GB Clear Springs Basic PDP 2021



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.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.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"2B/D PA; MOcaspofunginXE "caspofungin"5B/D PAclotrimazole mucous membraneXE "clotrimazole"4MOCRESEMBA ORALXE "CRESEMBA"5PA; MOfluconazole in nacl (iso-osm) intravenous piggyback 200 mg/100 mlXE "fluconazole in nacl (iso-osm)"4B/D PA; MOfluconazole in nacl (iso-osm) intravenous piggyback 400 mg/200 mlXE "fluconazole in nacl (iso-osm)"4B/D PAfluconazole oral suspension for reconstitutionXE "fluconazole"2MOfluconazole 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"4MOitraconazoleXE "itraconazole"4PA; MOketoconazole oralXE "ketoconazole"2MONOXAFIL ORAL SUSPENSIONXE "NOXAFIL"5PA; MO; QL (840 per 30 days)nystatin oral suspensionXE "nystatin"4MOnystatin oral tabletXE "nystatin"2MOposaconazole oral tablet,delayed release (dr/ec)XE "posaconazole"4PA; MO; QL (93 per 28 days)terbinafine hcl oralXE "terbinafine hcl"2MOvoriconazole intravenousXE "voriconazole"5PA; MOvoriconazole oral suspension for reconstitutionXE "voriconazole"5PA; MOvoriconazole oral tablet 200 mgXE "voriconazole"5PA; MO; QL (120 per 30 days)voriconazole oral tablet 50 mgXE "voriconazole"4PA; MO; QL (120 per 30 days)ANTIVIRALSabacavir oral solutionXE "abacavir"4MO; QL (960 per 30 days)abacavir oral tabletXE "abacavir"4MO; QL (60 per 30 days)abacavir-lamivudineXE "abacavir-lamivudine"4MO; QL (30 per 30 days)abacavir-lamivudine-zidovudineXE "abacavir-lamivudine-zidovudine"5MO; QL (60 per 30 days)acyclovir 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 hclXE "amantadine hcl"2MOAPTIVUSXE "APTIVUS"5MO; QL (120 per 30 days)APTIVUS (WITH VITAMIN E)XE "APTIVUS (WITH VITAMIN E)"5QL (285 per 28 days)atazanavir oral capsule 150 mg, 200 mgXE "atazanavir"4MO; QL (60 per 30 days)atazanavir oral capsule 300 mgXE "atazanavir"4MO; QL (30 per 30 days)ATRIPLAXE "ATRIPLA"5MO; QL (30 per 30 days)BARACLUDE ORAL SOLUTIONXE "BARACLUDE"5MOBIKTARVYXE "BIKTARVY"5MO; QL (30 per 30 days)CIMDUOXE "CIMDUO"5MO; QL (30 per 30 days)COMPLERAXE "COMPLERA"5MO; QL (30 per 30 days)CRIXIVAN ORAL CAPSULE 200 MGXE "CRIXIVAN"4MO; QL (90 per 30 days)CRIXIVAN ORAL CAPSULE 400 MGXE "CRIXIVAN"4MO; QL (180 per 30 days)DELSTRIGOXE "DELSTRIGO"5MO; QL (30 per 30 days)DESCOVYXE "DESCOVY"5MOdidanosine oral capsule,delayed release(dr/ec) 250 mg, 400 mgXE "didanosine"4MO; QL (30 per 30 days)DOVATOXE "DOVATO"5MO; QL (30 per 30 days)EDURANTXE "EDURANT"5MO; QL (30 per 30 days)efavirenz oral capsule 200 mgXE "efavirenz"4MO; QL (120 per 30 days)efavirenz oral capsule 50 mgXE "efavirenz"4MO; QL (180 per 30 days)efavirenz oral tabletXE "efavirenz"4MO; QL (30 per 30 days)EMTRIVA ORAL CAPSULEXE "EMTRIVA"4MO; QL (30 per 30 days)EMTRIVA ORAL SOLUTIONXE "EMTRIVA"4MO; QL (680 per 28 days)entecavirXE "entecavir"4MO; QL (30 per 30 days)EPCLUSAXE "EPCLUSA"5PA; MOEPIVIR HBV ORAL SOLUTIONXE "EPIVIR HBV"4MOEVOTAZXE "EVOTAZ"5MO; QL (30 per 30 days)famciclovirXE "famciclovir"3MOfosamprenavirXE "fosamprenavir"5MO; QL (120 per 30 days)FUZEON SUBCUTANEOUS RECON SOLNXE "FUZEON"5MO; QL (60 per 30 days)GENVOYAXE "GENVOYA"5MO; QL (30 per 30 days)HARVONI ORAL TABLET 90-400 MGXE "HARVONI"5PA; MOINTELENCE ORAL TABLET 100 MGXE "INTELENCE"5MO; QL (120 per 30 days)INTELENCE ORAL TABLET 200 MGXE "INTELENCE"5MO; QL (60 per 30 days)INTELENCE ORAL TABLET 25 MGXE "INTELENCE"4MO; QL (120 per 30 days)INVIRASE ORAL TABLETXE "INVIRASE"5MO; QL (120 per 30 days)ISENTRESS HDXE "ISENTRESS HD"5MO; QL (60 per 30 days)ISENTRESS ORAL POWDER IN PACKETXE "ISENTRESS"5MO; QL (60 per 30 days)ISENTRESS ORAL TABLETXE "ISENTRESS"5MO; QL (120 per 30 days)ISENTRESS ORAL TABLET,CHEWABLE 100 MGXE "ISENTRESS"5MO; QL (180 per 30 days)ISENTRESS ORAL TABLET,CHEWABLE 25 MGXE "ISENTRESS"4MO; QL (180 per 30 days)JULUCAXE "JULUCA"5MO; QL (30 per 30 days)KALETRA ORAL TABLET 100-25 MGXE "KALETRA"3MOKALETRA ORAL TABLET 200-50 MGXE "KALETRA"3MO; QL (150 per 30 days)lamivudine oral solutionXE "lamivudine"4MOlamivudine oral tablet 100 mgXE "lamivudine"4MOlamivudine oral tablet 150 mgXE "lamivudine"4MO; QL (60 per 30 days)lamivudine oral tablet 300 mgXE "lamivudine"4MO; QL (30 per 30 days)lamivudine-zidovudineXE "lamivudine-zidovudine"4MO; QL (60 per 30 days)LEXIVA ORAL SUSPENSIONXE "LEXIVA"4MO; QL (1575 per 28 days)lopinavir-ritonavirXE "lopinavir-ritonavir"4MO; QL (400 per 30 days)nevirapine oral suspensionXE "nevirapine"4QL (1200 per 30 days)nevirapine oral tabletXE "nevirapine"2MO; QL (60 per 30 days)nevirapine oral tablet extended release 24 hr 100 mgXE "nevirapine"4MO; QL (90 per 30 days)nevirapine oral tablet extended release 24 hr 400 mgXE "nevirapine"4MO; QL (30 per 30 days)NORVIR ORAL POWDER IN PACKETXE "NORVIR"4MO; QL (360 per 30 days)NORVIR ORAL SOLUTIONXE "NORVIR"4MO; QL (450 per 30 days)ODEFSEYXE "ODEFSEY"5MOoseltamivir oral capsule 30 mgXE "oseltamivir"4MOoseltamivir oral capsule 45 mgXE "oseltamivir"2MOoseltamivir oral capsule 75 mgXE "oseltamivir"4MO; QL (84 per 365 days)oseltamivir oral suspension for reconstitutionXE "oseltamivir"2MOPIFELTROXE "PIFELTRO"5MO; QL (30 per 30 days)PREZCOBIXXE "PREZCOBIX"5MO; QL (30 per 30 days)PREZISTA ORAL SUSPENSIONXE "PREZISTA"5MO; QL (360 per 30 days)PREZISTA ORAL TABLET 150 MGXE "PREZISTA"4MO; 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 (420 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"5MO; QL (180 per 30 days)ribavirin oral capsuleXE "ribavirin"2MOribavirin oral tablet 200 mgXE "ribavirin"4MOrimantadineXE "rimantadine"4MOritonavirXE "ritonavir"4MO; QL (360 per 30 days)SELZENTRY ORAL SOLUTIONXE "SELZENTRY"3MO; QL (1800 per 30 days)SELZENTRY ORAL TABLET 150 MG, 75 MGXE "SELZENTRY"5MO; QL (60 per 30 days)SELZENTRY ORAL TABLET 25 MGXE "SELZENTRY"3MO; QL (120 per 30 days)SELZENTRY ORAL TABLET 300 MGXE "SELZENTRY"5MO; QL (120 per 30 days)stavudine oral capsule 15 mg, 20 mgXE "stavudine"4MO; QL (120 per 30 days)stavudine oral capsule 30 mg, 40 mgXE "stavudine"4MO; QL (60 per 30 days)STRIBILDXE "STRIBILD"5MO; QL (30 per 30 days)SYMFIXE "SYMFI"5MO; QL (30 per 30 days)SYMFI LOXE "SYMFI LO"5MO; QL (30 per 30 days)SYMTUZAXE "SYMTUZA"5MO; QL (30 per 30 days)tenofovir disoproxil fumarateXE "tenofovir disoproxil fumarate"4MO; QL (30 per 30 days)TIVICAY ORAL TABLET 10 MGXE "TIVICAY"4MO; QL (60 per 30 days)TIVICAY ORAL TABLET 25 MG, 50 MGXE "TIVICAY"5MO; QL (60 per 30 days)TRIUMEQXE "TRIUMEQ"5MO; QL (30 per 30 days)TRUVADAXE "TRUVADA"5MO; QL (30 per 30 days)TYBOSTXE "TYBOST"3MO; QL (30 per 30 days)valacyclovir oral tablet 1 gramXE "valacyclovir"3MO; QL (120 per 30 days)valacyclovir oral tablet 500 mgXE "valacyclovir"3MO; QL (60 per 30 days)valganciclovir oral recon solnXE "valganciclovir"4MOvalganciclovir oral tabletXE "valganciclovir"5MOVEMLIDYXE "VEMLIDY"5PA; MOVIRACEPT ORAL TABLET 250 MGXE "VIRACEPT"5MO; QL (270 per 30 days)VIRACEPT ORAL TABLET 625 MGXE "VIRACEPT"5MO; QL (120 per 30 days)VIREAD ORAL POWDERXE "VIREAD"3MO; QL (225 per 30 days)VIREAD ORAL TABLET 150 MG, 200 MG, 250 MGXE "VIREAD"3MO; QL (30 per 30 days)VOSEVIXE "VOSEVI"5PA; MOXOFLUZAXE "XOFLUZA"4MO; QL (4 per 365 days)zidovudine oral capsuleXE "zidovudine"4MO; QL (180 per 30 days)zidovudine oral syrupXE "zidovudine"4MO; QL (1680 per 28 days)zidovudine oral tabletXE "zidovudine"2MO; QL (60 per 30 days)CEPHALOSPORINScefaclor oral capsuleXE "cefaclor"4MOcefaclor 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"2MOcefadroxil oral tabletXE "cefadroxil"4MOcefazolin in dextrose (iso-os) intravenous piggyback 1 gram/50 mlXE "cefazolin in dextrose (iso-os)"4MOcefazolin injection recon soln 1 gram, 500 mgXE "cefazolin"4MOcefazolin injection recon soln 10 gram, 100 gram, 300 gXE "cefazolin"4cefazolin intravenousXE "cefazolin"4cefdinirXE "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 capsuleXE "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"4cefpodoximeXE "cefpodoxime"4MOcefprozil oral suspension for reconstitutionXE "cefprozil"4MOcefprozil oral tabletXE "cefprozil"3MOCEFTAZIDIME IN D5WXE "CEFTAZIDIME IN D5W"4ceftazidime injection recon soln 1 gram, 2 gramXE "ceftazidime"4MOceftazidime injection recon soln 6 gramXE "ceftazidime"4ceftriaxone in dextrose,iso-osXE "ceftriaxone in dextrose,iso-os"4MOceftriaxone injection recon soln 1 gram, 2 gram, 250 mg, 500 mgXE "ceftriaxone"4MOceftriaxone injection recon soln 10 gramXE "ceftriaxone"4CEFTRIAXONE INJECTION RECON SOLN 100 GRAMXE "CEFTRIAXONE"4ceftriaxone intravenousXE "ceftriaxone"4MOcefuroxime axetil oral tabletXE "cefuroxime axetil"4MOcefuroxime sodium injection recon soln 750 mgXE "cefuroxime sodium"4MOcefuroxime sodium intravenous recon soln 1.5 gramXE "cefuroxime sodium"4MOcefuroxime sodium intravenous recon soln 7.5 gramXE "cefuroxime sodium"4cephalexin oral capsule 250 mg, 500 mgXE "cephalexin"2MOcephalexin oral suspension for reconstitutionXE "cephalexin"4MOcephalexin oral tabletXE "cephalexin"4MOTEFLAROXE "TEFLARO"5MOERYTHROMYCINS / OTHER MACROLIDESazithromycin intravenousXE "azithromycin"4MOazithromycin oral packetXE "azithromycin"4MOazithromycin oral suspension for reconstitutionXE "azithromycin"3MOazithromycin oral tabletXE "azithromycin"2MOclarithromycinXE "clarithromycin"4MOery-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"4MOALINIAXE "ALINIA"4MOamikacin injection solution 500 mg/2 mlXE "amikacin"4B/D PA; MOARIKAYCEXE "ARIKAYCE"4PA; MO; QL (235.2 per 28 days)atovaquoneXE "atovaquone"5MOatovaquone-proguanilXE "atovaquone-proguanil"4MOAZACTAM INJECTION RECON SOLN 2 GRAMXE "AZACTAM"4B/D PA; MOaztreonam injection recon soln 1 gramXE "aztreonam"3MOCAYSTONXE "CAYSTON"5PA; MO; QL (84 per 28 days)chloroquine phosphateXE "chloroquine phosphate"2MOclindamycin hcl oral capsule 150 mg, 300 mgXE "clindamycin hcl"2MOclindamycin hcl oral capsule 75 mgXE "clindamycin hcl"4MOCLINDAMYCIN 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"4MOclindamycin phosphate intravenous solution 600 mg/4 mlXE "clindamycin phosphate"4MOCOARTEMXE "COARTEM"4MO; QL (24 per 30 days)colistin (colistimethate na)XE "colistin (colistimethate na)"4MOdapsone oralXE "dapsone"3MODAPTOMYCIN INTRAVENOUS RECON SOLN 350 MGXE "DAPTOMYCIN"4MOdaptomycin intravenous recon soln 500 mgXE "daptomycin"5MOEMVERMXE "EMVERM"5MOertapenemXE "ertapenem"4MOethambutolXE "ethambutol"4MOFIRVANQXE "FIRVANQ"4MOgentamicin in nacl (iso-osm) intravenous piggyback 100 mg/100 ml, 60 mg/50 ml, 80 mg/50 mlXE "gentamicin in nacl (iso-osm)"4MOgentamicin in nacl (iso-osm) intravenous piggyback 80 mg/100 mlXE "gentamicin in nacl (iso-osm)"4gentamicin injection solution 40 mg/mlXE "gentamicin"4MOhydroxychloroquineXE "hydroxychloroquine"2MOimipenem-cilastatinXE "imipenem-cilastatin"4B/D PA; MOisoniazid oral solutionXE "isoniazid"4MOisoniazid oral tabletXE "isoniazid"2MOivermectin oralXE "ivermectin"3MOlinezolid in dextrose 5%XE "linezolid in dextrose 5%"5PAlinezolid oral suspension for reconstitutionXE "linezolid"5PA; MOlinezolid oral tabletXE "linezolid"4PA; MOlinezolid-0.9% sodium chlorideXE "linezolid-0.9% sodium chloride"5PAmefloquineXE "mefloquine"2MOmeropenemXE "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."4MOmetronidazole in nacl (iso-os)XE "metronidazole in nacl (iso-os)"4MOmetronidazole oral tabletXE "metronidazole"2MOneomycinXE "neomycin"2MOparomomycinXE "paromomycin"4MOPASERXE "PASER"4MOpentamidine inhalationXE "pentamidine"4B/D PA; MOpentamidine injectionXE "pentamidine"4MOPLAQUENILXE "PLAQUENIL"3MOPRIFTINXE "PRIFTIN"4MOPRIMAQUINEXE "PRIMAQUINE"4MOpyrazinamideXE "pyrazinamide"4MOquinine sulfateXE "quinine sulfate"4PA; MO; QL (42 per 7 days)rifabutinXE "rifabutin"4MOrifampinXE "rifampin"4MORIFATERXE "RIFATER"4MOSIRTURO ORAL TABLET 100 MGXE "SIRTURO"5PA; MOSIRTURO ORAL TABLET 20 MGXE "SIRTURO"5PA; LASIVEXTRO INTRAVENOUSXE "SIVEXTRO"5SIVEXTRO ORALXE "SIVEXTRO"5MOtigecyclineXE "tigecycline"5TOBI PODHALER INHALATION CAPSULE, W/INHALATION DEVICEXE "TOBI PODHALER"5PA; MOtobramycin in 0.225 % naclXE "tobramycin in 0.225 % nacl"5B/D PA; MOtobramycin sulfate injection recon solnXE "tobramycin sulfate"4tobramycin sulfate injection solutionXE "tobramycin sulfate"4MOTRECATORXE "TRECATOR"4MOVANCOMYCIN INJECTIONXE "VANCOMYCIN"4vancomycin intravenous recon soln 1,000 mg, 10 gram, 500 mg, 750 mgXE "vancomycin"4MOVANCOMYCIN INTRAVENOUS RECON SOLN 250 MGXE "VANCOMYCIN"4vancomycin oral capsule 125 mgXE "vancomycin"4MOvancomycin oral capsule 250 mgXE "vancomycin"5MOvancomycin oral recon solnXE "vancomycin"4MOXIFAXANXE "XIFAXAN"4MOPENICILLINSamoxicillin oral capsuleXE "amoxicillin"2MOamoxicillin oral suspension for reconstitutionXE "amoxicillin"2MOamoxicillin oral tabletXE "amoxicillin"2MOamoxicillin oral tablet,chewable 125 mgXE "amoxicillin"4MOamoxicillin oral tablet,chewable 250 mgXE "amoxicillin"2MOamoxicillin-pot clavulanate oral suspension for reconstitutionXE "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"4MOnafcillinXE "nafcillin"4MOnafcillin 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"4MOoxacillin injection recon soln 1 gram, 10 gramXE "oxacillin"4oxacillin 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 potassiumXE "penicillin v potassium"2MOPIPERACILLIN-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"2MOciprofloxacin in 5 % dextrose intravenous piggyback 200 mg/100 mlXE "ciprofloxacin in 5 % dextrose"4MOlevofloxacin in d5w intravenous piggyback 500 mg/100 ml, 750 mg/150 mlXE "levofloxacin in d5w"4MOlevofloxacin intravenousXE "levofloxacin"4MOlevofloxacin oral solutionXE "levofloxacin"4MOlevofloxacin oral tabletXE "levofloxacin"2MOSULFA'S / RELATED AGENTSsulfadiazineXE "sulfadiazine"4MOsulfamethoxazole-trimethoprim oral suspensionXE "sulfamethoxazole-trimethoprim"4MOsulfamethoxazole-trimethoprim oral tabletXE "sulfamethoxazole-trimethoprim"2MOTETRACYCLINESdoxy-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 mgXE "doxycycline monohydrate"4MOminocycline oral capsuleXE "minocycline"2MOminocycline oral tabletXE "minocycline"4MOtetracyclineXE "tetracycline"4MOURINARY TRACT AGENTSmethenamine hippurateXE "methenamine hippurate"4MOnitrofurantoinXE "nitrofurantoin"4MOnitrofurantoin macrocrystal oral capsule 100 mg, 50 mgXE "nitrofurantoin macrocrystal"3MOnitrofurantoin monohyd/m-crystXE "nitrofurantoin monohyd/m-cryst"3MOtrimethoprimXE "trimethoprim"2MOANTINEOPLASTIC / IMMUNOSUPPRESSANT DRUGSADJUNCTIVE AGENTSleucovorin calcium oralXE "leucovorin