28)55kelnor 1/35 (28)55kelnor 1-5055ketoconazole2, 38ketorolac58KINRIX (PF)51kionex (with sorbitol)40KISQALI14KISQALI FEMARA CO-PACK14klor-con63klor-con 1063klor-con 863klor-con m1063klor-con m1563klor-con m2063KORLYM46kurvelo (28)55KUVAN46Ll norgest/e.estradiol-e.estrad55labetalol32lactulose48lamivudine4lamivudine-zidovudine4lamotrigine18lansoprazole49larin 1.5/30 (21)55larin 1/20 (21)55larin fe 1.5/30 (28)55larin fe 1/20 (28)55larissia55LASTACAFT58latanoprost58LATUDA28layolis fe55leena 2855leflunomide53LENVIMA14lessina55letrozole14leucovorin calcium12LEUKERAN14leuprolide14levalbuterol hcl61LEVALBUTEROL TARTRATE61LEVEMIR FLEXTOUCH U-100 INSULN44LEVEMIR U-100 INSULIN44levetiracetam18levobunolol57levocarnitine40levocarnitine (with sugar)40levocetirizine59, 60levofloxacin11levofloxacin in d5w11levonest (28)55levonorgestrel-ethinyl estrad55levonorg-eth estrad triphasic55levora-2855levo-t47levothyroxine47levoxyl47LEXIVA4lidocaine37lidocaine hcl36, 37lidocaine viscous37lidocaine-prilocaine37linezolid8linezolid in dextrose 5%8linezolid-0.9% sodium chloride8LINZESS48liothyronine47lisinopril32lisinopril-hydrochlorothiazide32lithium carbonate28lithium citrate28LOKELMA40LONSURF14loperamide47lopinavir-ritonavir4lorazepam28lorazepam intensol28LORBRENA14lorcet (hydrocodone)23lorcet hd23lorcet plus23loryna (28)55losartan32losartan-hydrochlorothiazide32LOTEMAX59loteprednol etabonate59lovastatin35low-ogestrel (28)55loxapine succinate28LUMIGAN58LUPRON DEPOT14LUPRON DEPOT (3 MONTH)14LUPRON DEPOT (4 MONTH)14LUPRON DEPOT (6 MONTH)14LUPRON DEPOT-PED14LUPRON DEPOT-PED (3 MONTH)14lutera (28)55LYNPARZA14LYRICA CR18LYSODREN14lyza54Mmagnesium sulfate63malathion40maprotiline28marlissa (28)55MARPLAN28MATULANE14MAVYRET4meclizine48medroxyprogesterone54mefloquine8megestrol14MEKINIST14MEKTOVI14melodetta 24 fe55meloxicam24memantine21MEMANTINE21MENACTRA (PF)51MENVEO A-C-Y-W-135-DIP (PF)51mercaptopurine14meropenem8MEROPENEM-0.9% SODIUM CHLORIDE8mesalamine48mesalamine with cleansing wipe48MESNEX12metformin44methadone23methazolamide58methenamine hippurate12methimazole42methocarbamol22methotrexate sodium14methotrexate sodium (pf)14methyldopa32methylphenidate hcl28methylprednisolone42metoclopramide hcl48metolazone32metoprolol succinate32metoprolol ta-hydrochlorothiaz32metoprolol tartrate32metro i.v.8metronidazole9, 37, 54metronidazole in nacl (iso-os)9mibelas 24 fe56microgestin 1.5/30 (21)56microgestin 1/20 (21)56microgestin fe 1.5/30 (28)56microgestin fe 1/20 (28)56midodrine40miglustat46mili56MINITRAN35minocycline12minoxidil32mirtazapine28, 29misoprostol49MITIGARE52M-M-R II (PF)51moexipril32molindone29mometasone39mondoxyne nl12montelukast61morphine23morphine concentrate23MOVANTIK48MOXEZA57moxifloxacin11, 57mupirocin38MYCAMINE2mycophenolate mofetil14, 15mycophenolate sodium15myorisan37MYRBETRIQ62Nnabumetone24nadolol32nafcillin10nafcillin