Drug Name Strength Dosage Form Quantity Limit Days SupplyABACAVIR 20MG/ML SOLN 960 30

ABACAVIR 300MG TABS 60 30

ABACAVIR SULFATE/LAMIVUDINE/ZIDOVUDINE 300MG; 150MG; 300MG TABS 60 30

ABACAVIR/LAMIVUDINE 600MG; 300MG TABS 30 30

ABILIFY MAINTENA 300MG PRSY 1 28

ABILIFY MAINTENA 400MG PRSY 1 28

ABILIFY MAINTENA 300MG SRER 1 28

ABILIFY MAINTENA 400MG SRER 1 28

ACARBOSE 25MG TABS 90 30

ACARBOSE 50MG TABS 90 30

ACARBOSE 100MG TABS 90 30

ACETAMINOPHEN/CODEINE 120MG/5ML; 12MG/5ML SOLN 2700 30

ACETAMINOPHEN/CODEINE 300MG; 30MG TABS 360 30

ACETAMINOPHEN/CODEINE 300MG; 60MG TABS 180 30

ACETAMINOPHEN/CODEINE 300MG; 15MG TABS 360 30

ACETAMINOPHEN/CODEINE PHOSPHATE 300MG; 30MG TABS 360 30

ACTEMRA 200MG/10ML SOLN 40 28

ACTEMRA 80MG/4ML SOLN 40 28

ACTEMRA 400MG/20ML SOLN 40 28

ACTEMRA 162MG/0.9ML SOSY 3.6 28

ACYCLOVIR 0.05 OINT 30 30

ADACEL 15.5MCG/0.5ML; 2LF/0.5ML; 5LF/0.5ML SUSP 0.5 365

ADACEL 15.5MCG/0.5ML; 2LF/0.5ML; 5LF/0.5ML SUSP 0.5 365

ADEFOVIR DIPIVOXIL 10MG TABS 30 30

ADEMPAS 0.5MG TABS 90 30

ADEMPAS 2MG TABS 90 30

ADEMPAS 1MG TABS 90 30

ADEMPAS 1.5MG TABS 90 30

ADEMPAS 2.5MG TABS 90 30

ADVAIR DISKUS 100MCG/DOSE; 50MCG/DOSE AEPB 60 30

ADVAIR DISKUS 250MCG/DOSE; 50MCG/DOSE AEPB 60 30

ADVAIR DISKUS 500MCG/DOSE; 50MCG/DOSE AEPB 60 30

ADVAIR HFA 45MCG/ACT; 21MCG/ACT AERO 12 30

ADVAIR HFA 230MCG/ACT; 21MCG/ACT AERO 12 30

ADVAIR HFA 115MCG/ACT; 21MCG/ACT AERO 12 30

AFEDITAB CR 60MG TB24 60 30

AFEDITAB CR 30MG TB24 60 30

AFINITOR 7.5MG TABS 28 28

AFINITOR 5MG TABS 28 28

AFINITOR 2.5MG TABS 28 28

AFINITOR 10MG TABS 56 28

AFINITOR DISPERZ 3MG TBSO 56 28

AFINITOR DISPERZ 2MG TBSO 56 28

AFINITOR DISPERZ 5MG TBSO 112 28

ALBUTEROL SULFATE 1.25MG/3ML NEBU 360 30

ALBUTEROL SULFATE 0.005 NEBU 180 30

ALBUTEROL SULFATE 0.63MG/3ML NEBU 360 30

ALBUTEROL SULFATE 0.00083 NEBU 360 30

ALECENSA 150MG CAPS 240 30

ALENDRONATE SODIUM 40MG TABS 30 30

ALENDRONATE SODIUM 5MG TABS 30 30

ALENDRONATE SODIUM 70MG TABS 4 28

ALENDRONATE SODIUM 10MG TABS 30 30

ALENDRONATE SODIUM 35MG TABS 4 28

ALFUZOSIN HCL ER 10MG TB24 30 30

ALINIA 100MG/5ML SUSR 150 30

ALINIA 500MG TABS 20 30

ALIQOPA 60MG SOLR 3 28

ALORA 0.075MG/24HR PTTW 8 28

ALORA 0.1MG/24HR PTTW 8 28

ALORA 0.025MG/24HR PTTW 8 28

ALORA 0.05MG/24HR PTTW 8 28

ALOSETRON HYDROCHLORIDE 0.5MG TABS 60 30

ALOSETRON HYDROCHLORIDE 1MG TABS 60 30

ALPRAZOLAM 1MG TABS 90 30

ALPRAZOLAM 2MG TABS 150 30

ALPRAZOLAM 0.5MG TABS 90 30

ALPRAZOLAM 0.25MG TABS 90 30

ALPRAZOLAM ODT 1MG TBDP 90 30

ALPRAZOLAM ODT 0.25MG TBDP 90 30

ALPRAZOLAM ODT 0.5MG TBDP 90 30

ALPRAZOLAM ODT 2MG TBDP 150 30

ALUNBRIG 90MG TABS 30 30

ALUNBRIG 180MG TABS 30 30

ALUNBRIG 30MG TABS 180 30

ALUNBRIG 0 TBPK 60 365

AMETHIA 0; 0 TABS 91 91

AMETHIA LO 0; 0 TABS 91 91

AMITIZA 24MCG CAPS 60 30

AMITIZA 8MCG CAPS 60 30

AMLODIPINE BESYLATE 5MG TABS 60 30

AMLODIPINE BESYLATE 10MG TABS 30 30

AMLODIPINE BESYLATE 2.5MG TABS 120 30

AMLODIPINE BESYLATE/BENAZEPRIL

HYDROCHLORIDE

10MG; 20MG CAPS 30 30

AMLODIPINE BESYLATE/BENAZEPRIL

HYDROCHLORIDE

5MG; 40MG CAPS 60 30

AMLODIPINE BESYLATE/BENAZEPRIL

HYDROCHLORIDE

2.5MG; 10MG CAPS 60 30

2018 Cigna-HealthSpring Quantity Limit Criteria - MAPD/MMP - Cigna-HealthSpring Achieve, Primary, TotalCare, Traditions,

Preferred, Preferred Plus, Premier, PreventiveCare, and CarePlan

AMLODIPINE BESYLATE/BENAZEPRIL

HYDROCHLORIDE

10MG; 40MG CAPS 30 30

AMLODIPINE BESYLATE/BENAZEPRIL

HYDROCHLORIDE

5MG; 10MG CAPS 60 30

AMLODIPINE BESYLATE/BENAZEPRIL

HYDROCHLORIDE

5MG; 20MG CAPS 60 30

AMLODIPINE BESYLATE/VALSARTAN 10MG; 320MG TABS 30 30

AMLODIPINE BESYLATE/VALSARTAN 5MG; 160MG TABS 30 30

AMLODIPINE BESYLATE/VALSARTAN 10MG; 160MG TABS 30 30

AMLODIPINE BESYLATE/VALSARTAN 5MG; 320MG TABS 30 30

AMLODIPINE/OLMESARTAN MEDOXOMIL 10MG; 20MG TABS 30 30

AMLODIPINE/OLMESARTAN MEDOXOMIL 10MG; 40MG TABS 30 30

AMLODIPINE/OLMESARTAN MEDOXOMIL 5MG; 40MG TABS 30 30

AMLODIPINE/OLMESARTAN MEDOXOMIL 5MG; 20MG TABS 30 30

AMLODIPINE/VALSARTAN/HCTZ 5MG; 12.5MG; 160MG TABS 30 30

AMLODIPINE/VALSARTAN/HCTZ 10MG; 25MG; 320MG TABS 30 30

AMLODIPINE/VALSARTAN/HCTZ 10MG; 12.5MG; 160MG TABS 30 30

AMLODIPINE/VALSARTAN/HCTZ 5MG; 25MG; 160MG TABS 30 30

AMLODIPINE/VALSARTAN/HCTZ 10MG; 25MG; 160MG TABS 30 30

AMPHETAMINE/DEXTROAMPHETAMINE 3.75MG; 3.75MG; 3.75MG; 3.75MG CP24 30 30

AMPHETAMINE/DEXTROAMPHETAMINE 2.5MG; 2.5MG; 2.5MG; 2.5MG CP24 30 30

AMPHETAMINE/DEXTROAMPHETAMINE 5MG; 5MG; 5MG; 5MG CP24 30 30

AMPHETAMINE/DEXTROAMPHETAMINE 7.5MG; 7.5MG; 7.5MG; 7.5MG CP24 30 30

AMPHETAMINE/DEXTROAMPHETAMINE 1.25MG; 1.25MG; 1.25MG; 1.25MG CP24 60 30

AMPHETAMINE/DEXTROAMPHETAMINE 6.25MG; 6.25MG; 6.25MG; 6.25MG CP24 60 30

AMPHETAMINE/DEXTROAMPHETAMINE 2.5MG; 2.5MG; 2.5MG; 2.5MG TABS 60 30

AMPHETAMINE/DEXTROAMPHETAMINE 1.875MG; 1.875MG; 1.875MG; 1.875MG TABS 60 30

AMPHETAMINE/DEXTROAMPHETAMINE 3.125MG; 3.125MG; 3.125MG; 3.125MG TABS 60 30

AMPHETAMINE/DEXTROAMPHETAMINE 7.5MG; 7.5MG; 7.5MG; 7.5MG TABS 60 30

AMPHETAMINE/DEXTROAMPHETAMINE 3.75MG; 3.75MG; 3.75MG; 3.75MG TABS 60 30

AMPHETAMINE/DEXTROAMPHETAMINE 5MG; 5MG; 5MG; 5MG TABS 90 30

AMPHETAMINE/DEXTROAMPHETAMINE 1.25MG; 1.25MG; 1.25MG; 1.25MG TABS 60 30

AMPYRA 10MG TB12 60 30

ANASTROZOLE 1MG TABS 30 30

ANORO ELLIPTA 62.5MCG/INH; 25MCG/INH AEPB 60 30

APOKYN 30MG/3ML SOCT 60 30

APREPITANT 125MG CAPS 2 28

APREPITANT 0 CAPS 6 28

APREPITANT 80MG CAPS 4 28

APREPITANT 40MG CAPS 1 30

APRISO 0.375GM CP24 120 30

APTIOM 600MG TABS 60 30

APTIOM 800MG TABS 30 30

APTIOM 400MG TABS 30 30

APTIOM 200MG TABS 30 30

APTIVUS 250MG CAPS 120 30

APTIVUS 100MG/ML SOLN 285 28

ARANESP ALBUMIN FREE 300MCG/ML SOLN 4 28

ARANESP ALBUMIN FREE 200MCG/ML SOLN 4 28

ARANESP ALBUMIN FREE 25MCG/ML SOLN 4 28

ARANESP ALBUMIN FREE 40MCG/ML SOLN 4 28

ARANESP ALBUMIN FREE 60MCG/ML SOLN 4 28

ARANESP ALBUMIN FREE 100MCG/ML SOLN 4 28

ARANESP ALBUMIN FREE 10MCG/0.4ML SOSY 1.6 28

ARANESP ALBUMIN FREE 500MCG/ML SOSY 1 21

ARANESP ALBUMIN FREE 25MCG/0.42ML SOSY 1.68 28

ARANESP ALBUMIN FREE 300MCG/0.6ML SOSY 2.4 28

ARANESP ALBUMIN FREE 40MCG/0.4ML SOSY 1.6 28

ARANESP ALBUMIN FREE 200MCG/0.4ML SOSY 1.6 28

ARANESP ALBUMIN FREE 150MCG/0.3ML SOSY 1.2 28

ARANESP ALBUMIN FREE 60MCG/0.3ML SOSY 1.2 28

ARANESP ALBUMIN FREE 100MCG/0.5ML SOSY 2 28

ARIPIPRAZOLE 1MG/ML SOLN 900 30

ARIPIPRAZOLE 5MG TABS 30 30

ARIPIPRAZOLE 20MG TABS 30 30

ARIPIPRAZOLE 30MG TABS 30 30

ARIPIPRAZOLE 2MG TABS 30 30

ARIPIPRAZOLE 15MG TABS 30 30

ARIPIPRAZOLE 10MG TABS 30 30

ARIPIPRAZOLE ODT 15MG TBDP 60 30

ARIPIPRAZOLE ODT 10MG TBDP 60 30

ARISTADA 441MG/1.6ML PRSY 1.6 30

ARISTADA 662MG/2.4ML PRSY 2.4 30

ARISTADA 882MG/3.2ML PRSY 3.2 30

ARISTADA 1064MG/3.9ML PRSY 3.9 60

ARMODAFINIL 250MG TABS 30 30

ARMODAFINIL 200MG TABS 30 30

ARMODAFINIL 50MG TABS 30 30

ARMODAFINIL 150MG TABS 30 30

ARNUITY ELLIPTA 50MCG/ACT AEPB 30 30

ARNUITY ELLIPTA 100MCG/ACT AEPB 30 30

ARNUITY ELLIPTA 200MCG/ACT AEPB 30 30

ASCOMP/CODEINE 325MG; 50MG; 40MG; 30MG CAPS 180 30

ASHLYNA 0; 0 TABS 91 91

ASPIRIN/DIPYRIDAMOLE 25MG; 200MG CP12 60 30

ATAZANAVIR 150MG CAPS 30 30

ATAZANAVIR 200MG CAPS 60 30

ATAZANAVIR 300MG CAPS 30 30

ATAZANAVIR SULFATE 150MG CAPS 30 30

ATAZANAVIR SULFATE 200MG CAPS 60 30

ATAZANAVIR SULFATE 300MG CAPS 30 30

ATOMOXETINE 10MG CAPS 60 30

ATOMOXETINE 18MG CAPS 60 30

ATOMOXETINE 80MG CAPS 30 30

ATOMOXETINE 100MG CAPS 30 30

ATOMOXETINE 25MG CAPS 60 30

ATOMOXETINE 40MG CAPS 60 30

ATOMOXETINE 60MG CAPS 30 30

ATORVASTATIN CALCIUM 40MG TABS 30 30

ATORVASTATIN CALCIUM 10MG TABS 30 30

ATORVASTATIN CALCIUM 20MG TABS 30 30

ATORVASTATIN CALCIUM 80MG TABS 30 30

ATRIPLA 600MG; 200MG; 300MG TABS 30 30

ATROVENT HFA 17MCG/ACT AERS 25.8 30

AURYXIA 210MG TABS 360 30

AVITA 0.00025 CREA 45 30

AVITA 0.00025 GEL 45 30

AVONEX 30MCG/VIAL KIT 4 28

AVONEX 30MCG/0.5ML PSKT 4 28

AVONEX PEN 30MCG/0.5ML AJKT 4 28

AZELASTINE HCL 0.0015 SOLN 30 25

AZELASTINE HCL 0.001 SOLN 30 25

AZITHROMYCIN 100MG/5ML SUSR 150 30

AZITHROMYCIN 200MG/5ML SUSR 75 30

AZITHROMYCIN 500MG TABS 12 28

AZITHROMYCIN 250MG TABS 12 28

AZITHROMYCIN 250MG TABS 12 28

AZITHROMYCIN 500MG TABS 12 28

AZITHROMYCIN 600MG TABS 60 30

AZOR 10MG; 40MG TABS 30 30

AZOR 5MG; 20MG TABS 30 30

AZOR 5MG; 40MG TABS 30 30

AZOR 10MG; 20MG TABS 30 30

BANZEL 40MG/ML SUSP 2400 30

BANZEL 200MG TABS 60 30

BANZEL 400MG TABS 240 30

BARACLUDE 0.05MG/ML SOLN 630 30

BD ECLIPSE SYRINGE/1ML/30GX1/2" MISC 200 30

BD INSULIN SYRINGE SAFETYGLIDE/1ML/29G X

1/2"

MISC 200 30

BD INSULIN SYRINGE ULTRAFINE/0.3ML/31G X

5/16"

MISC 200 30

BD INSULIN SYRINGE ULTRAFINE/0.5ML/30G X

1/2"

MISC 200 30

BD INSULIN SYRINGE ULTRAFINE/1ML/31G X

5/16"