calcium"2MOMESNEX ORALXE "MESNEX"5MOXGEVAXE "XGEVA"5PA; MO; QL (1.7 per 28 days)ANTINEOPLASTIC / IMMUNOSUPPRESSANT DRUGSabirateroneXE "abiraterone"5PA; MO; QL (120 per 30 days)AFINITOR DISPERZ ORAL TABLET FOR SUSPENSION 2 MG, 3 MGXE "AFINITOR DISPERZ"5PA; MO; QL (30 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; MOALUNBRIG ORAL TABLET 180 MG, 90 MGXE "ALUNBRIG"5PA; MO; QL (30 per 30 days)ALUNBRIG ORAL TABLET 30 MGXE "ALUNBRIG"5PA; MO; QL (60 per 30 days)ALUNBRIG ORAL TABLETS,DOSE PACKXE "ALUNBRIG"5PA; MO; QL (30 per 30 days)anastrozoleXE "anastrozole"2MOAYVAKITXE "AYVAKIT"5PA; MO; LA; QL (30 per 30 days)azathioprineXE "azathioprine"2B/D PA; MOBALVERSA ORAL TABLET 3 MGXE "BALVERSA"5PA; MO; LA; QL (90 per 30 days)BALVERSA ORAL TABLET 4 MGXE "BALVERSA"5PA; MO; LA; QL (60 per 30 days)BALVERSA ORAL TABLET 5 MGXE "BALVERSA"5PA; MO; LA; QL (30 per 30 days)bexaroteneXE "bexarotene"5PA; MObicalutamideXE "bicalutamide"2MOBOSULIF ORAL TABLET 100 MGXE "BOSULIF"5PA; MO; QL (90 per 30 days)BOSULIF ORAL TABLET 400 MG, 500 MGXE "BOSULIF"5PA; MO; QL (30 per 30 days)BRAFTOVI ORAL CAPSULE 75 MGXE "BRAFTOVI"5PA; MO; LA; QL (180 per 30 days)BRUKINSAXE "BRUKINSA"5PA; MO; LA; QL (120 per 30 days)CABOMETYXXE "CABOMETYX"5PA; MOCALQUENCEXE "CALQUENCE"5PA; MO; LA; QL (60 per 30 days)CAPRELSA ORAL TABLET 100 MGXE "CAPRELSA"5PA; QL (60 per 30 days)CAPRELSA ORAL TABLET 300 MGXE "CAPRELSA"5PA; MO; QL (30 per 30 days)COMETRIQ ORAL CAPSULE 100 MG/DAY(80 MG X1-20 MG X1)XE "COMETRIQ"5PA; MO; QL (56 per 28 days)COMETRIQ ORAL CAPSULE 140 MG/DAY(80 MG X1-20 MG X3)XE "COMETRIQ"5PA; MO; QL (112 per 28 days)COMETRIQ ORAL CAPSULE 60 MG/DAY (20 MG X 3/DAY)XE "COMETRIQ"5PA; MO; QL (84 per 28 days)COPIKTRAXE "COPIKTRA"5PA; MO; QL (60 per 30 days)COTELLICXE "COTELLIC"5PA; MO; QL (63 per 28 days)cyclophosphamide oral capsuleXE "cyclophosphamide"2B/D PA; MOcyclosporine modifiedXE "cyclosporine modified"4B/D PA; MOcyclosporine oral capsuleXE "cyclosporine"4B/D PA; MODAURISMOXE "DAURISMO"5PA; MODROXIAXE "DROXIA"3MOELIGARDXE "ELIGARD"4PA; MOELIGARD (3 MONTH)XE "ELIGARD (3 MONTH)"4PA; MOELIGARD (4 MONTH)XE "ELIGARD (4 MONTH)"4PA; MOELIGARD (6 MONTH)XE "ELIGARD (6 MONTH)"4PA; MOEMCYTXE "EMCYT"4MOENVARSUS XRXE "ENVARSUS XR"4B/D PA; MOERIVEDGEXE "ERIVEDGE"5PA; MO; QL (28 per 28 days)ERLEADAXE "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; QL (6 per 21 days)flutamideXE "flutamide"4MOgengraf oral capsule 100 mg, 25 mgXE "gengraf"4B/D PA; MOgengraf oral solutionXE "gengraf"4B/D PA; MOGILOTRIFXE "GILOTRIF"5PA; MO; QL (30 per 30 days)hydroxyureaXE "hydroxyurea"2MOIBRANCEXE "IBRANCE"5PA; MO; QL (21 per 28 days)ICLUSIG ORAL TABLET 15 MGXE "ICLUSIG"5PA; QL (60 per 30 days)ICLUSIG ORAL TABLET 45 MGXE "ICLUSIG"5PA; QL (30 per 30 days)IDHIFAXE "IDHIFA"5PA; MO; LA; QL (30 per 30 days)imatinibXE "imatinib"5PA; MO; QL (90 per 30 days)IMBRUVICA ORAL CAPSULE 140 MGXE "IMBRUVICA"5PA; MO; QL (120 per 30 days)IMBRUVICA ORAL CAPSULE 70 MGXE "IMBRUVICA"5PA; MO; QL (30 per 30 days)IMBRUVICA ORAL TABLETXE "IMBRUVICA"5PA; MO; QL (30 per 30 days)INLYTA ORAL TABLET 1 MGXE "INLYTA"5PA; MO; QL (180 per 30 days)INLYTA ORAL TABLET 5 MGXE "INLYTA"5PA; MO; QL (60 per 30 days)INREBICXE "INREBIC"5PA; MO; QL (120 per 30 days)IRESSAXE "IRESSA"5PA; MOJAKAFIXE "JAKAFI"5PA; MO; QL (60 per 30 days)KISQALIXE "KISQALI"5PA; MOKISQALI FEMARA CO-PACKXE "KISQALI FEMARA CO-PACK"5PA; MOLENVIMAXE "LENVIMA"5PA; MOletrozoleXE "letrozole"2MOLEUKERANXE "LEUKERAN"4MOleuprolide subcutaneous kitXE "leuprolide"3PA; MOLONSURFXE "LONSURF"5PA; MOLORBRENA ORAL TABLET 100 MGXE "LORBRENA"5PA; MO; QL (30 per 30 days)LORBRENA ORAL TABLET 25 MGXE "LORBRENA"5PA; MO; QL (90 per 30 days)LUPRON DEPOTXE "LUPRON DEPOT"5PA; MOLUPRON DEPOT (3 MONTH)XE "LUPRON DEPOT (3 MONTH)"5PA; MOLUPRON DEPOT (4 MONTH)XE "LUPRON DEPOT (4 MONTH)"5PA; MOLUPRON DEPOT (6 MONTH)XE "LUPRON DEPOT (6 MONTH)"5PA; MOLUPRON 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"5PA; MOLYNPARZA ORAL TABLETXE "LYNPARZA"5PA; MO; LA; QL (120 per 30 days)LYSODRENXE "LYSODREN"3MOMATULANEXE "MATULANE"5MOmegestrol oral suspension 400 mg/10 ml (10 ml)XE "megestrol"4PAmegestrol oral suspension 400 mg/10 ml (40 mg/ml), 625 mg/5 ml (125 mg/ml)XE "megestrol"4PA; MOmegestrol oral tabletXE "megestrol"2PA; MOMEKINIST ORAL TABLET 0.5 MGXE "MEKINIST"5PA; MO; LA; QL (90 per 30 days)MEKINIST ORAL TABLET 2 MGXE "MEKINIST"5PA; MO; LA; QL (30 per 30 days)MEKTOVIXE "MEKTOVI"5PA; MO; LA; QL (180 per 30 days)mercaptopurineXE "mercaptopurine"4MOmethotrexate sodium (pf) injection solutionXE "methotrexate sodium (pf)"4B/D PA; MOmethotrexate sodium injectionXE "methotrexate sodium"4B/D PA; MOmethotrexate sodium oralXE "methotrexate sodium"2B/D PA; MOmycophenolate 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; LA; QL (180 per 30 days)NEXAVARXE "NEXAVAR"5PA; MO; LA; QL (120 per 30 days)nilutamideXE "nilutamide"5MO; QL (60 per 30 days)NINLAROXE "NINLARO"5PA; MONUBEQAXE "NUBEQA"5PA; MO; LAoctreotide acetate injection solution 1,000 mcg/ml, 100 mcg/ml, 200 mcg/ml, 500 mcg/mlXE "octreotide acetate"4PA; MOoctreotide acetate injection solution 50 mcg/mlXE "octreotide acetate"3PA; MOODOMZOXE "ODOMZO"5PA; MOPEMAZYREXE "PEMAZYRE"5PA; MO; QL (14 per 21 days)PIQRAYXE "PIQRAY"5PA; MOPOMALYSTXE "POMALYST"5PA; MO; 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; LA; QL (180 per 30 days)RETEVMO ORAL CAPSULE 80 MGXE "RETEVMO"5PA; MO; LA; QL (120 per 30 days)REVLIMID ORAL CAPSULE 10 MG, 15 MG, 2.5 MG, 25 MG, 5 MGXE "REVLIMID"5PA; MO; LA; QL (28 per 28 days)REVLIMID ORAL CAPSULE 20 MGXE "REVLIMID"5PA; MO; QL (28 per 28 days)ROZLYTREK ORAL CAPSULE 100 MGXE "ROZLYTREK"5PA; MO; QL (150 per 30 days)ROZLYTREK ORAL CAPSULE 200 MGXE "ROZLYTREK"5PA; MO; QL (90 per 30 days)RUBRACAXE "RUBRACA"5PA; MO; LARYDAPTXE "RYDAPT"5PA; MO; QL (240 per 30 days)SANDIMMUNE ORAL SOLUTIONXE "SANDIMMUNE"4B/D PA; MOSIGNIFORXE "SIGNIFOR"5PA; MO; LA; QL (60 per 30 days)sirolimus oral solutionXE "sirolimus"5B/D PA; MOsirolimus oral tabletXE "sirolimus"4B/D PA; MOSOLTAMOXXE "SOLTAMOX"4PA; MOSOMATULINE DEPOT SUBCUTANEOUS SYRINGE 120 MG/0.5 MLXE "SOMATULINE DEPOT"5PA; MO; QL (0.5 per 28 days)SOMATULINE DEPOT SUBCUTANEOUS SYRINGE 60 MG/0.2 MLXE "SOMATULINE DEPOT"5PA; MO; QL (0.2 per 28 days)SOMATULINE DEPOT SUBCUTANEOUS SYRINGE 90 MG/0.3 MLXE "SOMATULINE DEPOT"5PA; MO; QL (0.3 per 28 days)SPRYCEL ORAL TABLET 100 MG, 140 MG, 50 MG, 80 MGXE "SPRYCEL"5PA; MO; QL (30 per 30 days)SPRYCEL ORAL TABLET 20 MG, 70 MGXE "SPRYCEL"5PA; MO; QL (60 per 30 days)STIVARGAXE "STIVARGA"5PA; MO; QL (84 per 28 days)SUTENTXE "SUTENT"5PA; MO; QL (28 per 28 days)SYNRIBOXE "SYNRIBO"5PA; MOTABLOIDXE "TABLOID"4MOTABRECTAXE "TABRECTA"5PA; MOtacrolimus oralXE "tacrolimus"4B/D PA; MOTAFINLARXE "TAFINLAR"5PA; MO; LA; QL (120 per 30 days)TAGRISSOXE "TAGRISSO"5PA; MOTALZENNAXE "TALZENNA"5PA; MOtamoxifenXE "tamoxifen"2MOTARGRETIN TOPICALXE "TARGRETIN"5PA; MOTASIGNAXE "TASIGNA"5PA; MO; QL (120 per 30 days)TAZVERIKXE "TAZVERIK"5PA; MO; QL (240 per 30 days)THALOMID ORAL CAPSULE 100 MG, 200 MG, 50 MGXE "THALOMID"5PA; MO; QL (30 per 30 days)THALOMID ORAL CAPSULE 150 MGXE "THALOMID"5PA; MO; QL (60 per 30 days)TIBSOVOXE "TIBSOVO"5PA; MO; LA; QL (60 per 30 days)toremifeneXE "toremifene"5PA; MO; QL (30 per 30 days)TRELSTAR 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; LA; QL (120 per 30 days)TUKYSA ORAL TABLET 50 MGXE "TUKYSA"5PA; MO; LA; QL (300 per 30 days)TURALIOXE "TURALIO"5PA; MO; LA; QL (120 per 30 days)TYKERBXE "TYKERB"5PA; MO; QL (180 per 30 days)VENCLEXTA ORAL TABLET 10 MG, 50 MGXE "VENCLEXTA"4PA; MO; LAVENCLEXTA ORAL TABLET 100 MGXE "VENCLEXTA"5PA; MO; LAVENCLEXTA STARTING PACKXE "VENCLEXTA STARTING PACK"3PA; MO; LAVERZENIOXE "VERZENIO"5PA; MO; LA; QL (60 per 30 days)VITRAKVI ORAL CAPSULE 100 MGXE "VITRAKVI"5PA; MO; QL (60 per 30 days)VITRAKVI ORAL CAPSULE 25 MGXE "VITRAKVI"5PA; MO; QL (180 per 30 days)VITRAKVI ORAL SOLUTIONXE "VITRAKVI"5PA; MOVIZIMPROXE "VIZIMPRO"5PA; MO; QL (30 per 30 days)VOTRIENTXE "VOTRIENT"5PA; MO; QL (120 per 30 days)XALKORIXE "XALKORI"5PA; MO; QL (60 per 30 days)XATMEPXE "XATMEP"4B/D PA; MOXOSPATAXE "XOSPATA"5PA; MO; LA; QL (90 per 30 days)XPOVIO 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; QL (120 per 30 days)YONSAXE "YONSA"5PA; MO; QL (120 per 30 days)ZEJULAXE "ZEJULA"5PA; MO; QL (90 per 30 days)ZELBORAFXE "ZELBORAF"5PA; MO; QL (240 per 30 days)ZOLINZAXE "ZOLINZA"5PA; MO; QL (120 per 30 days)ZORTRESS ORAL TABLET 0.25 MG, 0.75 MG, 1 MGXE "ZORTRESS"5B/D PA; MO; QL (60 per 30 days)ZORTRESS ORAL TABLET 0.5 MGXE "ZORTRESS"5B/D PA; MO; QL (120 per 30 days)ZYDELIGXE "ZYDELIG"5PA; MO; QL (60 per 30 days)ZYKADIA ORAL TABLETXE "ZYKADIA"5PA; MO; QL (90 per 30 days)ZYTIGA ORAL TABLET 500 MGXE "ZYTIGA"5PA; MO; QL (60 per 30 days)AUTONOMIC / CNS DRUGS, NEUROLOGY / PSYCHANTICONVULSANTSAPTIOM ORAL TABLET 200 MG, 400 MG, 800 MGXE "APTIOM"5ST; MO; QL (30 per 30 days)APTIOM ORAL TABLET 600 MGXE "APTIOM"5ST; MO; QL (60 per 30 days)BANZEL ORAL SUSPENSIONXE "BANZEL"5ST; MO; QL (2760 per 30 days)BANZEL ORAL TABLET 200 MGXE "BANZEL"5ST; MO; QL (480 per 30 days)BANZEL ORAL TABLET 400 MGXE "BANZEL"5ST; MO; QL (240 per 30 days)BRIVIACT ORALXE "BRIVIACT"4MOcarbamazepine oral capsule, er multiphase 12 hrXE "carbamazepine"4MOcarbamazepine oral suspension 100 mg/5 mlXE "carbamazepine"4MOcarbamazepine oral tabletXE "carbamazepine"4MOcarbamazepine oral tablet extended release 12 hrXE "carbamazepine"4MOcarbamazepine oral tablet,chewableXE "carbamazepine"4MOCELONTIN ORAL CAPSULE 300 MGXE "CELONTIN"4MOclobazam oral suspensionXE "clobazam"4MO; QL (480 per 30 days)clobazam oral tabletXE "clobazam"4MO; QL (60 per 30 days)clonazepam 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"4MO; QL (90 per 30 days)clonazepam oral tablet,disintegrating 2 mgXE "clonazepam"4MO; QL (300 per 30 days)DIASTATXE "DIASTAT"4MODIASTAT ACUDIALXE "DIASTAT ACUDIAL"4MOdiazepam rectalXE "diazepam"4MODILANTIN 30 MGXE "DILANTIN 30 MG"4MOdivalproex oral capsule, delayed rel sprinkleXE "divalproex"4MOdivalproex oral tablet extended release 24 hrXE "divalproex"4MOdivalproex oral tablet,delayed release (dr/ec)XE "divalproex"3MOEPIDIOLEXXE "EPIDIOLEX"4PA; MOepitolXE "epitol"3MOethosuximideXE "ethosuximide"2MOfelbamate oral suspensionXE "felbamate"5MOfelbamate oral tabletXE "felbamate"4MOFYCOMPA ORAL SUSPENSIONXE "FYCOMPA"4ST; MOFYCOMPA ORAL TABLET 10 MG, 2 MG, 4 MG, 6 MG, 8 MGXE "FYCOMPA"4ST; MO; QL (30 per 30 days)FYCOMPA ORAL TABLET 12 MGXE "FYCOMPA"5ST; MO; QL (30 per 30 days)gabapentin oral capsuleXE "gabapentin"2MOgabapentin oral solution 250 mg/5 mlXE "gabapentin"4MOgabapentin oral solution 250 mg/5 ml (5 ml), 300 mg/6 ml (6 ml)XE "gabapentin"4gabapentin 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"2MOlamotrigine oral tablet extended release 24hrXE "lamotrigine"4MOlamotrigine oral tablet, chewable dispersibleXE "lamotrigine"2MOlevetiracetam oral solution 100 mg/mlXE "levetiracetam"4MOlevetiracetam oral solution 500 mg/5 ml (5 ml)XE "levetiracetam"4levetiracetam oral tablet 1,000 mg, 750 mgXE "levetiracetam"3MOlevetiracetam oral tablet 250 mg, 500 mgXE "levetiracetam"2MOlevetiracetam oral tablet extended release 24 hrXE "levetiracetam"4MONAYZILAMXE "NAYZILAM"4MO; QL (10 per 30 days)oxcarbazepine oral suspensionXE "oxcarbazepine"4MOoxcarbazepine oral tabletXE "oxcarbazepine"2MOPEGANONEXE "PEGANONE"4MOphenobarbital oral elixirXE "phenobarbital"4MOphenobarbital oral tablet 100 mg, 15 mg, 30 mg, 60 mgXE "phenobarbital"2MOphenobarbital oral tablet 16.2 mg, 32.4 mg, 64.8 mg, 97.2 mgXE "phenobarbital"4MOphenytoin oral suspension 100 mg/4 mlXE "phenytoin"4phenytoin oral suspension 125 mg/5 mlXE "phenytoin"4MOphenytoin oral tablet,chewableXE "phenytoin"4MOphenytoin sodium extendedXE "phenytoin sodium extended"2MOpregabalinXE "pregabalin"3MOprimidoneXE "primidone"2MOSPRITAM ORAL TABLET FOR SUSPENSION 1,000 MGXE "SPRITAM"4MO; QL (90 per 30 days)SPRITAM ORAL TABLET FOR SUSPENSION 250 MG, 500 MG, 750 MGXE "SPRITAM"4MO; QL (120 per 30 days)SYMPAZAN ORAL FILM 10 MG, 20 MGXE "SYMPAZAN"5MO; QL (60 per 30 days)SYMPAZAN ORAL FILM 5 MGXE "SYMPAZAN"4MO; QL (60 per 30 days)tiagabineXE "tiagabine"4MOtopiramate oral capsule, sprinkleXE "topiramate"4MOtopiramate 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"4MO; QL (10 per 30 days)vigabatrin oral powder in packetXE "vigabatrin"5PA; MO; LA; QL (180 per 30 days)vigabatrin oral tabletXE "vigabatrin"5PA; MO; QL (180 per 30 days)vigadroneXE "vigadrone"5PA; MO; QL (180 per 30 days)VIMPAT ORAL SOLUTIONXE "VIMPAT"4MO; QL (1200 per 30 days)VIMPAT ORAL TABLET 100 MGXE "VIMPAT"4MO; QL (120 per 30 days)VIMPAT ORAL TABLET 150 MG, 200 MG, 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; QL (60 per 30 days)benztropine oralXE "benztropine"2MObromocriptineXE "bromocriptine"4MOcarbidopaXE "carbidopa"4MOcarbidopa-levodopa oral tabletXE "carbidopa-levodopa"2MOcarbidopa-levodopa oral tablet extended releaseXE "carbidopa-levodopa"2MOcarbidopa-levodopa oral tablet,disintegratingXE "carbidopa-levodopa"4MOcarbidopa-levodopa-entacaponeXE "carbidopa-levodopa-entacapone"4MOentacaponeXE "entacapone"4MOGOCOVRI ORAL CAPSULE,EXTENDED RELEASE 24HR 137 MGXE "GOCOVRI"5PA; MO; QL (60 per 30 days)GOCOVRI ORAL CAPSULE,EXTENDED RELEASE 24HR 68.5 MGXE "GOCOVRI"5PA; MO; QL (31 per 31 days)NEUPROXE "NEUPRO"4MOpramipexole oral tabletXE "pramipexole"2MOpramipexole oral tablet extended release 24 hr 3.75 mgXE "pramipexole"2MOrasagilineXE "rasagiline"4MOropinirole oral tabletXE "ropinirole"2MORYTARYXE "RYTARY"4MOselegiline hclXE "selegiline hcl"3MOtrihexyphenidyl oral elixirXE "trihexyphenidyl"4MOtrihexyphenidyl oral tabletXE "trihexyphenidyl"2MOMIGRAINE / CLUSTER HEADACHE THERAPYAJOVY AUTOINJECTORXE "AJOVY AUTOINJECTOR"3PA; MO; QL (1.5 per 30 days)AJOVY SYRINGEXE "AJOVY SYRINGE"3PA; MO; QL (1.5 per 30 days)dihydroergotamine nasalXE "dihydroergotamine"5MO; QL (8 per 28 days)ergotamine-caffeineXE "ergotamine-caffeine"2MOmigergotXE "migergot"4MO; QL (20 per 28 days)naratriptanXE "naratriptan"4MO; 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 cartridgeXE "sumatriptan succinate"4MOsumatriptan succinate subcutaneous pen injectorXE "sumatriptan succinate"4MOsumatriptan succinate subcutaneous solutionXE "sumatriptan succinate"4MO; QL (8 per 28 days)sumatriptan succinate subcutaneous syringe 6 mg/0.5 mlXE "sumatriptan succinate"4MOzolmitriptanXE "zolmitriptan"4MO; QL (18 per 28 days)MISCELLANEOUS