in dextrose iso-osm10naloxone24naltrexone24NAMZARIC21naproxen24naproxen sodium24naratriptan20NARCAN24NATACYN57nateglinide44NATPARA46NAYZILAM18necon 0.5/35 (28)56NEEDLES, INSULIN DISP.,SAFETY44nefazodone29neomycin9neomycin-bacitracin-poly-hc59neomycin-bacitracin-polymyxin57neomycin-polymyxin b-dexameth59neomycin-polymyxin-gramicidin57neomycin-polymyxin-hc42, 59NEPHRAMINE 5.4 %64NERLYNX15NEULASTA50NEUPRO20nevirapine4NEXAVAR15niacin35NIACOR35nicardipine32NICOTROL41NICOTROL NS41nifedipine32nikki (28)56nilutamide15nimodipine32NINLARO15nitisinone41nitro-bid35NITRO-DUR35nitrofurantoin12nitrofurantoin macrocrystal12nitrofurantoin monohyd/m-cryst12nitroglycerin35nizatidine49nora-be54noreth-ethinyl estradiol-iron56norethindrone (contraceptive)54norethindrone acetate54norethindrone ac-eth estradiol54, 56norethindrone-e.estradiol-iron56norgestimate-ethinyl estradiol56NORMOSOL-M IN 5 % DEXTROSE64NORMOSOL-R63NORMOSOL-R IN 5 % DEXTROSE63NORMOSOL-R PH 7.464NORTHERA41nortrel 0.5/35 (28)56nortrel 1/35 (21)56nortrel 1/35 (28)56nortrel 7/7/7 (28)56nortriptyline29NORVIR4NOVOLIN 70/30 U-100 INSULIN44NOVOLIN N FLEXPEN44NOVOLIN N NPH U-100 INSULIN44NOVOLIN R FLEXPEN45NOVOLIN R REGULAR U-100 INSULN45NOVOLOG FLEXPEN U-100 INSULIN45NOVOLOG MIX 70-30 U-100 INSULN45NOVOLOG MIX 70-30FLEXPEN U-10045NOVOLOG PENFILL U-100 INSULIN45NOVOLOG U-100 INSULIN ASPART45NOXAFIL2NUBEQA15NUCALA61NUCYNTA ER24NUEDEXTA21NULYTELY LEMON-LIME48NULYTELY WITH FLAVOR PACKS48NUPLAZID29NUTRILIPID64nyamyc38nystatin2, 38nystop38OOCALIVA48ocella56OCTAGAM51octreotide acetate15ODEFSEY4ODOMZO15OFEV61ofloxacin42, 57olanzapine29olmesartan32olmesartan-amlodipin-hcthiazid33olmesartan-hydrochlorothiazide33olopatadine58omeprazole49ondansetron48ondansetron hcl48OPSUMIT61ORFADIN41ORKAMBI61orsythia56oseltamivir4OSPHENA54oxacillin10oxandrolone46oxcarbazepine18oxybutynin chloride62oxycodone23oxycodone-acetaminophen23OXYCONTIN23OZEMPIC45Ppacerone31paliperidone29pantoprazole50PANZYGA51paricalcitol46paroex oral rinse41paromomycin9paroxetine hcl29PASER9PAXIL29PAZEO58PEDIARIX (PF)51PEDVAX HIB (PF)51peg 3350-electrolytes48PEGANONE18PEGASYS50PEGASYS PROCLICK50peg-electrolyte48PEMAZYRE15penicillamine53PENICILLIN G POT IN DEXTROSE10, 11penicillin g potassium11penicillin g procaine11penicillin g sodium11penicillin v potassium11pentamidine9PENTASA48pentoxifylline34perindopril erbumine33permethrin40perphenazine29PERSERIS29phenelzine29phenobarbital18PHENYTEK18phenytoin18phenytoin sodium extended18PHOSPHOLINE IODIDE58PICATO37PIFELTRO4pilocarpine hcl41, 58pimozide29pimtrea (28)56pindolol33pioglitazone45piperacillin-tazobactam11PIPERACILLIN-TAZOBACTAM11PIQRAY15pirmella56piroxicam24PLASMA-LYTE 14864PLASMA-LYTE A64plenamine65PLENVU48podofilox37polymyxin b sulf-trimethoprim57POMALYST15portia 2856posaconazole2potassium chlorid-d5-0.45%nacl63potassium chloride63, 64potassium chloride in 