MISC 200 30

BD PEN NEEDLE/MINI/ULTRAFINE/31G X 3/16" MISC 200 30

BD PEN NEEDLE/NANO/ULTRA FINE/32G X 4MM MISC 200 30

BD PEN NEEDLE/ULTRAFINE/29G X 12.7MM MISC 200 30

BD SAFETYGLIDE 27G X 5/8" MISC 200 30

BENAZEPRIL HCL 40MG TABS 60 30

BENAZEPRIL HCL 5MG TABS 60 30

BENAZEPRIL HCL 10MG TABS 60 30

BENAZEPRIL HCL 20MG TABS 60 30

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE 20MG; 12.5MG TABS 60 30

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE 20MG; 25MG TABS 30 30

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE 5MG; 6.25MG TABS 30 30

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE 10MG; 12.5MG TABS 30 30

BENDEKA 100MG/4ML SOLN 8 21

BENICAR 20MG TABS 30 30

BENICAR 40MG TABS 30 30

BENICAR 5MG TABS 30 30

BENICAR HCT 12.5MG; 20MG TABS 30 30

BENICAR HCT 25MG; 40MG TABS 30 30

BENICAR HCT 12.5MG; 40MG TABS 30 30

BENLYSTA 120MG SOLR 30 28

BENLYSTA 400MG SOLR 9 28

BETASERON 0.3MG KIT 14 28

BICALUTAMIDE 50MG TABS 30 30

BIDIL 37.5MG; 20MG TABS 180 30

BIKTARVY 50MG; 200MG; 25MG TABS 30 30

BIMATOPROST 0.0003 SOLN 5 30

BOOSTRIX 18.5MCG/0.5ML; 2.5LF/0.5ML; 5LF/0.5ML SUSP 0.5 365

BOOSTRIX 18.5MCG/0.5ML; 2.5LF/0.5ML; 5LF/0.5ML SUSP 0.5 365

BORTEZOMIB 3.5MG SOLR 14 21

BOSULIF 500MG TABS 30 30

BOSULIF 100MG TABS 120 30

BOSULIF 400MG TABS 30 30

BREO ELLIPTA 200MCG/INH; 25MCG/INH AEPB 60 30

BREO ELLIPTA 100MCG/INH; 25MCG/INH AEPB 60 30

BRILINTA 60MG TABS 60 30

BRILINTA 90MG TABS 60 30

BRIVIACT 50MG/5ML SOLN 600 30

BRIVIACT 10MG/ML SOLN 1200 30

BRIVIACT 10MG TABS 60 30

BRIVIACT 25MG TABS 60 30

BRIVIACT 50MG TABS 60 30

BRIVIACT 75MG TABS 60 30

BRIVIACT 100MG TABS 120 30

BUDESONIDE 1MG/2ML SUSP 120 30

BUDESONIDE 0.25MG/2ML SUSP 120 30

BUDESONIDE 0.5MG/2ML SUSP 120 30

BUDESONIDE NASAL SPRAY 32MCG/ACT SUSP 17.2 30

BUPRENORPHINE HCL 0.3MG/ML SOLN 150 30

BUPRENORPHINE HCL 0.3MG/ML SOLN 150 30

BUPRENORPHINE HCL 8MG SUBL 90 30

BUPRENORPHINE HCL 2MG SUBL 90 30

BUPRENORPHINE HCL/NALOXONE HCL 2MG; 0.5MG SUBL 90 30

BUPRENORPHINE HCL/NALOXONE HCL 8MG; 2MG SUBL 90 30

BUPROBAN 150MG TB12 60 30

BUPROPION HCL 75MG TABS 180 30

BUPROPION HCL 100MG TABS 120 30

BUPROPION HCL ER 150MG TB12 60 30

BUPROPION HCL ER 200MG TB12 60 30

BUPROPION HCL ER 100MG TB12 60 30

BUPROPION HCL SR 100MG TB12 60 30

BUPROPION HCL SR 200MG TB12 60 30

BUPROPION HCL SR 150MG TB12 60 30

BUPROPION HCL SR 150MG TB12 60 30

BUPROPION HCL XL 150MG TB24 30 30

BUPROPION HCL XL 300MG TB24 30 30

BUTALBITAL/ACETAMINOPHEN/CAFFEINE 325MG; 50MG; 40MG CAPS 180 30

BUTALBITAL/ACETAMINOPHEN/CAFFEINE 300MG; 50MG; 40MG CAPS 180 30

BUTALBITAL/ACETAMINOPHEN/CAFFEINE 325MG; 50MG; 40MG TABS 180 30

BUTALBITAL/ACETAMINOPHEN/CAFFEINE/CODEI

NE

300MG; 50MG; 40MG; 30MG CAPS 180 30

BUTALBITAL/ACETAMINOPHEN/CAFFEINE/CODEI

NE

325MG; 50MG; 40MG; 30MG CAPS 180 30

BUTALBITAL/ASPIRIN/CAFFEINE 325MG; 50MG; 40MG CAPS 180 30

BUTALBITAL/ASPIRIN/CAFFEINE/CODEINE 325MG; 50MG; 40MG; 30MG CAPS 180 30

BUTORPHANOL TARTRATE 2MG/ML SOLN 240 30

BUTORPHANOL TARTRATE 1MG/ML SOLN 480 30

BUTORPHANOL TARTRATE 10MG/ML SOLN 5 30

BYDUREON 2MG SRER 4 28

BYDUREON BCISE 2MG/0.85ML AUIJ 4 28

BYDUREON PEN 2MG PEN 4 28

BYETTA 5MCG/0.02ML SOPN 1.2 30

BYETTA 10MCG/0.04ML SOPN 2.4 30

BYSTOLIC 5MG TABS 30 30

BYSTOLIC 10MG TABS 30 30

BYSTOLIC 2.5MG TABS 30 30

BYSTOLIC 20MG TABS 60 30

BYVALSON 5MG; 80MG TABS 30 30

CABERGOLINE 0.5MG TABS 16 28

CABOMETYX 20MG TABS 30 30

CABOMETYX 40MG TABS 60 30

CABOMETYX 60MG TABS 30 30

CALCIPOTRIENE 0.00005 CREA 120 30

CALCIPOTRIENE 0.00005 OINT 120 30

CALCIPOTRIENE 0.00005 SOLN 60 30

CALCITONIN-SALMON 200UNIT/ACT SOLN 3.7 30

CALCITRENE 0.00005 OINT 120 30

CALCITRIOL 3MCG/GM OINT 800 30

CALQUENCE 100MG CAPS 60 30

CAMRESE 0; 0 TABS 91 91

CAMRESE LO 0; 0 TABS 91 91

CANDESARTAN CILEXETIL 32MG TABS 30 30

CANDESARTAN CILEXETIL 16MG TABS 30 30

CANDESARTAN CILEXETIL 8MG TABS 30 30

CANDESARTAN CILEXETIL 4MG TABS 30 30

CANDESARTAN

CILEXETIL/HYDROCHLOROTHIAZIDE

16MG; 12.5MG TABS 30 30

CANDESARTAN

CILEXETIL/HYDROCHLOROTHIAZIDE

32MG; 12.5MG TABS 30 30

CANDESARTAN

CILEXETIL/HYDROCHLOROTHIAZIDE

32MG; 25MG TABS 30 30

CAPACET 325MG; 50MG; 40MG CAPS 180 30

CAPRELSA 100MG TABS 60 30

CAPRELSA 300MG TABS 30 30

CAPTOPRIL 12.5MG TABS 90 30

CAPTOPRIL 25MG TABS 90 30

CARVEDILOL PHOSPHATE 10MG CP24 30 30

CARVEDILOL PHOSPHATE 20MG CP24 30 30

CARVEDILOL PHOSPHATE 40MG CP24 30 30

CARVEDILOL PHOSPHATE 80MG CP24 30 30

CAYSTON 75MG SOLR 84 56

CELECOXIB 400MG CAPS 30 30

CELECOXIB 100MG CAPS 60 30

CELECOXIB 50MG CAPS 60 30

CELECOXIB 200MG CAPS 60 30

CHANTIX 1MG TABS 336 365

CHANTIX 0.5MG TABS 336 365

CHANTIX CONTINUING MONTH PAK 1MG TABS 336 365

CHANTIX STARTING MONTH PAK 0 TABS 336 365

CIMDUO 300MG; 300MG TABS 30 30

CINRYZE 500UNIT SOLR 100 30

CIPROFLOXACIN ER 500MG; 0 TB24 3 3

CIPROFLOXACIN ER 1000MG; 0 TB24 14 14

CITALOPRAM HYDROBROMIDE 10MG/5ML SOLN 600 30

CITALOPRAM HYDROBROMIDE 20MG TABS 60 30

CITALOPRAM HYDROBROMIDE 40MG TABS 30 30

CLARITHROMYCIN 250MG TABS 42 14

CLARITHROMYCIN 500MG TABS 42 14

CLARITHROMYCIN ER 500MG TB24 60 30

CLONAZEPAM 2MG TABS 300 30

CLONAZEPAM 0.5MG TABS 90 30

CLONAZEPAM 1MG TABS 120 30

CLONAZEPAM ODT 2MG TBDP 300 30

CLONAZEPAM ODT 0.125MG TBDP 90 30

CLONAZEPAM ODT 0.25MG TBDP 90 30

CLONAZEPAM ODT 0.5MG TBDP 90 30

CLONAZEPAM ODT 1MG TBDP 120 30

CLONIDINE HCL 0.1MG/24HR PTWK 4 28

CLONIDINE HCL 0.2MG/24HR PTWK 4 28

CLONIDINE HCL 0.3MG/24HR PTWK 8 28

CLONIDINE HCL ER 0.1MG TB12 120 30

CLOPIDOGREL 75MG TABS 30 30

CLOPIDOGREL 300MG TABS 2 365

CLORAZEPATE DIPOTASSIUM 3.75MG TABS 90 30

CLORAZEPATE DIPOTASSIUM 7.5MG TABS 90 30

CLORAZEPATE DIPOTASSIUM 15MG TABS 180 30

CLOZAPINE 100MG TABS 270 30

CLOZAPINE 200MG TABS 120 30

CLOZAPINE ODT 150MG TBDP 180 30

CLOZAPINE ODT 100MG TBDP 270 30

CLOZAPINE ODT 200MG TBDP 120 30

COARTEM 20MG; 120MG TABS 24 30

COLCHICINE 0.6MG CAPS 60 30

COLCHICINE 0.6MG TABS 120 30

COMBIVENT RESPIMAT 100MCG/ACT; 20MCG/ACT AERS 8 30

COMETRIQ 0 KIT 112 28

COMETRIQ 20MG KIT 84 28

COMETRIQ 0 KIT 56 28

COMPLERA 200MG; 25MG; 300MG TABS 30 30

COPAXONE 20MG/ML SOSY 30 30

COPAXONE 40MG/ML SOSY 12 28

COREG CR 10MG CP24 30 30

COREG CR 20MG CP24 30 30

COREG CR 40MG CP24 30 30

COREG CR 80MG CP24 30 30

CORLANOR 5MG TABS 60 30

CORLANOR 7.5MG TABS 60 30

COTELLIC 20MG TABS 63 28

CRESTOR 10MG TABS 30 30

CRESTOR 20MG TABS 30 30

CRESTOR 40MG TABS 30 30

CRESTOR 5MG TABS 30 30

CRIXIVAN 400MG CAPS 180 30

CRIXIVAN 200MG CAPS 270 30

CROMOLYN SODIUM 20MG/2ML NEBU 240 30

CYCLOBENZAPRINE HCL 10MG TABS 90 30

CYCLOBENZAPRINE HCL 5MG TABS 90 30

CYCLOSET 0.8MG TABS 180 30

CYSTARAN 0.0044 SOLN 60 28

DALIRESP 500MCG TABS 30 30

DALIRESP 250MCG TABS 60 365

DARAPRIM 25MG TABS 90 30

DARIFENACIN HYDROBROMIDE ER 15MG TB24 30 30

DARIFENACIN HYDROBROMIDE ER 7.5MG TB24 30 30

DAYSEE 0; 0 TABS 91 91

DENAVIR 0.01 CREA 5 30

DEPO-PROVERA 400MG/ML SUSP 10 28

DESCOVY 200MG; 25MG TABS 30 30

DESLORATADINE 5MG TABS 30 30

DESMOPRESSIN ACETATE 0.0001 SOLN 15 30

DESMOPRESSIN ACETATE 0.0001 SOLN 15 30

DESMOPRESSIN ACETATE 0.0001 SOLN 15 30

DESVENLAFAXINE ER 25MG TB24 30 30

DESVENLAFAXINE ER 100MG TB24 30 30

DESVENLAFAXINE ER 50MG TB24 30 30

DEXMETHYLPHENIDATE HCL 2.5MG TABS 60 30

DEXMETHYLPHENIDATE HCL 5MG TABS 60 30

DEXMETHYLPHENIDATE HCL 10MG TABS 60 30

DEXTROAMPHETAMINE SULFATE 5MG/5ML SOLN 1800 30

DEXTROAMPHETAMINE SULFATE 10MG TABS 180 30

DEXTROAMPHETAMINE SULFATE 5MG TABS 60 30

DEXTROAMPHETAMINE SULFATE ER 15MG CP24 120 30

DEXTROAMPHETAMINE SULFATE ER 5MG CP24 60 30

DEXTROAMPHETAMINE SULFATE ER 10MG CP24 90 30

DIASTAT ACUDIAL 20MG GEL 40 30

DIASTAT ACUDIAL 10MG GEL 20 30

DIASTAT PEDIATRIC 2.5MG GEL 5 30

DIAZEPAM 1MG/ML SOLN 1200 30

DIAZEPAM 5MG TABS 120 30

DIAZEPAM 10MG TABS 120 30

DIAZEPAM 2MG TABS 120 30

DIAZEPAM 20MG GEL 40 30

DIAZEPAM 2.5MG GEL 5 30

DIAZEPAM 10MG GEL 20 30

DIAZEPAM RECTAL GEL 2.5MG GEL 5 30

DIAZEPAM RECTAL GEL 10MG GEL 20 30

DIAZEPAM RECTAL GEL 20MG GEL 40 30

DICLOFENAC SODIUM 0.01 GEL 1000 30

DICLOFENAC SODIUM 0.015 SOLN 1050 30

DIDANOSINE 200MG CPDR 30 30

DIDANOSINE 125MG CPDR 30 30

DIDANOSINE 400MG CPDR 30 30

DIDANOSINE 250MG CPDR 30 30

DIGITEK 0.125MG TABS 30 30

DIGOX 125MCG TABS 30 30

DIGOXIN 125MCG TABS 30 30

DIHYDROERGOTAMINE MESYLATE 1MG/ML SOLN 30 28

DOFETILIDE 500MCG CAPS 60 30

DOFETILIDE 125MCG CAPS 60 30

DOFETILIDE 250MCG CAPS 60 30

DONEPEZIL HCL 23MG TABS 30 30

DONEPEZIL HCL 5MG TABS 30 30

DONEPEZIL HCL 10MG TABS 60 30

DONEPEZIL HCL 5MG TBDP 30 30

DONEPEZIL HCL 10MG TBDP 60 30

DONEPEZIL HYDROCHLORIDE 5MG TABS 30 30

DONEPEZIL HYDROCHLORIDE 10MG TABS 60 30

DORZOLAMIDE HCL 0.02 SOLN 10 30

DORZOLAMIDE HCL/TIMOLOL MALEATE 22.3MG/ML; 6.8MG/ML SOLN 10 30

DOXAZOSIN MESYLATE 2MG TABS 30 30

DOXAZOSIN MESYLATE 8MG TABS 60 30

DOXAZOSIN MESYLATE 4MG TABS 30 30

DOXAZOSIN MESYLATE 1MG TABS 30 30

DOXERCALCIFEROL 2.5MCG CAPS 120 30

DOXERCALCIFEROL 0.5MCG CAPS 90 30

DOXERCALCIFEROL 1MCG CAPS 240 30

DOXYCYCLINE MONOHYDRATE 75MG CAPS 60 30

DOXYCYCLINE MONOHYDRATE 100MG CAPS 60 30

DOXYCYCLINE MONOHYDRATE 50MG CAPS 60 30

DRONABINOL 2.5MG CAPS 60 30

DRONABINOL 10MG CAPS 60 30

DRONABINOL 5MG CAPS 60 30

DULOXETINE HCL 30MG CPEP 90 30

DULOXETINE HCL 20MG CPEP 60 30

DULOXETINE HCL 60MG CPEP 60 30

DURAMORPH 1MG/ML SOLN 180 30

DURAMORPH 0.5MG/ML SOLN 180 30

DUTASTERIDE 0.5MG CAPS 30 30

DUTASTERIDE/TAMSULOSIN HYDROCHLORIDE 0.5MG; 0.4MG CAPS 30 30

EDURANT 25MG TABS 30 30

EFAVIRENZ 50MG CAPS 90 30

EFAVIRENZ 200MG CAPS 60 30

EFAVIRENZ 600MG TABS 30 30

ELIDEL 0.01 CREA 100 90

ELIGARD 22.5MG KIT 1 90

ELIGARD 30MG KIT 1 120

ELIGARD 45MG KIT 1 180

ELIGARD 7.5MG KIT 1 30

ELIQUIS non-formulary for Primary, TotalCare,

Traditions and CarePlan)

5MG TABS 74 30

ELIQUIS non-formulary for Primary, TotalCare,

Traditions and CarePlan)

2.5MG TABS 60 30

ELIQUIS STARTER PACK non-formulary for

Primary, TotalCare, Traditions and CarePlan)