NEUROLOGICAL THERAPYAUSTEDOXE "AUSTEDO"5PA; MOCOPAXONE SUBCUTANEOUS SYRINGE 20 MG/MLXE "COPAXONE"5PA; MO; QL (30 per 30 days)COPAXONE SUBCUTANEOUS SYRINGE 40 MG/MLXE "COPAXONE"5PA; MO; QL (12 per 28 days)dalfampridineXE "dalfampridine"5PA; MO; QL (60 per 30 days)donepezil oral tablet 10 mg, 5 mgXE "donepezil"2MOdonepezil oral tablet 23 mgXE "donepezil"4MOdonepezil oral tablet,disintegratingXE "donepezil"4MOFIRDAPSEXE "FIRDAPSE"5PA; MO; QL (240 per 30 days)galantamine oral capsule,ext rel. pellets 24 hrXE "galantamine"4MO; QL (30 per 30 days)galantamine oral solutionXE "galantamine"4MO; QL (200 per 30 days)galantamine oral tabletXE "galantamine"4MO; QL (60 per 30 days)GILENYA ORAL CAPSULE 0.5 MGXE "GILENYA"5PA; MO; QL (30 per 30 days)MAYZENT ORAL TABLET 0.25 MGXE "MAYZENT"5PA; MO; QL (120 per 30 days)MAYZENT ORAL TABLET 2 MGXE "MAYZENT"5PA; MO; QL (30 per 30 days)memantine oral capsule,sprinkle,er 24hrXE "memantine"3MOmemantine oral solutionXE "memantine"4MO; QL (300 per 30 days)memantine oral tabletXE "memantine"3MOMEMANTINE ORAL TABLETS,DOSE PACKXE "MEMANTINE"3MONAMZARICXE "NAMZARIC"3MONUEDEXTAXE "NUEDEXTA"3PA; MOrivastigmineXE "rivastigmine"4MOrivastigmine tartrateXE "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 30 days)TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC) 240 MGXE "TECFIDERA"5PA; MO; QL (60 per 30 days)TEGSEDIXE "TEGSEDI"5PA; MO; LA; QL (6 per 28 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"2MOBACLOFEN ORAL TABLET 5 MGXE "BACLOFEN"2MOcyclobenzaprine oral tablet 10 mg, 5 mgXE "cyclobenzaprine"2MO; QL (90 per 30 days)metaxalone oral tablet 800 mgXE "metaxalone"4MOmethocarbamol oralXE "methocarbamol"3MOorphenadrine citrate oralXE "orphenadrine citrate"4MOpyridostigmine bromide oral syrupXE "pyridostigmine bromide"4MOpyridostigmine bromide oral tablet 60 mgXE "pyridostigmine bromide"2MOpyridostigmine bromide oral tablet extended releaseXE "pyridostigmine bromide"2MOtizanidine 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"3QL (5000 per 30 days)acetaminophen-codeine oral solution 120-12 mg/5 mlXE "acetaminophen-codeine"3MO; QL (5000 per 30 days)acetaminophen-codeine oral tablet 300-15 mg, 300-30 mgXE "acetaminophen-codeine"3MO; QL (360 per 30 days)acetaminophen-codeine oral tablet 300-60 mgXE "acetaminophen-codeine"3MO; QL (180 per 30 days)buprenorphine hcl sublingualXE "buprenorphine hcl"2MObutalbital compound w/codeineXE "butalbital compound w/codeine"4MO; QL (180 per 30 days)butalbital-acetaminophen oral tablet 50-325 mgXE "butalbital-acetaminophen"4MO; QL (360 per 30 days)butalbital-acetaminophen-caff oral tablet 50-325-40 mgXE "butalbital-acetaminophen-caff"4MO; QL (180 per 30 days)butalbital-aspirin-caffeine oral capsuleXE "butalbital-aspirin-caffeine"4MO; QL (180 per 30 days)codeine sulfate oral tablet 30 mg, 60 mgXE "codeine sulfate"4MO; QL (180 per 30 days)codeine-butalbital-asa-caffXE "codeine-butalbital-asa-caff"4MO; QL (180 per 30 days)endocet oral tablet 10-325 mg, 7.5-325 mgXE "endocet"4MO; QL (360 per 30 days)endocet oral tablet 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"4MO; QL (10 per 30 days)hydrocodone-acetaminophen oral solution 7.5-325 mg/15 mlXE "hydrocodone-acetaminophen"4MO; QL (5500 per 30 days)hydrocodone-acetaminophen oral tablet 10-325 mg, 5-325 mg, 7.5-325 mgXE "hydrocodone-acetaminophen"3MO; QL (360 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)"4MO; QL (240 per 30 days)hydromorphone oral liquidXE "hydromorphone"4MO; QL (1984 per 30 days)hydromorphone oral tablet 2 mg, 4 mgXE "hydromorphone"3MO; QL (180 per 30 days)hydromorphone oral tablet 8 mgXE "hydromorphone"4MO; QL (180 per 30 days)ibuprofen-oxycodoneXE "ibuprofen-oxycodone"4MO; QL (28 per 23 days)lorcet (hydrocodone)XE "lorcet (hydrocodone)"3MO; QL (360 per 30 days)methadone oral tablet 10 mgXE "methadone"2MO; QL (120 per 30 days)methadone oral tablet 5 mgXE "methadone"2MO; QL (240 per 30 days)morphine concentrate oral solutionXE "morphine concentrate"4MO; QL (300 per 30 days)morphine oral solutionXE "morphine"4MO; QL (900 per 30 days)morphine oral tabletXE "morphine"3MO; QL (180 per 30 days)morphine oral tablet extended release 100 mg, 200 mg, 30 mg, 60 mgXE "morphine"4MO; QL (90 per 30 days)morphine oral tablet extended release 15 mgXE "morphine"2MO; 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 (1080 per 30 days)oxycodone oral tablet 10 mg, 15 mg, 20 mg, 30 mgXE "oxycodone"4MO; QL (180 per 30 days)oxycodone oral tablet 5 mgXE "oxycodone"2MO; QL (180 per 30 days)oxycodone-acetaminophen oral tablet 10-325 mg, 2.5-325 mg, 7.5-325 mgXE "oxycodone-acetaminophen"4MO; QL (360 per 30 days)oxycodone-acetaminophen oral tablet 5-325 mgXE "oxycodone-acetaminophen"3MO; QL (360 per 30 days)oxycodone-aspirinXE "oxycodone-aspirin"4MO; QL (360 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 tabletXE "buprenorphine-naloxone"2MOcelecoxibXE "celecoxib"4MOdiclofenac potassiumXE "diclofenac potassium"4MOdiclofenac sodium oral tablet extended release 24 hrXE "diclofenac sodium"4MOdiclofenac sodium oral tablet,delayed release (dr/ec) 25 mgXE "diclofenac sodium"4MOdiclofenac sodium oral tablet,delayed release (dr/ec) 50 mg, 75 mgXE "diclofenac sodium"2MOdiclofenac sodium topical dropsXE "diclofenac sodium"4MOdiclofenac sodium topical gel 1 %XE "diclofenac sodium"4MOdiflunisalXE "diflunisal"4MOec-naproxenXE "ec-naproxen"2MOetodolacXE "etodolac"4MOflurbiprofen oral tablet 100 mgXE "flurbiprofen"2MOibu oral tablet 600 mg, 800 mgXE "ibu"1MOibuprofen oral suspensionXE "ibuprofen"1MOibuprofen oral tablet 400 mg, 600 mg, 800 mgXE "ibuprofen"1MOindomethacin oral capsuleXE "indomethacin"4MOketoprofen oral capsule 25 mgXE "ketoprofen"2MOketorolac oralXE "ketorolac"4MO; QL (20 per 30 days)meloxicam oral tabletXE "meloxicam"1MOnabumetoneXE "nabumetone"2MOnaloxone injection solutionXE "naloxone"2MOnaloxone injection syringeXE "naloxone"2MOnaltrexoneXE "naltrexone"2MOnaproxen oral suspensionXE "naproxen"4MOnaproxen oral tabletXE "naproxen"1MOnaproxen oral tablet,delayed release (dr/ec)XE "naproxen"2MOnaproxen sodium oral tablet 275 mg, 550 mgXE "naproxen sodium"4MONARCAN NASAL SPRAY,NON-AEROSOL 4 MG/ACTUATIONXE "NARCAN"3MONUCYNTA ERXE "NUCYNTA ER"4MOoxaprozinXE "oxaprozin"4MOpiroxicamXE "piroxicam"4MOSUBOXONEXE "SUBOXONE"3MOsulindacXE "sulindac"2MOTRAMADOL ORAL TABLET 100 MGXE "TRAMADOL"2MO; QL (120 per 30 days)tramadol oral tablet 50 mgXE "tramadol"2MO; QL (240 per 30 days)tramadol-acetaminophenXE "tramadol-acetaminophen"3MO; QL (240 per 30 days)PSYCHOTHERAPEUTIC DRUGSABILIFY MAINTENAXE "ABILIFY MAINTENA"5MOABILIFY MYCITEXE "ABILIFY MYCITE"5MOalprazolam 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"2MOamoxapineXE "amoxapine"4ST; MOaripiprazole oral solutionXE "aripiprazole"4MO; QL (750 per 30 days)aripiprazole oral tabletXE "aripiprazole"4MO; QL (30 per 30 days)aripiprazole oral tablet,disintegratingXE "aripiprazole"4MO; QL (60 per 30 days)armodafinil oral tablet 150 mg, 200 mg, 250 mgXE "armodafinil"4PA; MO; QL (30 per 30 days)armodafinil oral tablet 50 mgXE "armodafinil"3PA; MO; QL (30 per 30 days)atomoxetine oral capsule 10 mg, 18 mg, 25 mg, 40 mgXE "atomoxetine"4MO; QL (60 per 30 days)atomoxetine oral capsule 100 mg, 60 mg, 80 mgXE "atomoxetine"4MO; QL (30 per 30 days)bupropion hcl oral tabletXE "bupropion hcl"3MO; QL (180 per 30 days)bupropion hcl oral tablet extended release 24 hr 150 mg, 300 mgXE "bupropion hcl"3MO; QL (90 per 30 days)bupropion hcl oral tablet sustained-release 12 hr 100 mgXE "bupropion hcl"3MO; QL (120 per 30 days)bupropion hcl oral tablet sustained-release 12 hr 150 mgXE "bupropion hcl"3MO; QL (90 per 30 days)bupropion hcl oral tablet sustained-release 12 hr 200 mgXE "bupropion hcl"3MO; QL (60 per 30 days)buspironeXE "buspirone"2MOCAPLYTAXE "CAPLYTA"5MO; QL (30 per 30 days)chlordiazepoxide hclXE "chlordiazepoxide hcl"2MO; QL (120 per 30 days)chlorpromazine oral tablet 10 mg, 25 mgXE "chlorpromazine"4B/D PA; MOchlorpromazine oral tablet 100 mg, 200 mg, 50 mgXE "chlorpromazine"4MOcitalopram oral solutionXE "citalopram"4MOcitalopram oral tabletXE "citalopram"1MOclomipramineXE "clomipramine"4ST; MOclorazepate dipotassiumXE "clorazepate dipotassium"4MOclozapine oral tablet 100 mgXE "clozapine"4ST; MO; QL (180 per 30 days)clozapine oral tablet 200 mgXE "clozapine"4ST; MO; QL (120 per 30 days)clozapine oral tablet 25 mg, 50 mgXE "clozapine"3MOclozapine oral tablet,disintegrating 100 mgXE "clozapine"4ST; QL (180 per 30 days)clozapine oral tablet,disintegrating 12.5 mgXE "clozapine"4ST; QL (120 per 30 days)CLOZAPINE ORAL TABLET,DISINTEGRATING 150 MGXE "CLOZAPINE"4ST; QL (180 per 30 days)CLOZAPINE ORAL TABLET,DISINTEGRATING 200 MGXE "CLOZAPINE"4ST; QL (120 per 30 days)clozapine oral tablet,disintegrating 25 mgXE "clozapine"4ST; QL (90 per 30 days)desipramineXE "desipramine"4MODESVENLAFAXINE ORAL TABLET EXTENDED RELEASE 24 HR 100 MGXE "DESVENLAFAXINE"4MO; QL (120 per 30 days)DESVENLAFAXINE ORAL TABLET EXTENDED RELEASE 24 HR 50 MGXE "DESVENLAFAXINE"4MO; QL (30 per 30 days)desvenlafaxine succinateXE "desvenlafaxine succinate"4MO; QL (30 per 30 days)dexmethylphenidate oral tablet 10 mgXE "dexmethylphenidate"3MO; QL (60 per 30 days)dexmethylphenidate oral tablet 2.5 mgXE "dexmethylphenidate"3MO; QL (90 per 30 days)dexmethylphenidate oral tablet 5 mgXE "dexmethylphenidate"3MO; QL (120 per 30 days)dextroamphetamine oral capsule, extended release 10 mgXE "dextroamphetamine"2MO; QL (180 per 30 days)dextroamphetamine oral capsule, extended release 15 mgXE "dextroamphetamine"2MO; QL (120 per 30 days)dextroamphetamine oral capsule, extended release 5 mgXE "dextroamphetamine"2MO; QL (360 per 30 days)dextroamphetamine oral solutionXE "dextroamphetamine"4MOdextroamphetamine oral tablet 10 mgXE "dextroamphetamine"4MO; QL (180 per 30 days)dextroamphetamine oral tablet 5 mgXE "dextroamphetamine"4MO; QL (150 per 30 days)dextroamphetamine-amphetamine oral capsule,extended release 24hr 20 mg, 25 mg, 30 mgXE "dextroamphetamine-amphetamine"4MOdextroamphetamine-amphetamine oral tablet 10 mg, 12.5 mg, 15 mg, 20 mg, 5 mg, 7.5 mgXE "dextroamphetamine-amphetamine"2MO; QL (90 per 30 days)dextroamphetamine-amphetamine oral tablet 30 mgXE "dextroamphetamine-amphetamine"2MO; QL (60 per 30 days)diazepam intensolXE "diazepam intensol"4MO; QL (240 per 30 days)diazepam oral concentrateXE "diazepam"4MO; QL (240 per 30 days)diazepam oral solution 5 mg/5 ml (1 mg/ml)XE "diazepam"4MO; QL (1200 per 30 days)diazepam oral tabletXE "diazepam"2MO; QL (120 per 30 days)doxepin oral capsuleXE "doxepin"4MOdoxepin oral concentrateXE "doxepin"4MODRIZALMA SPRINKLEXE "DRIZALMA SPRINKLE"4MO; QL (60 per 30 days)duloxetineXE "duloxetine"4MO; QL (60 per 30 days)EMSAMXE "EMSAM"5ST; MO; QL (30 per 30 days)escitalopram oxalate oral solutionXE "escitalopram oxalate"4MO; QL (600 per 30 days)escitalopram oxalate oral tabletXE "escitalopram oxalate"2MOFANAPT ORAL TABLET 1 MG, 2 MG, 4 MGXE "FANAPT"4ST; MO; QL (60 per 30 days)FANAPT ORAL TABLET 10 MG, 12 MG, 6 MG, 8 MGXE "FANAPT"5ST; MO; QL (60 per 30 days)FANAPT ORAL TABLETS,DOSE PACKXE "FANAPT"4ST; MO; QL (8 per 28 days)FETZIMA ORAL CAPSULE,EXT REL 24HR DOSE PACKXE "FETZIMA"3MO; QL (28 per 28 days)FETZIMA ORAL CAPSULE,EXTENDED RELEASE 24 HRXE "FETZIMA"3MO; QL (30 per 30 days)fluoxetine oral capsuleXE "fluoxetine"2MOfluoxetine oral solutionXE "fluoxetine"2MOfluoxetine oral tablet 10 mg, 20 mgXE "fluoxetine"3MOfluphenazine decanoateXE "fluphenazine decanoate"4MOfluphenazine hcl injectionXE "fluphenazine hcl"4MOfluphenazine hcl oral concentrateXE "fluphenazine hcl"4MOfluphenazine hcl oral elixirXE "fluphenazine hcl"4MOfluphenazine hcl oral tabletXE "fluphenazine hcl"2MOfluvoxamine oral tabletXE "fluvoxamine"3MO; QL (90 per 30 days)GEODON INTRAMUSCULARXE "GEODON"4ST; MO; QL (18 per 30 days)guanfacine oral tablet extended release 24 hrXE "guanfacine"4MOguanidineXE "guanidine"3MOhaloperidol decanoate intramuscular solution 100 mg/ml, 100 mg/ml (1 ml), 50 mg/mlXE "haloperidol decanoate"4MOhaloperidol decanoate intramuscular solution 50 mg/ml(1ml)XE "haloperidol decanoate"2MOhaloperidol lactate injectionXE "haloperidol lactate"4MOhaloperidol lactate oralXE "haloperidol lactate"4MOhaloperidol oral tablet 0.5 mgXE "haloperidol"2MOhaloperidol oral tablet 1 mg, 10 mg, 2 mg, 5 mgXE "haloperidol"3MOhaloperidol oral tablet 20 mgXE "haloperidol"4MOimipramine hclXE "imipramine hcl"4MOINVEGA ORAL TABLET EXTENDED RELEASE 24HR 1.5 MG, 3 MG, 9 MGXE "INVEGA"5ST; MO; QL (30 per 30 days)INVEGA ORAL TABLET EXTENDED RELEASE 24HR 6 MGXE "INVEGA"5ST; MO; QL (60 per 30 days)INVEGA SUSTENNA INTRAMUSCULAR SYRINGE 117 MG/0.75 ML, 156 MG/ML, 234 MG/1.5 ML, 78 MG/0.5 MLXE "INVEGA SUSTENNA"5MOINVEGA SUSTENNA INTRAMUSCULAR SYRINGE 39 MG/0.25 MLXE "INVEGA SUSTENNA"4MOINVEGA TRINZAXE "INVEGA TRINZA"5MOLATUDA ORAL TABLET 120 MG, 20 MG, 40 MG, 60 MGXE "LATUDA"3MO; QL (30 per 30 days)LATUDA ORAL TABLET 80 MGXE "LATUDA"3MO; QL (60 per 30 days)lithium carbonate oral capsuleXE "lithium carbonate"2MOlithium carbonate oral tabletXE "lithium carbonate"2MOlithium carbonate oral tablet extended releaseXE "lithium carbonate"4MOlithium citrate oral solution 8 meq/5 mlXE "lithium citrate"4MOlorazepam intensolXE "lorazepam intensol"4MO; QL (240 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"4MOmaprotilineXE "maprotiline"4MOMARPLANXE "MARPLAN"4ST; MO; 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"4MO; 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"2MOmirtazapine oral tablet 7.5 mgXE "mirtazapine"2MO; QL (45 per 30 days)mirtazapine oral tablet,disintegratingXE "mirtazapine"4MO; QL (30 per 30 days)modafinil oral tablet 100 mgXE "modafinil"4PA; MO; QL (90 per 30 days)modafinil oral tablet 200 mgXE "modafinil"4PA; MO; QL (60 per 30 days)molindoneXE "molindone"4MOnefazodoneXE "nefazodone"4MOnortriptyline oral capsuleXE "nortriptyline"2MOnortriptyline oral solutionXE "nortriptyline"4MONUPLAZID ORAL CAPSULEXE "NUPLAZID"5PA; MO; LANUPLAZID ORAL TABLET 10 MGXE "NUPLAZID"5PA; MO; LAolanzapine intramuscularXE "olanzapine"4MO; QL (60 per 30 days)olanzapine oral tablet 10 mg, 15 mg, 2.5 mg, 5 mg, 7.5 mgXE "olanzapine"4MO; QL (30 per 30 days)olanzapine oral tablet 20 mgXE "olanzapine"4MO; QL (60 per 30 days)olanzapine oral tablet,disintegrating 10 mg, 5 mgXE "olanzapine"4MO; QL (60 per 30 days)olanzapine oral tablet,disintegrating 15 mg, 20 