0.9%nacl63potassium chloride in 5 % dex63potassium chloride in water63potassium chloride-0.45 % nacl64potassium chloride-d5-0.2%nacl64potassium chloride-d5-0.9%nacl64potassium citrate63PRADAXA34PRALUENT PEN35pramipexole20prasugrel34pravastatin35praziquantel9prazosin33prednisolone42prednisolone acetate59prednisolone sodium phosphate42, 59prednisone42prednisone intensol42pregabalin19premasol 10 %65prenatal vitamin oral tablet65prevalite35previfem56PREZCOBIX4PREZISTA4PRIFTIN9PRIMAQUINE9primidone19PRIVIGEN51probenecid52probenecid-colchicine52PROCALAMINE 3%65prochlorperazine48prochlorperazine maleate oral48PROCRIT50procto-med hc48procto-pak48proctosol hc48proctozone-hc48PROGRAF15PROLASTIN-C41PROLENSA58PROLIA52PROMACTA34promethazine60propafenone31propranolol33propranolol-hydrochlorothiazid33propylthiouracil42PROQUAD (PF)51PROSOL 20 %65protriptyline29PULMICORT FLEXHALER61, 62PULMOZYME62PURIXAN15pyrazinamide9pyridostigmine bromide22QQINLOCK15QUADRACEL (PF)51quetiapine29quinapril33quinapril-hydrochlorothiazide33quinidine sulfate31quinine sulfate9RRABAVERT (PF)51rabeprazole50raloxifene52ramipril33ranolazine35rasagiline20RAYALDEE46reclipsen (28)56RECOMBIVAX HB (PF)51, 52RECTIV48REGRANEX37RELENZA DISKHALER4RELISTOR49repaglinide45RESTASIS58RESTASIS MULTIDOSE58RETEVMO15REVLIMID15REXULTI29REYATAZ4RHOPRESSA58ribavirin4rifabutin9rifampin9RIFATER9riluzole41rimantadine4RINVOQ53risedronate52RISPERDAL CONSTA29risperidone29, 30ritonavir4rivastigmine21rivastigmine tartrate21rivelsa56rizatriptan20ropinirole20rosuvastatin35ROTARIX52ROTATEQ VACCINE52roweepra19roweepra xr19ROZLYTREK15RUBRACA15RYDAPT15SSAMSCA46SANDIMMUNE15SANTYL37SAPHRIS30scopolamine base49SECUADO30selegiline hcl20selenium sulfide36SELZENTRY5SEREVENT DISKUS62sertraline30setlakin56sevelamer carbonate41sharobel54SHINGRIX (PF)52SIGNIFOR15sildenafil63sildenafil (pulmonary arterial hypertension)62silver sulfadiazine37SIMBRINZA58simvastatin35sirolimus15SIRTURO9SIVEXTRO9SKYRIZI36sodium chloride41sodium chloride 0.45 %64sodium chloride 0.9 %41sodium chloride 3 %64sodium chloride 5 %64sodium phenylbutyrate41sodium polystyrene (sorb free)41sodium polystyrene sulfonate41SOLIQUA 100/3345SOLTAMOX15SOMATULINE DEPOT15SOMAVERT46sorine31sotalol31sotalol af31SOTYLIZE31SOVALDI5spironolactone33spironolacton-hydrochlorothiaz33sprintec (28)56SPRITAM19SPRYCEL15sps (with sorbitol)41sronyx56ssd37stavudine5STELARA36STIMATE46STIVARGA15STREPTOMYCIN9STRIBILD5sucralfate50sulfacetamide sodium58sulfacetamide sodium (acne)38sulfacetamide-prednisolone58sulfadiazine11sulfamethoxazole-trimethoprim11SULFAMYLON38sulfasalazine49sulindac24sumatriptan20sumatriptan succinate20SUPREP BOWEL PREP KIT49SUTENT15syeda56SYLATRON50SYMBICORT62SYMDEKO62SYMFI5SYMFI LO5SYMJEPI60SYMPAZAN19SYMTUZA5SYNAREL46SYNJARDY45SYNJARDY XR45SYNRIBO15SYNTHROID47TTABLOID15TABRECTA15tacrolimus15, 