5MG TABS 74 30

EMEND 125MG SUSR 6 28

EMSAM 12MG/24HR PT24 30 30

EMSAM 6MG/24HR PT24 30 30

EMSAM 9MG/24HR PT24 30 30

EMTRIVA 200MG CAPS 30 30

EMTRIVA 10MG/ML SOLN 680 28

ENABLEX 7.5MG TB24 30 30

ENABLEX 15MG TB24 30 30

ENALAPRIL MALEATE 5MG TABS 60 30

ENALAPRIL MALEATE 10MG TABS 60 30

ENALAPRIL MALEATE 20MG TABS 60 30

ENALAPRIL MALEATE 2.5MG TABS 60 30

ENALAPRIL MALEATE/HYDROCHLOROTHIAZIDE 5MG; 12.5MG TABS 60 30

ENALAPRIL MALEATE/HYDROCHLOROTHIAZIDE 10MG; 25MG TABS 60 30

ENBREL 25MG SOLR 8 28

ENBREL 50MG/ML SOSY 8 28

ENBREL 25MG/0.5ML SOSY 4.08 28

ENBREL MINI 50MG/ML SOCT 8 28

ENBREL SURECLICK 50MG/ML SOAJ 8 28

ENDOCET 325MG; 2.5MG TABS 360 30

ENDOCET 325MG; 5MG TABS 360 30

ENDOCET 325MG; 7.5MG TABS 240 30

ENDOCET 325MG; 10MG TABS 180 30

ENGERIX-B 10MCG/0.5ML SUSP 3 365

ENGERIX-B 20MCG/ML SUSP 8 365

ENOXAPARIN SODIUM 300MG/3ML SOLN 30 90

ENOXAPARIN SODIUM 80MG/0.8ML SOLN 24 90

ENOXAPARIN SODIUM 120MG/0.8ML SOLN 24 90

ENOXAPARIN SODIUM 60MG/0.6ML SOLN 18 90

ENOXAPARIN SODIUM 100MG/ML SOLN 30 90

ENOXAPARIN SODIUM 150MG/ML SOLN 30 90

ENOXAPARIN SODIUM 30MG/0.3ML SOLN 9 90

ENOXAPARIN SODIUM 40MG/0.4ML SOLN 12 90

ENTACAPONE 200MG TABS 240 30

ENTECAVIR 1MG TABS 30 30

ENTECAVIR 0.5MG TABS 30 30

ENTRESTO 24MG; 26MG TABS 60 30

ENTRESTO 49MG; 51MG TABS 60 30

ENTRESTO 97MG; 103MG TABS 60 30

EPCLUSA 400MG; 100MG TABS 28 28

EPINEPHRINE 0.3MG/0.3ML SOAJ 2 30

EPINEPHRINE 0.15MG/0.3ML SOAJ 2 30

EPINEPHRINE 0.3MG/0.3ML SOAJ 2 30

EPINEPHRINE 0.15MG/0.15ML SOAJ 2 30

EPIPEN 2-PAK 0.3MG/0.3ML SOAJ 2 30

EPIPEN-JR 2-PAK 0.15MG/0.3ML SOAJ 2 30

ERGOTAMINE TARTRATE/CAFFEINE 100MG; 1MG TABS 40 28

ERIVEDGE 150MG CAPS 28 28

ERLEADA 60MG TABS 120 30

ERWINAZE 10000UNIT SOLR 60 28

ESBRIET 267MG CAPS 270 30

ESBRIET 801MG TABS 90 30

ESBRIET 267MG TABS 270 30

ESCITALOPRAM OXALATE 5MG/5ML SOLN 600 30

ESCITALOPRAM OXALATE 5MG TABS 30 30

ESCITALOPRAM OXALATE 10MG TABS 60 30

ESCITALOPRAM OXALATE 20MG TABS 90 30

ESGIC 325MG; 50MG; 40MG CAPS 180 30

ESOMEPRAZOLE MAGNESIUM 40MG CPDR 60 30

ESOMEPRAZOLE MAGNESIUM 20MG CPDR 60 30

ESTRADIOL 37.5MCG/24HR PTWK 4 28

ESTRADIOL 0.025MG/24HR PTWK 4 28

ESTRADIOL 0.05MG/24HR PTWK 4 28

ESTRADIOL 0.06MG/24HR PTWK 4 28

ESTRADIOL 0.075MG/24HR PTWK 4 28

ESTRADIOL 0.1MG/24HR PTWK 4 28

ESTRADIOL 0.05MG/24HR PTTW 8 28

ESTRADIOL 0.0375MG/24HR PTTW 8 28

ESTRADIOL 0.075MG/24HR PTTW 8 28

ESTRADIOL 0.025MG/24HR PTTW 8 28

ESTRADIOL 0.1MG/24HR PTTW 8 28

ESTRADIOL 10MCG TABS 18 28

ESTRING 2MG RING 1 90

EVOTAZ 300MG; 150MG TABS 30 30

EXEMESTANE 25MG TABS 60 30

EZETIMIBE 10MG TABS 30 30

EZETIMIBE/SIMVASTATIN 10MG; 80MG TABS 30 30

EZETIMIBE/SIMVASTATIN 10MG; 40MG TABS 30 30

EZETIMIBE/SIMVASTATIN 10MG; 20MG TABS 30 30

EZETIMIBE/SIMVASTATIN 10MG; 10MG TABS 30 30

FAMCICLOVIR 250MG TABS 60 30

FAMCICLOVIR 500MG TABS 60 30

FAMCICLOVIR 125MG TABS 60 30

FANAPT 1MG TABS 60 30

FANAPT 8MG TABS 60 30

FANAPT 6MG TABS 60 30

FANAPT 4MG TABS 60 30

FANAPT 12MG TABS 60 30

FANAPT 10MG TABS 60 30

FANAPT 2MG TABS 60 30

FANAPT TITRATION PACK 0 TABS 16 365

FARESTON 60MG TABS 30 30

FARXIGA 5MG TABS 30 30

FARXIGA 10MG TABS 30 30

FARYDAK 15MG CAPS 6 21

FARYDAK 20MG CAPS 6 21

FARYDAK 10MG CAPS 6 21

FASLODEX 250MG/5ML SOLN 30 30

FELODIPINE ER 2.5MG TB24 60 30

FELODIPINE ER 5MG TB24 60 30

FELODIPINE ER 10MG TB24 60 30

FEMRING 0.1MG/24HR RING 1 90

FEMRING 0.05MG/24HR RING 1 90

FENOFIBRATE 43MG CAPS 60 30

FENOFIBRATE 150MG CAPS 30 30

FENOFIBRATE 50MG CAPS 60 30

FENOFIBRATE 130MG CAPS 30 30

FENOFIBRATE 54MG TABS 60 30

FENOFIBRATE 160MG TABS 30 30

FENOFIBRATE 48MG TABS 60 30

FENOFIBRATE 145MG TABS 30 30

FENOFIBRATE MICRONIZED 134MG CAPS 30 30

FENOFIBRATE MICRONIZED 200MG CAPS 30 30

FENOFIBRATE MICRONIZED 67MG CAPS 60 30

FENOFIBRIC ACID DR 45MG CPDR 60 30

FENOFIBRIC ACID DR 135MG CPDR 30 30

FENTANYL 25MCG/HR PT72 10 30

FENTANYL 37.5MCG/HR PT72 10 30

FENTANYL 62.5MCG/HR PT72 10 30

FENTANYL 87.5MCG/HR PT72 10 30

FENTANYL 12MCG/HR PT72 10 30

FENTANYL 100MCG/HR PT72 10 30

FENTANYL 75MCG/HR PT72 10 30

FENTANYL 50MCG/HR PT72 10 30

FENTANYL CITRATE ORAL TRANSMUCOSAL 800MCG LPOP 120 30

FENTANYL CITRATE ORAL TRANSMUCOSAL 200MCG LPOP 120 30

FENTANYL CITRATE ORAL TRANSMUCOSAL 400MCG LPOP 120 30

FENTANYL CITRATE ORAL TRANSMUCOSAL 600MCG LPOP 120 30

FENTANYL CITRATE ORAL TRANSMUCOSAL 1200MCG LPOP 120 30

FENTANYL CITRATE ORAL TRANSMUCOSAL 1600MCG LPOP 120 30

FETZIMA 20MG CP24 30 30

FETZIMA 80MG CP24 30 30

FETZIMA 40MG CP24 30 30

FETZIMA 120MG CP24 30 30

FETZIMA TITRATION PACK 0 C4PK 56 365

FINASTERIDE 5MG TABS 30 30

FIRAZYR 30MG/3ML SOLN 18 30

FIRMAGON 80MG SOLR 1 28

FIRMAGON 120MG SOLR 4 365

FLOVENT DISKUS 50MCG/BLIST AEPB 60 30

FLOVENT DISKUS 250MCG/BLIST AEPB 240 30

FLOVENT DISKUS 100MCG/BLIST AEPB 60 30

FLOVENT HFA 110MCG/ACT AERO 12 30

FLOVENT HFA 44MCG/ACT AERO 10.6 30

FLOVENT HFA 220MCG/ACT AERO 24 30

FLUNISOLIDE 0.00025 SOLN 50 30

FLUOXETINE 10MG CAPS 30 30

FLUOXETINE 20MG CAPS 120 30

FLUOXETINE DR 90MG CPDR 4 28

FLUOXETINE HCL 40MG CAPS 60 30

FLUOXETINE HCL 10MG CAPS 30 30

FLUOXETINE HCL 20MG CAPS 120 30

FLUOXETINE HCL 20MG/5ML SOLN 600 30

FLUOXETINE HCL 10MG TABS 30 30

FLUOXETINE HCL 20MG TABS 120 30

FLUTICASONE PROPIONATE 50MCG/ACT SUSP 16 30

FLUVOXAMINE MALEATE 100MG TABS 90 30

FLUVOXAMINE MALEATE 50MG TABS 30 30

FLUVOXAMINE MALEATE 25MG TABS 30 30

FLUVOXAMINE MALEATE ER 100MG CP24 60 30

FLUVOXAMINE MALEATE ER 150MG CP24 60 30

FONDAPARINUX SODIUM 7.5MG/0.6ML SOLN 18 90

FONDAPARINUX SODIUM 2.5MG/0.5ML SOLN 15 90

FONDAPARINUX SODIUM 10MG/0.8ML SOLN 24 90

FONDAPARINUX SODIUM 5MG/0.4ML SOLN 12 90

FORTEO 600MCG/2.4ML SOLN 2.4 28

FOSAMPRENAVIR CALCIUM 700MG TABS 120 30

FOSINOPRIL SODIUM 10MG TABS 60 30

FOSINOPRIL SODIUM 20MG TABS 60 30

FOSINOPRIL SODIUM 40MG TABS 60 30

FOSINOPRIL SODIUM/HYDROCHLOROTHIAZIDE 10MG; 12.5MG TABS 120 30

FOSINOPRIL SODIUM/HYDROCHLOROTHIAZIDE 20MG; 12.5MG TABS 120 30

FUZEON 90MG SOLR 60 30

FYCOMPA 0.5MG/ML SUSP 720 30

FYCOMPA 10MG TABS 30 30

FYCOMPA 8MG TABS 30 30

FYCOMPA 6MG TABS 30 30

FYCOMPA 2MG TABS 30 30

FYCOMPA 4MG TABS 30 30

FYCOMPA 12MG TABS 30 30

GABAPENTIN 300MG CAPS 270 30

GABAPENTIN 400MG CAPS 270 30

GABAPENTIN 100MG CAPS 180 30

GABAPENTIN 250MG/5ML SOLN 2160 30

GABAPENTIN 600MG TABS 180 30

GABITRIL 12MG TABS 120 30

GABITRIL 16MG TABS 90 30

GALANTAMINE HYDROBROMIDE 4MG/ML SOLN 200 30

GALANTAMINE HYDROBROMIDE 12MG TABS 60 30

GALANTAMINE HYDROBROMIDE 4MG TABS 60 30

GALANTAMINE HYDROBROMIDE 8MG TABS 60 30

GALANTAMINE HYDROBROMIDE ER 8MG CP24 30 30

GALANTAMINE HYDROBROMIDE ER 16MG CP24 30 30

GALANTAMINE HYDROBROMIDE ER 24MG CP24 30 30

GARDASIL 0 SUSP 1.5 365

GARDASIL 0 SUSP 1.5 365

GARDASIL 9 0 SUSP 1.5 365

GARDASIL 9 0 SUSY 1.5 365

GATTEX 5MG KIT 30 30

GEMFIBROZIL 600MG TABS 60 30

GENVOYA 150MG; 150MG; 200MG; 10MG TABS 30 30

GEODON 20MG SOLR 6 30

GILENYA 0.25MG CAPS 30 30

GILENYA 0.5MG CAPS 30 30

GILOTRIF 40MG TABS 30 30

GILOTRIF 20MG TABS 30 30

GILOTRIF 30MG TABS 30 30

GLIMEPIRIDE 1MG TABS 240 30

GLIMEPIRIDE 2MG TABS 120 30

GLIMEPIRIDE 4MG TABS 60 30

GLIPIZIDE 5MG TABS 60 30

GLIPIZIDE 10MG TABS 120 30

GLIPIZIDE ER 2.5MG TB24 240 30

GLIPIZIDE ER 5MG TB24 120 30

GLIPIZIDE ER 10MG TB24 60 30

GLIPIZIDE XL 10MG TB24 60 30

GLIPIZIDE XL 5MG TB24 120 30

GLIPIZIDE XL 2.5MG TB24 240 30

GLIPIZIDE/METFORMIN HCL 5MG; 500MG TABS 120 30

GLIPIZIDE/METFORMIN HCL 2.5MG; 500MG TABS 120 30

GLIPIZIDE/METFORMIN HCL 2.5MG; 250MG TABS 240 30

GLUCAGEN HYPOKIT 1MG SOLR 4 30

GLUCAGON EMERGENCY KIT 1MG KIT 4 30

GLYXAMBI 25MG; 5MG TABS 30 30

GLYXAMBI 10MG; 5MG TABS 30 30

GRANISETRON HCL 1MG TABS 30 30

HARVONI 90MG; 400MG TABS 28 28

HEPLISAV-B 20MCG/0.5ML SOLN 3 365

HETLIOZ 20MG CAPS 30 30

HUMIRA 10MG/0.2ML PSKT 2 28

HUMIRA 20MG/0.4ML PSKT 2 28

HUMIRA 40MG/0.8ML PSKT 4 28

HUMIRA 40MG/0.4ML PSKT 4 28

HUMIRA 10MG/0.1ML PSKT 2 28

HUMIRA 20MG/0.2ML PSKT 2 28

HUMIRA PEDIATRIC CROHNS DISEASE STARTER

PACK

40MG/0.8ML PSKT 6 365

HUMIRA PEDIATRIC CROHNS DISEASE STARTER

PACK

40MG/0.8ML PSKT 6 365

HUMIRA PEDIATRIC CROHNS DISEASE STARTER

PACK

0 PSKT 4 365

HUMIRA PEDIATRIC CROHNS DISEASE STARTER

PACK

80MG/0.8ML PSKT 6 365

HUMIRA PEN 40MG/0.8ML PNKT 4 28

HUMIRA PEN 40MG/0.4ML PNKT 4 28

HUMIRA PEN-CROHNS DISEASESTARTER 40MG/0.8ML PNKT 12 365

HUMIRA PEN-PSORIASIS STARTER 40MG/0.8ML PNKT 8 365

HYDROCODONE BITARTRATE/ACETAMINOPHEN 325MG/15ML; 7.5MG/15ML SOLN 2700 30

HYDROCODONE BITARTRATE/ACETAMINOPHEN 300MG; 10MG TABS 180 30

HYDROCODONE BITARTRATE/ACETAMINOPHEN 300MG; 5MG TABS 360 30

HYDROCODONE BITARTRATE/ACETAMINOPHEN 300MG; 7.5MG TABS 180 30

HYDROCODONE BITARTRATE/ACETAMINOPHEN 325MG; 2.5MG TABS 360 30

HYDROCODONE/ACETAMINOPHEN 325MG; 5MG TABS 360 30

HYDROCODONE/ACETAMINOPHEN 325MG; 7.5MG TABS 180 30

HYDROCODONE/ACETAMINOPHEN 325MG; 10MG TABS 180 30

HYDROCODONE/IBUPROFEN 2.5MG; 200MG TABS 150 30

HYDROCODONE/IBUPROFEN 7.5MG; 200MG TABS 150 30

HYDROCODONE/IBUPROFEN 5MG; 200MG TABS 150 30

HYDROCODONE/IBUPROFEN 10MG; 200MG TABS 150 30

HYDROMORPHONE HCL 1MG/ML LIQD 1200 30

HYDROMORPHONE HCL 2MG TABS 180 30

HYDROMORPHONE HCL 4MG TABS 180 30

HYDROMORPHONE HCL 8MG TABS 120 30

IBANDRONATE SODIUM 150MG TABS 1 28

IBRANCE 100MG CAPS 21 28

IBRANCE 75MG CAPS 21 28

IBRANCE 125MG CAPS 21 28

IBUDONE 5MG; 200MG TABS 150 30

ICLUSIG 15MG TABS 60 30

ICLUSIG 45MG TABS 30 30