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)perphenazine oral tablet 16 mg, 2 mgXE "perphenazine"4MOperphenazine oral tablet 4 mg, 8 mgXE "perphenazine"4B/D PA; MOperphenazine-amitriptylineXE "perphenazine-amitriptyline"4MOPERSERISXE "PERSERIS"4MOphenelzineXE "phenelzine"3MOpimozideXE "pimozide"4MOprotriptylineXE "protriptyline"4MOquetiapine oral tablet 100 mg, 200 mg, 25 mg, 50 mgXE "quetiapine"4MO; QL (90 per 30 days)quetiapine oral tablet 300 mg, 400 mgXE "quetiapine"4MO; QL (60 per 30 days)quetiapine oral tablet extended release 24 hrXE "quetiapine"4MOREXULTIXE "REXULTI"5MORISPERDAL CONSTA INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON 12.5 MG/2 MLXE "RISPERDAL CONSTA"4MORISPERDAL CONSTA INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON 25 MG/2 ML, 37.5 MG/2 ML, 50 MG/2 MLXE "RISPERDAL CONSTA"5MOrisperidone oral solutionXE "risperidone"4MO; QL (480 per 30 days)risperidone oral tabletXE "risperidone"2MOrisperidone oral tablet,disintegrating 0.25 mg, 1 mg, 2 mg, 3 mgXE "risperidone"4MO; QL (60 per 30 days)risperidone oral tablet,disintegrating 0.5 mg, 4 mgXE "risperidone"4MO; QL (120 per 30 days)SAPHRISXE "SAPHRIS"5MO; QL (60 per 30 days)SECUADOXE "SECUADO"5sertraline oral concentrateXE "sertraline"4MOsertraline oral tabletXE "sertraline"1MOSILENORXE "SILENOR"4MOthioridazineXE "thioridazine"4MOthiothixeneXE "thiothixene"4MOtranylcypromineXE "tranylcypromine"4MOtrazodone oral tablet 100 mg, 150 mg, 50 mgXE "trazodone"2MOtrazodone oral tablet 300 mgXE "trazodone"4MOtrifluoperazineXE "trifluoperazine"4MOtrimipramineXE "trimipramine"4MOTRINTELLIXXE "TRINTELLIX"4ST; MO; QL (30 per 30 days)venlafaxine oral capsule,extended release 24hr 150 mgXE "venlafaxine"2MO; QL (60 per 30 days)venlafaxine oral capsule,extended release 24hr 37.5 mg, 75 mgXE "venlafaxine"2MOvenlafaxine oral tabletXE "venlafaxine"2MOVERSACLOZXE "VERSACLOZ"5ST; QL (540 per 30 days)VIIBRYD ORAL TABLETXE "VIIBRYD"3MO; QL (30 per 30 days)VIIBRYD ORAL TABLETS,DOSE PACK 10 MG (7)- 20 MG (23)XE "VIIBRYD"3MO; QL (30 per 30 days)VRAYLAR ORAL CAPSULEXE "VRAYLAR"5ST; MO; QL (30 per 30 days)VRAYLAR ORAL CAPSULE,DOSE PACKXE "VRAYLAR"4ST; MOXYREMXE "XYREM"5PA; MO; LA; QL (540 per 30 days)zaleplon oral capsule 10 mgXE "zaleplon"3MO; QL (60 per 30 days)zaleplon oral capsule 5 mgXE "zaleplon"3MO; QL (30 per 30 days)ziprasidone hclXE "ziprasidone hcl"4MO; QL (60 per 30 days)ziprasidone mesylateXE "ziprasidone mesylate"2zolpidem oral tabletXE "zolpidem"2MO; QL (30 per 30 days)ZYPREXA RELPREVV INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION 210 MGXE "ZYPREXA RELPREVV"4ST; MO; QL (2 per 28 days)CARDIOVASCULAR, HYPERTENSION / LIPIDSANTIARRHYTHMIC AGENTSamiodarone oral tablet 100 mg, 400 mgXE "amiodarone"4MOamiodarone oral tablet 200 mgXE "amiodarone"2MOdofetilideXE "dofetilide"4MOflecainideXE "flecainide"2MOmexiletineXE "mexiletine"4MOpacerone oral tablet 100 mg, 400 mgXE "pacerone"4MOpacerone oral tablet 200 mgXE "pacerone"2MOpropafenone 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"3MOamiloride-hydrochlorothiazideXE "amiloride-hydrochlorothiazide"2MOamlodipineXE "amlodipine"1MOamlodipine-benazepril oral capsule 10-20 mg, 10-40 mg, 5-40 mgXE "amlodipine-benazepril"2MO; QL (30 per 30 days)amlodipine-benazepril oral capsule 2.5-10 mg, 5-10 mg, 5-20 mgXE "amlodipine-benazepril"2MO; QL (45 per 30 days)amlodipine-olmesartanXE "amlodipine-olmesartan"4MO; QL (30 per 30 days)amlodipine-valsartanXE "amlodipine-valsartan"2MOamlodipine-valsartan-hcthiazidXE "amlodipine-valsartan-hcthiazid"4MO; QL (30 per 30 days)atenololXE "atenolol"1MOatenolol-chlorthalidoneXE "atenolol-chlorthalidone"2MObenazeprilXE "benazepril"1MObenazepril-hydrochlorothiazideXE "benazepril-hydrochlorothiazide"2MObisoprolol fumarateXE "bisoprolol fumarate"2MObisoprolol-hydrochlorothiazideXE "bisoprolol-hydrochlorothiazide"1MObumetanide injectionXE "bumetanide"4MObumetanide oralXE "bumetanide"2MOBYSTOLICXE "BYSTOLIC"4MOcandesartan oral tablet 16 mg, 4 mg, 8 mgXE "candesartan"3MO; QL (60 per 30 days)candesartan oral tablet 32 mgXE "candesartan"3MO; QL (30 per 30 days)candesartan-hydrochlorothiazidXE "candesartan-hydrochlorothiazid"4MO; QL (30 per 30 days)captoprilXE "captopril"4MOcaptopril-hydrochlorothiazide oral tablet 25-15 mg, 25-25 mg, 50-15 mgXE "captopril-hydrochlorothiazide"2MOcaptopril-hydrochlorothiazide oral tablet 50-25 mgXE "captopril-hydrochlorothiazide"4MOcartia xtXE "cartia xt"3MOcarvedilolXE "carvedilol"1MOCATAPRES ORAL TABLET 0.3 MGXE "CATAPRES"2MOchlorthalidone oral tablet 25 mg, 50 mgXE "chlorthalidone"2MOclonidineXE "clonidine"4MOclonidine hcl oral tabletXE "clonidine hcl"1MODEMSERXE "DEMSER"5MOdiltiazem hcl oral capsule,extended release 12 hrXE "diltiazem hcl"4MOdiltiazem hcl oral capsule,extended release 24 hrXE "diltiazem hcl"3MOdiltiazem hcl oral capsule,extended release 24hrXE "diltiazem hcl"3MOdiltiazem hcl oral tabletXE "diltiazem hcl"2MOdilt-xrXE "dilt-xr"3MOdoxazosinXE "doxazosin"2MOenalapril maleateXE "enalapril maleate"1MOenalapril-hydrochlorothiazideXE "enalapril-hydrochlorothiazide"1MOeplerenoneXE "eplerenone"4MOfelodipineXE "felodipine"2MOfosinoprilXE "fosinopril"1MOfosinopril-hydrochlorothiazideXE "fosinopril-hydrochlorothiazide"2MOfurosemide injectionXE "furosemide"1MOfurosemide oral solution 10 mg/ml, 40 mg/5 ml (8 mg/ml)XE "furosemide"1MOfurosemide oral tabletXE "furosemide"1MOguanfacine oral tabletXE "guanfacine"2MOhydralazine oralXE "hydralazine"2MOhydrochlorothiazideXE "hydrochlorothiazide"1MOindapamideXE "indapamide"2MOirbesartanXE "irbesartan"1MO; QL (30 per 30 days)irbesartan-hydrochlorothiazideXE "irbesartan-hydrochlorothiazide"2MO; QL (30 per 30 days)isradipineXE "isradipine"4MOKATERZIAXE "KATERZIA"4MO; QL (300 per 30 days)labetalol oralXE "labetalol"2MOlisinoprilXE "lisinopril"1MOlisinopril-hydrochlorothiazideXE "lisinopril-hydrochlorothiazide"1MOlosartanXE "losartan"1MOlosartan-hydrochlorothiazideXE "losartan-hydrochlorothiazide"1MOmethyldopaXE "methyldopa"2MOmetolazoneXE "metolazone"3MOmetoprolol succinateXE "metoprolol succinate"2MOmetoprolol ta-hydrochlorothiazXE "metoprolol ta-hydrochlorothiaz"3MOmetoprolol tartrate oralXE "metoprolol tartrate"1MOminoxidil oralXE "minoxidil"2MOmoexiprilXE "moexipril"2MOnadololXE "nadolol"4MOnicardipine oralXE "nicardipine"4MOnifedipine oral tablet extended releaseXE "nifedipine"3MOnifedipine oral tablet extended release 24hrXE "nifedipine"3MOnimodipineXE "nimodipine"4MOolmesartanXE "olmesartan"2MOolmesartan-amlodipin-hcthiazidXE "olmesartan-amlodipin-hcthiazid"2MO; QL (30 per 30 days)olmesartan-hydrochlorothiazideXE "olmesartan-hydrochlorothiazide"4MOperindopril erbumineXE "perindopril erbumine"2MOpindololXE "pindolol"4MOprazosinXE "prazosin"2MOpropranolol oral capsule,extended release 24 hrXE "propranolol"4MOpropranolol oral solutionXE "propranolol"2MOpropranolol oral tabletXE "propranolol"2MOpropranolol-hydrochlorothiazidXE "propranolol-hydrochlorothiazid"2MOquinaprilXE "quinapril"1MOquinapril-hydrochlorothiazideXE "quinapril-hydrochlorothiazide"2MOramiprilXE "ramipril"1MOspironolactone oral tablet 100 mg, 50 mgXE "spironolactone"2MOspironolactone oral tablet 25 mgXE "spironolactone"1MOspironolacton-hydrochlorothiazXE "spironolacton-hydrochlorothiaz"2MOtaztia xtXE "taztia xt"4MOtelmisartanXE "telmisartan"2MO; QL (30 per 30 days)telmisartan-hydrochlorothiazidXE "telmisartan-hydrochlorothiazid"4MO; QL (30 per 30 days)terazosinXE "terazosin"1MOtiadylt erXE "tiadylt er"4MOtimolol 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"1MOUPTRAVI ORAL TABLET 1,000 MCGXE "UPTRAVI"5PA; MO; LA; QL (90 per 30 days)UPTRAVI ORAL TABLET 1,200 MCG, 1,400 MCG, 1,600 MCGXE "UPTRAVI"5PA; MO; LA; QL (60 per 30 days)UPTRAVI ORAL TABLET 200 MCGXE "UPTRAVI"5PA; MO; LA; QL (240 per 30 days)UPTRAVI ORAL TABLET 400 MCGXE "UPTRAVI"5PA; MO; LA; QL (320 per 30 days)UPTRAVI ORAL TABLET 600 MCGXE "UPTRAVI"5PA; MO; LA; QL (150 per 30 days)UPTRAVI ORAL TABLET 800 MCGXE "UPTRAVI"5PA; MO; LA; QL (120 per 30 days)UPTRAVI ORAL TABLETS,DOSE PACKXE "UPTRAVI"5PA; MO; LA; QL (200 per 30 days)valsartan oral tablet 160 mg, 320 mgXE "valsartan"2MO; QL (30 per 30 days)valsartan oral tablet 40 mg, 80 mgXE "valsartan"2MO; QL (90 per 30 days)valsartan-hydrochlorothiazideXE "valsartan-hydrochlorothiazide"2MO; QL (30 per 30 days)verapamil oral capsule, 24 hr er pellet ctXE "verapamil"2MOverapamil oral capsule,ext rel. pellets 24 hr 120 mg, 180 mg, 240 mgXE "verapamil"2MOverapamil 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"3MO; QL (60 per 30 days)CABLIVI INJECTION KITXE "CABLIVI"5PA; MO; LA; QL (32 per 30 days)cilostazolXE "cilostazol"2MOclopidogrel oral tablet 75 mgXE "clopidogrel"2MOELIQUISXE "ELIQUIS"3MOELIQUIS DVT-PE TREAT 30D STARTXE "ELIQUIS DVT-PE TREAT 30D START"3MOenoxaparin subcutaneous syringe 100 mg/ml, 150 mg/mlXE "enoxaparin"4MO; QL (60 per 28 days)enoxaparin subcutaneous syringe 120 mg/0.8 ml, 80 mg/0.8 mlXE "enoxaparin"4MO; QL (48 per 28 days)enoxaparin subcutaneous syringe 30 mg/0.3 mlXE "enoxaparin"4MO; QL (18 per 28 days)enoxaparin subcutaneous syringe 40 mg/0.4 mlXE "enoxaparin"4MO; QL (24 per 28 days)enoxaparin subcutaneous syringe 60 mg/0.6 mlXE "enoxaparin"4MO; QL (36 per 28 days)fondaparinux subcutaneous syringe 10 mg/0.8 ml, 5 mg/0.4 ml, 7.5 mg/0.6 mlXE "fondaparinux"4MO; QL (14 per 28 days)fondaparinux subcutaneous syringe 2.5 mg/0.5 mlXE "fondaparinux"4MO; QL (7 per 28 days)heparin (porcine) injection solutionXE "heparin (porcine)"3MOjantovenXE "jantoven"1MOpentoxifyllineXE "pentoxifylline"2MOPROMACTA ORAL POWDER IN PACKET 12.5 MGXE "PROMACTA"5MO; QL (180 per 30 days)PROMACTA ORAL TABLETXE "PROMACTA"5MO; QL (30 per 30 days)warfarinXE "warfarin"1MOXARELTOXE "XARELTO"3MOXARELTO DVT-PE TREAT 30D STARTXE "XARELTO DVT-PE TREAT 30D START"3MOLIPID/CHOLESTEROL LOWERING AGENTSamlodipine-atorvastatinXE "amlodipine-atorvastatin"4MOatorvastatinXE "atorvastatin"1MOcholestyramine (with sugar)XE "cholestyramine (with sugar)"4MOcholestyramine lightXE "cholestyramine light"4MOcolesevelam oral powder in packetXE "colesevelam"2MOcolestipol oral granulesXE "colestipol"4MOcolestipol oral packetXE "colestipol"4MOcolestipol oral tabletXE "colestipol"3MOezetimibeXE "ezetimibe"3MOezetimibe-simvastatinXE "ezetimibe-simvastatin"4MOfenofibrate micronized oral capsule 130 mg, 134 mg, 67 mgXE "fenofibrate micronized"2MO; QL (30 per 30 days)fenofibrate micronized oral capsule 200 mgXE "fenofibrate micronized"3MO; QL (30 per 30 days)fenofibrate nanocrystallized oral tablet 145 mgXE "fenofibrate nanocrystallized"4MO; QL (30 per 30 days)fenofibrate nanocrystallized oral tablet 48 mgXE "fenofibrate nanocrystallized"2MO; QL (60 per 30 days)FENOFIBRATE ORAL CAPSULE 150 MGXE "FENOFIBRATE"4MO; QL (30 per 30 days)fenofibrate oral tablet 160 mgXE "fenofibrate"2MO; QL (30 per 30 days)fenofibrate oral tablet 54 mgXE "fenofibrate"2MO; QL (60 per 30 days)gemfibrozilXE "gemfibrozil"2MOLIVALOXE "LIVALO"3MOlovastatinXE "lovastatin"1MOniacin oral tablet extended release 24 hrXE "niacin"4MOomega-3 acid ethyl estersXE "omega-3 acid ethyl esters"4MOPRALUENT PENXE "PRALUENT PEN"4PA; MOpravastatinXE "pravastatin"1MO; QL (30 per 30 days)prevaliteXE "prevalite"4MOREPATHAXE "REPATHA"4PA; MOREPATHA PUSHTRONEXXE "REPATHA PUSHTRONEX"4PA; MOREPATHA SURECLICKXE "REPATHA SURECLICK"4PA; MOrosuvastatinXE "rosuvastatin"2MOsimvastatin oral tabletXE "simvastatin"1MOVASCEPAXE "VASCEPA"4MOWELCHOL ORAL TABLETXE "WELCHOL"3MOZYPITAMAG ORAL TABLET 2 MG, 4 MGXE "ZYPITAMAG"3MO; QL (30 per 30 days)MISCELLANEOUS CARDIOVASCULAR AGENTSCORLANOR ORAL SOLUTIONXE "CORLANOR"4PACORLANOR ORAL TABLETXE "CORLANOR"4PA; MOdigitek oral tablet 125 mcg (0.125 mg)XE "digitek"2MOdigitek oral tablet 250 mcg (0.25 mg)XE "digitek"3MOdigox oral tablet 125 mcg (0.125 mg)XE "digox"2MOdigox oral tablet 250 mcg (0.25 mg)XE "digox"3MOdigoxin oral solution 50 mcg/ml (0.05 mg/ml)XE "digoxin"4MOdigoxin oral tablet 125 mcg (0.125 mg)XE "digoxin"2MOdigoxin oral tablet 250 mcg (0.25 mg)XE "digoxin"3MOENTRESTOXE "ENTRESTO"3PA; MOranolazine oral tablet extended release 12 hr 1,000 mgXE "ranolazine"4MO; QL (60 per 30 days)ranolazine oral tablet extended release 12 hr 500 mgXE "ranolazine"4MO; QL (120 per 30 days)NITRATESisosorbide dinitrate oral tablet 10 mg, 20 mg, 30 mg, 5 mgXE "isosorbide dinitrate"3MOisosorbide dinitrate oral tablet 40 mgXE "isosorbide dinitrate"4MOisosorbide mononitrateXE "isosorbide mononitrate"2MOnitro-bidXE "nitro-bid"3MOnitroglycerin sublingualXE "nitroglycerin"2MOnitroglycerin transdermal patch 24 hourXE "nitroglycerin"2MOnitroglycerin translingual spray,non-aerosolXE "nitroglycerin"4MODERMATOLOGICALS/TOPICAL THERAPYANTIPSORIATIC / ANTISEBORRHEICacitretin oral capsule 10 mg, 25 mgXE "acitretin"4PA; MOacitretin oral capsule 17.5 mgXE "acitretin"5PA; MOcalcipotriene scalpXE "calcipotriene"4MOcalcipotriene topical ointmentXE "calcipotriene"4MO; QL (120 per 30 days)COSENTYXXE "COSENTYX"5PA; MO; QL (8 per 28 days)COSENTYX (2 SYRINGES)XE "COSENTYX (2 SYRINGES)"5PA; MO; QL (8 per 28 days)COSENTYX PENXE "COSENTYX PEN"5PA; MO; QL (8 per 28 days)COSENTYX PEN (2 PENS)XE "COSENTYX PEN (2 PENS)"5PA; MO; QL (8 per 28 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; 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 lactateXE "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)EUCRISAXE "EUCRISA"4ST; MOFLUOROPLEXXE "FLUOROPLEX"4MOfluorouracil topical cream 5 %XE "fluorouracil"4MOfluorouracil topical solution 2 %XE "fluorouracil"2MOfluorouracil topical solution 5 %XE "fluorouracil"4MOimiquimod topical cream in packetXE "imiquimod"4MOlidocaine hcl laryngotrachealXE "lidocaine hcl"2MOlidocaine hcl mucous membrane jellyXE "lidocaine hcl"3MOlidocaine hcl mucous membrane jelly in applicatorXE "lidocaine hcl"3MOlidocaine hcl mucous membrane solution 4 % (40 mg/ml)XE "lidocaine hcl"2MOlidocaine topical adhesive patch,medicated 5 %XE "lidocaine"4PA; MO; QL (90 per 30 days)lidocaine topical ointmentXE "lidocaine"4MO; QL (72 per 30 days)lidocaine viscousXE "lidocaine viscous"2MOlidocaine-prilocaine topical creamXE "lidocaine-prilocaine"4MOPICATOXE "PICATO"4MOpimecrolimusXE "pimecrolimus"4ST; MOpodofiloxXE "podofilox"4MOREGRANEXXE "REGRANEX"5PA; MOSANTYLXE "SANTYL"4MOsilver sulfadiazineXE "silver sulfadiazine"2MOssdXE "ssd"2MOtacrolimus topical ointment 0.03 %XE "tacrolimus"4PA; MO; QL (100 per 30 days)tacrolimus topical ointment 