37TAFINLAR15TAGRISSO16TALZENNA16tamoxifen16tamsulosin63TARGRETIN16tarina 24 fe56tarina fe 1/20 (28)56tarina fe 1-20 eq (28)56TASIGNA16tazarotene38tazicef7TAZORAC38taztia xt33TAZVERIK16TDVAX52TECFIDERA21, 22TEFLARO7telmisartan33telmisartan-amlodipine33telmisartan-hydrochlorothiazid33TENIVAC (PF)52tenofovir disoproxil fumarate5terazosin33terbinafine hcl2terbutaline62terconazole54TERIPARATIDE52testosterone46, 47TESTOSTERONE46testosterone cypionate46testosterone enanthate46TETANUS,DIPHTHERIA TOX PED(PF)52tetrabenazine22tetracycline12TEXACORT39THALOMID16THEO-2462theophylline62thioridazine30thiothixene30tiadylt er33tiagabine19TIBSOVO16tigecycline9timolol maleate33, 57TIVICAY5tizanidine22TOBRADEX59TOBRADEX ST59tobramycin57tobramycin in 0.225 % nacl9tobramycin sulfate9tobramycin-dexamethasone59tolterodine62topiramate19toremifene16torsemide33TOVIAZ62TPN ELECTROLYTES64TRADJENTA45tramadol24tramadol-acetaminophen24trandolapril33tranexamic acid54tranylcypromine30travasol 10 %65travoprost58trazodone30TRECATOR9TRELEGY ELLIPTA62TRELSTAR16TRESIBA FLEXTOUCH U-10045TRESIBA FLEXTOUCH U-20045TRESIBA U-100 INSULIN45tretinoin (antineoplastic)16tretinoin topical38triamcinolone acetonide39, 40, 41triamterene-hydrochlorothiazid33trientine41tri-estarylla56trifluoperazine30trifluridine57trihexyphenidyl20TRIKAFTA62tri-legest fe56tri-lo-estarylla56tri-lo-sprintec56trilyte with flavor packets49trimethoprim12tri-mili56trimipramine30TRINTELLIX30tri-previfem (28)56tri-sprintec (28)56TRIUMEQ5trivora (28)56tri-vylibra56tri-vylibra lo56TROPHAMINE 10 %65trospium62TRULICITY45TRUMENBA52TRUVADA5TUKYSA16TURALIO16TWINRIX (PF)52TYBOST5tydemy57TYKERB16TYMLOS52TYPHIM VI52Uunithroid47UPTRAVI33ursodiol49Vvalacyclovir5VALCHLOR37valganciclovir5valproic acid19valproic acid (as sodium salt)19valsartan33valsartan-hydrochlorothiazide33VALTOCO19vancomycin9VANCOMYCIN9vandazole54VAQTA (PF)52VARIVAX (PF)52VASCEPA35velivet triphasic regimen (28)57VELTASSA41VEMLIDY5VENCLEXTA16VENCLEXTA STARTING PACK16venlafaxine30VENTAVIS62VENTOLIN HFA62verapamil33VERSACLOZ30VERZENIO16VICTOZA 2-PAK45VICTOZA 3-PAK45vienva57vigabatrin19vigadrone19VIIBRYD30VIMPAT19VIOKACE49VIRACEPT5VIREAD5VITRAKVI16VIVITROL24VIZIMPRO16voriconazole2VOSEVI5VOTRIENT16VRAYLAR30vyfemla (28)57vylibra57Wwarfarin34wymzya fe57XXALKORI16XARELTO34XARELTO DVT-PE TREAT 30D START34XATMEP16XCOPRI19XCOPRI MAINTENANCE PACK19XCOPRI TITRATION PACK19XELJANZ53XELJANZ XR53XGEVA12XIFAXAN9XIGDUO XR45, 46XOLAIR62XOSPATA16XPOVIO16XTANDI16xulane54XULTOPHY 100/3.646XYREM30YYF-VAX (PF)52yuvafem54Zzafirlukast62zaleplon30zarah57ZARXIO50ZEJULA16ZELBORAF16ZEMAIRA41zenatane38ZENPEP49zidovudine5ZIEXTENZO50ziprasidone hcl30ziprasidone mesylate30ZIRGAN57ZOLINZA16zolmitriptan20zolpidem30zonisamide19ZORTRESS16ZOSTAVAX (PF)52zovia 1/35e (28)57ZYDELIG16ZYKADIA16ZYLET59ZYPREXA RELPREVV30ZYTIGA17 ................
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