IDHIFA 50MG TABS 30 30

IDHIFA 100MG TABS 30 30

ILARIS 150MG/ML SOLN 2 28

ILARIS 150MG SOLR 2 28

IMATINIB MESYLATE 400MG TABS 60 30

IMATINIB MESYLATE 100MG TABS 60 30

IMBRUVICA 140MG CAPS 120 30

IMBRUVICA 70MG CAPS 30 30

IMBRUVICA 280MG TABS 30 30

IMBRUVICA 420MG TABS 30 30

IMBRUVICA 560MG TABS 30 30

IMBRUVICA 140MG TABS 30 30

IMIQUIMOD 0.05 CREA 12 30

INCRUSE ELLIPTA 62.5MCG/INH AEPB 30 30

INFUMORPH 200 10MG/ML SOLN 200 30

INFUMORPH 500 25MG/ML SOLN 200 30

INLYTA 1MG TABS 120 30

INLYTA 5MG TABS 120 30

INTELENCE 25MG TABS 120 30

INTELENCE 200MG TABS 60 30

INTELENCE 100MG TABS 60 30

INTROVALE 0.03MG; 0.15MG TABS 91 91

INVEGA SUSTENNA 78MG/0.5ML SUSP 0.5 28

INVEGA SUSTENNA 156MG/ML SUSP 1 28

INVEGA SUSTENNA 39MG/0.25ML SUSP 0.25 28

INVEGA SUSTENNA 117MG/0.75ML SUSP 0.75 28

INVEGA SUSTENNA 234MG/1.5ML SUSP 1.5 28

INVEGA TRINZA 546MG/1.75ML SUSP 1.75 90

INVEGA TRINZA 273MG/0.875ML SUSP 0.88 90

INVEGA TRINZA 410MG/1.315ML SUSP 1.32 90

INVEGA TRINZA 819MG/2.625ML SUSP 2.63 90

INVIRASE 200MG CAPS 300 30

INVIRASE 500MG TABS 120 30

INVOKAMET 50MG; 1000MG TABS 60 30

INVOKAMET 150MG; 1000MG TABS 60 30

INVOKAMET 50MG; 500MG TABS 60 30

INVOKAMET 150MG; 500MG TABS 60 30

INVOKAMET XR 150MG; 1000MG TB24 60 30

INVOKAMET XR 150MG; 500MG TB24 60 30

INVOKAMET XR 50MG; 500MG TB24 60 30

INVOKAMET XR 50MG; 1000MG TB24 60 30

INVOKANA 300MG TABS 30 30

INVOKANA 100MG TABS 30 30

IPRATROPIUM BROMIDE 0.0002 SOLN 300 30

IPRATROPIUM BROMIDE 0.0003 SOLN 30 30

IPRATROPIUM BROMIDE 0.0006 SOLN 30 30

IPRATROPIUM BROMIDE/ALBUTEROL SULFATE 2.5MG/3ML; 0.5MG/3ML SOLN 540 30

IRBESARTAN 300MG TABS 30 30

IRBESARTAN 150MG TABS 30 30

IRBESARTAN 75MG TABS 30 30

IRBESARTAN/HYDROCHLOROTHIAZIDE 12.5MG; 300MG TABS 30 30

IRBESARTAN/HYDROCHLOROTHIAZIDE 12.5MG; 150MG TABS 30 30

IRESSA 250MG TABS 30 30

ISENTRESS 25MG CHEW 180 30

ISENTRESS 100MG CHEW 180 30

ISENTRESS 100MG PACK 180 30

ISENTRESS 400MG TABS 60 30

ISENTRESS HD 600MG TABS 60 30

ITRACONAZOLE 100MG CAPS 120 30

JAKAFI 10MG TABS 60 30

JAKAFI 20MG TABS 60 30

JAKAFI 5MG TABS 60 30

JAKAFI 15MG TABS 60 30

JAKAFI 25MG TABS 60 30

JANUMET 500MG; 50MG TABS 60 30

JANUMET 1000MG; 50MG TABS 60 30

JANUMET XR 500MG; 50MG TB24 30 30

JANUMET XR 1000MG; 50MG TB24 60 30

JANUMET XR 1000MG; 100MG TB24 30 30

JANUVIA 50MG TABS 30 30

JANUVIA 25MG TABS 30 30

JANUVIA 100MG TABS 30 30

JARDIANCE 10MG TABS 30 30

JARDIANCE 25MG TABS 30 30

JENTADUETO 2.5MG; 500MG TABS 60 30

JENTADUETO 2.5MG; 850MG TABS 60 30

JENTADUETO 2.5MG; 1000MG TABS 60 30

JENTADUETO XR 2.5MG; 1000MG TB24 60 30

JENTADUETO XR 5MG; 1000MG TB24 30 30

JOLESSA 0.03MG; 0.15MG TABS 91 91

JULUCA 50MG; 25MG TABS 30 30

KALETRA 400MG/5ML; 100MG/5ML SOLN 480 30

KALETRA 200MG; 50MG TABS 120 30

KALETRA 100MG; 25MG TABS 300 30

KALYDECO 50MG PACK 60 30

KALYDECO 75MG PACK 60 30

KALYDECO 150MG TABS 60 30

KETEK 300MG TABS 20 30

KETEK 400MG TABS 20 30

KINERET 100MG/0.67ML SOSY 20.1 30

KISQALI 200MG TABS 63 28

KISQALI 200MG TABS 63 28

KISQALI 200MG TABS 63 28

KISQALI FEMARA 200 DOSE 2.5MG; 200MG TBPK 49 28

KISQALI FEMARA 400 DOSE 2.5MG; 200MG TBPK 70 28

KISQALI FEMARA 600 DOSE 2.5MG; 200MG TBPK 91 28

KORLYM 300MG TABS 120 30

LAMIVUDINE 10MG/ML SOLN 900 30

LAMIVUDINE 150MG TABS 60 30

LAMIVUDINE 300MG TABS 30 30

LAMIVUDINE/ZIDOVUDINE 150MG; 300MG TABS 60 30

LATANOPROST 0.00005 SOLN 5 30

LATUDA 20MG TABS 30 30

LATUDA 60MG TABS 30 30

LATUDA 120MG TABS 30 30

LATUDA 40MG TABS 30 30

LATUDA 80MG TABS 60 30

LEFLUNOMIDE 10MG TABS 30 30

LEFLUNOMIDE 20MG TABS 30 30

LENVIMA 10 MG DAILY DOSE 10MG CPPK 30 30

LENVIMA 14 MG DAILY DOSE 0 CPPK 60 30

LENVIMA 18 MG DAILY DOSE 0 CPPK 90 30

LENVIMA 20 MG DAILY DOSE 10MG CPPK 60 30

LENVIMA 24 MG DAILY DOSE 0 CPPK 90 30

LENVIMA 8 MG DAILY DOSE 4MG CPPK 60 30

LETAIRIS 5MG TABS 30 30

LETAIRIS 10MG TABS 30 30

LETROZOLE 2.5MG TABS 30 30

LEVALBUTEROL TARTRATE HFA 45MCG/ACT AERO 30 30

LEVETIRACETAM ER 750MG TB24 120 30

LEVETIRACETAM ER 500MG TB24 180 30

LEVOCETIRIZINE DIHYDROCHLORIDE 2.5MG/5ML SOLN 300 30

LEVOCETIRIZINE DIHYDROCHLORIDE 5MG TABS 30 30

LEVOFLOXACIN 250MG TABS 30 30

LEVOFLOXACIN 500MG TABS 30 30

LEVOFLOXACIN 750MG TABS 30 30

LEVONORGESTREL AND ETHINYL ESTRADIOL 0; 0 TABS 91 91

LEVONORGESTREL/ETHINYL ESTRADIOL 0; 0 TABS 91 91

LEVONORGESTREL/ETHINYL ESTRADIOL 0.03MG; 0.15MG TABS 91 91

LEVORPHANOL TARTRATE 2MG TABS 120 30

LEXIVA 50MG/ML SUSP 1575 28

LEXIVA 700MG TABS 120 30

LIALDA 1.2GM TBEC 120 30

LIDOCAINE 0.05 OINT 120 30

LIDOCAINE 0.05 PTCH 90 30

LINEZOLID 100MG/5ML SUSR 1800 30

LINEZOLID 600MG TABS 60 30

LINZESS 145MCG CAPS 30 30

LINZESS 290MCG CAPS 30 30

LINZESS 72MCG CAPS 30 30

LISINOPRIL 5MG TABS 60 30

LISINOPRIL 40MG TABS 60 30

LISINOPRIL 2.5MG TABS 60 30

LISINOPRIL 10MG TABS 60 30

LISINOPRIL 20MG TABS 60 30

LISINOPRIL 30MG TABS 60 30

LISINOPRIL/HYDROCHLOROTHIAZIDE 12.5MG; 10MG TABS 60 30

LISINOPRIL/HYDROCHLOROTHIAZIDE 25MG; 20MG TABS 60 30

LISINOPRIL/HYDROCHLOROTHIAZIDE 12.5MG; 20MG TABS 120 30

LIVALO 1MG TABS 30 30

LIVALO 2MG TABS 30 30

LIVALO 4MG TABS 30 30

LONSURF 8.19MG; 20MG TABS 80 28

LONSURF 6.14MG; 15MG TABS 100 28

LOPINAVIR/RITONAVIR 400MG/5ML; 100MG/5ML SOLN 480 30

LORAZEPAM 2MG/ML CONC 150 30

LORAZEPAM 1MG TABS 90 30

LORAZEPAM 2MG TABS 150 30

LORAZEPAM 0.5MG TABS 90 30

LORAZEPAM INTENSOL 2MG/ML CONC 150 30

LORCET 325MG; 5MG TABS 360 30

LORCET HD 325MG; 10MG TABS 180 30

LORCET PLUS 325MG; 7.5MG TABS 180 30

LORTAB 325MG; 7.5MG TABS 180 30

LORTAB 325MG; 5MG TABS 360 30

LORTAB 325MG; 10MG TABS 180 30

LOSARTAN POTASSIUM 50MG TABS 60 30

LOSARTAN POTASSIUM 100MG TABS 30 30

LOSARTAN POTASSIUM 25MG TABS 60 30

LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE 12.5MG; 50MG TABS 60 30

LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE 25MG; 100MG TABS 30 30

LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE 12.5MG; 100MG TABS 30 30

LOVASTATIN 20MG TABS 30 30

LOVASTATIN 40MG TABS 60 30

LOVASTATIN 10MG TABS 30 30

LOXAPINE 5MG CAPS 120 30

LOXAPINE 10MG CAPS 120 30

LOXAPINE SUCCINATE 10MG CAPS 120 30

LOXAPINE SUCCINATE 5MG CAPS 120 30

LUMIGAN 0.0001 SOLN 5 30

LUPRON DEPOT (1-MONTH) 7.5MG KIT 1 30

LUPRON DEPOT (1-MONTH) 3.75MG KIT 1 30

LUPRON DEPOT (3-MONTH) 11.25MG KIT 1 84

LUPRON DEPOT (3-MONTH) 22.5MG KIT 1 84

LUPRON DEPOT (4-MONTH) 30MG KIT 1 112

LUPRON DEPOT (6-MONTH) 45MG KIT 1 168

LUPRON DEPOT-PED (1-MONTH) 7.5MG KIT 1 30

LUPRON DEPOT-PED (1-MONTH) 11.25MG KIT 1 30

LUPRON DEPOT-PED (1-MONTH) 15MG KIT 1 30

LUPRON DEPOT-PED (3-MONTH) 11.25MG KIT 1 84

LUPRON DEPOT-PED (3-MONTH) 30MG KIT 1 84

LYNPARZA 100MG TABS 120 30

LYNPARZA 150MG TABS 120 30

LYNPARZA 50MG CAPS 448 28

LYRICA 100MG CAPS 90 30

LYRICA 25MG CAPS 90 30

LYRICA 50MG CAPS 90 30

LYRICA 150MG CAPS 90 30

LYRICA 75MG CAPS 90 30

LYRICA 200MG CAPS 90 30

LYRICA 300MG CAPS 60 30

LYRICA 225MG CAPS 60 30

LYRICA 20MG/ML SOLN 900 30

LYRICA CR 82.5MG TB24 90 30

LYRICA CR 165MG TB24 90 30

LYRICA CR 330MG TB24 60 30

MAPROTILINE HCL 25MG TABS 90 30

MAPROTILINE HCL 50MG TABS 90 30

MAPROTILINE HCL 75MG TABS 90 30

MARGESIC 325MG; 50MG; 40MG CAPS 180 30

MARPLAN 10MG TABS 180 30

MEDROXYPROGESTERONE ACETATE 150MG/ML SUSP 1 90

MEDROXYPROGESTERONE ACETATE 150MG/ML SUSY 1 90

MEKINIST 2MG TABS 30 30

MEKINIST 0.5MG TABS 90 30

MELOXICAM 7.5MG TABS 30 30

MELOXICAM 15MG TABS 30 30

MEMANTINE HCL 5MG TABS 90 30

MEMANTINE HCL 10MG TABS 60 30

MEMANTINE HCL TITRATION PAK 0 TABS 49 28

MEMANTINE HYDROCHLORIDE 2MG/ML SOLN 300 30

MEMANTINE HYDROCHLORIDE ER 7MG CP24 30 30

MEMANTINE HYDROCHLORIDE ER 28MG CP24 30 30

MEMANTINE HYDROCHLORIDE ER 14MG CP24 30 30

MEMANTINE HYDROCHLORIDE ER 21MG CP24 30 30

MENOSTAR 14MCG/24HR PTWK 4 28

METADATE ER 20MG TBCR 90 30

METFORMIN HCL 850MG TABS 90 30

METFORMIN HCL 1000MG TABS 60 30

METFORMIN HCL 500MG TABS 150 30

METFORMIN HCL ER 500MG TB24 120 30

METFORMIN HCL ER 750MG TB24 60 30

METFORMIN HCL ER 1000MG TB24 60 30

METFORMIN HCL ER 500MG TB24 60 30

METHADONE HCL 10MG/ML CONC 500 30

METHADONE HCL 10MG/ML SOLN 150 30

METHADONE HCL 5MG/5ML SOLN 600 30

METHADONE HCL 10MG/5ML SOLN 450 30

METHADONE HCL 10MG TABS 120 30

METHADONE HCL 5MG TABS 180 30

METHADONE HCL INTENSOL 10MG/ML CONC 500 30

METHYLPHENIDATE HCL 20MG TABS 90 30

METHYLPHENIDATE HCL 10MG TABS 90 30

METHYLPHENIDATE HCL 5MG TABS 90 30

METHYLPHENIDATE HCL ER 36MG TB24 60 30

METHYLPHENIDATE HCL ER 18MG TB24 120 30

METHYLPHENIDATE HCL ER 54MG TB24 30 30

METHYLPHENIDATE HCL ER 27MG TB24 30 30

METHYLPHENIDATE HCL ER 20MG TBCR 90 30

METHYLPHENIDATE HCL ER 10MG TBCR 30 30

METHYLPHENIDATE HCL ER 36MG TBCR 60 30

METHYLPHENIDATE HCL ER 54MG TBCR 30 30

METHYLPHENIDATE HCL ER 18MG TBCR 120 30

METHYLPHENIDATE HCL ER 27MG TBCR 30 30

METHYLPHENIDATE HCL SR 20MG TBCR 90 30

METOPROLOL SUCCINATE ER 100MG TB24 60 30

METOPROLOL SUCCINATE ER 50MG TB24 60 30

METOPROLOL SUCCINATE ER 25MG TB24 60 30

METOPROLOL SUCCINATE ER 200MG TB24 60 30

MIGERGOT 100MG; 2MG SUPP 20 28

MIGLITOL 50MG TABS 90 30

MIGLITOL 100MG TABS 90 30

MIGLITOL 25MG TABS 90 30

MIGLUSTAT 100MG CAPS 90 30

MINITRAN 0.4MG/HR PT24 30 30

MINITRAN 0.6MG/HR PT24 30 30

MINITRAN 0.2MG/HR PT24 30 30

MINITRAN 0.1MG/HR PT24 30 30

MINIVELLE 0.025MG/24HR PTTW 8 28

MINIVELLE 0.05MG/24HR PTTW 8 28

MINIVELLE 0.075MG/24HR PTTW 8 28

MINIVELLE 0.1MG/24HR PTTW 8 28