0.1 %XE "tacrolimus"4MOVALCHLORXE "VALCHLOR"5PA; MO; QL (60 per 14 days)THERAPY FOR ACNEamnesteemXE "amnesteem"4MOclaravis oral capsule 20 mg, 30 mg, 40 mgXE "claravis"4MOclindamycin phosphate topical gelXE "clindamycin phosphate"4MOCLINDAMYCIN PHOSPHATE TOPICAL GEL, ONCE DAILYXE "CLINDAMYCIN PHOSPHATE"4MOclindamycin phosphate topical lotionXE "clindamycin phosphate"4MOclindamycin phosphate topical solutionXE "clindamycin phosphate"4MOclindamycin-benzoyl peroxide topical gel 1-5 %XE "clindamycin-benzoyl peroxide"4MOclindamycin-benzoyl peroxide topical gel with pump 1-5 %XE "clindamycin-benzoyl peroxide"4MOerythromycin with ethanol topical gelXE "erythromycin with ethanol"4MOerythromycin with ethanol topical solutionXE "erythromycin with ethanol"3MOerythromycin-benzoyl peroxideXE "erythromycin-benzoyl peroxide"4MOisotretinoinXE "isotretinoin"4MOmetronidazole topicalXE "metronidazole"4MOtazaroteneXE "tazarotene"4PA; MOTAZORAC TOPICAL CREAM 0.05 %XE "TAZORAC"3PA; MOTAZORAC TOPICAL GELXE "TAZORAC"3PA; MOtretinoin topical creamXE "tretinoin topical"3PA; MOTOPICAL ANTIBACTERIALSgentamicin topicalXE "gentamicin"2MOmupirocinXE "mupirocin"2MOsulfacetamide sodium (acne)XE "sulfacetamide sodium (acne)"4MOTOPICAL ANTIFUNGALSciclopiroxXE "ciclopirox"4MOclotrimazole topicalXE "clotrimazole"3MOclotrimazole-betamethasone topical creamXE "clotrimazole-betamethasone"3MOclotrimazole-betamethasone topical lotionXE "clotrimazole-betamethasone"4MOeconazoleXE "econazole"4MOJUBLIAXE "JUBLIA"4MOketoconazole topical creamXE "ketoconazole"2MOketoconazole topical shampooXE "ketoconazole"2MOnyamycXE "nyamyc"2MOnystatin topicalXE "nystatin"2MOnystatin-triamcinoloneXE "nystatin-triamcinolone"4MOnystopXE "nystop"2MOTOPICAL CORTICOSTEROIDSalclometasoneXE "alclometasone"2MObetamethasone dipropionateXE "betamethasone dipropionate"4MObetamethasone valerate topical creamXE "betamethasone valerate"3MObetamethasone valerate topical lotionXE "betamethasone valerate"3MObetamethasone valerate topical ointmentXE "betamethasone valerate"3MObetamethasone, augmentedXE "betamethasone, augmented"4MOdesonide topical creamXE "desonide"4MOdesonide topical lotionXE "desonide"4MOdesonide topical ointmentXE "desonide"4MOdesoximetasone topical creamXE "desoximetasone"4MOdesoximetasone topical gelXE "desoximetasone"4MOdesoximetasone topical ointmentXE "desoximetasone"4MOfluocinolone topical creamXE "fluocinolone"4MOfluocinolone topical ointmentXE "fluocinolone"4MOfluocinolone topical solutionXE "fluocinolone"4MOfluocinonide topical gelXE "fluocinonide"4MOfluocinonide topical ointmentXE "fluocinonide"4MOfluocinonide topical solutionXE "fluocinonide"4MOfluocinonide-eXE "fluocinonide-e"4MOfluocinonide-emollientXE "fluocinonide-emollient"4MOfluticasone propionate topical creamXE "fluticasone propionate"2MOfluticasone propionate topical ointmentXE "fluticasone propionate"2MOhalobetasol propionate topical creamXE "halobetasol propionate"4MOhalobetasol propionate topical ointmentXE "halobetasol propionate"4MOhydrocortisone topical cream 1 %, 2.5 %XE "hydrocortisone"2MOhydrocortisone topical lotion 2.5 %XE "hydrocortisone"2MOhydrocortisone topical ointment 1 %, 2.5 %XE "hydrocortisone"2MOhydrocortisone valerateXE "hydrocortisone valerate"4MOmometasone topicalXE "mometasone"2MOprednicarbateXE "prednicarbate"4MOtriamcinolone acetonide topical creamXE "triamcinolone acetonide"2MOtriamcinolone acetonide topical lotionXE "triamcinolone acetonide"3MOtriamcinolone acetonide topical ointment 0.025 %, 0.1 %, 0.5 %XE "triamcinolone acetonide"2MOtriderm topical cream 0.1 %XE "triderm"2MOTOPICAL SCABICIDES / PEDICULICIDESmalathionXE "malathion"4MOpermethrin topical creamXE "permethrin"3MODIAGNOSTICS / MISCELLANEOUS AGENTSMISCELLANEOUS AGENTSacamprosateXE "acamprosate"4MOanagrelideXE "anagrelide"2MOAURYXIAXE "AURYXIA"3PA; MOCARBAGLUXE "CARBAGLU"5PA; MOCHEMETXE "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"4B/D PAd2.5 %-0.45 % sodium chlorideXE "d2.5 %-0.45 % sodium chloride"4B/D PAd5 % and 0.9 % sodium chlorideXE "d5 % and 0.9 % sodium chloride"4B/D PA; MOd5 %-0.45 % sodium chlorideXE "d5 %-0.45 % sodium chloride"4B/D PA; MOdeferasirox oral tabletXE "deferasirox"5PA; MOdeferasirox oral tablet, dispersibleXE "deferasirox"5PA; MOdextrose 10 % and 0.2 % naclXE "dextrose 10 % and 0.2 % nacl"4B/D PAdextrose 10 % in water (d10w)XE "dextrose 10 % in water (d10w)"4B/D PA; MOdextrose 5 % in water (d5w)XE "dextrose 5 % in water (d5w)"4B/D PA; MOdextrose 5%-0.2 % sod chlorideXE "dextrose 5%-0.2 % sod chloride"4B/D PAdextrose with sodium chlorideXE "dextrose with sodium chloride"4B/D PAdisulfiramXE "disulfiram"2MOENDARIXE "ENDARI"5PA; MO; LA; QL (180 per 30 days)FERRIPROXXE "FERRIPROX"5PA; MOFERRIPROX (2 TIMES A DAY)XE "FERRIPROX (2 TIMES A DAY)"5PAINCRELEXXE "INCRELEX"5PA; MOkionex (with sorbitol)XE "kionex (with sorbitol)"3MOlevocarnitine (with sugar)XE "levocarnitine (with sugar)"4MOlevocarnitine oral solution 100 mg/mlXE "levocarnitine"4MOlevocarnitine oral tabletXE "levocarnitine"4MOLOKELMAXE "LOKELMA"3MOmidodrine oral tablet 10 mgXE "midodrine"4MOmidodrine oral tablet 2.5 mg, 5 mgXE "midodrine"3MOnitisinoneXE "nitisinone"5PA; MONORTHERAXE "NORTHERA"5MOORFADIN ORAL CAPSULE 20 MGXE "ORFADIN"5PA; MOORFADIN ORAL SUSPENSIONXE "ORFADIN"5PA; MO; LApilocarpine hcl oralXE "pilocarpine hcl"4MOPROLASTIN-C INTRAVENOUS RECON SOLNXE "PROLASTIN-C"5PAPROLASTIN-C INTRAVENOUS SOLUTIONXE "PROLASTIN-C"5PA; MO; LARAVICTIXE "RAVICTI"5PA; MOriluzoleXE "riluzole"4MOsevelamer carbonateXE "sevelamer carbonate"4MOsevelamer hclXE "sevelamer hcl"4MOsodium chloride 0.9 % intravenousXE "sodium chloride 0.9 %"4MOsodium chloride irrigationXE "sodium chloride"2MOsodium phenylbutyrateXE "sodium phenylbutyrate"5PA; MOsodium polystyrene (sorb free)XE "sodium polystyrene (sorb free)"4MOsodium polystyrene sulfonate oral powderXE "sodium polystyrene sulfonate"4MOsps (with sorbitol) oralXE "sps (with sorbitol)"4MOsps (with sorbitol) rectalXE "sps (with sorbitol)"4TIGLUTIKXE "TIGLUTIK"5MO; QL (600 per 30 days)trientineXE "trientine"5PA; MOVELTASSAXE "VELTASSA"3MOXURIDENXE "XURIDEN"5PA; MO; QL (120 per 30 days)SMOKING DETERRENTSbupropion hcl (smoking deter)XE "bupropion hcl (smoking deter)"3MOCHANTIXXE "CHANTIX"3MOCHANTIX CONTINUING MONTH BOXXE "CHANTIX CONTINUING MONTH BOX"3MOCHANTIX STARTING MONTH BOXXE "CHANTIX STARTING MONTH BOX"3MONICOTROLXE "NICOTROL"4MOEAR, NOSE / THROAT MEDICATIONSMISCELLANEOUS AGENTSazelastine nasalXE "azelastine"4MO; QL (60 per 30 days)chlorhexidine gluconate mucous membraneXE "chlorhexidine gluconate"2MOipratropium bromide nasal spray,non-aerosol 0.03 %XE "ipratropium bromide"2MO; QL (60 per 30 days)ipratropium bromide nasal spray,non-aerosol 42 mcg (0.06 %)XE "ipratropium bromide"2MO; QL (30 per 30 days)paroex oral rinseXE "paroex oral rinse"2MOtriamcinolone acetonide dentalXE "triamcinolone acetonide"4MOMISCELLANEOUS OTIC PREPARATIONSacetic acid otic (ear)XE "acetic acid"2MOciprofloxacin hcl otic (ear)XE "ciprofloxacin hcl"4MOflac otic oilXE "flac otic oil"2fluocinolone acetonide oilXE "fluocinolone acetonide oil"4MOofloxacin otic (ear)XE "ofloxacin"4MOOTIC STEROID / ANTIBIOTICCIPRODEXXE "CIPRODEX"4MOCIPROFLOXACIN-FLUOCINOLONEXE "CIPROFLOXACIN-FLUOCINOLONE"4MO; QL (14 per 28 days)neomycin-polymyxin-hc otic (ear)XE "neomycin-polymyxin-hc"3MOENDOCRINE/DIABETESADRENAL HORMONESdexamethasone intensolXE "dexamethasone intensol"4MOdexamethasone oral elixirXE "dexamethasone"4MOdexamethasone oral solutionXE "dexamethasone"4MOdexamethasone oral tabletXE "dexamethasone"2MOfludrocortisoneXE "fludrocortisone"2MOhydrocortisone oralXE "hydrocortisone"2MOmethylprednisoloneXE "methylprednisolone"2MOprednisolone oral solution 15 mg/5 mlXE "prednisolone"4MOprednisolone sodium phosphate oral solution 15 mg/5 ml (3 mg/ml), 25 mg/5 ml (5 mg/ml), 5 mg base/5 ml (6.7 mg/5 ml)XE "prednisolone sodium phosphate"4MOprednisolone sodium phosphate oral solution 15 mg/5 ml (5 ml)XE "prednisolone sodium phosphate"4prednisone intensolXE "prednisone intensol"4MOprednisone oral solutionXE "prednisone"4MOprednisone oral tabletXE "prednisone"1MOprednisone oral tablets,dose packXE "prednisone"2MOANTITHYROID AGENTSmethimazole oral tablet 10 mg, 5 mgXE "methimazole"2MOpropylthiouracilXE "propylthiouracil"4MODIABETES THERAPYacarbose oral tablet 100 mgXE "acarbose"2MO; QL (90 per 30 days)acarbose oral tablet 25 mg, 50 mgXE "acarbose"2MO; QL (150 per 30 days)alcohol padsXE "alcohol pads"3MOFIASP FLEXTOUCH U-100 INSULINXE "FIASP FLEXTOUCH U-100 INSULIN"3MOFIASP PENFILL U-100 INSULINXE "FIASP PENFILL U-100 INSULIN"3MOFIASP U-100 INSULINXE "FIASP U-100 INSULIN"3MOGAUZE PADS 2 X 2XE "GAUZE PAD"3MOglimepirideXE "glimepiride"1MOglipizide oral tabletXE "glipizide"1MOglipizide 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"1MOglipizide-metformin oral tablet 2.5-250 mg, 2.5-500 mgXE "glipizide-metformin"2MO; QL (90 per 30 days)glipizide-metformin oral tablet 5-500 mgXE "glipizide-metformin"2MO; 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)"3MOglyburideXE "glyburide"4MOglyburide micronizedXE "glyburide micronized"4MOHUMULIN R U-500 (CONC) INSULINXE "HUMULIN R U-500 (CONC) INSULIN"5MOHUMULIN R U-500 (CONC) KWIKPENXE "HUMULIN R U-500 (CONC) KWIKPEN"5MOINSULIN ASP PRT-INSULIN ASPARTXE "INSULIN ASP PRT-INSULIN ASPART"3INSULIN ASPART U-100XE "INSULIN ASPART U-100"3MOINSULIN PEN NEEDLEXE "INSULIN PEN NEEDLE"3MOINSULIN SYRINGE (DISP) U-100 0.3 ML, 1 ML, 1/2 MLXE "INSULIN SYRINGE (DISP) U-100"3MOINVOKAMETXE "INVOKAMET"3MO; QL (60 per 30 days)INVOKAMET XRXE "INVOKAMET XR"3MO; QL (60 per 30 days)INVOKANAXE "INVOKANA"3MO; QL (30 per 30 days)JANUMETXE "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)LANTUS SOLOSTAR U-100 INSULINXE "LANTUS SOLOSTAR U-100 INSULIN"3MOLANTUS U-100 INSULINXE "LANTUS U-100 INSULIN"3MOLEVEMIR FLEXTOUCH U-100 INSULNXE "LEVEMIR FLEXTOUCH U-100 INSULN"3MOLEVEMIR U-100 INSULINXE "LEVEMIR U-100 INSULIN"3MOmetformin oral tabletXE "metformin"1MOmetformin oral tablet extended release 24 hrXE "metformin"1MOnateglinideXE "nateglinide"2MO; 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"3MONOVOLIN 70-30 FLEXPEN U-100XE "NOVOLIN 70-30 FLEXPEN U-100"3MONOVOLIN N NPH U-100 INSULINXE "NOVOLIN N NPH U-100 INSULIN"3MONOVOLIN R REGULAR U-100 INSULNXE "NOVOLIN R REGULAR U-100 INSULN"3MONOVOLOG FLEXPEN U-100 INSULINXE "NOVOLOG FLEXPEN U-100 INSULIN"3MONOVOLOG MIX 70-30 U-100 INSULNXE "NOVOLOG MIX 70-30 U-100 INSULN"3MONOVOLOG MIX 70-30FLEXPEN U-100XE "NOVOLOG MIX 70-30FLEXPEN U-100"3MONOVOLOG PENFILL U-100 INSULINXE "NOVOLOG PENFILL U-100 INSULIN"3MONOVOLOG U-100 INSULIN ASPARTXE "NOVOLOG U-100 INSULIN ASPART"3MOOZEMPIC 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)PROGLYCEMXE "PROGLYCEM"5MOrepaglinide oral tablet 0.5 mg, 1 mgXE "repaglinide"2MO; QL (120 per 30 days)repaglinide oral tablet 2 mgXE "repaglinide"2MO; QL (240 per 30 days)RYBELSUSXE "RYBELSUS"3MO; QL (30 per 30 days)SOLIQUA 100/33XE "SOLIQUA 100/33"3MO; 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, 25-1,000 MGXE "SYNJARDY XR"3MO; QL (30 per 30 days)SYNJARDY XR ORAL TABLET, IR - ER, BIPHASIC 24HR 12.5-1,000 MG, 5-1,000 MGXE "SYNJARDY XR"3MO; QL (60 per 30 days)TOUJEO MAX U-300 SOLOSTARXE "TOUJEO MAX U-300 SOLOSTAR"3MOTOUJEO SOLOSTAR U-300 INSULINXE "TOUJEO SOLOSTAR U-300 INSULIN"3MOTRESIBA FLEXTOUCH U-100XE "TRESIBA FLEXTOUCH U-100"3MOTRESIBA FLEXTOUCH U-200XE "TRESIBA FLEXTOUCH U-200"3MOTRESIBA U-100 INSULINXE "TRESIBA U-100 INSULIN"3MOTRULICITYXE "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)XULTOPHY 100/3.6XE "XULTOPHY 100/3.6"3MO; QL (15 per 30 days)MISCELLANEOUS HORMONESANADROL-50XE "ANADROL-50"5MOcabergolineXE "cabergoline"4MOcalcitonin (salmon)XE "calcitonin (salmon)"3MOcalcitriol oral capsuleXE "calcitriol"2B/D PA; MOcalcitriol oral solutionXE "calcitriol"4B/D PA; MOcinacalcet oral tablet 30 mgXE "cinacalcet"3PA; MO; QL (60 per 30 days)cinacalcet oral tablet 60 mgXE "cinacalcet"5PA; MO; QL (60 per 30 days)cinacalcet oral tablet 90 mgXE "cinacalcet"5PA; MO; QL (120 per 30 days)danazolXE "danazol"4MOdesmopressin nasal spray with pumpXE "desmopressin"4MOdesmopressin nasal spray,non-aerosolXE "desmopressin"4MOdesmopressin oralXE "desmopressin"3MOGALAFOLDXE "GALAFOLD"5PA; MO; LA; QL (15 per 30 days)KORLYMXE "KORLYM"5PA; MOKUVAN ORAL POWDER IN PACKET 100 MGXE "KUVAN"5PA; MO; LAKUVAN ORAL POWDER IN PACKET 500 MGXE "KUVAN"5PA; MOKUVAN ORAL TABLET,SOLUBLEXE "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; MOSAMSCAXE "SAMSCA"5PA; MOSOMAVERTXE "SOMAVERT"5PA; MO; QL (30 per 30 days)STIMATEXE "STIMATE"5MOSYNARELXE "SYNAREL"5PA; MOtestosterone cypionate intramuscular oil 100 mg/ml, 200 mg/ml, 200 mg/ml (1 ml)XE "testosterone cypionate"4MOtestosterone enanthateXE "testosterone enanthate"4MOtestosterone transdermal gelXE "testosterone"3MOTESTOSTERONE TRANSDERMAL GEL IN METERED-DOSE PUMP 12.5 MG/ 1.25 GRAM (1 %)XE "TESTOSTERONE"3MOtestosterone transdermal gel in metered-dose pump 20.25 mg/1.25 gram (1.62 %)XE "testosterone"3MOtestosterone transdermal gel in packetXE "testosterone"3MOTHYROID HORMONESeuthyroxXE "euthyrox"3MOlevo-tXE "levo-t"1levothyroxine oralXE "levothyroxine"1MOlevoxyl 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"3MOunithroid 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"3MOGASTROENTEROLOGYANTIDIARRHEALS / ANTISPASMODICSdicyclomine oral capsuleXE "dicyclomine"1MOdicyclomine oral solutionXE "dicyclomine"4MOdicyclomine oral tabletXE "dicyclomine"1MOdiphenoxylate-atropine oral liquidXE "diphenoxylate-atropine"4MOdiphenoxylate-atropine oral tabletXE "diphenoxylate-atropine"3MOglycopyrrolate oral tablet 1 mg, 2 mgXE "glycopyrrolate"3MOloperamide oral capsuleXE "loperamide"2MOMYTESIXE "MYTESI"3PA; MOMISCELLANEOUS GASTROINTESTINAL AGENTSalosetronXE "alosetron"5MO; QL (60 per 30 days)AMITIZAXE "AMITIZA"3MO; QL (60 per 30 days)aprepitant oral capsuleXE "aprepitant"4B/D PA; MO; QL (30 per 30 days)aprepitant oral capsule,dose packXE "aprepitant"4B/D PA; MO; QL (12 per 30 days)balsalazideXE "balsalazide"2MObudesonide oral capsule,delayed,extend.releaseXE "budesonide"4MObudesonide oral tablet,delayed and ext.releaseXE "budesonide"5MOCLENPIQXE "CLENPIQ"4MOcomproXE "compro"4MOconstuloseXE "constulose"2MOCREONXE "CREON"3MOcromolyn oralXE "cromolyn"4MOCYSTADANEXE "CYSTADANE"5MOdronabinolXE "dronabinol"4B/D PA; MO; QL (60 per 30 days)EMEND ORAL SUSPENSION FOR