MINIVELLE 0.0375MG/24HR PTTW 8 28

MIRTAZAPINE 7.5MG TABS 30 30

MIRTAZAPINE 15MG TABS 30 30

MIRTAZAPINE 30MG TABS 30 30

MIRTAZAPINE 45MG TABS 30 30

MIRTAZAPINE ODT 30MG TBDP 30 30

MIRTAZAPINE ODT 45MG TBDP 30 30

MIRTAZAPINE ODT 15MG TBDP 30 30

MITIGARE 0.6MG CAPS 60 30

M-M-R II 0; 0; 0 INJ 2 365

MODAFINIL 100MG TABS 30 30

MODAFINIL 200MG TABS 30 30

MOEXIPRIL/HYDROCHLOROTHIAZIDE 25MG; 15MG TABS 60 30

MOEXIPRIL/HYDROCHLOROTHIAZIDE 12.5MG; 15MG TABS 60 30

MOEXIPRIL/HYDROCHLOROTHIAZIDE 12.5MG; 7.5MG TABS 30 30

MOMETASONE FUROATE 50MCG/ACT SUSP 34 30

MONDOXYNE NL 75MG CAPS 60 30

MONDOXYNE NL 50MG CAPS 60 30

MONDOXYNE NL 100MG CAPS 60 30

MONTELUKAST SODIUM 4MG CHEW 30 30

MONTELUKAST SODIUM 5MG CHEW 30 30

MONTELUKAST SODIUM 4MG PACK 30 30

MONTELUKAST SODIUM 10MG TABS 30 30

MORPHINE SULFATE 1MG/ML SOLN 180 30

MORPHINE SULFATE 0.5MG/ML SOLN 180 30

MORPHINE SULFATE 8MG/ML SOLN 250 30

MORPHINE SULFATE 10MG/ML SOLN 200 30

MORPHINE SULFATE 2MG/ML SOLN 1260 30

MORPHINE SULFATE 4MG/ML SOLN 630 30

MORPHINE SULFATE 8MG/ML SOLN 250 30

MORPHINE SULFATE 10MG/ML SOLN 200 30

MORPHINE SULFATE 1MG/ML SOLN 180 30

MORPHINE SULFATE 100MG/5ML SOLN 180 30

MORPHINE SULFATE 10MG/5ML SOLN 700 30

MORPHINE SULFATE 20MG/5ML SOLN 300 30

MORPHINE SULFATE 15MG TABS 120 30

MORPHINE SULFATE 30MG TABS 120 30

MORPHINE SULFATE ER 30MG TBCR 90 30

MORPHINE SULFATE ER 100MG TBCR 90 30

MORPHINE SULFATE ER 15MG TBCR 90 30

MORPHINE SULFATE ER 200MG TBCR 90 30

MORPHINE SULFATE ER 60MG TBCR 90 30

MOXIFLOXACIN HCL 400MG TABS 30 30

MOZOBIL 24MG/1.2ML SOLN 9.6 30

MULTAQ 400MG TABS 60 30

MYRBETRIQ 25MG TB24 30 30

MYRBETRIQ 50MG TB24 30 30

NADOLOL/BENDROFLUMETHIAZIDE 5MG; 80MG TABS 30 30

NADOLOL/BENDROFLUMETHIAZIDE 5MG; 40MG TABS 30 30

NALBUPHINE HCL 10MG/ML SOLN 180 30

NALBUPHINE HCL 20MG/ML SOLN 90 30

NAMENDA XR 21MG CP24 30 30

NAMENDA XR 14MG CP24 30 30

NAMENDA XR 7MG CP24 30 30

NAMENDA XR 28MG CP24 30 30

NAMENDA XR TITRATION PACK 0 CP24 56 365

NAMZARIC 10MG; 0 C4PK 56 365

NAMZARIC 10MG; 7MG CP24 30 30

NAMZARIC 10MG; 21MG CP24 30 30

NAMZARIC 10MG; 28MG CP24 30 30

NAMZARIC 10MG; 14MG CP24 30 30

NARATRIPTAN HCL 1MG TABS 9 30

NARATRIPTAN HCL 2.5MG TABS 9 30

NARCAN 4MG/0.1ML LIQD 4 30

NASONEX 50MCG/ACT SUSP 34 30

NATEGLINIDE 60MG TABS 90 30

NATEGLINIDE 120MG TABS 90 30

NATPARA 75MCG CART 2 28

NATPARA 25MCG CART 2 28

NATPARA 50MCG CART 2 28

NATPARA 100MCG CART 2 28

NEBUPENT 300MG SOLR 6 28

NEFAZODONE HCL 50MG TABS 60 30

NEFAZODONE HCL 150MG TABS 60 30

NEFAZODONE HCL 200MG TABS 60 30

NEFAZODONE HCL 100MG TABS 60 30

NEFAZODONE HCL 250MG TABS 60 30

NERLYNX 40MG TABS 180 30

NEUPRO 2MG/24HR PT24 30 30

NEUPRO 3MG/24HR PT24 30 30

NEUPRO 8MG/24HR PT24 30 30

NEUPRO 1MG/24HR PT24 30 30

NEUPRO 4MG/24HR PT24 30 30

NEUPRO 6MG/24HR PT24 30 30

NEVIRAPINE 50MG/5ML SUSP 1200 30

NEVIRAPINE 200MG TABS 60 30

NEVIRAPINE ER 100MG TB24 90 30

NEVIRAPINE ER 400MG TB24 30 30

NEXAVAR 200MG TABS 120 30

NIACIN ER 500MG TBCR 30 30

NIACIN ER 1000MG TBCR 60 30

NIACIN ER 750MG TBCR 60 30

NICOTROL INHALER 10MG INHA 1008 90

NICOTROL NS 10MG/ML SOLN 30 30

NIFEDICAL XL 60MG TB24 60 30

NIFEDICAL XL 30MG TB24 60 30

NIFEDIPINE ER 60MG TB24 60 30

NIFEDIPINE ER 30MG TB24 60 30

NIFEDIPINE ER 90MG TB24 30 30

NIFEDIPINE ER 30MG TB24 60 30

NIFEDIPINE ER 60MG TB24 60 30

NIFEDIPINE ER 90MG TB24 30 30

NILUTAMIDE 150MG TABS 60 30

NINLARO 2.3MG CAPS 3 28

NINLARO 3MG CAPS 3 28

NINLARO 4MG CAPS 3 28

NISOLDIPINE ER 8.5MG TB24 30 30

NISOLDIPINE ER 17MG TB24 30 30

NISOLDIPINE ER 34MG TB24 30 30

NISOLDIPINE ER 25.5MG TB24 30 30

NITROGLYCERIN TRANSDERMAL 0.1MG/HR PT24 30 30

NITROGLYCERIN TRANSDERMAL 0.2MG/HR PT24 30 30

NITROGLYCERIN TRANSDERMAL 0.4MG/HR PT24 30 30

NITROGLYCERIN TRANSDERMAL 0.6MG/HR PT24 30 30

NORTHERA 300MG CAPS 180 30

NORTHERA 100MG CAPS 90 30

NORTHERA 200MG CAPS 180 30

NORVIR 100MG CAPS 360 30

NORVIR 100MG PACK 360 30

NORVIR 80MG/ML SOLN 480 30

NORVIR 100MG TABS 360 30

NOVOFINE 30GX8MM MISC 200 30

NOVOFINE 31 MISC 200 30

NOVOFINE 32GX6MM MISC 200 30

NOVOFINE AUTOCOVER 30GX8MM MISC 200 30

NOVOTWIST 30GX8MM MISC 200 30

NOVOTWIST 32GX5MM MISC 200 30

NOXAFIL 40MG/ML SUSP 600 30

NOXAFIL 100MG TBEC 96 30

NUEDEXTA 20MG; 10MG CAPS 60 30

NULOJIX 250MG SOLR 150 30

NUPLAZID 17MG TABS 60 30

ODEFSEY 200MG; 25MG; 25MG TABS 30 30

ODOMZO 200MG CAPS 30 30

OFEV 100MG CAPS 60 30

OFEV 150MG CAPS 60 30

OLANZAPINE 10MG SOLR 30 30

OLANZAPINE 7.5MG TABS 30 30

OLANZAPINE 10MG TABS 30 30

OLANZAPINE 20MG TABS 30 30

OLANZAPINE 15MG TABS 30 30

OLANZAPINE 2.5MG TABS 30 30

OLANZAPINE 5MG TABS 30 30

OLANZAPINE ODT 10MG TBDP 30 30

OLANZAPINE ODT 5MG TBDP 30 30

OLANZAPINE ODT 15MG TBDP 30 30

OLANZAPINE ODT 20MG TBDP 30 30

OLANZAPINE/FLUOXETINE 25MG; 3MG CAPS 30 30

OLANZAPINE/FLUOXETINE 25MG; 6MG CAPS 30 30

OLANZAPINE/FLUOXETINE 50MG; 6MG CAPS 30 30

OLANZAPINE/FLUOXETINE 25MG; 12MG CAPS 30 30

OLANZAPINE/FLUOXETINE 50MG; 12MG CAPS 30 30

OLMESARTAN MEDOXOMIL 40MG TABS 30 30

OLMESARTAN MEDOXOMIL 5MG TABS 30 30

OLMESARTAN MEDOXOMIL 20MG TABS 30 30

OLMESARTAN

MEDOXOMIL/HYDROCHLOROTHIAZIDE

12.5MG; 20MG TABS 30 30

OLMESARTAN

MEDOXOMIL/HYDROCHLOROTHIAZIDE

12.5MG; 40MG TABS 30 30

OLMESARTAN

MEDOXOMIL/HYDROCHLOROTHIAZIDE

25MG; 40MG TABS 30 30

OLOPATADINE HCL 0.001 SOLN 5 30

OLOPATADINE HYDROCHLORIDE 0.002 SOLN 2.5 30

OMEGA-3-ACID ETHYL ESTERS 375MG; 465MG; 1GM CAPS 120 30

OMEPRAZOLE 20MG CPDR 60 30

OMEPRAZOLE 40MG CPDR 60 30

OMEPRAZOLE 10MG CPDR 60 30

ONDANSETRON HCL 4MG/5ML SOLN 450 30

ONDANSETRON HCL 24MG TABS 15 30

ONDANSETRON HCL 4MG TABS 90 30

ONDANSETRON HCL 8MG TABS 90 30

ONDANSETRON ODT 8MG TBDP 90 30

ONDANSETRON ODT 4MG TBDP 90 30

ONFI 2.5MG/ML SUSP 480 30

ONFI 20MG TABS 60 30

ONFI 10MG TABS 60 30

OPDIVO 40MG/4ML SOLN 80 28

OPDIVO 100MG/10ML SOLN 80 28

OPDIVO 240MG/24ML SOLN 48 28

OPSUMIT 10MG TABS 30 30

ORKAMBI 125MG; 100MG TABS 120 30

ORKAMBI 125MG; 200MG TABS 120 30

ORPHENADRINE CITRATE ER 100MG TB12 60 30

OSELTAMIVIR PHOSPHATE 45MG CAPS 56 365

OSELTAMIVIR PHOSPHATE 75MG CAPS 56 365

OSELTAMIVIR PHOSPHATE 30MG CAPS 112 365

OSELTAMIVIR PHOSPHATE 6MG/ML SUSR 700 365

OXANDROLONE 2.5MG TABS 120 30

OXANDROLONE 10MG TABS 60 30

OXAZEPAM 10MG CAPS 120 30

OXAZEPAM 15MG CAPS 120 30

OXAZEPAM 30MG CAPS 120 30

OXYBUTYNIN CHLORIDE 5MG/5ML SYRP 600 30

OXYBUTYNIN CHLORIDE 5MG TABS 120 30

OXYBUTYNIN CHLORIDE ER 15MG TB24 60 30

OXYBUTYNIN CHLORIDE ER 10MG TB24 30 30

OXYBUTYNIN CHLORIDE ER 5MG TB24 30 30

OXYCODONE HCL 5MG CAPS 120 30

OXYCODONE HCL 100MG/5ML CONC 120 30

OXYCODONE HCL 5MG/5ML SOLN 1200 30

OXYCODONE HCL 10MG TABS 120 30

OXYCODONE HCL 20MG TABS 120 30

OXYCODONE HCL 5MG TABS 120 30

OXYCODONE HCL 15MG TABS 120 30

OXYCODONE HCL 30MG TABS 90 30

OXYCODONE/ACETAMINOPHEN 325MG; 5MG TABS 360 30

OXYCODONE/ACETAMINOPHEN 325MG; 2.5MG TABS 360 30

OXYCODONE/ACETAMINOPHEN 325MG; 7.5MG TABS 240 30

OXYCODONE/ACETAMINOPHEN 325MG; 10MG TABS 180 30

OXYCODONE/ASPIRIN 325MG; 4.835MG TABS 180 30

OXYCODONE/IBUPROFEN 400MG; 5MG TABS 28 30

OZEMPIC 2MG/1.5ML SOPN 3 28

OZEMPIC 2MG/1.5ML SOPN 3 28

PALIPERIDONE ER 3MG TB24 30 30

PALIPERIDONE ER 1.5MG TB24 30 30

PALIPERIDONE ER 9MG TB24 30 30

PALIPERIDONE ER 6MG TB24 60 30

PANTOPRAZOLE SODIUM 20MG TBEC 60 30

PANTOPRAZOLE SODIUM 40MG TBEC 60 30

PARICALCITOL 2MCG CAPS 90 30

PARICALCITOL 1MCG CAPS 90 30

PARICALCITOL 4MCG CAPS 60 30

PAROXETINE HCL 20MG TABS 90 30

PAROXETINE HCL 40MG TABS 60 30

PAROXETINE HCL 10MG TABS 30 30

PAROXETINE HCL 30MG TABS 60 30

PAROXETINE HCL ER 37.5MG TB24 60 30

PAROXETINE HCL ER 12.5MG TB24 30 30

PAROXETINE HCL ER 25MG TB24 60 30

PAXIL 10MG/5ML SUSP 900 30

PAZEO 0.007 SOLN 2.5 30

PEGASYS 180MCG/0.5ML KIT 2 28

PEGASYS 180MCG/ML SOLN 4 28

PEGASYS 180MCG/0.5ML SOLN 2 28

PEGASYS PROCLICK 180MCG/0.5ML SOLN 2 28

PEGASYS PROCLICK 135MCG/0.5ML SOLN 2 28

PERFOROMIST 20MCG/2ML NEBU 120 30

PERINDOPRIL ERBUMINE 8MG TABS 60 30

PERINDOPRIL ERBUMINE 4MG TABS 60 30

PERINDOPRIL ERBUMINE 2MG TABS 60 30

PHENOBARBITAL 20MG/5ML ELIX 1500 30

PHENOBARBITAL 32.4MG TABS 120 30

PHENOBARBITAL 97.2MG TABS 120 30

PHENOBARBITAL 16.2MG TABS 120 30

PHENOBARBITAL 64.8MG TABS 120 30

PHENOBARBITAL 60MG TABS 120 30

PHENOBARBITAL 15MG TABS 120 30

PHENOBARBITAL 30MG TABS 120 30

PHENOBARBITAL 100MG TABS 120 30

PICATO 0.00015 GEL 3 56

PICATO 0.0005 GEL 2 56

PIOGLITAZONE HCL 15MG TABS 30 30

PIOGLITAZONE HCL 30MG TABS 30 30

PIOGLITAZONE HCL 45MG TABS 30 30

PIOGLITAZONE HCL/METFORMIN HCL 500MG; 15MG TABS 90 30

PIOGLITAZONE HCL/METFORMIN HCL 850MG; 15MG TABS 90 30

POMALYST 1MG CAPS 21 28

POMALYST 2MG CAPS 21 28

POMALYST 3MG CAPS 21 28

POMALYST 4MG CAPS 21 28

PORTRAZZA 800MG/50ML SOLN 100 21

POTIGA 50MG TABS 90 30

POTIGA 400MG TABS 90 30

POTIGA 300MG TABS 90 30

POTIGA 200MG TABS 90 30

PRADAXA 110MG CAPS 60 30

PRADAXA 150MG CAPS 60 30

PRADAXA 75MG CAPS 60 30

PRAMIPEXOLE DIHYDROCHLORIDE 1.5MG TABS 90 30

PRAMIPEXOLE DIHYDROCHLORIDE 0.25MG TABS 90 30

PRAMIPEXOLE DIHYDROCHLORIDE 0.125MG TABS 90 30

PRAMIPEXOLE DIHYDROCHLORIDE 0.5MG TABS 90 30

PRAMIPEXOLE DIHYDROCHLORIDE 1MG TABS 90 30

PRAMIPEXOLE DIHYDROCHLORIDE 0.75MG TABS 90 30

PRAMIPEXOLE DIHYDROCHLORIDE ER 4.5MG TB24 30 30

PRAMIPEXOLE DIHYDROCHLORIDE ER 3.75MG TB24 30 30

PRAMIPEXOLE DIHYDROCHLORIDE ER 2.25MG TB24 30 30

PRAMIPEXOLE DIHYDROCHLORIDE ER 1.5MG TB24 90 30