RECONSTITUTIONXE "EMEND"4B/D PA; MOenuloseXE "enulose"2MOGATTEX 30-VIALXE "GATTEX 30-VIAL"5PA; MOGATTEX ONE-VIALXE "GATTEX ONE-VIAL"5PA; MOgavilyte-cXE "gavilyte-c"2MOgavilyte-nXE "gavilyte-n"2MOgenerlacXE "generlac"2MOgranisetron hcl oralXE "granisetron hcl"4B/D PA; MO; QL (60 per 30 days)hydrocortisone rectalXE "hydrocortisone"4MOhydrocortisone topical cream with perineal applicatorXE "hydrocortisone"2MOhydrocortisone-pramoxine rectal cream 1-1 %XE "hydrocortisone-pramoxine"4MOlactulose oral solutionXE "lactulose"2MOLIALDAXE "LIALDA"3MO; QL (120 per 30 days)LINZESSXE "LINZESS"3MO; QL (30 per 30 days)meclizine oral tablet 12.5 mg, 25 mgXE "meclizine"2MOmesalamine oral capsule,extended release 24hrXE "mesalamine"3MO; QL (120 per 30 days)mesalamine rectal enemaXE "mesalamine"4MOmesalamine with cleansing wipeXE "mesalamine with cleansing wipe"4MOmetoclopramide hcl oral solutionXE "metoclopramide hcl"2MOmetoclopramide hcl oral tabletXE "metoclopramide hcl"1MOMOVANTIKXE "MOVANTIK"4MO; QL (30 per 30 days)OCALIVAXE "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"2B/D PAondansetron hcl oral tablet 4 mg, 8 mgXE "ondansetron hcl"2B/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"4MOprochlorperazineXE "prochlorperazine"4MOprochlorperazine maleate oralXE "prochlorperazine maleate oral"2MOprocto-med hcXE "procto-med hc"4MOprocto-pakXE "procto-pak"4MOproctosol hc topicalXE "proctosol hc"3MOproctozone-hcXE "proctozone-hc"4MORECTIVXE "RECTIV"4MOscopolamine baseXE "scopolamine base"4MOSUCRAIDXE "SUCRAID"5MOsulfasalazineXE "sulfasalazine"2MOSUPREP BOWEL PREP KITXE "SUPREP BOWEL PREP KIT"4MOSYNDROSXE "SYNDROS"5B/D PA; MO; QL (120 per 30 days)TRANSDERM-SCOPXE "TRANSDERM-SCOP"4MOtrilyte with flavor packetsXE "trilyte with flavor packets"2MOUCERIS RECTALXE "UCERIS"4MOursodiol oral capsuleXE "ursodiol"4MOursodiol oral tablet 250 mgXE "ursodiol"2MOursodiol oral tablet 500 mgXE "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"3MOULCER THERAPYDEXILANTXE "DEXILANT"3MOesomeprazole magnesium oral capsule,delayed release(dr/ec)XE "esomeprazole magnesium"4MOfamotidine oral suspensionXE "famotidine"1MOfamotidine oral tablet 20 mg, 40 mgXE "famotidine"1MOmisoprostolXE "misoprostol"3MOnizatidineXE "nizatidine"3MOomeprazole oral capsule,delayed release(dr/ec)XE "omeprazole"1MOpantoprazole oral tablet,delayed release (dr/ec)XE "pantoprazole"2MOsucralfate oral suspensionXE "sucralfate"4MOsucralfate oral tabletXE "sucralfate"2MOIMMUNOLOGY, VACCINES / BIOTECHNOLOGYBIOTECHNOLOGY DRUGSACTIMMUNEXE "ACTIMMUNE"5PA; MO; LAARCALYSTXE "ARCALYST"5PA; MOBETASERON SUBCUTANEOUS KITXE "BETASERON"5PA; MO; QL (15 per 30 days)INTRON A INJECTIONXE "INTRON A"5PA; MOLEUKINE INJECTION RECON SOLNXE "LEUKINE"5PA; MONEUPOGENXE "NEUPOGEN"5PA; MO; QL (14 per 30 days)NORDITROPIN FLEXPROXE "NORDITROPIN FLEXPRO"5PA; MOPEGASYS PROCLICK SUBCUTANEOUS PEN INJECTOR 180 MCG/0.5 MLXE "PEGASYS PROCLICK"5PA; QL (2 per 28 days)PEGASYS SUBCUTANEOUS SOLUTIONXE "PEGASYS"5PA; MO; QL (4 per 28 days)PEGASYS SUBCUTANEOUS SYRINGEXE "PEGASYS"5PA; MO; QL (2 per 28 days)PROCRIT INJECTION SOLUTION 10,000 UNIT/ML, 4,000 UNIT/MLXE "PROCRIT"4PA; MO; QL (12 per 28 days)PROCRIT INJECTION SOLUTION 2,000 UNIT/MLXE "PROCRIT"4PA; MO; QL (23 per 30 days)PROCRIT INJECTION SOLUTION 20,000 UNIT/MLXE "PROCRIT"5PA; MO; QL (12 per 28 days)PROCRIT INJECTION SOLUTION 3,000 UNIT/MLXE "PROCRIT"4PA; MO; QL (16 per 30 days)PROCRIT INJECTION SOLUTION 40,000 UNIT/MLXE "PROCRIT"5PA; MO; QL (12 per 30 days)RETACRIT INJECTION SOLUTION 10,000 UNIT/ML, 4,000 UNIT/MLXE "RETACRIT"4PA; MO; QL (12 per 28 days)RETACRIT INJECTION SOLUTION 2,000 UNIT/MLXE "RETACRIT"4PA; MO; QL (23 per 30 days)RETACRIT INJECTION SOLUTION 3,000 UNIT/MLXE "RETACRIT"4PA; MO; QL (16 per 30 days)RETACRIT INJECTION SOLUTION 40,000 UNIT/MLXE "RETACRIT"4PA; MO; QL (12 per 30 days)SYLATRON SUBCUTANEOUS KIT 200 MCG, 300 MCGXE "SYLATRON"5PA; MO; QL (4 per 28 days)ZIEXTENZOXE "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; 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"5B/D PA; MOPANZYGAXE "PANZYGA"5B/D PA; MOPEDIARIX (PF)XE "PEDIARIX (PF)"3MOPEDVAX HIB (PF)XE "PEDVAX HIB (PF)"3MOPRIVIGENXE "PRIVIGEN"5B/D PA; 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)"3MOTDVAXXE "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)"3MOVARIZIG INTRAMUSCULAR SOLUTIONXE "VARIZIG"3MOYF-VAX (PF)XE "YF-VAX (PF)"3MOZOSTAVAX (PF)XE "ZOSTAVAX (PF)"3MO; QL (1 per 365 days)MUSCULOSKELETAL / RHEUMATOLOGYGOUT THERAPYallopurinolXE "allopurinol"1MOcolchicine oral tabletXE "colchicine"4MOCOLCRYSXE "COLCRYS"3MOfebuxostatXE "febuxostat"3MOMITIGAREXE "MITIGARE"3MOprobenecidXE "probenecid"3MOprobenecid-colchicineXE "probenecid-colchicine"3MOOSTEOPOROSIS THERAPYalendronate oral tablet 10 mg, 35 mg, 70 mgXE "alendronate"1MOibandronate oralXE "ibandronate"3MO; QL (1 per 30 days)PROLIAXE "PROLIA"4MO; QL (1 per 180 days)raloxifeneXE "raloxifene"3MO; QL (30 per 30 days)risedronate oral tablet 150 mgXE "risedronate"4MO; QL (1 per 30 days)risedronate oral tablet 35 mg, 35 mg (12 pack), 35 mg (4 pack)XE "risedronate"4MO; QL (4 per 28 days)TERIPARATIDEXE "TERIPARATIDE"5PA; MO; QL (2.48 per 28 days)TYMLOSXE "TYMLOS"5PA; MOOTHER RHEUMATOLOGICALSBENLYSTA SUBCUTANEOUSXE "BENLYSTA"5MOENBREL 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; MO; QL (6 per 180 days)HUMIRA PEN PSOR-UVEITS-ADOL HSXE "HUMIRA PEN PSOR-UVEITS-ADOL HS"5PA; MO; QL (4 per 180 days)HUMIRA 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)XE "HUMIRA(CF)"5PA; MO; QL (2 per 28 days)HUMIRA(CF) PEDI CROHNS STARTER SUBCUTANEOUS SYRINGE KIT 80 MG/0.8 MLXE "HUMIRA(CF) PEDI CROHNS STARTER"5PA; MO; QL (3 per 180 days)HUMIRA(CF) PEDI CROHNS STARTER SUBCUTANEOUS SYRINGE KIT 80 MG/0.8 ML-40 MG/0.4 MLXE "HUMIRA(CF) PEDI CROHNS STARTER"5PA; MO; QL (2 per 180 days)HUMIRA(CF) PEN CROHNS-UC-HSXE "HUMIRA(CF) PEN CROHNS-UC-HS"5PA; MO; QL (3 per 180 days)HUMIRA(CF) PEN PSOR-UV-ADOL HSXE "HUMIRA(CF) PEN PSOR-UV-ADOL HS"5PA; MO; QL (3 per 180 days)KEVZARA SUBCUTANEOUS SYRINGEXE "KEVZARA"5PA; MO; QL (2.28 per 28 days)leflunomideXE "leflunomide"3MOpenicillamine oral tabletXE "penicillamine"4MORINVOQXE "RINVOQ"5PA; MO; QL (30 per 30 days)SAVELLA ORAL TABLETXE "SAVELLA"3MO; QL (60 per 30 days)SAVELLA ORAL TABLETS,DOSE PACKXE "SAVELLA"3MO; QL (110 per 365 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"4MOdeblitaneXE "deblitane"4MODEPO-PROVERA INTRAMUSCULAR SUSPENSION 400 MG/MLXE "DEPO-PROVERA"4B/D PA; MODUAVEEXE "DUAVEE"4MOerrinXE "errin"4MOestradiol oralXE "estradiol"2MOestradiol transdermalXE "estradiol"4MOestradiol vaginal creamXE "estradiol"3MOestradiol vaginal tabletXE "estradiol"4MOfyavolvXE "fyavolv"4MOIMVEXXY MAINTENANCE PACKXE "IMVEXXY MAINTENANCE PACK"4MOIMVEXXY STARTER PACKXE "IMVEXXY STARTER PACK"4MOjinteliXE "jinteli"4MOlyzaXE "lyza"4MOmedroxyprogesterone intramuscularXE "medroxyprogesterone"4MOmedroxyprogesterone oralXE "medroxyprogesterone"1MOnora-beXE "nora-be"4MOnorethindrone (contraceptive)XE "norethindrone (contraceptive)"4MOnorethindrone acetateXE "norethindrone acetate"3MOnorethindrone ac-eth estradiol oral tablet 1-5 mg-mcgXE "norethindrone ac-eth estradiol"4MOPREMARIN ORALXE "PREMARIN"3MOPREMARIN VAGINALXE "PREMARIN"3MOPREMPHASEXE "PREMPHASE"3MOPREMPROXE "PREMPRO"3MOprogesterone micronizedXE "progesterone micronized"3MOsharobelXE "sharobel"4MOyuvafemXE "yuvafem"4MOMISCELLANEOUS OB/GYNclindamycin phosphate vaginalXE "clindamycin phosphate"4MOeluryngXE "eluryng"4MOetonogestrel-ethinyl estradiolXE "etonogestrel-ethinyl estradiol"4MOINTRAROSAXE "INTRAROSA"4PA; MOmetronidazole vaginalXE "metronidazole"4MOOSPHENAXE "OSPHENA"4PA; MOterconazoleXE "terconazole"3MOtranexamic acid oralXE "tranexamic acid"3MOvandazoleXE "vandazole"4MOORAL CONTRACEPTIVES / RELATED AGENTSaltavera (28)XE "altavera (28)"4MOapriXE "apri"4MOaranelle (28)XE "aranelle (28)"4MOaubraXE "aubra"4MOaubra eqXE "aubra eq"4MOavianeXE "aviane"4MObalziva (28)XE "balziva (28)"4MObriellynXE "briellyn"4MOcaziant (28)XE "caziant (28)"4MOcryselle (28)XE "cryselle (28)"4MOcyclafem 1/35 (28)XE "cyclafem 1/35 (28)"4MOcyclafem 7/7/7 (28)XE "cyclafem 7/7/7 (28)"4MOcyred eqXE "cyred eq"4MOdesog-e.estradiol/e.estradiolXE "desog-e.estradiol/e.estradiol"4MOdrospirenone-ethinyl estradiol oral tablet 3-0.03 mgXE "drospirenone-ethinyl estradiol"4MOemoquetteXE "emoquette"4MOenpresseXE "enpresse"4MOenskyceXE "enskyce"4MOestaryllaXE "estarylla"4MOethynodiol diac-eth estradiol oral tablet 1-35 mg-mcgXE "ethynodiol diac-eth estradiol"4falmina (28)XE "falmina (28)"4MOgianvi (28)XE "gianvi (28)"4MOhailey 24 feXE "hailey 24 fe"4MOintrovaleXE "introvale"4MOisibloomXE "isibloom"4MOjasmiel (28)XE "jasmiel (28)"4MOjuleberXE "juleber"4MOjunel 1.5/30 (21)XE "junel 1.5/30 (21)"4MOjunel 1/20 (21)XE "junel 1/20 (21)"4MOjunel fe 1.5/30 (28)XE "junel fe 1.5/30 (28)"4MOjunel fe 1/20 (28)XE "junel fe 1/20 (28)"4MOkariva (28)XE "kariva (28)"4MOkelnor 1/35 (28)XE "kelnor 1/35 (28)"4MOkelnor 1-50XE "kelnor 1-50"4MOkurvelo (28)XE "kurvelo (28)"4MOl norgest/e.estradiol-e.estrad oral tablets,dose pack,3 month 0.15 mg-20 mcg/ 0.15 mg-25 mcgXE "l norgest/e.estradiol-e.estrad"4MOlarin 1.5/30 (21)XE "larin 1.5/30 (21)"4MOlarin 1/20 (21)XE "larin 1/20 (21)"4MOlarin fe 1.5/30 (28)XE "larin fe 1.5/30 (28)"4MOlarin fe 1/20 (28)XE "larin fe 1/20 (28)"4MOlarissiaXE "larissia"4MOleena 28XE "leena 28"4MOlessinaXE "lessina"4MOlevonest (28)XE "levonest (28)"4MOlevonorgestrel-ethinyl estrad oral tablet 0.1-20 mg-mcg, 0.15-0.03 mgXE "levonorgestrel-ethinyl estrad"4MOlevonorgestrel-ethinyl estrad oral tablets,dose pack,3 monthXE "levonorgestrel-ethinyl estrad"4MOlevonorg-eth estrad triphasicXE "levonorg-eth estrad triphasic"4MOlevora-28XE "levora-28"4MOloryna (28)XE "loryna (28)"4MOlow-ogestrel (28)XE "low-ogestrel (28)"4MOlutera (28)XE "lutera (28)"4MOmarlissa (28)XE "marlissa (28)"4MOmicrogestin 1.5/30 (21)XE "microgestin 1.5/30 (21)"4MOmicrogestin 1/20 (21)XE "microgestin 1/20 (21)"4MOmicrogestin fe 1.5/30 (28)XE "microgestin fe 1.5/30 (28)"4MOmicrogestin fe 1/20 (28)XE "microgestin fe 1/20 (28)"4MOmiliXE "mili"4MOnecon 0.5/35 (28)XE "necon 0.5/35 (28)"4MOnikki (28)XE "nikki (28)"4MOnorgestimate-ethinyl estradiol oral tablet 0.18/0.215/0.25 mg-35 mcg (28), 0.25-35 mg-mcgXE "norgestimate-ethinyl estradiol"4MOnortrel 0.5/35 (28)XE "nortrel 0.5/35 (28)"4MOnortrel 1/35 (21)XE "nortrel 1/35 (21)"4MOnortrel 1/35 (28)XE "nortrel 1/35 (28)"4MOnortrel 7/7/7 (28)XE "nortrel 7/7/7 (28)"4MOocellaXE "ocella"4MOorsythiaXE "orsythia"4MOpimtrea (28)XE "pimtrea (28)"4MOpirmella oral tablet 1-35 mg-mcgXE "pirmella"4MOportia 28XE "portia 28"4MOprevifemXE "previfem"4MOreclipsen (28)XE "reclipsen (28)"4MOsetlakinXE "setlakin"4MOsprintec (28)XE "sprintec (28)"4MOsronyxXE "sronyx"4MOsyedaXE "syeda"4MOtarina 24 feXE "tarina 24 fe"4MOtarina fe 1/20 (28)XE "tarina fe 1/20 (28)"4MOtarina fe 1-20 eq (28)XE "tarina fe 1-20 eq (28)"4MOtri-estaryllaXE "tri-estarylla"4MOtri-legest feXE "tri-legest fe"4MOtri-miliXE "tri-mili"4MOtri-previfem (28)XE "tri-previfem (28)"4MOtri-sprintec (28)XE "tri-sprintec (28)"4MOtrivora (28)XE "trivora (28)"4MOtri-vylibraXE "tri-vylibra"4MOvelivet triphasic regimen (28)XE "velivet triphasic regimen (28)"4MOvienvaXE "vienva"4MOvyfemla (28)XE "vyfemla (28)"4MOvylibraXE "vylibra"4MOzovia 1/35e (28)XE "zovia 1/35e (28)"4MOOPHTHALMOLOGYANTIBIOTICSak-poly-bacXE "ak-poly-bac"2MObacitracin ophthalmic (eye)XE "bacitracin"4MObacitracin-polymyxin b ophthalmic (eye)XE "bacitracin-polymyxin b"2MOBESIVANCEXE "BESIVANCE"4MOciprofloxacin hcl ophthalmic (eye)XE "ciprofloxacin hcl"2MOerythromycin ophthalmic (eye)XE "erythromycin"2MOgatifloxacinXE "gatifloxacin"4MOgentak ophthalmic (eye) ointmentXE "gentak"2MOgentamicin ophthalmic (eye) dropsXE "gentamicin"2MOMOXEZAXE "MOXEZA"3MOmoxifloxacin ophthalmic (eye)XE "moxifloxacin"3MONATACYNXE "NATACYN"4MOneomycin-bacitracin-polymyxinXE "neomycin-bacitracin-polymyxin"4MOneomycin-polymyxin-gramicidinXE "neomycin-polymyxin-gramicidin"4MOofloxacin ophthalmic (eye)XE "ofloxacin"2MOpolymyxin b sulf-trimethoprimXE "polymyxin b sulf-trimethoprim"2MOtobramycinXE "tobramycin"2MOANTIVIRALStrifluridineXE "trifluridine"3MOZIRGANXE "ZIRGAN"4MOBETA-BLOCKERSbetaxolol ophthalmic (eye)XE "betaxolol"4MOcarteololXE "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"1MOtimolol maleate ophthalmic (eye) gel forming solutionXE "timolol maleate"4MOMISCELLANEOUS OPHTHALMOLOGICSatropine ophthalmic (eye) dropsXE "atropine"4MOazelastine ophthalmic (eye)XE "azelastine"4MOBEPREVEXE "BEPREVE"4MOBLEPHAMIDE S.O.P.XE "BLEPHAMIDE S.O.P."4MOcromolyn ophthalmic (eye)XE "cromolyn"2MOCYSTARANXE "CYSTARAN"5MOolopatadine ophthalmic (eye)XE "olopatadine"3MOPAZEOXE "PAZEO"4MOpilocarpine hcl ophthalmic (eye) drops 1 %XE "pilocarpine hcl"2MOpilocarpine hcl ophthalmic (eye) drops 2 %, 4 %XE "pilocarpine hcl"4MORESTASISXE "RESTASIS"3MORESTASIS MULTIDOSEXE "RESTASIS MULTIDOSE"3MOsulfacetamide sodium ophthalmic (eye) dropsXE "sulfacetamide sodium"2MOsulfacetamide sodium ophthalmic (eye) ointmentXE "sulfacetamide sodium"4MOsulfacetamide-prednisoloneXE "sulfacetamide-prednisolone"2MONON-STEROIDAL ANTI-INFLAMMATORY AGENTSbromfenacXE "bromfenac"4MOdiclofenac sodium ophthalmic (eye)XE "diclofenac sodium"2MOflurbiprofen sodiumXE "flurbiprofen sodium"2MOILEVROXE "ILEVRO"3MOketorolac ophthalmic (eye)XE "ketorolac"2MOPROLENSAXE "PROLENSA"4MOORAL DRUGS FOR GLAUCOMAacetazolamide oral capsule, extended releaseXE "acetazolamide"4MOacetazolamide oral tabletXE "acetazolamide"3MOmethazolamideXE "methazolamide"4MOOTHER GLAUCOMA DRUGSAZOPTXE "AZOPT"3MOCOMBIGANXE "COMBIGAN"4MOdorzolamideXE "dorzolamide"2MOdorzolamide-timololXE "dorzolamide-timolol"4MOdorzolamide-timolol (pf) ophthalmic (eye) dropperetteXE "dorzolamide-timolol (pf)"4MOlatanoprostXE "latanoprost"2MOLUMIGAN OPHTHALMIC (EYE) DROPS 0.01 %XE "LUMIGAN"3MOSIMBRINZAXE "SIMBRINZA"4MOtravoprostXE "travoprost"3MOSTEROID-ANTIBIOTIC COMBINATIONSneomycin-bacitracin-poly-hcXE "neomycin-bacitracin-poly-hc"4MOneomycin-polymyxin b-dexamethXE "neomycin-polymyxin b-dexameth"2MOneomycin-polymyxin-hc ophthalmic (eye)XE "neomycin-polymyxin-hc"4MOtobramycin-dexamethasoneXE "tobramycin-dexamethasone"4MOZYLETXE "ZYLET"4MOSTEROIDSdexamethasone sodium phosphate ophthalmic (eye)XE "dexamethasone sodium phosphate"4MODUREZOLXE "DUREZOL"3MOfluorometholoneXE "fluorometholone"4MOLOTEMAX OPHTHALMIC (EYE) DROPS,GELXE "LOTEMAX"4MOLOTEMAX OPHTHALMIC (EYE) OINTMENTXE "LOTEMAX"4MOLOTEMAX SMXE "LOTEMAX SM"4MOloteprednol etabonateXE "loteprednol etabonate"4MOprednisolone acetateXE "prednisolone acetate"3MOprednisolone sodium phosphate ophthalmic (eye)XE "prednisolone sodium phosphate"2MOSYMPATHOMIMETICSALPHAGAN P OPHTHALMIC (EYE) DROPS 0.1 %XE "ALPHAGAN P"3MOapraclonidineXE "apraclonidine"4MObrimonidine ophthalmic (eye) drops 0.15 %XE "brimonidine"4MObrimonidine ophthalmic (eye) drops 0.2 %XE "brimonidine"2MORESPIRATORY AND ALLERGYANTIHISTAMINE / ANTIALLERGENIC AGENTScetirizine oral solution 1 mg/mlXE "cetirizine"2MOcyproheptadine oral tabletXE "cyproheptadine"4MOdesloratadine oral tabletXE "desloratadine"2MOEPINEPHRINE INJECTION AUTO-INJECTOR 0.15 MG/0.15 ML, 0.3 MG/0.3 MLXE "EPINEPHRINE"2MOepinephrine injection auto-injector 0.15 mg/0.3 ml, 0.3 mg/0.3 mlXE "epinephrine"2MOhydroxyzine hcl oral solution 10 mg/5 mlXE "hydroxyzine hcl"4MOhydroxyzine hcl oral tabletXE "hydroxyzine hcl"3MOhydroxyzine pamoateXE "hydroxyzine pamoate"3MOlevocetirizine oral tabletXE "levocetirizine"2MOpromethazine oral tabletXE "promethazine"2MOSYMJEPIXE "SYMJEPI"3MOPULMONARY AGENTSacetylcysteineXE "acetylcysteine"4B/D PA; MOADEMPASXE "ADEMPAS"5PA; MO; 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 solution for nebulizationXE "albuterol sulfate"2B/D PA; MOalbuterol sulfate oral syrupXE "albuterol sulfate"2MOalbuterol sulfate oral tabletXE "albuterol sulfate"4MOambrisentanXE "ambrisentan"5PA; MO; 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)bosentanXE "bosentan"5PA; MO; QL (60 per 30 days)BREO ELLIPTAXE "BREO ELLIPTA"3MO; QL (60 per 30 days)BROVANAXE "BROVANA"4B/D PA; MObudesonide inhalationXE "budesonide"4B/D PA; MOCOMBIVENT RESPIMATXE "COMBIVENT RESPIMAT"4MO; QL (4 per 20 days)cromolyn inhalationXE "cromolyn"3B/D PA; MODALIRESPXE "DALIRESP"3MO; QL (30 per 30 days)ESBRIET ORAL CAPSULEXE "ESBRIET"5PA; MOESBRIET ORAL TABLET 801 MGXE "ESBRIET"5PA; MOFLOVENT DISKUSXE "FLOVENT DISKUS"3MO; QL (60 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"4MO; QL (50 per 30 days)fluticasone propionate nasalXE "fluticasone propionate"2MO; QL (16 per 30 days)FLUTICASONE PROPION-SALMETEROL INHALATION AEROSOL POWDR BREATH ACTIVATEDXE "FLUTICASONE PROPION-SALMETEROL"3MO; QL (1 per 30 days)ipratropium bromide inhalationXE "ipratropium bromide"2B/D PA; MOipratropium-albuterolXE "ipratropium-albuterol"2B/D PA; MOKALYDECOXE "KALYDECO"5PA; MOmontelukast oral granules in packetXE "montelukast"4MO; QL (30 per 30 days)montelukast oral tabletXE "montelukast"1MOmontelukast oral tablet,chewableXE "montelukast"2MO; QL (30 per 30 days)OFEVXE "OFEV"5PA; MOOPSUMITXE "OPSUMIT"5PA; MO; QL (30 per 30 days)ORKAMBI ORAL GRANULES IN PACKETXE "ORKAMBI"5PA; MO; LA; QL (56 per 28 days)ORKAMBI ORAL TABLETXE "ORKAMBI"5PA; MO; LA; QL (120 per 30 days)PULMOZYMEXE "PULMOZYME"5PA; MORUCONESTXE "RUCONEST"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)SPIRIVA RESPIMATXE "SPIRIVA RESPIMAT"3MO; QL (4 per 30 days)SPIRIVA WITH HANDIHALERXE "SPIRIVA WITH HANDIHALER"3MO; QL (30 per 30 days)SYMDEKOXE "SYMDEKO"5PA; MO; LA; QL (56 per 28 days)TAKHZYROXE "TAKHZYRO"5PA; MO; LA; QL (4 per 28 days)terbutaline oralXE "terbutaline"4MOtheophylline oral elixirXE "theophylline"4theophylline oral solutionXE "theophylline"4MOtheophylline oral tablet extended release 12 hr 300 mgXE "theophylline"2MOtheophylline oral tablet extended release 24 hrXE "theophylline"2MOTRACLEER ORAL TABLET FOR SUSPENSIONXE "TRACLEER"5PA; MO; LA; QL (120 per 30 days)TRELEGY ELLIPTAXE "TRELEGY ELLIPTA"3MO; QL (60 per 30 days)TRIKAFTAXE "TRIKAFTA"5PA; MO; LA; QL (84 per 28 days)VENTOLIN HFAXE "VENTOLIN HFA"3MO; QL (36 per 30 days)XOLAIRXE "XOLAIR"5PA; MOzafirlukastXE "zafirlukast"4MO; QL (60 per 30 days)UROLOGICALSANTICHOLINERGICS / ANTISPASMODICSdarifenacinXE "darifenacin"4MOMYRBETRIQXE "MYRBETRIQ"3MOoxybutynin chlorideXE "oxybutynin chloride"4MOtolterodineXE "tolterodine"4MOBENIGN PROSTATIC HYPERPLASIA(BPH) THERAPYalfuzosinXE "alfuzosin"2MOdutasterideXE "dutasteride"2MOdutasteride-tamsulosinXE "dutasteride-tamsulosin"4MOfinasteride oral tablet 5 mgXE "finasteride"1MOsilodosinXE "silodosin"4MOtamsulosinXE "tamsulosin"2MOMISCELLANEOUS UROLOGICALSbethanechol chlorideXE "bethanechol chloride"3MOCYSTAGONXE "CYSTAGON"4PA; MOELMIRONXE "ELMIRON"4MOpotassium citrateXE "potassium citrate"4MOVITAMINS, HEMATINICS / ELECTROLYTESELECTROLYTEScalcium acetate(phosphat bind)XE "calcium acetate(phosphat bind)"3MOklor-con 10XE "klor-con 10"2MOklor-con 8XE "klor-con 8"2MOklor-con m10XE "klor-con m10"2MOklor-con m15XE "klor-con m15"3MOklor-con m20XE "klor-con m20"2MOmagnesium sulfate injection solutionXE "magnesium sulfate"4MOmagnesium sulfate injection syringeXE "magnesium sulfate"4NORMOSOL-RXE "NORMOSOL-R"4B/D PA; MONORMOSOL-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"4B/D PApotassium chlorid-d5-0.45%nacl intravenous parenteral solution 20 meq/lXE "potassium chlorid-d5-0.45%nacl"4B/D PA; MOpotassium chloride in 0.9%nacl intravenous parenteral solution 20 meq/l, 40 meq/lXE "potassium chloride in 0.9%nacl"4B/D PApotassium chloride in 5 % dex intravenous parenteral solution 20 meq/lXE "potassium chloride in 5 % dex"4B/D PApotassium chloride in 5 % dex intravenous parenteral solution 40 meq/lXE "potassium chloride in 5 % dex"4potassium chloride in water intravenous piggyback 20 meq/100 mlXE "potassium chloride in water"4potassium chloride intravenousXE "potassium chloride"4MOpotassium chloride oral capsule, extended releaseXE "potassium chloride"3MOpotassium chloride oral liquidXE "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"4B/D PApotassium chloride-d5-0.2%nacl intravenous parenteral solution 20 meq/lXE "potassium chloride-d5-0.2%nacl"4B/D PA; MOpotassium chloride-d5-0.9%nacl intravenous parenteral solution 20 meq/lXE "potassium chloride-d5-0.9%nacl"4B/D PA; MOpotassium chloride-d5-0.9%nacl intravenous parenteral solution 40 meq/lXE "potassium chloride-d5-0.9%nacl"4B/D PAsodium chloride 0.45 % intravenous parenteral solutionXE "sodium chloride 0.45 %"4MOsodium chloride 3 %XE "sodium chloride 3 %"4MOsodium chloride 5 %XE "sodium chloride 5 %"4MOTPN ELECTROLYTESXE "TPN ELECTROLYTES"4B/D PAMISCELLANEOUS NUTRITION PRODUCTSAMINOSYN II 10 %XE "AMINOSYN II 10 %"4B/D PAAMINOSYN-PF 10 %XE "AMINOSYN-PF 10 %"4B/D PAAMINOSYN-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 PAFREAMINE 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"4B/D PAISOLYTE-P IN 5 % DEXTROSEXE "ISOLYTE-P IN 5 % DEXTROSE"4B/D PAISOLYTE-SXE "ISOLYTE-S"4B/D PANEPHRAMINE 5.4 %XE "NEPHRAMINE 5.4 %"4B/D PANORMOSOL-M IN 5 % DEXTROSEXE "NORMOSOL-M IN 5 % DEXTROSE"4B/D PANORMOSOL-R PH 7.4XE "NORMOSOL-R PH 7.4"4B/D PANUTRILIPIDXE "NUTRILIPID"4B/D PAPLASMA-LYTE 148XE "PLASMA-LYTE 148"4B/D PAPLASMA-LYTE AXE "PLASMA-LYTE A"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; MOIndexINDEX \e "" \c "3" \h "A" \z "1033" Aabacavir2abacavir-lamivudine2abacavir-lamivudine-zidovudine2ABELCET2ABILIFY MAINTENA27ABILIFY MYCITE27abiraterone12acamprosate42acarbose45acebutolol33acetaminophen-codeine24acetazolamide59acetic acid44acetylcysteine60acitretin39ACTHIB (PF)52ACTIMMUNE51acyclovir2, 3acyclovir sodium3ADACEL(TDAP ADOLESN/ADULT)(PF)52adefovir3ADEMPAS60ADVAIR DISKUS60ADVAIR HFA60AFINITOR12AFINITOR DISPERZ12AJOVY AUTOINJECTOR22AJOVY SYRINGE22ak-poly-bac57albendazole8albuterol sulfate60alclometasone41alcohol pads45ALECENSA12alendronate53alfuzosin62ALINIA8aliskiren33allopurinol53alosetron49ALPHAGAN P60alprazolam27altavera (28)56ALUNBRIG12, 13amantadine hcl3AMBISOME2ambrisentan60amikacin8amiloride33amiloride-hydrochlorothiazide33AMINOSYN II 10 %64AMINOSYN-PF 10 %64AMINOSYN-PF 7 % (SULFITE-FREE)64amiodarone33AMITIZA49amitriptyline27amlodipine33amlodipine-atorvastatin37amlodipine-benazepril33amlodipine-olmesartan33amlodipine-valsartan34amlodipine-valsartan-hcthiazid34ammonium lactate39amnesteem40amoxapine27amoxicillin10amoxicillin-pot clavulanate10amphotericin b2ampicillin10ampicillin sodium10ampicillin-sulbactam10ANADROL-5047anagrelide42anastrozole13ANORO ELLIPTA60APOKYN21apraclonidine60aprepitant49apri56APTIOM19APTIVUS3APTIVUS (WITH VITAMIN E)3aranelle (28)56ARCALYST51ARIKAYCE8aripiprazole27armodafinil27ARNUITY ELLIPTA61aspirin-dipyridamole36atazanavir3atenolol34atenolol-chlorthalidone34atomoxetine27atorvastatin37atovaquone8atovaquone-proguanil8ATRIPLA3atropine58ATROVENT HFA61aubra56aubra eq56AURYXIA42AUSTEDO23aviane56AYVAKIT13AZACTAM8azathioprine13azelastine44, 58azithromycin7AZOPT59aztreonam8Bbacitracin57bacitracin-polymyxin b58baclofen24BACLOFEN24balsalazide49BALVERSA13balziva (28)56BANZEL19BARACLUDE3BCG VACCINE, LIVE (PF)52benazepril34benazepril-hydrochlorothiazide34BENLYSTA54benztropine21BEPREVE58BESIVANCE58betamethasone dipropionate41betamethasone valerate41betamethasone, augmented41BETASERON51betaxolol58bethanechol chloride62bexarotene13BEXSERO52bicalutamide13BICILLIN L-A10BIKTARVY3bisoprolol fumarate34bisoprolol-hydrochlorothiazide34BLEPHAMIDE S.O.P.58BOOSTRIX TDAP52bosentan61BOSULIF13BRAFTOVI13BREO ELLIPTA61briellyn56BRILINTA36brimonidine60BRIVIACT19bromfenac59bromocriptine21BROVANA61BRUKINSA13budesonide49, 61bumetanide34buprenorphine hcl24buprenorphine-naloxone26bupropion hcl27bupropion hcl (smoking deter)43buspirone27butalbital compound w/codeine24butalbital-acetaminophen24butalbital-acetaminophen-caff24butalbital-aspirin-caffeine24BYSTOLIC34Ccabergoline47CABLIVI36CABOMETYX13calcipotriene39calcitonin (salmon)47calcitriol47calcium acetate(phosphat bind)62CALQUENCE13camila55candesartan34candesartan-hydrochlorothiazid34CAPLYTA27CAPRELSA13captopril34captopril-hydrochlorothiazide34CARBAGLU42carbamazepine19carbidopa21carbidopa-levodopa21, 22carbidopa-levodopa-entacapone22carteolol58cartia xt34carvedilol34caspofungin2CATAPRES34CAYSTON8caziant (28)56cefaclor6cefadroxil6cefazolin6cefazolin in dextrose (iso-os)6cefdinir6cefepime6CEFEPIME IN DEXTROSE 5 %6cefepime in dextrose,iso-osm6cefixime6cefoxitin6cefoxitin in dextrose, iso-osm6cefpodoxime6cefprozil7ceftazidime7CEFTAZIDIME IN D5W7ceftriaxone7CEFTRIAXONE7ceftriaxone in dextrose,iso-os7cefuroxime axetil7cefuroxime sodium7celecoxib26CELONTIN19cephalexin7cetirizine60CHANTIX43CHANTIX CONTINUING MONTH BOX44CHANTIX STARTING MONTH BOX44CHEMET42chlordiazepoxide hcl27chlorhexidine gluconate44chloroquine phosphate8chlorpromazine27chlorthalidone34cholestyramine (with sugar)37cholestyramine light37ciclopirox41cilostazol36CIMDUO3cinacalcet47CIPRO11CIPRODEX44ciprofloxacin hcl11, 44, 58ciprofloxacin in 5 % dextrose11CIPROFLOXACIN-FLUOCINOLONE44citalopram27claravis40clarithromycin7CLENPIQ49clindamycin hcl8CLINDAMYCIN IN 0.9 % SOD CHLOR8clindamycin in 5 % dextrose8clindamycin palmitate hcl8clindamycin pediatric8clindamycin phosphate8, 40, 55CLINDAMYCIN PHOSPHATE40clindamycin-benzoyl peroxide40CLINIMIX 5%/D15W SULFITE FREE64CLINIMIX 4.25%/D10W SULF FREE64CLINIMIX 4.25%/D5W SULFIT FREE42CLINIMIX 5%-D20W(SULFITE-FREE)64clobazam19clomipramine27clonazepam19clonidine34clonidine hcl34clopidogrel36clorazepate dipotassium27clotrimazole2, 41clotrimazole-betamethasone41clozapine27, 28CLOZAPINE28COARTEM8codeine sulfate24codeine-butalbital-asa-caff24colchicine53COLCRYS53colesevelam37colestipol37colistin (colistimethate na)8COMBIGAN59COMBIVENT RESPIMAT61COMETRIQ13COMPLERA3compro49constulose49COPAXONE23COPIKTRA13CORLANOR38COSENTYX39COSENTYX (2 SYRINGES)39COSENTYX PEN39COSENTYX PEN (2 PENS)39COTELLIC13CREON49CRESEMBA2CRIXIVAN3cromolyn49, 58, 61cryselle (28)56cyclafem 1/35 (28)56cyclafem 7/7/7 (28)56cyclobenzaprine24cyclophosphamide13cyclosporine13cyclosporine modified13cyproheptadine60cyred eq56CYSTADANE49CYSTAGON62CYSTARAN58Dd10 %-0.45 % sodium chloride42d2.5 %-0.45 % sodium chloride42d5 % and 0.9 % sodium chloride42d5 %-0.45 % sodium chloride42dalfampridine23DALIRESP61danazol47dapsone8DAPTACEL (DTAP PEDIATRIC) (PF)52daptomycin8DAPTOMYCIN8darifenacin62DAURISMO13deblitane55deferasirox42DELSTRIGO3DEMSER34DEPO-PROVERA55DESCOVY3desipramine28desloratadine60desmopressin47desog-e.estradiol/e.estradiol56desonide41desoximetasone41DESVENLAFAXINE28desvenlafaxine succinate28dexamethasone44dexamethasone intensol44dexamethasone sodium phosphate59DEXILANT50dexmethylphenidate28dextroamphetamine28dextroamphetamine-amphetamine28dextrose 10 % and 0.2 % nacl42dextrose 10 % in water (d10w)42dextrose 5 % in water (d5w)42dextrose 5%-0.2 % sod chloride43dextrose with sodium chloride43DIASTAT19DIASTAT ACUDIAL19diazepam19, 29diazepam intensol28diclofenac potassium26diclofenac sodium26, 59dicloxacillin10dicyclomine48didanosine3diflunisal26digitek38digox38digoxin38dihydroergotamine22DILANTIN 30 MG19diltiazem hcl34dilt-xr34diphenoxylate-atropine48disulfiram43divalproex19dofetilide33donepezil23dorzolamide59dorzolamide-timolol59dorzolamide-timolol (pf)59DOVATO3doxazosin34doxepin29doxy-10012doxycycline hyclate12doxycycline monohydrate12DRIZALMA SPRINKLE29dronabinol49drospirenone-ethinyl estradiol56DROXIA13DUAVEE55duloxetine29DUPIXENT SYRINGE39DUREZOL59dutasteride62dutasteride-tamsulosin62Eec-naproxen26econazole41EDURANT3efavirenz3ELIGARD13ELIGARD (3 MONTH)13ELIGARD (4 MONTH)14ELIGARD (6 MONTH)14ELIQUIS36ELIQUIS DVT-PE TREAT 30D START36ELMIRON62eluryng55EMCYT14EMEND49emoquette56EMSAM29EMTRIVA3EMVERM8enalapril maleate34enalapril-hydrochlorothiazide34ENBREL54ENBREL MINI54ENBREL SURECLICK54ENDARI43endocet24ENGERIX-B (PF)52ENGERIX-B PEDIATRIC (PF)52enoxaparin37enpresse56enskyce56entacapone22entecavir3ENTRESTO38enulose49ENVARSUS XR14EPCLUSA3EPIDIOLEX19epinephrine60EPINEPHRINE60epitol19EPIVIR HBV3eplerenone34ergotamine-caffeine22ERIVEDGE14ERLEADA14erlotinib14errin55ertapenem8ery-tab7ERY-TAB7ERYTHROCIN7erythrocin (as stearate)7erythromycin8, 58erythromycin ethylsuccinate8erythromycin with ethanol40erythromycin-benzoyl peroxide40ESBRIET61escitalopram oxalate29esomeprazole magnesium51estarylla56estradiol55ethambutol8ethosuximide19ethynodiol diac-eth estradiol56etodolac26etonogestrel-ethinyl estradiol55EUCRISA39euthyrox48everolimus (antineoplastic)14everolimus (immunosuppressive)14EVOTAZ3exemestane14ezetimibe37ezetimibe-simvastatin37Ffalmina (28)56famciclovir3famotidine51FANAPT29FARYDAK14febuxostat53felbamate19, 20felodipine34fenofibrate38FENOFIBRATE38fenofibrate micronized37fenofibrate nanocrystallized37fentanyl25fentanyl citrate25FERRIPROX43FERRIPROX (2 TIMES A DAY)43FETZIMA29FIASP FLEXTOUCH U-100 INSULIN45FIASP PENFILL U-100 INSULIN45FIASP