PRAMIPEXOLE DIHYDROCHLORIDE ER 0.75MG TB24 90 30

PRAMIPEXOLE DIHYDROCHLORIDE ER 3MG TB24 30 30

PRAMIPEXOLE DIHYDROCHLORIDE ER 0.375MG TB24 90 30

PRASUGREL 5MG TABS 30 30

PRASUGREL 10MG TABS 30 30

PRAVASTATIN SODIUM 80MG TABS 30 30

PRAVASTATIN SODIUM 10MG TABS 30 30

PRAVASTATIN SODIUM 20MG TABS 30 30

PRAVASTATIN SODIUM 40MG TABS 30 30

PREMARIN 0.625MG TABS 30 30

PREMARIN 0.45MG TABS 30 30

PREMARIN 0.9MG TABS 30 30

PREMARIN 1.25MG TABS 30 30

PREMARIN 0.3MG TABS 30 30

PREZCOBIX 150MG; 800MG TABS 30 30

PREZISTA 100MG/ML SUSP 400 30

PREZISTA 600MG TABS 60 30

PREZISTA 150MG TABS 180 30

PREZISTA 800MG TABS 30 30

PREZISTA 75MG TABS 210 30

PRISTIQ 25MG TB24 30 30

PRISTIQ 100MG TB24 30 30

PRISTIQ 50MG TB24 30 30

PROAIR HFA 108MCG/ACT AERS 17 30

PROAIR RESPICLICK 108MCG/ACT AEPB 2 30

PROCRIT 2000UNIT/ML SOLN 12 28

PROCRIT 3000UNIT/ML SOLN 12 28

PROCRIT 10000UNIT/ML SOLN 12 28

PROCRIT 4000UNIT/ML SOLN 12 28

PROCRIT 40000UNIT/ML SOLN 6 28

PROCRIT 20000UNIT/ML SOLN 12 28

PROLIA 60MG/ML SOLN 1 180

PROMACTA 12.5MG TABS 30 30

PROMACTA 50MG TABS 30 30

PROMACTA 75MG TABS 30 30

PROMACTA 25MG TABS 30 30

PROQUAD 0; 0; 0; 0 INJ 2 365

PULMOZYME 1MG/ML SOLN 150 30

PURIXAN 2000MG/100ML SUSP 300 30

QUASENSE 0.03MG; 0.15MG TABS 91 91

QUETIAPINE FUMARATE 200MG TABS 60 30

QUETIAPINE FUMARATE 300MG TABS 60 30

QUETIAPINE FUMARATE 400MG TABS 60 30

QUETIAPINE FUMARATE 25MG TABS 60 30

QUETIAPINE FUMARATE 50MG TABS 60 30

QUETIAPINE FUMARATE 100MG TABS 60 30

QUETIAPINE FUMARATE ER 400MG TB24 60 30

QUETIAPINE FUMARATE ER 300MG TB24 60 30

QUETIAPINE FUMARATE ER 150MG TB24 30 30

QUETIAPINE FUMARATE ER 200MG TB24 30 30

QUETIAPINE FUMARATE ER 50MG TB24 60 30

QUINAPRIL HCL 10MG TABS 60 30

QUINAPRIL HCL 40MG TABS 60 30

QUINAPRIL HCL 20MG TABS 60 30

QUINAPRIL HCL 5MG TABS 60 30

QUINAPRIL/HYDROCHLOROTHIAZIDE 12.5MG; 20MG TABS 60 30

QUINAPRIL/HYDROCHLOROTHIAZIDE 12.5MG; 10MG TABS 30 30

QUINAPRIL/HYDROCHLOROTHIAZIDE 25MG; 20MG TABS 60 30

QUININE SULFATE 324MG CAPS 42 7

RALOXIFENE HYDROCHLORIDE 60MG TABS 30 30

RAMIPRIL 1.25MG CAPS 60 30

RAMIPRIL 2.5MG CAPS 60 30

RAMIPRIL 5MG CAPS 60 30

RAMIPRIL 10MG CAPS 60 30

RANEXA 1000MG TB12 60 30

RANEXA 500MG TB12 60 30

RASAGILINE MESYLATE 0.5MG TABS 30 30

RASAGILINE MESYLATE 1MG TABS 30 30

REBIF 44MCG/0.5ML SOSY 6 28

REBIF 22MCG/0.5ML SOSY 6 28

REBIF REBIDOSE 22MCG/0.5ML SOAJ 6 28

REBIF REBIDOSE 44MCG/0.5ML SOAJ 6 28

REBIF REBIDOSE TITRATION PACK 0 SOAJ 4.2 28

REBIF TITRATION PACK 0 SOSY 4.2 28

RECOMBIVAX HB 10MCG/ML SUSP 3 365

RECOMBIVAX HB 10MCG/ML SUSP 3 365

RECOMBIVAX HB 40MCG/ML SUSP 3 365

RECOMBIVAX HB 5MCG/0.5ML SUSP 3 365

REGRANEX 0.0001 GEL 15 30

RELISTOR 12MG/0.6ML SOLN 16.8 28

RELISTOR 8MG/0.4ML SOLN 11.2 28

RELISTOR 12MG/0.6ML SOLN 16.8 28

RENVELA 2.4GM PACK 180 30

RENVELA 0.8GM PACK 180 30

RENVELA 800MG TABS 540 30

REPAGLINIDE 0.5MG TABS 120 30

REPAGLINIDE 1MG TABS 120 30

REPAGLINIDE 2MG TABS 240 30

REPATHA 140MG/ML SOSY 3 30

REPATHA PUSHTRONEX SYSTEM 420MG/3.5ML SOCT 3.5 30

REPATHA SURECLICK 140MG/ML SOAJ 3 30

REPREXAIN 10MG; 200MG TABS 150 30

RESCRIPTOR 200MG TABS 180 30

RESCRIPTOR 100MG TABS 270 30

RESTASIS 0.0005 EMUL 60 30

REVLIMID 15MG CAPS 21 28

REVLIMID 20MG CAPS 21 28

REVLIMID 25MG CAPS 21 28

REVLIMID 2.5MG CAPS 28 28

REVLIMID 5MG CAPS 28 28

REVLIMID 10MG CAPS 28 28

REXULTI 0.5MG TABS 30 30

REXULTI 0.25MG TABS 30 30

REXULTI 2MG TABS 30 30

REXULTI 4MG TABS 30 30

REXULTI 1MG TABS 30 30

REXULTI 3MG TABS 30 30

REYATAZ 200MG CAPS 60 30

REYATAZ 150MG CAPS 30 30

REYATAZ 300MG CAPS 30 30

REYATAZ 50MG PACK 180 30

RIBAVIRIN 200MG CAPS 168 28

RIBAVIRIN 200MG TABS 168 28

RIOMET 500MG/5ML SOLN 750 30

RISEDRONATE SODIUM 35MG TABS 4 28

RISEDRONATE SODIUM 30MG TABS 30 30

RISEDRONATE SODIUM 35MG TABS 4 28

RISEDRONATE SODIUM 5MG TABS 30 30

RISEDRONATE SODIUM 150MG TABS 1 30

RISEDRONATE SODIUM 35MG TABS 4 28

RISPERDAL CONSTA 12.5MG SUSR 2 28

RISPERDAL CONSTA 25MG SUSR 2 28

RISPERDAL CONSTA 50MG SUSR 2 28

RISPERDAL CONSTA 37.5MG SUSR 2 28

RISPERIDONE 1MG/ML SOLN 240 30

RISPERIDONE 1MG TABS 60 30

RISPERIDONE 2MG TABS 60 30

RISPERIDONE 4MG TABS 120 30

RISPERIDONE 3MG TABS 60 30

RISPERIDONE 0.5MG TABS 60 30

RISPERIDONE 0.25MG TABS 60 30

RISPERIDONE M-TAB 0.5MG TBDP 60 30

RISPERIDONE M-TAB 1MG TBDP 60 30

RISPERIDONE M-TAB 2MG TBDP 60 30

RISPERIDONE M-TAB 3MG TBDP 60 30

RISPERIDONE M-TAB 4MG TBDP 120 30

RISPERIDONE ODT 0.25MG TBDP 60 30

RISPERIDONE ODT 3MG TBDP 60 30

RISPERIDONE ODT 4MG TBDP 120 30

RISPERIDONE ODT 1MG TBDP 60 30

RISPERIDONE ODT 0.5MG TBDP 60 30

RISPERIDONE ODT 2MG TBDP 60 30

RITONAVIR 100MG TABS 360 30

RIVASTIGMINE TARTRATE 1.5MG CAPS 60 30

RIVASTIGMINE TARTRATE 3MG CAPS 60 30

RIVASTIGMINE TARTRATE 4.5MG CAPS 60 30

RIVASTIGMINE TARTRATE 6MG CAPS 60 30

RIVASTIGMINE TRANSDERMAL SYSTEM 4.6MG/24HR PT24 30 30

RIVASTIGMINE TRANSDERMAL SYSTEM 9.5MG/24HR PT24 30 30

RIVASTIGMINE TRANSDERMAL SYSTEM 13.3MG/24HR PT24 30 30

RIZATRIPTAN BENZOATE 10MG TABS 12 30

RIZATRIPTAN BENZOATE 5MG TABS 12 30

RIZATRIPTAN BENZOATE ODT 5MG TBDP 12 30

RIZATRIPTAN BENZOATE ODT 10MG TBDP 12 30

ROSUVASTATIN CALCIUM 5MG TABS 30 30

ROSUVASTATIN CALCIUM 10MG TABS 30 30

ROSUVASTATIN CALCIUM 40MG TABS 30 30

ROSUVASTATIN CALCIUM 20MG TABS 30 30

ROWEEPRA XR 750MG TB24 120 30

ROWEEPRA XR 500MG TB24 180 30

ROZEREM 8MG TABS 30 30

RUBRACA 200MG TABS 120 30

RUBRACA 300MG TABS 120 30

RUBRACA 250MG TABS 120 30

RUCONEST 2100UNIT SOLR 8 30

RYDAPT 25MG CAPS 224 28

SABRIL 500MG PACK 200 30

SABRIL 500MG TABS 180 30

SAMSCA 15MG TABS 30 30

SAMSCA 30MG TABS 60 30

SANCUSO 3.1MG/24HR PTCH 4 28

SAPHRIS 2.5MG SUBL 60 30

SAPHRIS 5MG SUBL 60 30

SAPHRIS 10MG SUBL 60 30

SAVAYSA 30MG TABS 30 30

SAVAYSA 60MG TABS 30 30

SAVAYSA 15MG TABS 30 30

SCOPOLAMINE 1MG/3DAYS PT72 10 30

SELZENTRY 20MG/ML SOLN 1610 26

SELZENTRY 300MG TABS 120 30

SELZENTRY 75MG TABS 60 30

SELZENTRY 25MG TABS 240 30

SELZENTRY 150MG TABS 60 30

SENSIPAR 60MG TABS 60 30

SENSIPAR 90MG TABS 120 30

SENSIPAR 30MG TABS 60 30

SEREVENT DISKUS 50MCG/DOSE AEPB 60 30

SERTRALINE HCL 20MG/ML CONC 300 30

SERTRALINE HCL 25MG TABS 30 30

SERTRALINE HCL 100MG TABS 60 30

SERTRALINE HCL 50MG TABS 120 30

SETLAKIN 0.03MG; 0.15MG TABS 91 91

SHINGRIX 50MCG SUSR 2 999

SIGNIFOR 0.6MG/ML SOLN 60 30

SIGNIFOR 0.9MG/ML SOLN 60 30

SIGNIFOR 0.3MG/ML SOLN 60 30

SILDENAFIL 20MG TABS 90 30

SILENOR 3MG TABS 30 30

SILENOR 6MG TABS 30 30

SIMVASTATIN 80MG TABS 30 30

SIMVASTATIN 10MG TABS 30 30

SIMVASTATIN 5MG TABS 30 30

SIMVASTATIN 20MG TABS 30 30

SIMVASTATIN 40MG TABS 30 30

SIRTURO 100MG TABS 188 365

SOLIQUA 100/33 100UNIT/ML; 33MCG/ML SOPN 18 30

SOMATULINE DEPOT 60MG/0.2ML SOLN 0.2 28

SOMATULINE DEPOT 90MG/0.3ML SOLN 0.3 28

SOMATULINE DEPOT 120MG/0.5ML SOLN 0.5 28

SOMAVERT 25MG SOLR 30 30

SOMAVERT 10MG SOLR 30 30

SOMAVERT 15MG SOLR 30 30

SOMAVERT 20MG SOLR 30 30

SOMAVERT 30MG SOLR 30 30

SPRITAM 250MG TB3D 60 30

SPRITAM 1000MG TB3D 60 30

SPRITAM 500MG TB3D 60 30

SPRITAM 750MG TB3D 120 30

SPRYCEL 20MG TABS 30 30

SPRYCEL 100MG TABS 30 30

SPRYCEL 50MG TABS 30 30

SPRYCEL 70MG TABS 30 30

SPRYCEL 80MG TABS 30 30

SPRYCEL 140MG TABS 30 30

STAMARIL 0 SUSR 1 999

STAVUDINE 40MG CAPS 60 30

STAVUDINE 30MG CAPS 60 30

STAVUDINE 15MG CAPS 60 30

STAVUDINE 20MG CAPS 60 30

STAVUDINE 1MG/ML SOLR 2400 30

STRIBILD 150MG; 150MG; 200MG; 300MG TABS 30 30

SUBOXONE 12MG; 3MG FILM 90 30

SUBOXONE 4MG; 1MG FILM 90 30

SUBOXONE 8MG; 2MG FILM 90 30

SUBOXONE 2MG; 0.5MG FILM 90 30

SUMATRIPTAN 5MG/ACT SOLN 12 30

SUMATRIPTAN 20MG/ACT SOLN 12 30

SUMATRIPTAN SUCCINATE 4MG/0.5ML SOAJ 8 30

SUMATRIPTAN SUCCINATE 6MG/0.5ML SOAJ 4 30

SUMATRIPTAN SUCCINATE 6MG/0.5ML SOAJ 4 30

SUMATRIPTAN SUCCINATE 6MG/0.5ML SOLN 4 30

SUMATRIPTAN SUCCINATE 6MG/0.5ML SOSY 4 30

SUMATRIPTAN SUCCINATE 25MG TABS 9 30

SUMATRIPTAN SUCCINATE 100MG TABS 9 30

SUMATRIPTAN SUCCINATE 50MG TABS 9 30

SUMATRIPTAN SUCCINATE REFILL 4MG/0.5ML SOCT 8 30

SUMATRIPTAN SUCCINATE REFILL 6MG/0.5ML SOCT 4 30

SUSTIVA 50MG CAPS 90 30

SUSTIVA 200MG CAPS 60 30

SUSTIVA 600MG TABS 30 30

SUTENT 50MG CAPS 28 28

SUTENT 37.5MG CAPS 28 28

SUTENT 25MG CAPS 28 28

SUTENT 12.5MG CAPS 28 28

SYLATRON 200MCG KIT 4 28

SYLATRON 300MCG KIT 4 28

SYLATRON 600MCG KIT 4 28

SYLATRON 600MCG KIT 4 28

SYMFI 600MG; 300MG; 300MG TABS 30 30

SYMFI LO 400MG; 300MG; 300MG TABS 30 30

SYMLINPEN 120 2700MCG/2.7ML SOPN 10.8 28

SYMLINPEN 60 1500MCG/1.5ML SOPN 6 30

SYNJARDY 5MG; 500MG TABS 60 30

SYNJARDY 12.5MG; 1000MG TABS 60 30

SYNJARDY 5MG; 1000MG TABS 60 30

SYNJARDY 12.5MG; 500MG TABS 60 30

SYNJARDY XR 5MG; 1000MG TB24 60 30

SYNJARDY XR 10MG; 1000MG TB24 30 30

SYNJARDY XR 12.5MG; 1000MG TB24 60 30

SYNJARDY XR 25MG; 1000MG TB24 30 30

SYNRIBO 3.5MG SOLR 28 28

TACROLIMUS 0.0003 OINT 100 90

TACROLIMUS 0.001 OINT 100 90

TAFINLAR 75MG CAPS 120 30

TAFINLAR 50MG CAPS 120 30

TAGRISSO 80MG TABS 30 30

TAGRISSO 40MG TABS 30 30

TAMIFLU 75MG CAPS 56 365

TAMIFLU 45MG CAPS 56 365

TAMIFLU 30MG CAPS 112 365

TAMIFLU 6MG/ML SUSR 700 365

TAMSULOSIN HCL 0.4MG CAPS 60 30

TARCEVA 25MG TABS 60 30

TARCEVA 100MG TABS 30 30

TARCEVA 150MG TABS 30 30

TARGRETIN 0.01 GEL 60 30

TASIGNA 150MG CAPS 112 28

TASIGNA 200MG CAPS 112 28

TASIGNA 50MG CAPS 420 30

TAZAROTENE 0.001 CREA 120 30

TAZORAC 0.0005 CREA 120 30

TAZORAC 0.001 CREA 120 30

TAZORAC 0.0005 GEL 100 30

TAZORAC 0.001 GEL 100 30

TECENTRIQ 1200MG/20ML SOLN 20 21

TECFIDERA 240MG CPDR 60 30

TECFIDERA 120MG CPDR 14 30

TECFIDERA STARTER PACK 0 MISC 120 365

TECHLITE PEN NEEDLES/31G X 6 MM MISC 200 30

TECHLITE PEN NEEDLES/31G X 8MM MISC 200 30

TECHLITE PEN NEEDLES/32G X 4MM MISC 200 30

TECHLITE PEN NEEDLES/32G X 6MM MISC 200 30

TECHLITE PEN NEEDLES/32G X 8MM MISC 200 30

TEKTURNA 150MG TABS 30 30

TEKTURNA 300MG TABS 30 30

TEKTURNA HCT 150MG; 12.5MG TABS 30 30

TEKTURNA HCT 150MG; 25MG TABS 30 30

TEKTURNA HCT 300MG; 25MG TABS 30 30

TEKTURNA HCT 300MG; 12.5MG TABS 30 30

TELMISARTAN 40MG TABS 30 30

TELMISARTAN 80MG TABS 30 30

TELMISARTAN 20MG TABS 30 30

TELMISARTAN/AMLODIPINE 5MG; 80MG TABS 30 30

TELMISARTAN/AMLODIPINE 5MG; 40MG TABS 30 30

TELMISARTAN/AMLODIPINE 10MG; 40MG TABS 30 30

TELMISARTAN/AMLODIPINE 10MG; 80MG TABS 30 30

TELMISARTAN/HYDROCHLOROTHIAZIDE 12.5MG; 40MG TABS 30 30

TELMISARTAN/HYDROCHLOROTHIAZIDE 12.5MG; 80MG TABS 30 30

TELMISARTAN/HYDROCHLOROTHIAZIDE 25MG; 80MG TABS 30 30

TEMAZEPAM 15MG CAPS 60 365

TEMAZEPAM 30MG CAPS 60 365

TEMAZEPAM 7.5MG CAPS 60 365

TEMAZEPAM 22.5MG CAPS 60 365

TENIVAC 2LFU; 5LFU INJ 0.5 28

TENOFOVIR DISOPROXIL FUMARATE 300MG TABS 30 30

TERAZOSIN HCL 10MG CAPS 60 30

TERBINAFINE HCL 250MG TABS 90 365

TESTOSTERONE 25MG/2.5GM GEL 300 30

TESTOSTERONE 50MG/5GM GEL 300 30

TESTOSTERONE ENANTHATE 200MG/ML SOLN 5 30

TESTOSTERONE PUMP 0.01 GEL 300 30

TETRABENAZINE 12.5MG TABS 90 30

TETRABENAZINE 25MG TABS 120 30

THALOMID 50MG CAPS 28 28

THALOMID 100MG CAPS 28 28

THALOMID 200MG CAPS 56 28

THALOMID 150MG CAPS 28 28

TIAGABINE HYDROCHLORIDE 2MG TABS 240 30

TIAGABINE HYDROCHLORIDE 12MG TABS 120 30

TIAGABINE HYDROCHLORIDE 16MG TABS 90 30

TIVICAY 50MG TABS 60 30

TIVICAY 25MG TABS 60 30

TIVICAY 10MG TABS 60 30

TOBI PODHALER 28MG CAPS 1568 365

TOBRAMYCIN 300MG/5ML NEBU 280 56

TOLTERODINE TARTRATE 1MG TABS 60 30

TOLTERODINE TARTRATE 2MG TABS 60 30

TOLTERODINE TARTRATE ER 2MG CP24 30 30

TOLTERODINE TARTRATE ER 4MG CP24 30 30

TORISEL 25MG/ML SOLN 4 28

TRACLEER 62.5MG TABS 60 30

TRACLEER 125MG TABS 60 30

TRACLEER 32MG TBSO 60 30

TRADJENTA 5MG TABS 30 30

TRAMADOL HCL 50MG TABS 240 30

TRAMADOL HYDROCHLORIDE/ACETAMINOPHEN 325MG; 37.5MG TABS 240 30

TRANDOLAPRIL 1MG TABS 30 30

TRANDOLAPRIL 4MG TABS 60 30

TRANDOLAPRIL 2MG TABS 60 30

TRANEXAMIC ACID 650MG TABS 30 28

TRANSDERM-SCOP 1MG/3DAYS PT72 10 30

TRAVATAN Z 0.00004 SOLN 5 30

TREANDA 180MG/2ML SOLN 4 21

TREANDA 45MG/0.5ML SOLN 6 21

TREANDA 25MG SOLR 8 21

TRELEGY ELLIPTA 100MCG/INH; 62.5MCG/INH; 25MCG/INH AEPB 60 30

TRELSTAR 11.25MG SUSR 1 84

TRELSTAR 3.75MG SUSR 1 28

TRELSTAR MIXJECT 22.5MG SUSR 1 168

TRELSTAR MIXJECT 11.25MG SUSR 1 84

TRELSTAR MIXJECT 3.75MG SUSR 1 28

TRETINOIN 0.001 CREA 45 30

TRETINOIN 0.0005 CREA 45 30

TRETINOIN 0.00025 CREA 45 30

TRETINOIN 0.0005 GEL 45 30

TRETINOIN 0.0001 GEL 45 30

TRETINOIN 0.00025 GEL 45 30

TRINTELLIX 5MG TABS 30 30

TRINTELLIX 20MG TABS 30 30

TRINTELLIX 10MG TABS 30 30

TRIPTODUR 22.5MG SRER 1 168

TRIUMEQ 600MG; 50MG; 300MG TABS 30 30

TROKENDI XR 100MG CP24 30 30

TROKENDI XR 25MG CP24 30 30

TROKENDI XR 50MG CP24 30 30

TROKENDI XR 200MG CP24 60 30

TRULANCE 3MG TABS 30 30

TRULICITY 1.5MG/0.5ML SOPN 2 28

TRULICITY 0.75MG/0.5ML SOPN 2 28

TRUVADA 133MG; 200MG TABS 30 30

TRUVADA 167MG; 250MG TABS 30 30

TRUVADA 100MG; 150MG TABS 30 30

TRUVADA 200MG; 300MG TABS 30 30

TYBOST 150MG TABS 30 30

TYKERB 250MG TABS 180 30

TYSABRI 300MG/15ML CONC 15 28

TYZEKA 600MG TABS 30 30

ULORIC 80MG TABS 30 30

ULORIC 40MG TABS 30 30

VALACYCLOVIR HCL 500MG TABS 30 30

VALACYCLOVIR HCL 1GM TABS 30 30

VALCHLOR 0.00016 GEL 60 30

VALSARTAN 80MG TABS 30 30

VALSARTAN 160MG TABS 30 30

VALSARTAN 320MG TABS 30 30

VALSARTAN 40MG TABS 30 30

VALSARTAN/HYDROCHLOROTHIAZIDE 12.5MG; 80MG TABS 30 30

VALSARTAN/HYDROCHLOROTHIAZIDE 12.5MG; 160MG TABS 30 30

VALSARTAN/HYDROCHLOROTHIAZIDE 25MG; 160MG TABS 30 30

VALSARTAN/HYDROCHLOROTHIAZIDE 12.5MG; 320MG TABS 30 30

VALSARTAN/HYDROCHLOROTHIAZIDE 25MG; 320MG TABS 30 30

VANCOMYCIN HCL 125MG CAPS 40 10

VANCOMYCIN HCL 250MG CAPS 80 10

VARIVAX 1350PFU/0.5ML INJ 1 365

VARIZIG 125UNIT SOLR 12 30

VARIZIG 125UNIT/1.2ML SOLN 12 30

VASCEPA 0.5GM CAPS 240 30

VASCEPA 1GM CAPS 120 30

VELCADE 3.5MG SOLR 14 21

VELPHORO 500MG CHEW 180 30

VENCLEXTA 50MG TABS 30 30

VENCLEXTA 10MG TABS 60 30

VENCLEXTA 100MG TABS 120 30

VENCLEXTA STARTING PACK 0 TBPK 84 365

VENLAFAXINE HCL 75MG TABS 90 30

VENLAFAXINE HCL 50MG TABS 90 30

VENLAFAXINE HCL 25MG TABS 90 30

VENLAFAXINE HCL 100MG TABS 90 30

VENLAFAXINE HCL 37.5MG TABS 90 30

VENLAFAXINE HCL ER 37.5MG CP24 30 30

VENLAFAXINE HCL ER 150MG CP24 60 30

VENLAFAXINE HCL ER 75MG CP24 90 30

VENTAVIS 10MCG/ML SOLN 270 30

VENTAVIS 20MCG/ML SOLN 270 30

VENTOLIN HFA 108MCG/ACT AERS 36 30

VERAPAMIL HCL ER 100MG CP24 30 30

VERAPAMIL HCL ER 200MG CP24 60 30

VERAPAMIL HCL ER 180MG CP24 30 30

VERAPAMIL HCL ER 120MG CP24 30 30

VERAPAMIL HCL ER 240MG CP24 30 30

VERAPAMIL HCL ER 300MG CP24 30 30

VERAPAMIL HCL SR 360MG CP24 30 30

VERSACLOZ 50MG/ML SUSP 540 30

VERZENIO 50MG TABS 60 30

VERZENIO 100MG TABS 60 30

VERZENIO 150MG TABS 60 30

VERZENIO 200MG TABS 60 30

VESICARE 5MG TABS 30 30

VESICARE 10MG TABS 30 30

VIBERZI 75MG TABS 60 30

VIBERZI 100MG TABS 60 30

VICODIN 300MG; 5MG TABS 360 30

VICODIN ES 300MG; 7.5MG TABS 180 30

VICODIN HP 300MG; 10MG TABS 180 30

VICTOZA 18MG/3ML SOPN 9 30

VIDEX EC 125MG CPDR 30 30

VIDEX PEDIATRIC 4GM SOLR 1200 30

VIDEX PEDIATRIC 2GM SOLR 1200 30

VIGABATRIN 500MG PACK 200 30

VIIBRYD 0 KIT 30 30

VIIBRYD 40MG TABS 30 30

VIIBRYD 10MG TABS 30 30

VIIBRYD 20MG TABS 30 30

VIIBRYD STARTER PACK 0 KIT 30 30

VIMPAT 200MG/20ML SOLN 1200 30

VIMPAT 10MG/ML SOLN 1200 30

VIMPAT 100MG TABS 60 30

VIMPAT 200MG TABS 60 30

VIMPAT 150MG TABS 60 30

VIMPAT 50MG TABS 60 30

VIRACEPT 250MG TABS 270 30

VIRACEPT 625MG TABS 120 30

VIRAMUNE 50MG/5ML SUSP 1200 30

VIREAD 40MG/GM POWD 240 30

VIREAD 250MG TABS 30 30

VIREAD 150MG TABS 30 30

VIREAD 200MG TABS 30 30

VIREAD 300MG TABS 30 30

VITEKTA 150MG TABS 30 30

VITEKTA 85MG TABS 30 30

VORICONAZOLE 40MG/ML SUSR 300 30

VORICONAZOLE 50MG TABS 90 30

VORICONAZOLE 200MG TABS 90 30

VOSEVI 400MG; 100MG; 100MG TABS 30 30

VOTRIENT 200MG TABS 120 30

VRAYLAR 3MG CAPS 30 30

VRAYLAR 1.5MG CAPS 30 30

VRAYLAR 4.5MG CAPS 30 30

VRAYLAR 6MG CAPS 30 30

VRAYLAR 0 CPPK 14 365

XALKORI 200MG CAPS 60 30

XALKORI 250MG CAPS 60 30

XARELTO 15MG TABS 60 30

XARELTO 20MG TABS 30 30

XARELTO 10MG TABS 90 90

XARELTO STARTER PACK 0 TBPK 102 365

XGEVA 120MG/1.7ML SOLN 1.7 28

XIFAXAN 200MG TABS 9 30

XIFAXAN 550MG TABS 90 30

XIGDUO XR 5MG; 500MG TB24 30 30

XIGDUO XR 5MG; 1000MG TB24 60 30

XIGDUO XR 10MG; 500MG TB24 30 30

XIGDUO XR 10MG; 1000MG TB24 30 30

XIGDUO XR 2.5MG; 1000MG TB24 30 30

XOLAIR 150MG SOLR 6 28

XTAMPZA ER 9MG C12A 60 30

XTAMPZA ER 13.5MG C12A 60 30

XTAMPZA ER 18MG C12A 60 30

XTAMPZA ER 27MG C12A 60 30

XTAMPZA ER 36MG C12A 60 30

XTANDI 40MG CAPS 120 30

XULTOPHY 100/3.6 100UNIT/ML; 3.6MG/ML SOPN 15 30

XYLON 10MG; 200MG TABS 150 30

XYREM 500MG/ML SOLN 540 30

YERVOY 200MG/40ML SOLN 80 21

YONSA 125MG TABS 120 30

YUVAFEM 10MCG TABS 18 28

ZAFIRLUKAST 20MG TABS 60 30

ZAFIRLUKAST 10MG TABS 60 30

ZALEPLON 5MG CAPS 30 30

ZALEPLON 10MG CAPS 30 30

ZALTRAP 100MG/4ML SOLN 40 28

ZALTRAP 200MG/8ML SOLN 40 28

ZAVESCA 100MG CAPS 90 30

ZEBUTAL 325MG; 50MG; 40MG CAPS 180 30

ZEJULA 100MG CAPS 90 30

ZELBORAF 240MG TABS 240 30

ZERIT 1MG/ML SOLR 2400 30

ZETIA 10MG TABS 30 30

ZIAGEN 20MG/ML SOLN 960 30

ZIDOVUDINE 100MG CAPS 180 30

ZIDOVUDINE 50MG/5ML SYRP 1680 28

ZIDOVUDINE 300MG TABS 60 30ZIOPTAN 0.015MG/ML SOLN 30 30

ZIPRASIDONE HCL 60MG CAPS 60 30

ZIPRASIDONE HCL 20MG CAPS 60 30

ZIPRASIDONE HCL 40MG CAPS 60 30

ZIPRASIDONE HCL 80MG CAPS 60 30

ZMAX 2GM SUSR 60 30

ZOLEDRONIC ACID 4MG/5ML CONC 15 21

ZOLEDRONIC ACID 5MG/100ML SOLN 100 365

ZOLEDRONIC ACID 4MG SOLR 3 21

ZOLINZA 100MG CAPS 120 30

ZOLPIDEM TARTRATE 5MG TABS 30 30

ZOLPIDEM TARTRATE 10MG TABS 30 30

ZORTRESS 0.75MG TABS 60 30

ZORTRESS 0.5MG TABS 120 30

ZORTRESS 0.25MG TABS 60 30

ZOSTAVAX 19400UNT/0.65ML SUSR 1 999

ZOVIRAX 0.05 CREA 5 30

ZUBSOLV 5.7MG; 1.4MG SUBL 90 30

ZUBSOLV 1.4MG; 0.36MG SUBL 90 30

ZUBSOLV 8.6MG; 2.1MG SUBL 90 30

ZUBSOLV 11.4MG; 2.9MG SUBL 90 30

ZUBSOLV 2.9MG; 0.71MG SUBL 90 30

ZUBSOLV 0.7MG; 0.18MG SUBL 30 30

ZYCLARA 0.0375 CREA 56 30

ZYCLARA PUMP 0.025 CREA 15 30

ZYCLARA PUMP 0.0375 CREA 56 30

ZYDELIG 100MG TABS 60 30

ZYDELIG 150MG TABS 60 30

ZYKADIA 150MG CAPS 140 28

ZYPREXA RELPREVV 405MG SUSR 1 28

ZYPREXA RELPREVV 210MG SUSR 2 28

ZYPREXA RELPREVV 300MG SUSR 2 28

ZYTIGA 250MG TABS 120 30

ZYTIGA 500MG TABS 60 30

Structure BookmarksWorkbookWorksheetTableSpan2018 Cigna-HealthSpring Quantity Limit Criteria - MAPD/MMP - Cigna-HealthSpring Achieve, Primary, TotalCare, Traditions, Preferred, Preferred Plus, Premier, PreventiveCare, and CarePlan2018 Cigna-HealthSpring Quantity Limit Criteria - MAPD/MMP - Cigna-HealthSpring Achieve, Primary, TotalCare, Traditions, Preferred, Preferred Plus, Premier, PreventiveCare, and CarePlan2018 Cigna-HealthSpring Quantity Limit Criteria - MAPD/MMP - Cigna-HealthSpring Achieve, Primary, TotalCare, Traditions, Preferred, Preferred Plus, Premier, PreventiveCare, and CarePlan