U-100 INSULIN45finasteride62FIRDAPSE23FIRVANQ8flac otic oil44flecainide33FLOVENT DISKUS61FLOVENT HFA61fluconazole2fluconazole in nacl (iso-osm)2flucytosine2fludrocortisone44flunisolide61fluocinolone41fluocinolone acetonide oil44fluocinonide41fluocinonide-e41fluocinonide-emollient41fluorometholone59FLUOROPLEX39fluorouracil39fluoxetine29fluphenazine decanoate29fluphenazine hcl29flurbiprofen26flurbiprofen sodium59flutamide14fluticasone propionate42, 61FLUTICASONE PROPION-SALMETEROL61fluvoxamine29fondaparinux37fosamprenavir3fosinopril34fosinopril-hydrochlorothiazide34FREAMINE HBC 6.9 %64furosemide34FUZEON3fyavolv55FYCOMPA20Ggabapentin20GALAFOLD47galantamine23GARDASIL 9 (PF)52gatifloxacin58GATTEX 30-VIAL49GATTEX ONE-VIAL49GAUZE PAD45gavilyte-c49gavilyte-n49gemfibrozil38generlac49gengraf14gentak58gentamicin9, 41, 58gentamicin in nacl (iso-osm)8GENVOYA3GEODON29gianvi (28)56GILENYA23GILOTRIF14glimepiride45glipizide45glipizide-metformin45GLUCAGEN HYPOKIT45GLUCAGON (HCL) EMERGENCY KIT45GLUCAGON EMERGENCY KIT (HUMAN)45glyburide45glyburide micronized45glycopyrrolate48GOCOVRI22granisetron hcl49griseofulvin microsize2griseofulvin ultramicrosize2guanfacine29, 35guanidine29Hhailey 24 fe56halobetasol propionate42haloperidol30haloperidol decanoate29, 30haloperidol lactate30HARVONI3HAVRIX (PF)52heparin (porcine)37HEPATAMINE 8%64HIBERIX (PF)52HUMIRA54HUMIRA PEN54HUMIRA PEN CROHNS-UC-HS START54HUMIRA PEN PSOR-UVEITS-ADOL HS54HUMIRA(CF)54HUMIRA(CF) PEDI CROHNS STARTER54HUMIRA(CF) PEN CROHNS-UC-HS54HUMIRA(CF) PEN PSOR-UV-ADOL HS54HUMULIN R U-500 (CONC) INSULIN45HUMULIN R U-500 (CONC) KWIKPEN45hydralazine35hydrochlorothiazide35hydrocodone-acetaminophen25hydrocodone-ibuprofen25hydrocortisone42, 44, 49hydrocortisone valerate42hydrocortisone-pramoxine49hydromorphone25hydromorphone (pf)25hydroxychloroquine9hydroxyurea14hydroxyzine hcl60hydroxyzine pamoate60Iibandronate53IBRANCE14ibu26ibuprofen26ibuprofen-oxycodone25ICLUSIG14IDHIFA14ILEVRO59imatinib14IMBRUVICA14imipenem-cilastatin9imipramine hcl30imiquimod39IMOVAX RABIES VACCINE (PF)52IMVEXXY MAINTENANCE PACK55IMVEXXY STARTER PACK55INCRELEX43indapamide35indomethacin26INFANRIX (DTAP) (PF)52INLYTA14INREBIC14INSULIN ASP PRT-INSULIN ASPART45INSULIN ASPART U-10045INSULIN PEN NEEDLE45INSULIN SYRINGE (DISP) U-10045INTELENCE3, 4intralipid64INTRALIPID64INTRAROSA55INTRON A51introvale56INVEGA30INVEGA SUSTENNA30INVEGA TRINZA30INVIRASE4INVOKAMET45INVOKAMET XR45INVOKANA45IPOL52ipratropium bromide44, 61ipratropium-albuterol61irbesartan35irbesartan-hydrochlorothiazide35IRESSA14ISENTRESS4ISENTRESS HD4isibloom56ISOLYTE S PH 7.464ISOLYTE-P IN 5 % DEXTROSE64ISOLYTE-S64isoniazid9isosorbide dinitrate38isosorbide mononitrate38isotretinoin40isradipine35itraconazole2ivermectin9IXIARO (PF)52JJAKAFI14jantoven37JANUMET45JANUMET XR46JANUVIA46JARDIANCE46jasmiel (28)56jinteli55JUBLIA41juleber56JULUCA4junel 1.5/30 (21)56junel 1/20 (21)56junel fe 1.5/30 (28)56junel fe 1/20 (28)56KKALETRA4KALYDECO61kariva (28)56KATERZIA35kelnor 1/35 (28)56kelnor 1-5056ketoconazole2, 41ketoprofen26ketorolac26, 59KEVZARA54KINRIX (PF)52kionex (with sorbitol)43KISQALI14KISQALI FEMARA CO-PACK15klor-con 1062klor-con 862klor-con m1063klor-con m1563klor-con m2063KORLYM47kurvelo (28)56KUVAN47Ll norgest/e.estradiol-e.estrad56labetalol35lactulose49lamivudine4lamivudine-zidovudine4lamotrigine20LANTUS SOLOSTAR U-100 INSULIN46LANTUS U-100 INSULIN46larin 1.5/30 (21)56larin 1/20 (21)56larin fe 1.5/30 (28)56larin fe 1/20 (28)56larissia56latanoprost59LATUDA30leena 2856leflunomide54LENVIMA15lessina56letrozole15leucovorin calcium12LEUKERAN15LEUKINE51leuprolide15LEVEMIR FLEXTOUCH U-100 INSULN46LEVEMIR U-100 INSULIN46levetiracetam20levobunolol58levocarnitine43levocarnitine (with sugar)43levocetirizine60levofloxacin11levofloxacin in d5w11levonest (28)56levonorgestrel-ethinyl estrad56, 57levonorg-eth estrad triphasic57levora-2857levo-t48levothyroxine48levoxyl48LEXIVA4LIALDA49lidocaine40lidocaine hcl39, 40lidocaine viscous40lidocaine-prilocaine40linezolid9linezolid in dextrose 5%9linezolid-0.9% sodium chloride9LINZESS49liothyronine48lisinopril35lisinopril-hydrochlorothiazide35lithium carbonate30lithium citrate30LIVALO38LOKELMA43LONSURF15loperamide48lopinavir-ritonavir4lorazepam30lorazepam intensol30LORBRENA15lorcet (hydrocodone)25loryna (28)57losartan35losartan-hydrochlorothiazide35LOTEMAX59LOTEMAX SM59loteprednol etabonate60lovastatin38low-ogestrel (28)57loxapine succinate30LUMIGAN59LUPRON DEPOT15LUPRON DEPOT (3 MONTH)15LUPRON DEPOT (4 MONTH)15LUPRON DEPOT (6 MONTH)15LUPRON DEPOT-PED15LUPRON DEPOT-PED (3 MONTH)15lutera (28)57LYNPARZA15LYSODREN15lyza55Mmagnesium sulfate63malathion42maprotiline30marlissa (28)57MARPLAN30MATULANE15MAYZENT23meclizine49medroxyprogesterone55mefloquine9megestrol15MEKINIST15MEKTOVI15meloxicam26memantine23MEMANTINE23MENACTRA (PF)52MENVEO A-C-Y-W-135-DIP (PF)52mercaptopurine15meropenem9MEROPENEM-0.9% SODIUM CHLORIDE9mesalamine49mesalamine with cleansing wipe49MESNEX12metaxalone24metformin46methadone25methazolamide59methenamine hippurate12methimazole45methocarbamol24methotrexate sodium15methotrexate sodium (pf)15methyldopa35methylphenidate hcl30, 31methylprednisolone44metoclopramide hcl49metolazone35metoprolol succinate35metoprolol ta-hydrochlorothiaz35metoprolol tartrate35metro i.v.9metronidazole9, 40, 55metronidazole in nacl (iso-os)9mexiletine33microgestin 1.5/30 (21)57microgestin 1/20 (21)57microgestin fe 1.5/30 (28)57microgestin fe 1/20 (28)57midodrine43migergot22miglustat48mili57minocycline12minoxidil35mirtazapine31misoprostol51MITIGARE53M-M-R II (PF)52modafinil31moexipril35molindone31mometasone42montelukast61morphine25morphine concentrate25MOVANTIK50MOXEZA58moxifloxacin58mupirocin41mycophenolate mofetil15mycophenolate sodium15MYRBETRIQ62MYTESI49Nnabumetone26nadolol35nafcillin11nafcillin in dextrose iso-osm11naloxone26naltrexone26NAMZARIC23naproxen26naproxen sodium26naratriptan22NARCAN26NATACYN58nateglinide46NATPARA48NAYZILAM20necon 0.5/35 (28)57NEEDLES, INSULIN DISP.,SAFETY46nefazodone31neomycin9neomycin-bacitracin-poly-hc59neomycin-bacitracin-polymyxin58neomycin-polymyxin b-dexameth59neomycin-polymyxin-gramicidin58neomycin-polymyxin-hc44, 59NEPHRAMINE 5.4 %64NERLYNX16NEUPOGEN51NEUPRO22nevirapine4NEXAVAR16niacin38nicardipine35NICOTROL44nifedipine35nikki (28)57nilutamide16nimodipine35NINLARO16nitisinone43nitro-bid38nitrofurantoin12nitrofurantoin macrocrystal12nitrofurantoin monohyd/m-cryst12nitroglycerin39nizatidine51nora-be55NORDITROPIN FLEXPRO51norethindrone (contraceptive)55norethindrone acetate55norethindrone ac-eth estradiol55norgestimate-ethinyl estradiol57NORMOSOL-M IN 5 % DEXTROSE64NORMOSOL-R63NORMOSOL-R IN 5 % DEXTROSE63NORMOSOL-R PH 7.464NORTHERA43nortrel 0.5/35 (28)57nortrel 1/35 (21)57nortrel 1/35 (28)57nortrel 7/7/7 (28)57nortriptyline31NORVIR4NOVOLIN 70/30 U-100 INSULIN46NOVOLIN 70-30 FLEXPEN U-10046NOVOLIN N NPH U-100 INSULIN46NOVOLIN R REGULAR U-100 INSULN46NOVOLOG FLEXPEN U-100 INSULIN46NOVOLOG MIX 70-30 U-100 INSULN46NOVOLOG MIX 70-30FLEXPEN U-10046NOVOLOG PENFILL U-100 INSULIN46NOVOLOG U-100 INSULIN ASPART46NOXAFIL2NUBEQA16NUCYNTA ER26NUEDEXTA23NUPLAZID31NUTRILIPID64nyamyc41nystatin2, 41nystatin-triamcinolone41nystop41OOCALIVA50ocella57OCTAGAM52octreotide acetate16ODEFSEY4ODOMZO16OFEV61ofloxacin44, 58olanzapine31olmesartan35olmesartan-amlodipin-hcthiazid35olmesartan-hydrochlorothiazide35olopatadine58omega-3 acid ethyl esters38omeprazole51ondansetron50ondansetron hcl50OPSUMIT61ORFADIN43ORKAMBI61orphenadrine citrate24orsythia57oseltamivir4OSPHENA55oxacillin11oxandrolone48oxaprozin26oxcarbazepine20oxybutynin chloride62oxycodone25oxycodone-acetaminophen25oxycodone-aspirin25OXYCONTIN26OZEMPIC46Ppacerone33paliperidone31pantoprazole51PANZYGA52paricalcitol48paroex oral rinse44paromomycin9paroxetine hcl31PASER9PAXIL31PAZEO58PEDIARIX (PF)52PEDVAX HIB (PF)52peg 3350-electrolytes50PEGANONE20PEGASYS51PEGASYS PROCLICK51peg-electrolyte50PEMAZYRE16penicillamine54PENICILLIN G POT IN DEXTROSE11penicillin g potassium11penicillin g procaine11penicillin g sodium11penicillin v potassium11pentamidine9PENTASA50pentoxifylline37perindopril erbumine35permethrin42perphenazine31perphenazine-amitriptyline31PERSERIS31phenelzine31phenobarbital20phenytoin20phenytoin sodium extended20PICATO40PIFELTRO4pilocarpine hcl43, 58pimecrolimus40pimozide31pimtrea (28)57pindolol35pioglitazone46piperacillin-tazobactam11PIPERACILLIN-TAZOBACTAM11PIQRAY16pirmella57piroxicam26PLAQUENIL9PLASMA-LYTE 14864PLASMA-LYTE A64podofilox40polymyxin b sulf-trimethoprim58POMALYST16portia 2857posaconazole2potassium chlorid-d5-0.45%nacl63potassium chloride63potassium chloride in 0.9%nacl63potassium chloride in 5 % dex63potassium chloride in water63potassium chloride-0.45 % nacl63potassium chloride-d5-0.2%nacl63potassium chloride-d5-0.9%nacl63potassium citrate62PRALUENT PEN38pramipexole22pravastatin38prazosin35prednicarbate42prednisolone44prednisolone acetate60prednisolone sodium phosphate44, 60prednisone44, 45prednisone intensol44pregabalin20PREMARIN55premasol 10 %64PREMPHASE55PREMPRO55prevalite38previfem57PREZCOBIX4PREZISTA4, 5PRIFTIN9PRIMAQUINE9primidone20PRIVIGEN52probenecid53probenecid-colchicine53PROCALAMINE 3%64prochlorperazine50prochlorperazine maleate oral50PROCRIT51procto-med hc50procto-pak50proctosol hc50proctozone-hc50progesterone micronized55PROGLYCEM46PROGRAF16PROLASTIN-C43PROLENSA59PROLIA53PROMACTA37promethazine60propafenone33propranolol35propranolol-hydrochlorothiazid35propylthiouracil45PROQUAD (PF)52PROSOL 20 %64protriptyline31PULMOZYME61PURIXAN16pyrazinamide9pyridostigmine bromide24QQINLOCK16QUADRACEL (PF)53quetiapine31, 32quinapril35quinapril-hydrochlorothiazide35quinidine sulfate33quinine sulfate9RRABAVERT (PF)53raloxifene53ramipril35ranolazine38rasagiline22RAVICTI43reclipsen (28)57RECOMBIVAX HB (PF)53RECTIV50REGRANEX40RELENZA DISKHALER5repaglinide46REPATHA38REPATHA PUSHTRONEX38REPATHA SURECLICK38RESTASIS58RESTASIS MULTIDOSE59RETACRIT51, 52RETEVMO16REVLIMID16REXULTI32REYATAZ5ribavirin5rifabutin9rifampin9RIFATER9riluzole43rimantadine5RINVOQ54risedronate54RISPERDAL CONSTA32risperidone32ritonavir5rivastigmine23rivastigmine tartrate23rizatriptan22ropinirole22rosuvastatin38ROTARIX53ROTATEQ VACCINE53ROZLYTREK16RUBRACA16RUCONEST61RYBELSUS47RYDAPT16RYTARY22SSAMSCA48SANDIMMUNE16SANTYL40SAPHRIS32SAVELLA54, 55scopolamine base50SECUADO32selegiline hcl22selenium sulfide39SELZENTRY5SEREVENT DISKUS61sertraline32setlakin57sevelamer carbonate43sevelamer hcl43sharobel55SHINGRIX (PF)53SIGNIFOR16sildenafil (pulmonary arterial hypertension)62SILENOR32silodosin62silver sulfadiazine40SIMBRINZA59simvastatin38sirolimus16SIRTURO9SIVEXTRO9SKYRIZI39sodium chloride43sodium chloride 0.45 %63sodium chloride 0.9 %43sodium chloride 3 %63sodium chloride 5 %64sodium phenylbutyrate43sodium polystyrene (sorb free)43sodium polystyrene sulfonate43SOLIQUA 100/3347SOLTAMOX16SOMATULINE DEPOT16, 17SOMAVERT48sorine33sotalol33sotalol af33SOTYLIZE33SPIRIVA RESPIMAT62SPIRIVA WITH HANDIHALER62spironolactone35spironolacton-hydrochlorothiaz35sprintec (28)57SPRITAM21SPRYCEL17sps (with sorbitol)43sronyx57ssd40stavudine5STELARA39STIMATE48STIVARGA17STRIBILD5SUBOXONE26SUCRAID50sucralfate51sulfacetamide sodium59sulfacetamide sodium (acne)41sulfacetamide-prednisolone59sulfadiazine12sulfamethoxazole-trimethoprim12sulfasalazine50sulindac26sumatriptan22sumatriptan succinate22SUPREP BOWEL PREP KIT50SUTENT17syeda57SYLATRON52SYMDEKO62SYMFI5SYMFI LO5SYMJEPI60SYMPAZAN21SYMTUZA5SYNAREL48SYNDROS50SYNJARDY47SYNJARDY XR47SYNRIBO17SYNTHROID48TTABLOID17TABRECTA17tacrolimus17, 40TAFINLAR17TAGRISSO17TAKHZYRO62TALZENNA17tamoxifen17tamsulosin62TARGRETIN17tarina 24 fe57tarina fe 1/20 (28)57tarina fe 1-20 eq (28)57TASIGNA17tazarotene40TAZORAC40taztia xt35TAZVERIK17TDVAX53TECFIDERA23TEFLARO7TEGSEDI24telmisartan35telmisartan-hydrochlorothiazid36TENIVAC (PF)53tenofovir disoproxil fumarate5terazosin36terbinafine hcl2terbutaline62terconazole55TERIPARATIDE54testosterone48TESTOSTERONE48testosterone cypionate48testosterone enanthate48TETANUS,DIPHTHERIA TOX PED(PF)53tetrabenazine24tetracycline12THALOMID17theophylline62thioridazine32thiothixene32tiadylt er36tiagabine21TIBSOVO17tigecycline9TIGLUTIK43timolol maleate36, 58TIVICAY5tizanidine24TOBI PODHALER9tobramycin58tobramycin in 0.225 % nacl9tobramycin sulfate9tobramycin-dexamethasone59tolterodine62topiramate21toremifene17torsemide36TOUJEO MAX U-300 SOLOSTAR47TOUJEO SOLOSTAR U-300 INSULIN47TPN ELECTROLYTES64TRACLEER62tramadol27TRAMADOL27tramadol-acetaminophen27trandolapril36tranexamic acid55TRANSDERM-SCOP50tranylcypromine32travasol 10 %64travoprost59trazodone32TRECATOR10TRELEGY ELLIPTA62TRELSTAR17TRESIBA FLEXTOUCH U-10047TRESIBA FLEXTOUCH U-20047TRESIBA U-100 INSULIN47tretinoin (antineoplastic)17tretinoin topical40triamcinolone acetonide42, 44triamterene-hydrochlorothiazid36triderm42trientine43tri-estarylla57trifluoperazine32trifluridine58trihexyphenidyl22TRIKAFTA62tri-legest fe57trilyte with flavor packets50trimethoprim12tri-mili57trimipramine32TRINTELLIX32tri-previfem (28)57tri-sprintec (28)57TRIUMEQ5trivora (28)57tri-vylibra57TROPHAMINE 10 %64TRULICITY47TRUMENBA53TRUVADA5TUKYSA17TURALIO17TWINRIX (PF)53TYBOST5TYKERB18TYMLOS54TYPHIM VI53UUCERIS50unithroid48UPTRAVI36ursodiol50Vvalacyclovir5VALCHLOR40valganciclovir5valproic acid21valproic acid (as sodium salt)21valsartan36valsartan-hydrochlorothiazide36VALTOCO21vancomycin10VANCOMYCIN10vandazole56VAQTA (PF)53VARIVAX (PF)53VARIZIG53VASCEPA38velivet triphasic regimen (28)57VELTASSA43VEMLIDY5VENCLEXTA18VENCLEXTA STARTING PACK18venlafaxine32VENTOLIN HFA62verapamil36VERSACLOZ32VERZENIO18VICTOZA 2-PAK47VICTOZA 3-PAK47vienva57vigabatrin21vigadrone21VIIBRYD32VIMPAT21VIOKACE50VIRACEPT5VIREAD5, 6VITRAKVI18VIZIMPRO18voriconazole2VOSEVI6VOTRIENT18VRAYLAR32, 33vyfemla (28)57vylibra57Wwarfarin37WELCHOL38XXALKORI18XARELTO37XARELTO DVT-PE TREAT 30D START37XATMEP18XCOPRI21XCOPRI MAINTENANCE PACK21XCOPRI TITRATION PACK21XELJANZ55XELJANZ XR55XGEVA12XIFAXAN10XOFLUZA6XOLAIR62XOSPATA18XPOVIO18XTANDI18XULTOPHY 100/3.647XURIDEN43XYREM33YYF-VAX (PF)53YONSA18yuvafem55Zzafirlukast62zaleplon33ZEJULA18ZELBORAF18ZENPEP50zidovudine6ZIEXTENZO52ziprasidone hcl33ziprasidone mesylate33ZIRGAN58ZOLINZA18zolmitriptan23zolpidem33zonisamide21ZORTRESS18ZOSTAVAX (PF)53zovia 1/35e (28)57ZYDELIG18ZYKADIA18ZYLET59ZYPITAMAG38ZYPREXA RELPREVV33ZYTIGA19 ................
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