Drug NameDrug NameDrug Name

StrengthStrength

Dosage FormDosage Form

Quantity LimitQuantity Limit

Days SupplyDays Supply

ABACAVIRABACAVIRABACAVIR

20MG/ML20MG/ML

SOLNSOLN

960960

3030

ABACAVIRABACAVIRABACAVIR

300MG300MG

TABSTABS

6060

3030

ABACAVIR SULFATE/LAMIVUDINE/ZIDOVUDINEABACAVIR SULFATE/LAMIVUDINE/ZIDOVUDINEABACAVIR SULFATE/LAMIVUDINE/ZIDOVUDINE

300MG; 150MG; 300MG300MG; 150MG; 300MG

TABSTABS

6060

3030

ABACAVIR/LAMIVUDINEABACAVIR/LAMIVUDINEABACAVIR/LAMIVUDINE

600MG; 300MG600MG; 300MG

TABSTABS

3030

3030

ABILIFY MAINTENAABILIFY MAINTENAABILIFY MAINTENA

300MG300MG

PRSYPRSY

11

2828

ABILIFY MAINTENAABILIFY MAINTENAABILIFY MAINTENA

400MG400MG

PRSYPRSY

11

2828

ABILIFY MAINTENAABILIFY MAINTENAABILIFY MAINTENA

300MG300MG

SRERSRER

11

2828

ABILIFY MAINTENAABILIFY MAINTENAABILIFY MAINTENA

400MG400MG

SRERSRER

11

2828

ACARBOSEACARBOSEACARBOSE

25MG25MG

TABSTABS

9090

3030

ACARBOSEACARBOSEACARBOSE

50MG50MG

TABSTABS

9090

3030

ACARBOSEACARBOSEACARBOSE

100MG100MG

TABSTABS

9090

3030

ACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINE

120MG/5ML; 12MG/5ML120MG/5ML; 12MG/5ML

SOLNSOLN

27002700

3030

ACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINE

300MG; 30MG300MG; 30MG

TABSTABS

360360

3030

ACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINE

300MG; 60MG300MG; 60MG

TABSTABS

180180

3030

ACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINEACETAMINOPHEN/CODEINE

300MG; 15MG300MG; 15MG

TABSTABS

360360

3030

ACETAMINOPHEN/CODEINE PHOSPHATEACETAMINOPHEN/CODEINE PHOSPHATEACETAMINOPHEN/CODEINE PHOSPHATE

300MG; 30MG300MG; 30MG

TABSTABS

360360

3030

ACTEMRAACTEMRAACTEMRA

200MG/10ML200MG/10ML

SOLNSOLN

4040

2828

ACTEMRAACTEMRAACTEMRA

80MG/4ML80MG/4ML

SOLNSOLN

4040

2828

ACTEMRAACTEMRAACTEMRA

400MG/20ML400MG/20ML

SOLNSOLN

4040

2828

ACTEMRAACTEMRAACTEMRA

162MG/0.9ML162MG/0.9ML

SOSYSOSY

3.63.6

2828

ACYCLOVIRACYCLOVIRACYCLOVIR

0.050.05

OINTOINT

3030

3030

ADACELADACELADACEL

15.5MCG/0.5ML; 2LF/0.5ML; 5LF/0.5ML15.5MCG/0.5ML; 2LF/0.5ML; 5LF/0.5ML

SUSPSUSP

0.50.5

365365

ADACELADACELADACEL

15.5MCG/0.5ML; 2LF/0.5ML; 5LF/0.5ML15.5MCG/0.5ML; 2LF/0.5ML; 5LF/0.5ML

SUSPSUSP

0.50.5

365365

ADEFOVIR DIPIVOXILADEFOVIR DIPIVOXILADEFOVIR DIPIVOXIL

10MG10MG

TABSTABS

3030

3030

ADEMPASADEMPASADEMPAS

0.5MG0.5MG

TABSTABS

9090

3030

ADEMPASADEMPASADEMPAS

2MG2MG

TABSTABS

9090

3030

ADEMPASADEMPASADEMPAS

1MG1MG

TABSTABS

9090

3030

ADEMPASADEMPASADEMPAS

1.5MG1.5MG

TABSTABS

9090

3030

ADEMPASADEMPASADEMPAS

2.5MG2.5MG

TABSTABS

9090

3030

ADVAIR DISKUSADVAIR DISKUSADVAIR DISKUS

100MCG/DOSE; 50MCG/DOSE100MCG/DOSE; 50MCG/DOSE

AEPBAEPB

6060

3030

ADVAIR DISKUSADVAIR DISKUSADVAIR DISKUS

250MCG/DOSE; 50MCG/DOSE250MCG/DOSE; 50MCG/DOSE

AEPBAEPB

6060

3030

ADVAIR DISKUSADVAIR DISKUSADVAIR DISKUS

500MCG/DOSE; 50MCG/DOSE500MCG/DOSE; 50MCG/DOSE

AEPBAEPB

6060

3030

ADVAIR HFAADVAIR HFAADVAIR HFA

45MCG/ACT; 21MCG/ACT45MCG/ACT; 21MCG/ACT

AEROAERO

1212

3030

ADVAIR HFAADVAIR HFAADVAIR HFA

230MCG/ACT; 21MCG/ACT230MCG/ACT; 21MCG/ACT

AEROAERO

1212

3030

ADVAIR HFAADVAIR HFAADVAIR HFA

115MCG/ACT; 21MCG/ACT115MCG/ACT; 21MCG/ACT

AEROAERO

1212

3030

AFEDITAB CRAFEDITAB CRAFEDITAB CR

60MG60MG

TB24TB24

6060

3030

AFEDITAB CRAFEDITAB CRAFEDITAB CR

30MG30MG

TB24TB24

6060

3030

AFINITORAFINITORAFINITOR

7.5MG7.5MG

TABSTABS

2828

2828

AFINITORAFINITORAFINITOR

5MG5MG

TABSTABS

2828

2828

AFINITORAFINITORAFINITOR

2.5MG2.5MG

TABSTABS

2828

2828

AFINITORAFINITORAFINITOR

10MG10MG

TABSTABS

5656

2828

AFINITOR DISPERZAFINITOR DISPERZAFINITOR DISPERZ

3MG3MG

TBSOTBSO

5656

2828

AFINITOR DISPERZAFINITOR DISPERZAFINITOR DISPERZ

2MG2MG

TBSOTBSO

5656

2828

AFINITOR DISPERZAFINITOR DISPERZAFINITOR DISPERZ

5MG5MG

TBSOTBSO

112112

2828

ALBUTEROL SULFATEALBUTEROL SULFATEALBUTEROL SULFATE

1.25MG/3ML1.25MG/3ML

NEBUNEBU

360360

3030

ALBUTEROL SULFATEALBUTEROL SULFATEALBUTEROL SULFATE

0.0050.005

NEBUNEBU

180180

3030

ALBUTEROL SULFATEALBUTEROL SULFATEALBUTEROL SULFATE

0.63MG/3ML0.63MG/3ML

NEBUNEBU

360360

3030

ALBUTEROL SULFATEALBUTEROL SULFATEALBUTEROL SULFATE

0.000830.00083

NEBUNEBU

360360

3030

ALECENSAALECENSAALECENSA

150MG150MG

CAPSCAPS

240240

3030

ALENDRONATE SODIUMALENDRONATE SODIUMALENDRONATE SODIUM

40MG40MG

TABSTABS

3030

3030

ALENDRONATE SODIUMALENDRONATE SODIUMALENDRONATE SODIUM

5MG5MG

TABSTABS

3030

3030

ALENDRONATE SODIUMALENDRONATE SODIUMALENDRONATE SODIUM

70MG70MG

TABSTABS

44

2828

ALENDRONATE SODIUMALENDRONATE SODIUMALENDRONATE SODIUM

10MG10MG

TABSTABS

3030

3030

ALENDRONATE SODIUMALENDRONATE SODIUMALENDRONATE SODIUM

35MG35MG

TABSTABS

44

2828

ALFUZOSIN HCL ERALFUZOSIN HCL ERALFUZOSIN HCL ER

10MG10MG

TB24TB24

3030

3030

ALINIAALINIAALINIA

100MG/5ML100MG/5ML

SUSRSUSR

150150

3030

ALINIAALINIAALINIA

500MG500MG

TABSTABS

2020

3030

ALIQOPAALIQOPAALIQOPA

60MG60MG

SOLRSOLR

33

2828

ALORAALORAALORA

0.075MG/24HR0.075MG/24HR

PTTWPTTW

88

2828

ALORAALORAALORA

0.1MG/24HR0.1MG/24HR

PTTWPTTW

88

2828

ALORAALORAALORA

0.025MG/24HR0.025MG/24HR

PTTWPTTW

88

2828

ALORAALORAALORA

0.05MG/24HR0.05MG/24HR

PTTWPTTW

88

2828

ALOSETRON HYDROCHLORIDEALOSETRON HYDROCHLORIDEALOSETRON HYDROCHLORIDE

0.5MG0.5MG

TABSTABS

6060

3030

ALOSETRON HYDROCHLORIDEALOSETRON HYDROCHLORIDEALOSETRON HYDROCHLORIDE

1MG1MG

TABSTABS

6060

3030

ALPRAZOLAMALPRAZOLAMALPRAZOLAM

1MG1MG

TABSTABS

9090

3030

ALPRAZOLAMALPRAZOLAMALPRAZOLAM

2MG2MG

TABSTABS

150150

3030

ALPRAZOLAMALPRAZOLAMALPRAZOLAM

0.5MG0.5MG

TABSTABS

9090

3030

ALPRAZOLAMALPRAZOLAMALPRAZOLAM

0.25MG0.25MG

TABSTABS

9090

3030

ALPRAZOLAM ODTALPRAZOLAM ODTALPRAZOLAM ODT

1MG1MG

TBDPTBDP

9090

3030

ALPRAZOLAM ODTALPRAZOLAM ODTALPRAZOLAM ODT

0.25MG0.25MG

TBDPTBDP

9090

3030

ALPRAZOLAM ODTALPRAZOLAM ODTALPRAZOLAM ODT

0.5MG0.5MG

TBDPTBDP

9090

3030

ALPRAZOLAM ODTALPRAZOLAM ODTALPRAZOLAM ODT

2MG2MG

TBDPTBDP

150150

3030

ALUNBRIGALUNBRIGALUNBRIG

90MG90MG

TABSTABS

3030

3030

ALUNBRIGALUNBRIGALUNBRIG

180MG180MG

TABSTABS

3030

3030

ALUNBRIGALUNBRIGALUNBRIG

30MG30MG

TABSTABS

180180

3030

ALUNBRIGALUNBRIGALUNBRIG

00

TBPKTBPK

6060

365365

AMETHIAAMETHIAAMETHIA

0; 00; 0

TABSTABS

9191

9191

AMETHIA LOAMETHIA LOAMETHIA LO

0; 00; 0

TABSTABS

9191

9191

AMITIZAAMITIZAAMITIZA

24MCG24MCG

CAPSCAPS

6060

3030

AMITIZAAMITIZAAMITIZA

8MCG8MCG

CAPSCAPS

6060

3030

AMLODIPINE BESYLATEAMLODIPINE BESYLATEAMLODIPINE BESYLATE

5MG5MG

TABSTABS

6060

3030

AMLODIPINE BESYLATEAMLODIPINE BESYLATEAMLODIPINE BESYLATE

10MG10MG

TABSTABS

3030

3030

AMLODIPINE BESYLATEAMLODIPINE BESYLATEAMLODIPINE BESYLATE

2.5MG2.5MG

TABSTABS

120120

3030

AMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDE

10MG; 20MG10MG; 20MG

CAPSCAPS

3030

3030

AMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDE

5MG; 40MG5MG; 40MG

CAPSCAPS

6060

3030

AMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDE

2.5MG; 10MG2.5MG; 10MG

CAPSCAPS

6060

3030

SpanAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDE

10MG; 40MG10MG; 40MG

CAPSCAPS

3030

3030

AMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDE

5MG; 10MG5MG; 10MG

CAPSCAPS

6060

3030

AMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDEAMLODIPINE BESYLATE/BENAZEPRIL HYDROCHLORIDE

5MG; 20MG5MG; 20MG

CAPSCAPS

6060

3030

AMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTAN

10MG; 320MG10MG; 320MG

TABSTABS

3030

3030

AMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTAN

5MG; 160MG5MG; 160MG

TABSTABS

3030

3030

AMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTAN

10MG; 160MG10MG; 160MG

TABSTABS

3030

3030

AMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTANAMLODIPINE BESYLATE/VALSARTAN

5MG; 320MG5MG; 320MG

TABSTABS

3030

3030

AMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMIL

10MG; 20MG10MG; 20MG

TABSTABS

3030

3030

AMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMIL

10MG; 40MG10MG; 40MG

TABSTABS

3030

3030

AMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMIL

5MG; 40MG5MG; 40MG

TABSTABS

3030

3030

AMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMILAMLODIPINE/OLMESARTAN MEDOXOMIL

5MG; 20MG5MG; 20MG

TABSTABS

3030

3030

AMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZ

5MG; 12.5MG; 160MG5MG; 12.5MG; 160MG

TABSTABS

3030

3030

AMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZ

10MG; 25MG; 320MG10MG; 25MG; 320MG

TABSTABS

3030

3030

AMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZ

10MG; 12.5MG; 160MG10MG; 12.5MG; 160MG

TABSTABS

3030

3030

AMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZ

5MG; 25MG; 160MG5MG; 25MG; 160MG

TABSTABS

3030

3030

AMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZAMLODIPINE/VALSARTAN/HCTZ

10MG; 25MG; 160MG10MG; 25MG; 160MG

TABSTABS

3030

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

3.75MG; 3.75MG; 3.75MG; 3.75MG3.75MG; 3.75MG; 3.75MG; 3.75MG

CP24CP24

3030

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

2.5MG; 2.5MG; 2.5MG; 2.5MG2.5MG; 2.5MG; 2.5MG; 2.5MG

CP24CP24

3030

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

5MG; 5MG; 5MG; 5MG5MG; 5MG; 5MG; 5MG

CP24CP24

3030

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

7.5MG; 7.5MG; 7.5MG; 7.5MG7.5MG; 7.5MG; 7.5MG; 7.5MG

CP24CP24

3030

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

1.25MG; 1.25MG; 1.25MG; 1.25MG1.25MG; 1.25MG; 1.25MG; 1.25MG

CP24CP24

6060

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

6.25MG; 6.25MG; 6.25MG; 6.25MG6.25MG; 6.25MG; 6.25MG; 6.25MG

CP24CP24

6060

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

2.5MG; 2.5MG; 2.5MG; 2.5MG2.5MG; 2.5MG; 2.5MG; 2.5MG

TABSTABS

6060

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

1.875MG; 1.875MG; 1.875MG; 1.875MG1.875MG; 1.875MG; 1.875MG; 1.875MG

TABSTABS

6060

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

3.125MG; 3.125MG; 3.125MG; 3.125MG3.125MG; 3.125MG; 3.125MG; 3.125MG

TABSTABS

6060

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

7.5MG; 7.5MG; 7.5MG; 7.5MG7.5MG; 7.5MG; 7.5MG; 7.5MG

TABSTABS

6060

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

3.75MG; 3.75MG; 3.75MG; 3.75MG3.75MG; 3.75MG; 3.75MG; 3.75MG

TABSTABS

6060

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

5MG; 5MG; 5MG; 5MG5MG; 5MG; 5MG; 5MG

TABSTABS

9090

3030

AMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINEAMPHETAMINE/DEXTROAMPHETAMINE

1.25MG; 1.25MG; 1.25MG; 1.25MG1.25MG; 1.25MG; 1.25MG; 1.25MG

TABSTABS

6060

3030

AMPYRAAMPYRAAMPYRA

10MG10MG

TB12TB12

6060

3030

ANASTROZOLEANASTROZOLEANASTROZOLE

1MG1MG

TABSTABS

3030

3030

ANORO ELLIPTAANORO ELLIPTAANORO ELLIPTA

62.5MCG/INH; 25MCG/INH62.5MCG/INH; 25MCG/INH

AEPBAEPB

6060

3030

APOKYNAPOKYNAPOKYN

30MG/3ML30MG/3ML

SOCTSOCT

6060

3030

APREPITANTAPREPITANTAPREPITANT

125MG125MG

CAPSCAPS

22

2828

APREPITANTAPREPITANTAPREPITANT

00

CAPSCAPS

66

2828

APREPITANTA